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Sample records for neonatal death rate

  1. Neonatal Death

    Science.gov (United States)

    ... a premature baby include pneumonia (a lung infection), sepsis (a blood infection) and meningitis (an infection in the fluid around the brain and spinal cord). What birth defects most often cause neonatal death? The most common birth defects that cause ...

  2. Consanguinity and neonatal death: a nested case-control study.

    Directory of Open Access Journals (Sweden)

    Reza Chaman

    2014-12-01

    Full Text Available Although numerous studies have found higher rates of abortion and still births following consanguinity (familial marriages, the question of whether consanguinity significantly increases the risk of neonatal death has inadequately been addressed.This study aims to evaluate familial marriage effects on neonatal death in rural areas in Iran.In this nested case-control study, 6900 newbornswho were born in rural areas of Kohgiluyeh and Boyerahmad Province (South-West of Iranwere followed till the end of neonatal period, and neonatal death was the outcome of interest. Subsequently 97 cases and 97 controls were selected in study cohort by using risk set sampling model. Crude and adjusted odds ratios (OR were estimated by usinga conditional logistic regression model.In the final model, prematurity (OR = 5.57, low birthweight (LBW (OR = 7.68, consanguinity (first cousins (OR = 5.23, C-section (OR = 7.27, birth rank more than 3 (OR = 6.95 and birthsinterval less than 24 months (OR = 4.65 showed significant statistical association with neonatal mortality (p < 0.05.According to our findings, after adjusting the effects of other significant risk factors, familial marriageto first cousins is considered asan important risk factor for neonatal death.

  3. [Forensic approach of infanticide and neonatal death].

    Science.gov (United States)

    Beauthier, J P

    2007-01-01

    The foetal of neonatal death brings up many questions as well on the physiopathological level as on the medico-legal one. We consider here the various natural and violent origins which allow understanding this difficult forensic activity. The approach of forensic anthropology and recent medical techniques (X-rays and echography) are also studied in order to be helpful to the medical examiner.

  4. 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).

  5. Brain death in neonates: a case report

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    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

  6. Rates of Very Preterm Birth in Europe and Neonatal Mortality Rates

    DEFF Research Database (Denmark)

    2008-01-01

    ) 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...

  7. Neonatal death in Low-Middle Income Countries: A Global Network Study

    Science.gov (United States)

    Belizán, José M; McClure, Elizabeth M; Goudar, Shivaprasad S; Pasha, Omrana; Esamai, Fabian; Patel, Archana; Chomba, Elwyn; Garces, Ana; Wright, Linda L; Koso-Thomas, Marion; Moore, Janet; Althabe, Fernando; Kodkany, Bhala S; Sami, Neelofar; Manasyan, Albert; Derman, Richard J; Liechty, Edward A; Hibberd, Patricia; Carlo, Waldemar A; Hambidge, K Michael; Buekens, Pierre; Jobe, Alan H; Goldenberg, Robert L

    2015-01-01

    Objective To determine population-based neonatal mortality rates in low and middle income countries and to examine gestational age, birth-weight and timing of death to assess the potentially preventable neonatal deaths. Methods A prospective observational study was conducted in communities in five low-income countries (Kenya, Zambia, Guatemala, India, and Pakistan) and one mid-income country (Argentina). Over a two-year period, all pregnant women in the study communities were enrolled by trained study staff and their infants followed to 28 days of age. Results Between October 2009 and March 2011, 153,728 babies were delivered and followed through day 28. Neonatal death rates ranged from 41 per 1000 births in Pakistan to 8 per 1000 in Argentina. 54% of the neonatal deaths were >37 weeks and 46% weighed 2500 grams or more. Half the deaths occurred within 24 hours of delivery. Conclusions In our population-based low and middle income country registries, the majority of neonatal deaths occurred in babies >37 weeks gestation and almost half weighed at least 2500 grams. Most deaths occurred shortly after birth. With access to better medical care and hospitalization, especially in the intrapartum and early neonatal period, many of these neonatal deaths might be prevented. PMID:22644832

  8. Death in CHARGE syndrome after the neonatal period

    NARCIS (Netherlands)

    Bergman, J. E. H.; Blake, K. D.; Bakker, M. K.; Sarvaas, G. J. du Marchie; Free, R. H.; van Ravenswaaij-Arts, C. M. A.

    2010-01-01

    CHARGE syndrome is a multiple congenital anomaly syndrome that can be life-threatening in the neonatal period. Complex heart defects, bilateral choanal atresia, esophageal atresia, severe T-cell deficiency, and brain anomalies can cause neonatal death. As little is known about the causes of death in

  9. Death in CHARGE syndrome after the neonatal period

    NARCIS (Netherlands)

    Bergman, J. E. H.; Blake, K. D.; Bakker, M. K.; Sarvaas, G. J. du Marchie; Free, R. H.; van Ravenswaaij-Arts, C. M. A.

    CHARGE syndrome is a multiple congenital anomaly syndrome that can be life-threatening in the neonatal period. Complex heart defects, bilateral choanal atresia, esophageal atresia, severe T-cell deficiency, and brain anomalies can cause neonatal death. As little is known about the causes of death in

  10. 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

    ) 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......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...... in one region). PARTICIPANTS: All births that occurred between 22+0 and 31+6 weeks of gestation in 2003. MAIN OUTCOME MEASURE: Neonatal death rate adjusted for rate of delivery at this gestation. RESULTS: Rate of delivery of all births at 22+0-31+6 weeks of gestation and live births only were calculated...

  11. The Use of Control Charts in Neonatal Death Monitoring

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    Mostafa Farah Bakhsh

    2015-07-01

    Full Text Available Background and Objectives : Data are managed in two approaches in health information system:       Data–led and Action–led. In action–led approach, data are used in process improvement. In most of health facilities, functional data are not used in a proper way. This study aimed to explore the use of control charts in neonatal death monitoring. Materials and Methods : This study was conducted for designing a practical model of control charts in primary health care. The live births number and neonatal death number were gathered monthly in a two-year period from 19 districts. Data were analyzed in Excel software and control chart was depicted in SPSS 16. Results : Neonatal mortality rate was 12.37 and 10.7 in 1000 live births respectively in 2007 and 2008 in rural population of East Azerbaijan province. Average of index was 11.54 in a two-year period with standard deviation of 2.75. Monthly NMR was 5.18 -15.93. Conclusion : Opportunities are missed for an on-time correction of causes with an annual calculation of NMR. Control charts are very effective in organizational learning and process improvements. These charts convert the data into information and knowledge. The use of control charts in primary health care shows errors and problems on-time.

  12. 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. http://blogs.cdc.gov/nchs-data-visualization/deaths-in-the-us/

  13. 高死亡率地区早产儿死亡的路径分析%Pathway analysis of premature death in areas with high neonatal mortality rate

    Institute of Scientific and Technical Information of China (English)

    马艺; 李丽娟

    2014-01-01

    目的:了解高死亡率地区早产儿死亡的死亡路径及就医情况。方法采用典型抽样的方法在新生儿高死亡率地区的4个县开展调查,对死亡早产儿的看护人进行一对一的问卷调查。结果266例新生儿死亡中有110例(41.4%)为早产儿,这些早产儿平均死亡年龄为2.5天。89.1%的早产儿出生在医疗机构,但是大部分死于家中(45.4%),其次是县级医疗机构(27.3%)。结论加强孕期保健工作,预防早产发生,提高县级医疗机构对早产儿的护理和抢救水平是降低早产儿死亡率的主要措施。%Objective To investigate the pathway of premature death and medical care seeking behavior in areas with high mortality rate . Methods Typical sampling was used in this survey .Four counties with high neonatal mortality rate were sampled out .Caregivers of the premature death were interviewed face-to-face.Results There were 110 preterm births among 266 (41.4%) neonatal deaths .The median death age was 2.5 days.Totally 89.1% preterm infants were born in health facilities, but most of them died at home (45.4%) and secondly at the county-leveled hospitals (27.3%).Conclusion Strengthening pregnancy health care, preventing premature birth, and improving premature infant care and rescue level of county medical institutions are the main measures to reduce the mortality of premature infants.

  14. Rates of very preterm birth in Europe and neonatal mortality rates.

    NARCIS (Netherlands)

    Field, D.; Draper, E.S.; Fenton, A.; Papiernik, E.; Zeitlin, J.; Blondel, B.; Cuttini, M.; Maier, R.F.; Weber, T.; Carrapato, M.; Kollee, L.A.A.; Gadzin, J.; Reempts, P. Van

    2009-01-01

    OBJECTIVE: To estimate the influence of variation in the rate of very preterm delivery on the reported rate of neonatal death in 10 European regions. DESIGN: Comparison of 10 separate geographically defined European populations, from nine European countries, over a 1-year period (7 months in one reg

  15. Rates of very preterm birth in Europe and neonatal mortality rates

    NARCIS (Netherlands)

    Field, D.; Draper, E. S.; Fenton, A.; Papiernik, E.; Zeitlin, J.; Blondel, B.; Cuttini, M.; Maier, R. F.; Weber, T.; Carrapato, M.; Kollee, L.; Gadzin, J.; Van Reempts, P.

    2009-01-01

    Objective: To estimate the influence of variation in the rate of very preterm delivery on the reported rate of neonatal death in 10 European regions. Design: Comparison of 10 separate geographically defined European populations, from nine European countries, over a 1-year period (7 months in one reg

  16. Rates of very preterm birth in Europe and neonatal mortality rates

    NARCIS (Netherlands)

    Field, D.; Draper, E. S.; Fenton, A.; Papiernik, E.; Zeitlin, J.; Blondel, B.; Cuttini, M.; Maier, R. F.; Weber, T.; Carrapato, M.; Kollee, L.; Gadzin, J.; Van Reempts, P.

    Objective: To estimate the influence of variation in the rate of very preterm delivery on the reported rate of neonatal death in 10 European regions. Design: Comparison of 10 separate geographically defined European populations, from nine European countries, over a 1-year period (7 months in one

  17. Rates of very preterm birth in Europe and neonatal mortality rates.

    NARCIS (Netherlands)

    Field, D.; Draper, E.S.; Fenton, A.; Papiernik, E.; Zeitlin, J.; Blondel, B.; Cuttini, M.; Maier, R.F.; Weber, T.; Carrapato, M.; Kollee, L.A.A.; Gadzin, J.; Reempts, P. Van

    2009-01-01

    OBJECTIVE: To estimate the influence of variation in the rate of very preterm delivery on the reported rate of neonatal death in 10 European regions. DESIGN: Comparison of 10 separate geographically defined European populations, from nine European countries, over a 1-year period (7 months in one

  18. High risk pregnancies and factors associated with neonatal death

    Directory of Open Access Journals (Sweden)

    Marcela de Oliveira Demitto

    Full Text Available Abstract OBJECTIVE To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. METHOD 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. RESULTS 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. CONCLUSION 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.

  19. Heart rate variability in neonates of type 1 diabetic pregnancy.

    Science.gov (United States)

    Russell, Noirin E; Higgins, Mary F; Kinsley, Brendan F; Foley, Michael E; McAuliffe, Fionnuala M

    2016-01-01

    Cardiomyopathy is a common finding in offspring of pre-gestational type 1 diabetic pregnancy. Echocardiographic and biochemical evidence of fetal cardiac dysfunction have also been reported. Studies suggest that offspring of diabetic mothers (ODM) undergo a fetal programming effect due to the hyperglycaemic intrauterine milieu which increases their risk of cardiovascular morbidity in adult life. Decreased neonatal heart rate variability (HRV) has been described in association with in-utero growth restriction, prematurity, sudden infant death syndrome and congenital heart disease. The effect of in-utero exposure to hyperglycaemia in diabetic pregnancy on neonatal HRV is unknown. Our aim was to determine if neonatal HRV differs between normal and diabetic pregnancy. This was a prospective observational study of 38 patients with pregestational type 1 diabetes and 26 controls. HRV assessment was performed using Powerlab (ADI Instruments Ltd). Heart rate variability assessment and cord blood sampling for pH and glucose were performed for all neonates. Maternal glycaemic control was assessed via measurement of glycosylated haemoglobin in each trimester in the diabetic cohort. Neonates of diabetic mothers had evidence of altered heart rate variability, with increased low frequency to high frequency ratio (LF: HF), suggestive of a shift towards sympathetic predominance (pheart to fluctuations in maternal glycaemia with subsequent alterations in HRV may explain why infants of diabetic mothers are at greater risk of cardiovascular disease in later life. Copyright © 2015. Published by Elsevier Ireland Ltd.

  20. 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

  1. Stable rates of neonatal sepsis in a tertiary neonatal unit.

    Science.gov (United States)

    Lean, Wei Ling; Kamlin, Camille O; Garland, Suzanne M; Jacobs, Susan E

    2015-03-01

    To describe the rate of early- and late-onset sepsis in neonates admitted to the neonatal intensive care unit at the Royal Women's Hospital and to compare the rate of late-onset sepsis (LOS) with a published (2008) cohort from the same unit. The secondary aim was to examine clinicians' compliance with antibiotic guidelines. Infants born sepsis and compliance with antibiotic guidelines were applied. One hundred and seventy-two infants met the inclusion criteria, with 152 having blood culture evaluations for early-onset sepsis (EOS) and 58 having 109 evaluations for LOS. Definite EOS occurred in 1.3% with Escherichia coli isolated. The rate of definite LOS in 2011 of 22% was not significantly different than the 27% in 2008, with coagulase-negative staphylococcus the main isolate. Antibiotic continuation beyond 72 h in infants with negative blood cultures was the main reason for non-compliance with antibiotic guidelines. The rate of EOS is comparable with published reports and the rate of LOS has remained stable over a 3-year period. Discontinuation of antibiotics with negative septic markers and blood cultures at 48-72 h is encouraged. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  2. By the way knowledge: grandparents, stillbirth and neonatal death.

    Science.gov (United States)

    Murphy, Samantha; Jones, Kerry Sian

    2014-09-01

    Over the past 50 years, academic interest in the experiences of parents who lose a baby to stillbirth or neonatal death has grown. Stillbirth is defined in the UK as the death of a baby after 24 weeks' gestation and neonatal death is death within the first 4 weeks of life. Less is known about the experience of grandparents after such an event. As grandparents might expect to play an important role in their putative grandchild's life, including the provision of childcare to support parental employment, it seems likely that the baby's death will impact upon them. We argue that existing academic knowledge of grandparents' experiences of reproductive loss is 'by the way' knowledge, garnered incidentally from other research projects, for example, losing a grandchild per se or where researchers have interviewed grandparents as part of wider family research. The experience of grandparents who lose a grandchild at or around the time of birth should not go unnoticed. Research into their experiences can inform about the place in the family, if any, that is afforded to the unborn child before birth and whether, like fathers and the siblings of babies who have died, grandparents are also 'forgotten mourners'.

  3. HSMR : Comparing Death Rates Across UK Hospitals

    NARCIS (Netherlands)

    Nauta, Frans; Teeuwen, Ben; Ngo, Thuy

    2011-01-01

    The Hospital Standardized Mortality Ratio (HSMR) is a measurement tool that shows hospitals’ death rates. The HSMR compares deaths that occur in hospitals with death ratios that one would normally expect based on patients’ diseases. It is used as a benchmark for adjusted hospital death rates. These

  4. 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

  5. Survey of characteristics of neonatal death in neonatal intensive care unit of Boo-Ali Sina educational & therapeutic center between 2003-2006

    Directory of Open Access Journals (Sweden)

    Azita Bala Ghafari

    2009-01-01

    Full Text Available , , , (Received 24 June, 2009 ; Accepted 16 September, 2009AbstractBackground and purpose: The neonatal mortality rate is an important index for evaluation of public health. It involves the death of infants under 28 days. Obviously, recognizing the characteristics of neonatal mortality in this center, may be useful for promoting the procedures in the NICU, as well as planning to impede the severe complications or death.Materials and methods: This is a descriptive study performed by analyzing the available data from the medical records of NICU patients at Boo-Ali Sina Educational & Therapeutic Center during 2003 and 2006. The number of deaths, names, and medical records number of the dead infants were collected. Among 1238 patients in the NICU, 363 deaths were reported. According to medical records, 222 deaths occurred in neonates aged 0 to 27 days. Data were collected using a checklist, the validity and reliability of which were approved by clinicians. The Descriptive methods were used in analyzing the data.Results: The findings include: 140 subjects were male (63.1%; 72 from single birth (77.5%; the age-group of mothers of 38 cases (37.7% was 20-24 y; 132 cases (59.5% resided in villages; 129 cases (58.1% with prenatal care; 120 cased of Caesarian section (54%; 155 cases (76% with birth weight lower than 2500 grams and 154 preterm (75.5%. Mortality during neonatal period was divided in two groups: early death (0-6 days 142 cases (62% and late death (7-27 days 80 cases (36%.Conclusion: Correct and exact completion of NICU forms would help undertaking descriptive and analytic epidemiologic studies.Key words: Neonatal mortality, early neonatal mortality, late neonatal mortality, NICUJ Mazand Univ Med Sci 2009; 20(74: 79-83 (Persian

  6. 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

  7. Estimating pneumonia deaths of post-neonatal children in countries of low or no death certification in 2008.

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    Evropi Theodoratou

    Full Text Available BACKGROUND: Pneumonia is the leading cause of child deaths globally. The aims of this study were to: a estimate the number and global distribution of pneumonia deaths for children 1-59 months for 2008 for countries with low (85% coverage of death certification countries was used. For 87 high child-mortality countries pneumonia death estimates were obtained by applying a regression model developed from published and unpublished verbal autopsy data from high child-mortality settings. The total number of 1-59 months pneumonia deaths for the year 2008 for these 122 countries was estimated to be 1.18 M (95% CI 0.77 M-1.80 M, which represented 23.27% (95% CI 17.15%-32.75% of all 1-59 month child deaths. The country level estimation correlation coefficient between these two methods was 0.40. INTERPRETATION: Although the overall number of post-neonatal pneumonia deaths was similar irrespective to the method of estimation used, the country estimate correlation coefficient was low, and therefore country-specific estimates should be interpreted with caution. Pneumonia remains the leading cause of child deaths and is greatest in regions of poverty and high child-mortality. Despite the concerns about gender inequity linked with childhood mortality we could not estimate sex-specific pneumonia mortality rates due to the inadequate data. Life-saving interventions effective in preventing and treating pneumonia mortality exist but few children in high pneumonia disease burden regions are able to access them. To achieve the United Nations Millennium Development Goal 4 target to reduce child deaths by two-thirds in year 2015 will require the scale-up of access to these effective pneumonia interventions.

  8. Declines in stillbirth and neonatal mortality rates in Europe between 2004 and 2010

    DEFF Research Database (Denmark)

    Zeitlin, Jennifer; Mortensen, Laust; Cuttini, Marina

    2016-01-01

    and neonatal deaths by gestational age (GA) were collected using a common protocol by the Euro-Peristat project in 2004 and 2010. We analysed stillbirths at ≥28 weeks GA in 22 countries and live births ≥24 weeks GA for neonatal mortality in 18 countries. Per cent changes over time were assessed by calculating....... Conclusions: Stillbirths and neonatal deaths declined at all gestational ages in countries with both high and low levels of mortality in 2004. These results raise questions about how low-mortality countries achieve continued declines and highlight the importance of improving care across the GA spectrum.......Background: Stillbirth and neonatal mortality rates declined in Europe between 2004 and 2010. We hypothesised that declines might be greater for countries with higher mortality in 2004 and disproportionally affect very preterm infants at highest risk. Methods: Data about live births, stillbirths...

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

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    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

  10. At Major Teaching Hospitals, Lower Death Rates

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_165869.html At Major Teaching Hospitals, Lower Death Rates Researchers assess 30-day ... TUESDAY, May 23, 2017 (HealthDay News) -- Major U.S. teaching hospitals are often considered more expensive than the ...

  11. Facility Delivery, Postnatal Care and Neonatal Deaths in India: Nationally-Representative Case-Control Studies.

    Directory of Open Access Journals (Sweden)

    Shaza A Fadel

    Full Text Available Clinical studies demonstrate the efficacy of interventions to reduce neonatal deaths, but there are fewer studies of their real-life effectiveness. In India, women often seek facility delivery after complications arise, rather than to avoid complications. Our objective was to quantify the association of facility delivery and postnatal checkups with neonatal mortality while examining the "reverse causality" in which the mothers deliver at a health facility due to adverse perinatal events.We conducted nationally representative case-control studies of about 300,000 live births and 4,000 neonatal deaths to examine the effect of, place of delivery and postnatal checkup on neonatal mortality. We compared neonatal deaths to all live births and to a subset of live births reporting excessive bleeding or obstructed labour that were more comparable to cases in seeking care.In the larger study of 2004-8 births, facility delivery without postnatal checkup was associated with an increased odds of neonatal death (Odds ratio = 2.5; 99% CI 2.2-2.9, especially for early versus late neonatal deaths. However, use of more comparable controls showed marked attenuation (Odds ratio = 0.5; 0.4-0.5. Facility delivery with postnatal checkup was associated with reduced odds of neonatal death. Excess risks were attenuated in the earlier study of 2001-4 births.The combined effect of facility deliveries with postnatal checks ups is substantially higher than just facility delivery alone. Evaluation of the real-life effectiveness of interventions to reduce child and maternal deaths need to consider reverse causality. If these associations are causal, facility delivery with postnatal check up could avoid about 1/3 of all neonatal deaths in India (~100,000/year.

  12. Declining death rates reflect progress against cancer.

    Directory of Open Access Journals (Sweden)

    Ahmedin Jemal

    Full Text Available BACKGROUND: The success of the "war on cancer" initiated in 1971 continues to be debated, with trends in cancer mortality variably presented as evidence of progress or failure. We examined temporal trends in death rates from all-cancer and the 19 most common cancers in the United States from 1970-2006. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed trends in age-standardized death rates (per 100,000 for all cancers combined, the four most common cancers, and 15 other sites from 1970-2006 in the United States using joinpoint regression model. The age-standardized death rate for all-cancers combined in men increased from 249.3 in 1970 to 279.8 in 1990, and then decreased to 221.1 in 2006, yielding a net decline of 21% and 11% from the 1990 and 1970 rates, respectively. Similarly, the all-cancer death rate in women increased from 163.0 in 1970 to 175.3 in 1991 and then decreased to 153.7 in 2006, a net decline of 12% and 6% from the 1991 and 1970 rates, respectively. These decreases since 1990/91 translate to preventing of 561,400 cancer deaths in men and 205,700 deaths in women. The decrease in death rates from all-cancers involved all ages and racial/ethnic groups. Death rates decreased for 15 of the 19 cancer sites, including the four major cancers, with lung, colorectum and prostate cancers in men and breast and colorectum cancers in women. CONCLUSIONS/SIGNIFICANCE: Progress in reducing cancer death rates is evident whether measured against baseline rates in 1970 or in 1990. The downturn in cancer death rates since 1990 result mostly from reductions in tobacco use, increased screening allowing early detection of several cancers, and modest to large improvements in treatment for specific cancers. Continued and increased investment in cancer prevention and control, access to high quality health care, and research could accelerate this progress.

  13. Developing a Fuzzy Expert System to Predict the Risk of Neonatal Death.

    Science.gov (United States)

    Safdari, Reza; Kadivar, Maliheh; Langarizadeh, Mostafa; Nejad, Ahmadreaza Farzaneh; Kermani, Farzaneh

    2016-02-01

    This study aims at developing a fuzzy expert system to predict the possibility of neonatal death. A questionnaire was given to Iranian neonatologists and the more important factors were identified based on their answers. Then, a computing model was designed considering the fuzziness of variables having the highest neonatal mortality risk. The inference engine used was Mamdani's method and the output was the risk of neonatal death given as a percentage. To validate the designed system, neonates' medical records real data at a Tehran hospital were used. MATLAB software was applied to build the model, and user interface was developed by C# programming in Visual Studio platform as bilingual (English and Farsi user interface). According to the results, the accuracy, sensitivity, and specificity of the model were 90%, 83% and 97%, respectively. The designed fuzzy expert system for neonatal death prediction showed good accuracy as well as proper specificity, and could be utilized in general hospitals as a clinical decision support tool.

  14. Causes of neonatal and maternal deaths in Dhaka slums: Implications for service delivery

    Directory of Open Access Journals (Sweden)

    Khatun Fatema

    2012-01-01

    Full Text Available Abstract Background Bangladesh has about 5.7 million people living in urban slums that are characterized by adverse living conditions, poor access to healthcare services and health outcomes. In an attempt to ensure safe maternal, neonatal and child health services in the slums BRAC started a programme, MANOSHI, in 2007. This paper reports the causes of maternal and neonatal deaths in slums and discusses the implications of those deaths for Maternal Neonatal and Child Health service delivery. Methods Slums in three areas of Dhaka city were selected purposively. Data on causes of deaths were collected during 2008-2009 using verbal autopsy form. Two trained physicians independently assigned the cause of deaths. Results A total of 260 newborn and 38 maternal deaths were identified between 2008 and 2009. The majority (75% of neonatal deaths occurred during 0-7 days. The main causes of deaths were birth asphyxia (42%, sepsis (20% and birth trauma (7%. Post partum hemorrhage (37% and eclampsia (16% were the major direct causes and hepatic failure due to viral hepatitis was the most prevalent indirect cause (11% of maternal deaths. Conclusion Delivery at a health facility with child assessment within a day of delivery and appropriate treatment could reduce neonatal deaths. Maternal mortality is unlikely to reduce without delivering at facilities with basic Emergency Obstetric Care (EOC and arrangements for timely referral to EOC. There is a need for a comprehensive package of services that includes control of infectious diseases during pregnancy, EOC and adequate after delivery care.

  15. Prognostic models for stillbirth and neonatal death in very preterm birth: A validation study

    NARCIS (Netherlands)

    E. Schuit (Ewoud); C.W.P.M. Hukkelhoven (Chantal); B.N. Manktelow (Bradley); D.N.M. Papatsonis (Dimitri); M.J.K. de Kleine (Martin); E.S. Draper (Elizabeth); E.W. Steyerberg (Ewout); Y. Vergouwe (Yvonne)

    2012-01-01

    textabstractOBJECTIVES: To validate externally 2 prognostic models for stillbirth and neonatal death in very preterm infants who are either known to be alive at the onset of labor or admitted for neonatal intensive care. PATIENTS AND METHODS: All infants, with gestational age 22 to 32 weeks, of Euro

  16. Prognostic models for stillbirth and neonatal death in very preterm birth: A validation study

    NARCIS (Netherlands)

    E. Schuit (Ewoud); C.W.P.M. Hukkelhoven (Chantal); B.N. Manktelow (Bradley); D.N.M. Papatsonis (Dimitri); M.J.K. de Kleine (Martin); E.S. Draper (Elizabeth); E.W. Steyerberg (Ewout); Y. Vergouwe (Yvonne)

    2012-01-01

    textabstractOBJECTIVES: To validate externally 2 prognostic models for stillbirth and neonatal death in very preterm infants who are either known to be alive at the onset of labor or admitted for neonatal intensive care. PATIENTS AND METHODS: All infants, with gestational age 22 to 32 weeks, of

  17. A prospective study of maternal, fetal and neonatal deaths in low- and middle-income countries

    Science.gov (United States)

    Saleem, Sarah; Goudar, Shivaprasad S; Patel, Archana; Esamai, Fabian; Garces, Ana; Chomba, Elwyn; Althabe, Fernando; Moore, Janet; Kodkany, Bhalachandra; Pasha, Omrana; Belizan, Jose; Mayansyan, Albert; Derman, Richard J; Hibberd, Patricia L; Liechty, Edward A; Krebs, Nancy F; Hambidge, K Michael; Buekens, Pierre; Carlo, Waldemar A; Wright, Linda L; Koso-Thomas, Marion; Jobe, Alan H; Goldenberg, Robert L

    2014-01-01

    Abstract Objective To quantify maternal, fetal and neonatal mortality in low- and middle-income countries, to identify when deaths occur and to identify relationships between maternal deaths and stillbirths and neonatal deaths. Methods A prospective study of pregnancy outcomes was performed in 106 communities at seven sites in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. Pregnant women were enrolled and followed until six weeks postpartum. Findings Between 2010 and 2012, 214 070 of 220 235 enrolled women (97.2%) completed follow-up. The maternal mortality ratio was 168 per 100 000 live births, ranging from 69 per 100 000 in Argentina to 316 per 100 000 in Pakistan. Overall, 29% (98/336) of maternal deaths occurred around the time of delivery: most were attributed to haemorrhage (86/336), pre-eclampsia or eclampsia (55/336) or sepsis (39/336). Around 70% (4349/6213) of stillbirths were probably intrapartum; 34% (1804/5230) of neonates died on the day of delivery and 14% (755/5230) died the day after. Stillbirths were more common in women who died than in those alive six weeks postpartum (risk ratio, RR: 9.48; 95% confidence interval, CI: 7.97–11.27), as were perinatal deaths (RR: 4.30; 95% CI: 3.26–5.67) and 7-day (RR: 3.94; 95% CI: 2.74–5.65) and 28-day neonatal deaths (RR: 7.36; 95% CI: 5.54–9.77). Conclusion Most maternal, fetal and neonatal deaths occurred at or around delivery and were attributed to preventable causes. Maternal death increased the risk of perinatal and neonatal death. Improving obstetric and neonatal care around the time of birth offers the greatest chance of reducing mortality. PMID:25177075

  18. 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 neonatal death and causes of death...

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

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    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.

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

    DEFF Research Database (Denmark)

    Kristensen, J; Vestergaard, M; Wisborg, K

    2005-01-01

    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...... 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......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...

  1. 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....... RESULTS: Maternal obesity was associated with a more than doubled risk of stillbirth (odds ratio = 2.8, 95% confidence interval [CI]: 1.5-5.3) and neonatal death (odds ratio = 2.6, 95% CI: 1.2-5.8) compared with women of normal weight. No statistically significantly increased risk of stillbirth...

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

    Science.gov (United States)

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

  3. Cause-specific neonatal deaths in rural Bangladesh, 1987-2005: Levels, trends and determinants

    OpenAIRE

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

    2014-01-01

    This paper reports on an analysis of neonatal mortality from communicable and non-communicable diseases in Bangladesh. The competing-risks model employed incorporated both observed and unobserved heterogeneity and allowed the two heterogeneity terms to be correlated. The data used came from the Health and Demographic Surveillance System, Matlab. The results confirm the conclusions of previous studies about the levels, trends, and causes of neonatal death in the Matlab area: the education of t...

  4. Reporting detection of Chlamydia trachomatis DNA in tissues of neonatal death cases

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    Maria Hernandez Trejo

    2014-04-01

    Full Text Available OBJECTIVE: to determine whether C. trachomatis was present in neonates with infection, but without an isolated pathogen, who died during the first week of life. METHODS: early neonatal death cases whose causes of death had been previously adjudicated by the institutional mortality committee were randomly selected. End-point and real-time polymerase chain reaction of the C. trachomatis omp1 gene was used to blindly identify the presence of chlamydial DNA in the paraffinized samples of five organs (from authorized autopsies of each of the dead neonates. Additionally, differential diagnoses were conducted by amplifying a fragment of the 16S rRNA of Mycoplasma spp. RESULTS: in five cases (35.7%, C. trachomatis DNA was found in one or more organs. Severe neonatal infection was present in three cases; one of them corresponded to genotype D of C. trachomatis. Interestingly, another case fulfilled the same criteria but had a positive polymerase chain reaction for Mycoplasma hominis, a pathogen known to produce sepsis in newborns. CONCLUSION: the use of molecular biology techniques in these cases of early infant mortality demonstrated that C. trachomatis could play a role in the development of severe infection and in early neonatal death, similarly to that observed with Mycoplasma hominis. Further study is required to determine the pathogenesis of this perinatal infection.

  5. 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.

  6. Rates of Early Deaths Rise for Whites, Drop for Blacks

    Science.gov (United States)

    ... 26, 2017 WEDNESDAY, Jan. 25, 2017 (HealthDay News) -- Premature death rates in the United States have fallen for ... 1999 to 2014. They found that rates of premature death (between ages 25 to 64) declined among blacks, ...

  7. Higher Death Rate Among Youth With First Episode Psychosis

    Science.gov (United States)

    ... Releases News Release Thursday, April 6, 2017 Higher death rate among youth with first episode psychosis NIH- ... experiencing first episode psychosis have a much higher death rate than previously thought. Researchers analyzed data on ...

  8. Vanadate induces necrotic death in neonatal rat cardiomyocytes through mitochondrial membrane depolarization.

    Science.gov (United States)

    Soares, Sandra Sofia; Henao, Fernando; Aureliano, Manuel; Gutiérrez-Merino, Carlos

    2008-03-01

    Besides the well-known inotropic effects of vanadium in cardiac muscle, previous studies have shown that vanadate can stimulate cell growth or induce cell death. In this work, we studied the toxicity to neonatal rat ventricular myocytes (cardiomyocytes) of two vanadate solutions containing different oligovanadates distribution, decavanadate (containing decameric vanadate, V 10) and metavanadate (containing monomeric vanadate and also di-, tetra-, and pentavanadate). Incubation for 24 h with decavanadate or metavanadate induced necrotic cell death of cardiomyocytes, without significant caspase-3 activation. Only 10 microM total vanadium of either decavanadate (1 microM V 10) or metavanadate (10 microM total vanadium) was needed to produce 50% loss of cell viability after 24 h (assessed with MTT and propidium iodide assays). Atomic absorption spectroscopy showed that vanadium accumulation in cardiomyocytes after 24 h was the same when incubation was done with decavanadate or metavanadate. A decrease of 75% of the rate of mitochondrial superoxide anion generation, monitored with dihydroethidium, and a sustained rise of cytosolic calcium (monitored with Fura-2-loaded cardiomyocytes) was observed after 24 h of incubation of cardiomyocytes with decavanadate or metavanadate concentrations close to those inducing 50% loss of cell viability produced. In addition, mitochondrial membrane depolarization within cardiomyocytes, monitored with tetramethylrhodamine ethyl esther or with 3,3',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolcarbocyanine iodide, were observed after only 6 h of incubation with decavanadate or metavanadate. The concentration needed for 50% mitochondrial depolarization was 6.5 +/- 1 microM total vanadium for both decavanadate (0.65 microM V 10) and metavanadate. In conclusion, mitochondrial membrane depolarization was an early event in decavanadate- and monovanadate-induced necrotic cell death of cardiomyocytes.

  9. [Dealing with parents facing imminent death of their neonate: introducing palliative care in maternity wards and neonatal intensive care units].

    Science.gov (United States)

    Storme, Laurent; de Mézerac, Isabelle

    2010-06-01

    Following antenatal diagnosis of a lethal disorder, some parents are so overwhelmed by grief that therapeutic abortion is seen as the least traumatic option. However, the impending death and anticipated mourning create a particularly complex emotional situation. When faced with such dramatic circumstances, some parents seek to restore meaning to their parenthood by accompanying their baby through to the end of its life. Methods derived from hospice care may be appropriate in such situations, considering the unborn child as "a living being among the living ", pregnancy as the first chapter of every life, and death as a natural process. This approach, which may be adopted in maternity wards and neonatal intensive care units, requires the medical team to provide consistent information to the parents and to ensure their close involvement. These new parental demands must be clearly understood if they are to be met as effectively as possible.

  10. Reducing the Teen Death Rate. KIDS COUNT Indicator Brief

    Science.gov (United States)

    Shore, Rima; Shore, Barbara

    2009-01-01

    Life continues to hold considerable risk for adolescents in the United States. In 2006, the teen death rate stood at 64 deaths per 100,000 teens (13,739 teens) (KIDS COUNT Data Center, 2009). Although it has declined by 4 percent since 2000, the rate of teen death in this country remains substantially higher than in many peer nations, based…

  11. Association of Fetal Heart Rate Baseline Change and Neonatal Outcomes.

    Science.gov (United States)

    Yang, Michael; Stout, Molly J; López, Julia D; Colvin, Ryan; Macones, George A; Cahill, Alison G

    2017-07-01

    Objective The objective of this study was to describe the incidence of baseline change within normal range during labor and its prediction of neonatal outcomes. Materials and Methods This was a prospective cohort of singleton, nonanomalous, term neonates with continuous electronic fetal monitoring and normal baseline fetal heart rate throughout the last 2 hours of labor. We determined baseline in 10-minute segments using Eunice Kennedy Shriver National Institute of Child Health and Human Development criteria. We evaluated baseline changes of ≥ 20 and ≥ 30 bpm for association with acidemia (umbilical cord arterial pH ≤ 7.10) and neonatal intensive care unit (NICU) admission. Finally, we performed a sensitivity analysis of normal neonates, excluding those with acidemia, NICU admission, or 5-minute Apgar bpm; 272 (9.0%) had ≥ 30 bpm. Among normal neonates (n = 2,939), 1,221 (41.5%) had change ≥20 bpm. Acidemia was not associated with baseline change of any direction or magnitude. NICU admission was associated with decrease ≥ 20 bpm (adjusted odds ratio [aOR]: 2.93; 95% confidence interval [CI]: 1.19 - 7.21) or any direction ≥ 20 bpm (aOR: 4.06; 95% CI: 1.46-11.29). For decrease ≥ 20 bpm, sensitivity and specificity were 40.0 and 81.7%; for any direction ≥ 20 bpm, 75.0 and 58.3%. Conclusion Changes of normal baseline are common in term labor and poorly predict morbidity, regardless of direction or magnitude. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Tobacco Smoke Exposure as Risk Factor in Early Neonatal Death in Mataram, Nusa Tenggara Barat (NTB

    Directory of Open Access Journals (Sweden)

    Musrifa .

    2014-08-01

    Full Text Available Objective: To investigate tobacco smoke exposure as risk factor of early neonatal death in Mataram, NTB.Method: The study design was case control with a total sample of 87 consisting of 29 cases and 58 controls (1:2.Dependent variable was early neonatal death, independent variable was tobacco smoke exposure. Frequency ofantenatal visit, family income, delivery complications, anemia and low birth weight were confounding variables. Datawere collected through interview and registered cohort data from nine health centres during the period of 1 January-31December 2013. Data were analyzed by using bivariate and multivariate (logistic regression to calculate crude OR andadjusted OR.Result: Results of bivariate analysis indicated that tobacco smoke exposure during pregnancy, extent of exposure ?3cigarettes/days during pregnancy, and amount of exposure ?6 cigarettes/days last 24 hours were 2.75 (95%CI: 0.72-10.50; 2.34 (95%CI: 0.77-7.08; and 2.18 (95%CI: 0.65-7.29 respectively, increasing neonatal death but was notstatistically significant. Multivariate analysis indicated that tobacco smoke exposure during pregnancy was 1.32 (95%CI:0.03-69.90. OR of other variables: low birth weight, family income under Rp. 1,100,000,- and delivery complicationswere 204.39 (95%CI: 20.37-2050.07; 7.86 (95%CI: 1.45-42.83 and 7.55 (95%CI: 1.01-56.38 respectively.Conclusion: Tobacco smoke exposure was not statistically significant risk factor, specifically the smoking habits of thehusband. Study discovered that low birth weight, family income under Rp. 1,100,000,- and delivery complication duringbirth were statistically significant factors. Further study is needed to confirm these findings.Key words: tobacco smoke exposure, early neonatal death, risk factors, Nusa Tenggara Barat

  13. Gallbladder Cancer Incidence and Death Rates

    Science.gov (United States)

    ... with a poor outcome, often death. The journal Cancer Epidemiology, Biomarkers and Prevention published a CDC study looking ... cancer incidence and mortality, United States, 1999–2011. Cancer Epidemiology, Biomarkers and Prevention 2015. More Information Gallbladder Cancer ( ...

  14. Phenobarbital for Neonatal Seizures: Response Rate and Predictors of Refractoriness.

    Science.gov (United States)

    Spagnoli, Carlotta; Seri, Stefano; Pavlidis, Elena; Mazzotta, Silvia; Pelosi, Annalisa; Pisani, Francesco

    2016-10-01

    Background Phenobarbital is the first-line choice for neonatal seizures treatment, despite a response rate of approximately 45%. Failure to respond to acute anticonvulsants is associated with poor neurodevelopmental outcome, but knowledge on predictors of refractoriness is limited. Objective To quantify response rate to phenobarbital and to establish variables predictive of its lack of efficacy. Methods We retrospectively evaluated newborns with electrographically confirmed neonatal seizures admitted between January 1999 and December 2012 to the neonatal intensive care unit of Parma University Hospital (Italy), excluding neonates with status epilepticus. Response was categorized as complete (cessation of clinical and electrographic seizures after phenobarbital administration), partial (reduction but not cessation of electrographic seizures with the first bolus, response to the second bolus), or absent (no response after the second bolus). Multivariate analysis was used to identify independent predictors of refractoriness. Results Out of 91 newborns receiving phenobarbital, 57 (62.6%) responded completely, 15 (16.5%) partially, and 19 (20.9%) did not respond. Seizure type (p = 0.02), background electroencephalogram (EEG; p ≤ 0.005), and neurologic examination (p  ≤  0.005) correlated with response to phenobarbital. However, EEG (p  ≤  0.02) and seizure type (p  ≤  0.001) were the only independent predictors. Conclusion Our results suggest a prominent role of neurophysiological variables (background EEG and electrographic-only seizure type) in predicting the absence of response to phenobarbital in high-risk newborns. Georg Thieme Verlag KG Stuttgart · New York.

  15. The Regional Centralization of Electronic Fetal Heart Rate Monitoring and Its Impact on Neonatal Acidemia and the Cesarean Birth Rate

    Directory of Open Access Journals (Sweden)

    Kaori Michikata

    2016-01-01

    Full Text Available Objective. The improvement of the accuracy of fetal heart rate (FHR pattern interpretation to improve perinatal outcomes remains an elusive challenge. We examined the impact of an FHR centralization system on the incidence of neonatal acidemia and cesarean births. Methods. We performed a regional, population-based, before-and-after study of 9,139 deliveries over a 3-year period. The chi-squared test was used for the statistical analysis. Results. The before-and-after study showed no difference in the rates of acidemia, cesarean births, or perinatal death in the whole population. A subgroup analysis using the 4 hospitals in which an FHR centralization system was continuously connected (compliant group and 3 hospitals in which the FHR centralization system was connected on demand (noncompliant group showed that the incidence acidemia was significantly decreased (from 0.47% to 0.11% without a corresponding increase in the cesarean birth rate due to nonreassuring FHR patterns in the compliant group. Although there was no difference in the incidence of nonreassuring FHR patterns in the noncompliant group, the total cesarean birth rate was significantly higher than that in the compliant group. Conclusion. The continuous FHR centralization system, in which specialists help to interpret results and decide clinical actions, was beneficial in reducing the incidence of neonatal acidemia (pH < 7.1 without increasing the cesarean birth rate due to nonreassuring FHR patterns.

  16. Subclavian Vein Cannulation Success Rate in Neonates and Children

    Science.gov (United States)

    Aminnejad, Reza; Razavi, Seyed Sajjad; Mohajerani, Seyed Amir; Mahdavi, Seyed Alireza

    2015-01-01

    Background: Central vein cannulation allows the administration of large volumes of fluids in short times and at high osmolarities for rehydration, volume replacement, chemotherapy, and parenteral nutrition. Percutaneous central venous line insertion has replaced peripheral venous cut-down as the primary mode of short-term venous access in children. Objectives: The aim of our study was to delineate some aspects of this procedure as well as its success rate and relative risk in pediatrics. Patients and Methods: Totally, 3264 subclavian vein cannulations in neonates and children were analyzed regarding successful catheterization attempts and early complication rates after the procedure retrospectively in Mofid Hospital (Tehran, Iran). Results: There were 1340 newborn patients (first 28 days of life) in our study population. In these newborns, only 55 cannulations failed; one patient was complicated with pneumothorax; guide wires malfunctioned in 21 cases; and first- attempt cannulation success was reported in only 981 cases. In the remaining 1924 patients, between one month and 8 years old, only 14 attempts at the cannulation of the subclavian vein failed and 1655 cases had first-attempt cannulation success. Conclusions: The cannulation of the central vein in neonates and children in a skilled hand would be performed with great success rate and low complications. PMID:26161322

  17. Heart rate variability in sleeping preterm neonates exposed to cool and warm thermal conditions.

    Directory of Open Access Journals (Sweden)

    Erwan Stéphan-Blanchard

    Full Text Available Sudden infant death syndrome (SIDS remains the main cause of postneonatal infant death. Thermal stress is a major risk factor and makes infants more vulnerable to SIDS. Although it has been suggested that thermal stress could lead to SIDS by disrupting autonomic functions, clinical and physiopathological data on this hypothesis are scarce. We evaluated the influence of ambient temperature on autonomic nervous activity during sleep in thirty-four preterm neonates (mean ± SD gestational age: 31.4±1.5 weeks, postmenstrual age: 36.2±0.9 weeks. Heart rate variability was assessed as a function of the sleep stage at three different ambient temperatures (thermoneutrality and warm and cool thermal conditions. An elevated ambient temperature was associated with a higher basal heart rate and lower short- and long-term variability in all sleep stages, together with higher sympathetic activity and lower parasympathetic activity. Our study results showed that modification of the ambient temperature led to significant changes in autonomic nervous system control in sleeping preterm neonates. The latter changes are very similar to those observed in infants at risk of SIDS. Our findings may provide greater insight into the thermally-induced disease mechanisms related to SIDS and may help improve prevention strategies.

  18. Heart rate variability in sleeping preterm neonates exposed to cool and warm thermal conditions.

    Science.gov (United States)

    Stéphan-Blanchard, Erwan; Chardon, Karen; Léké, André; Delanaud, Stéphane; Bach, Véronique; Telliez, Frédéric

    2013-01-01

    Sudden infant death syndrome (SIDS) remains the main cause of postneonatal infant death. Thermal stress is a major risk factor and makes infants more vulnerable to SIDS. Although it has been suggested that thermal stress could lead to SIDS by disrupting autonomic functions, clinical and physiopathological data on this hypothesis are scarce. We evaluated the influence of ambient temperature on autonomic nervous activity during sleep in thirty-four preterm neonates (mean ± SD gestational age: 31.4±1.5 weeks, postmenstrual age: 36.2±0.9 weeks). Heart rate variability was assessed as a function of the sleep stage at three different ambient temperatures (thermoneutrality and warm and cool thermal conditions). An elevated ambient temperature was associated with a higher basal heart rate and lower short- and long-term variability in all sleep stages, together with higher sympathetic activity and lower parasympathetic activity. Our study results showed that modification of the ambient temperature led to significant changes in autonomic nervous system control in sleeping preterm neonates. The latter changes are very similar to those observed in infants at risk of SIDS. Our findings may provide greater insight into the thermally-induced disease mechanisms related to SIDS and may help improve prevention strategies.

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

    NARCIS (Netherlands)

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

    2016-01-01

    Background: 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

  20. Long-term recurrence and death rates after acute pancreatitis

    DEFF Research Database (Denmark)

    Lund, Helle; Tønnesen, Hanne; Tønnesen, Maja Hanne

    2006-01-01

    The aim of this study was to compare long-term recurrence and death rates after a first episode of acute pancreatitis in patients with and without gallstones. Additionally, it was of interest to find out if there were factors predictive of readmission or death.......The aim of this study was to compare long-term recurrence and death rates after a first episode of acute pancreatitis in patients with and without gallstones. Additionally, it was of interest to find out if there were factors predictive of readmission or death....

  1. Long-term recurrence and death rates after acute pancreatitis

    DEFF Research Database (Denmark)

    Lund, Helle; Tønnesen, Hanne; Tønnesen, Maja Hanne

    2006-01-01

    The aim of this study was to compare long-term recurrence and death rates after a first episode of acute pancreatitis in patients with and without gallstones. Additionally, it was of interest to find out if there were factors predictive of readmission or death.......The aim of this study was to compare long-term recurrence and death rates after a first episode of acute pancreatitis in patients with and without gallstones. Additionally, it was of interest to find out if there were factors predictive of readmission or death....

  2. Variations in breastfeeding rates for very preterm infants between regions and neonatal units in Europe

    DEFF Research Database (Denmark)

    Bonet, Mercedes; Blondel, Béatrice; Agostino, Rocco

    2011-01-01

    To compare breastfeeding rates at discharge for very preterm infants between European regions and neonatal units, and to identify characteristics associated with breast feeding using multilevel models....

  3. Exchange-Driven Growth with Birth Rate Less Than Death

    Institute of Scientific and Technical Information of China (English)

    LIN Zhen-Quan; KE Jian-Hong; YE Gao-Xiang

    2005-01-01

    We further study the kinetic behavior of the exchange-driven growth with birth and death for the case of birth rate kernel being less than that of death based on the mean-field theory. The symmetric exchange rate kernel is K(k,j) = K'(k,j) = Ikjv, and the birth and death rates are proportional to the aggregate's size. The long time asymptotic behavior of the aggregate size distribution ak(t) is found to obey a much unusual scaling law with an exponentially growing scaling function φ(x) = exp(x).

  4. Erythropoietin reduces neuronal cell death and hyperalgesia induced by peripheral inflammatory pain in neonatal rats

    Directory of Open Access Journals (Sweden)

    Hofmann Cane

    2011-07-01

    Full Text Available Abstract Painful stimuli during neonatal stage may affect brain development and contribute to abnormal behaviors in adulthood. Very few specific therapies are available for this developmental disorder. A better understanding of the mechanisms and consequences of painful stimuli during the neonatal period is essential for the development of effective therapies. In this study, we examined brain reactions in a neonatal rat model of peripheral inflammatory pain. We focused on the inflammatory insult-induced brain responses and delayed changes in behavior and pain sensation. Postnatal day 3 pups received formalin injections into the paws once a day for 3 days. The insult induced dysregulation of several inflammatory factors in the brain and caused selective neuronal cell death in the cortex, hippocampus and hypothalamus. On postnatal day 21, rats that received the inflammatory nociceptive insult exhibited increased local cerebral blood flow in the somatosensory cortex, hyperalgesia, and decreased exploratory behaviors. Based on these observations, we tested recombinant human erythropoietin (rhEPO as a potential treatment to prevent the inflammatory pain-induced changes. rhEPO treatment (5,000 U/kg/day, i.p., coupled to formalin injections, ameliorated neuronal cell death and normalized the inflammatory response. Rats that received formalin plus rhEPO exhibited normal levels of cerebral blood flow, pain sensitivity and exploratory behavior. Treatment with rhEPO also restored normal brain and body weights that were reduced in the formalin group. These data suggest that severe inflammatory pain has adverse effects on brain development and rhEPO may be a possible therapy for the prevention and treatment of this developmental disorder.

  5. Caspase dependence of the death of neonatal retinal ganglion cells induced by axon damage and induction of autophagy as a survival mechanism

    Directory of Open Access Journals (Sweden)

    C. Sternberg

    2010-10-01

    Full Text Available We examined the degeneration of post-mitotic ganglion cells in ex-vivo neonatal retinal explants following axon damage. Ultrastructural features of both apoptosis and autophagy were detected. Degenerating cells reacted with antibodies specific for activated caspase-3 or -9, consistent with the presence of caspase activity. Furthermore, peptidic inhibitors of caspase-9, -6 or -3 prevented cell death (100 µM Ac-LEDH-CHO, 50 µM Ac-VEID-CHO and 10 µM Z-DEVD-fmk, respectively. Interestingly, inhibition of autophagy by 7-10 mM 3-methyl-adenine increased the rate of cell death. Immunohistochemistry data, caspase activation and caspase inhibition data suggest that axotomy of neonatal retinal ganglion cells triggers the intrinsic apoptotic pathway, which, in turn, is counteracted by a pro-survival autophagic response, demonstrated by electron microscopy profiles and pharmacological autophagy inhibitor.

  6. Premature death rates diverge in the United States

    Science.gov (United States)

    An NCI press release on a study that shows premature death rates have declined in the United States among Hispanics, blacks, and Asian/Pacific Islanders but increased among whites and American Indian/Alaska Natives.

  7. U.S. Maternal Death Rate Is Rising

    Science.gov (United States)

    ... have already reported a spike in the nation's maternal mortality figures, but they estimated a rate of 16 ... why? "Our study couldn't get into the causes of death," MacDorman said. "We were just trying ...

  8. U.S. Cancer Death Rates Continue to Fall

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162896.html U.S. Cancer Death Rates Continue to Fall: Report Researchers ... be diagnosed with cancer and about 600,000 U.S. cancer patients will die. "The drop in cancer ...

  9. Colon Cancer Rates, Deaths Drop in Americans Over 50

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163856.html Colon Cancer Rates, Deaths Drop in Americans Over 50 Report ... be an estimated 95,500 new cases of colon cancer and 39,900 new cases of rectal cancer ...

  10. Does an increased cesarean section rate improve neonatal outcome in term pregnancies?

    Science.gov (United States)

    Kupari, Marja; Talola, Nina; Luukkaala, Tiina; Tihtonen, Kati

    2016-07-01

    To clarify whether an increased cesarean section rate improves the short-term neonatal outcome in singleton term pregnancies with cephalic presentation. A retrospective study of institutional data on the mode of delivery and neonatal outcome. The study included two cohorts: 1998-1999 (n = 7437) and 2004-2005 (n = 8505), since the institutional cesarean section rate increased sharply between these cohorts and has remained stable after the latter study period. The caesarean section rate almost doubled from 6.8 to 11.3 % (p cesarean section rate from a low to a moderate does not improve the short-term neonatal outcome in term singleton pregnancies. On the contrary neonatal intensive care unit admissions increased with increasing caesarean section rate. Furthermore it is possible to achieve good neonatal outcome with a low cesarean section rate.

  11. U.S. congressional district cancer death rates

    Directory of Open Access Journals (Sweden)

    Pickle Linda W

    2006-06-01

    Full Text Available Abstract Background Geographic patterns of cancer death rates in the U.S. have customarily been presented by county or aggregated into state economic or health service areas. Herein, we present the geographic patterns of cancer death rates in the U.S. by congressional district. Many congressional districts do not follow state or county boundaries. However, counties are the smallest geographical units for which death rates are available. Thus, a method based on the hierarchical relationship of census geographic units was developed to estimate age-adjusted death rates for congressional districts using data obtained at county level. These rates may be useful in communicating to legislators and policy makers about the cancer burden and potential impact of cancer control in their jurisdictions. Results Mortality data were obtained from the National Center for Health Statistics (NCHS for 1990–2001 for 50 states, the District of Columbia, and all counties. We computed annual average age-adjusted death rates for all cancer sites combined, the four major cancers (lung and bronchus, prostate, female breast, and colorectal cancer and cervical cancer. Cancer death rates varied widely across congressional districts for all cancer sites combined, for the four major cancers, and for cervical cancer. When examined at the national level, broad patterns of mortality by sex, race and region were generally similar with those previously observed based on county and state economic area. Conclusion We developed a method to generate cancer death rates by congressional district using county-level mortality data. Characterizing the cancer burden by congressional district may be useful in promoting cancer control and prevention programs, and persuading legislators to enact new cancer control programs and/or strengthening existing ones. The method can be applied to state legislative districts and other analyses that involve data aggregation from different geographic

  12. Óbitos neonatais: por que e como informar? Neonatal death: why and how to inform?

    Directory of Open Access Journals (Sweden)

    Linda Délia Carvalho de Oliveira Pedrosa

    2005-12-01

    Full Text Available Os óbitos neonatais se constituem no mais importante componente da mortalidade infantil (MI no Brasil, tendo como principais causas a asfixia, o baixo peso ao nascer, as afecções respiratórias do recém-nascido, as infecções e a prematuridade. São situações vinculadas a falhas de prevenção e a ampla rede de determinantes desses óbitos precisa ser conhecida a partir das informações disponibilizadas pelos sistemas nacionais de informação. Uma boa cobertura do sistema, agilidade e coleta de informações confiáveis em todos os níveis e o controle do fluxo dessas informações, asseguram a validade dos indicadores gerados, permitindo a escolha da melhor abordagem preventiva. Neste artigo, são apresentadas as diversas fontes de pesquisa em óbitos neonatais, seus usos e limitações ressaltando o papel dos profissionais de saúde na geração de dados confiáveis. Foram consultados manuais técnicos do Ministério da Saúde, teses, dissertações e livros sobre o tema e realizada uma revisão nos bancos de dados eletrônicos Medline, LILACS, SCIELO e PAHO em artigos disponíveis de 1980 a 2004, a partir dos descritores "mortalidade infantil", "mortalidade neonatal", "mortalidade neonatal precoce", "causa básica de óbito", "sistemas de informação", "informação em saúde", "registros médicos", "registros de mortalidade".The neonatal death constitutes the major component of the infant mortality (MI in Brazil, having the asphyxia, the low birthweight, the newborn respiratory affection, the infection and prematurity as the main causes. These situations connect to the prevention failures so the wide determinant network of these obits need to be recognized from available data by national systems of information. A good system covering, agility and reliable information collection in all the levels and the flow information control, assure the validity of the produced indicators, allowing the choice of the best preventive approach

  13. 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.

  14. 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.

  15. Sound and vibration: effects on infants' heart rate and heart rate variability during neonatal transport.

    Science.gov (United States)

    Karlsson, Björn-Markus; Lindkvist, Marie; Lindkvist, Markus; Karlsson, Marcus; Lundström, Ronnie; Håkansson, Stellan; Wiklund, Urban; van den Berg, Johannes

    2012-02-01

    To measure the effect of sound and whole-body vibration on infants' heart rate and heart rate variability during ground and air ambulance transport. Sixteen infants were transported by air ambulance with ground ambulance transport to and from the airports. Whole-body vibration and sound levels were recorded and heart parameters were obtained by ECG signal. Sound and whole-body vibration levels exceeded the recommended limits. Mean whole-body vibration and sound levels were 0.19 m/s(2) and 73 dBA, respectively. Higher whole-body vibration was associated with a lower heart rate (p < 0.05), and higher sound level was linked to a higher heart rate (p = 0.05). The heart rate variability was significantly higher at the end of the transport than at the beginning (p < 0.01). Poorer physiological status was associated with lower heart rate variability (p < 0.001) and a lower heart rate (p < 0.01). Infants wearing earmuffs had a lower heart rate (p < 0.05). Sound and whole-body vibration during neonatal transport exceed recommended levels for adults, and sound seem to have a more stressful effect on the infant than vibrations. Infants should wear earmuffs during neonatal transport because of the stress-reducing effect. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  16. G-CSF protects motoneurons against axotomy-induced apoptotic death in neonatal mice

    Directory of Open Access Journals (Sweden)

    Pitzer Claudia

    2010-02-01

    Full Text Available Abstract Background Granulocyte colony stimulating factor (G-CSF is a growth factor essential for generation of neutrophilic granulocytes. Apart from this hematopoietic function, we have recently uncovered potent neuroprotective and regenerative properties of G-CSF in the central nervous system (CNS. The G-CSF receptor and G-CSF itself are expressed in α motoneurons, G-CSF protects motoneurons, and improves outcome in the SOD1(G93A transgenic mouse model for amyotrophic lateral sclerosis (ALS. In vitro, G-CSF acts anti-apoptotically on motoneuronal cells. Due to the pleiotrophic effects of G-CSF and the complexity of the SOD1 transgenic ALS models it was however not possible to clearly distinguish between directly mediated anti-apoptotic and indirectly protective effects on motoneurons. Here we studied whether G-CSF is able to protect motoneurons from purely apoptotic cell death induced by a monocausal paradigm, neonatal sciatic nerve axotomy. Results We performed sciatic nerve axotomy in neonatal mice overexpressing G-CSF in the CNS and found that G-CSF transgenic mice displayed significantly higher numbers of surviving lumbar motoneurons 4 days following axotomy than their littermate controls. Also, surviving motoneurons in G-CSF overexpressing animals were larger, suggesting additional trophic effects of this growth factor. Conclusions In this model of pure apoptotic cell death the protective effects of G-CSF indicate direct actions of G-CSF on motoneurons in vivo. This shows that G-CSF exerts potent anti-apoptotic activities towards motoneurons in vivo and suggests that the protection offered by G-CSF in ALS mouse models is due to its direct neuroprotective activity.

  17. The Mortality Rate of Nosocomial Infection in Neonatal Intensive Care Unit (NICU of Taleghani Educational and Treatment Center, Tabriz, 2013

    Directory of Open Access Journals (Sweden)

    Parvin Abbasian

    2015-09-01

    Full Text Available Background and Objectives : Information about nosocomial infections (NIs is necessary for both appropriate management and establishment of preventative measures in hospitals. Neonates admitted to the Neonatal Intensive Care Unit (NICU are at high-risk of developing nosocomial infection. The aim of this study was to determine the mortality rate of nosocomial infections and the distribution of pathogens among newborns who were admitted to the neonatal intensive care unit in Taleghani educational and treatment center, Tabriz. Material and Methods : This was a cross-sectional study. The sampling method was census. The inclusion criteria were dead infants who developed signs of infection after 48 hours of hospitalization and those who had symptoms at the admission were excluded. Data were collected through hospital records and were analyzed using Excel software. Results: From 904 infants admitted to NICU, 39 (4.3% acquired hospital infection. Mortality from nosocomial infections in NICU was 20.5% that was 12% of the total deaths. Coagulase-negative staphylococcal Cook (37.5% and Escherichia coli (25% were the most commonly identified agents among dead neonates. Conclusion: For more reduction in nosocomial infection and its mortality rate, mercury hygiene principles and also optimizing bed spaces are recommended. ​

  18. Measurement of neonatal heart rate using handheld Doppler ultrasound.

    Science.gov (United States)

    Dyson, Amanda; Jeffrey, Michele; Kluckow, Martin

    2017-03-01

    This pilot study aimed to determine whether handheld Doppler ultrasound is feasible and reliable for measuring neonatal heart rate (HR) when compared with ECG. Stable newborns were recruited from the neonatal intensive care unit and postnatal ward between July 2014 and January 2015 at Royal North Shore Hospital, Sydney, Australia. Each newborn had their HR recorded every 15 s over 145 s using four different modalities: ECG, counted audible Doppler (AD) over 10 s, pulse oximetry (PO) and the Doppler display (DD). The correlation and variation between each modality and ECG. 51 newborns with a median gestational age of 38 weeks (27-41) and a mean weight of 2.78 kg (0.82 to 4.76) with a median postnatal age of 3 days (0-87) were studied. There was a mean difference of 0.69 bpm (95% CI -2.9 to +1.5) between AD-HR and ECG-HR with good correlation between modalities (r=0.94, p<0.01). The median time to achieve AD-HR was 3 s (1-45). The mean difference between DD-HR and ECG-HR was 5.37 bpm (95% CI -12.8 to +2.1) with moderate correlation (r=0.37, p=0.04). The mean difference between PO-HR and ECG-HR was 0.49 bpm (95% CI -1.5 to +0.51) with good correlation (r=0.99, p<0.01). The variability between AD-HR and ECG-HR decreased with decreasing weight. AD-HR correlates well with ECG-HR. Further research in the delivery room is recommended before using AD-HR in this area. 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/.

  19. 90例新生儿死亡病例临床分析%Clinical Analysis of 90 Cases of Neonatal Deaths

    Institute of Scientific and Technical Information of China (English)

    刘美华

    2015-01-01

    目的:回顾性总结和分析东港市妇幼保健院住院新生儿死亡病例的死亡主要原因及防治措施。方法收集东港市妇幼保健院新生儿科2011年1月~2015年6月住院新生儿死亡病例,分析住院新生儿死亡病例的临床主要死因。结果共收治住院新生儿3125例,死亡90例,总病死率2.88%。其中早产儿49人(54.44%),足月儿41人(45.56%);出生7 d内死亡有60例,占新生儿死亡的67.67%;死亡病因前4位为:感染致败血症,窒息致多器官衰竭,先天发育畸形及呼吸系统疾病合并呼吸衰竭。结论加强产前各种检查,降低早产发生率,降低出生缺陷,预防感染,提高新生儿窒息复苏技术,加强早产儿的监护、护理和治疗措施,可有效降低新生儿死亡率。%Objective To retrospectively summarize and analyze the main causes and prevention measures of neonatal death in donggang maternal and child health hospital. MethodsWe colected donggang city maternal and child health care hospital neonatal from January 2011 to June 2015,hospitalized cases of neonatal death and analysis of hospitalized neonatal death were the main clinical death.Results There were 3 125 cases of neonatal hospitalization,90 cases died,the total mortality rate was 2.88%. The premature 49(54.44%),moon 41(45.56%),born within 7 days of death in 60 cases,accounting for neonatal death 67.67%,death causes before 4: infection induced sepsis,asphyxia,resulting in multiple organ failure,congenital malformations and respiratory system diseases complicated with respiratory failure. Conclusion To strengthen prenatal examination,reduce the incidence of premature birth,reduce birth defects,prevention of infection,improve neonatal asphyxia recovery technology,strengthen the monitoring of premature infants, care and treatment measures,can effectively reduce the neonatal mortality.

  20. Grief response of parents to neonatal death and parent participation in deciding care.

    Science.gov (United States)

    Benfield, D G; Leib, S A; Vollman, J H

    1978-08-01

    We determined the grief response to neonatal death of 50 mother-father pairs by administering a questionnaire and conducting a semistructured interview during the infant postmortem review. As measured by a parent grief score, maternal grief significantly exceeded paternal grief (t = 5.89, P less than .0001). Parent grief was not significantly related to birth weight, duration of life, extent of parent-infant contact, previous perinatal loss, parent age, or distance from the hospital of birth to the regional center (Pearson product-moment correlation coefficients). However, the attitudes and behavior of family, friends, and health care personnel in the hospital of birth often adversely influenced parent grieving. Of 39 mother-father pairs whose infants required respirator support, 18 participated in a group decision with their physician to withdraw respirator support when the prospects of infant survival seemed hopeless (limited respirator care group). No significant differences in parent grief scores were found (t tests) when the limited respirator care group was compared to those parents of infants who died despite uninterrupted respirator care. Our data suggest that informed parents can participate as partners with their physician in difficult infant care decision, even when death results, and adjust to their loss with healthy grieving.

  1. Survival Rate of Low and Very Low Birth Weight Neonates in an Iranian Community

    Directory of Open Access Journals (Sweden)

    A Puyanfar

    2012-02-01

    Full Text Available Background: This study aimed to assess the incidence and survival rates of neonates weighing less than 2500g for duration of the first 28 days in an Iranian community.Methods: In this prospective longitudinal study, all neonates with birth weight less than 2500g were selected from the list of all neonates born in the only public-sector referral hospital, for a six months period. The weight of neonates at birth along with some demographic variables was recorded on a checklist. A cohort of neonates with birth weight less than 2500g were followed for 28 days. Mortality within 28 days of birth was used as end point. Continuous variables were summarized using mean and 95% confidence intervals, while categorical variables were presented as ratios and percentages.Results: About 1750 neonates were born of which 168 neonates with birth weights less than 2500g were recorded giving a proportion of 9.6%. Of 168 neonates, 21 (12.5% had very low birth weights (VLBW (birth weights<1500g. Survival rates for the groups of LBW (1500neonates were 98.4% and 66.6%, respectively. Regression analysis showed birth weight has, unsurprisingly, the most effect (beta= 0.501 on the survival rate among variables studied in this research.Conclusion: The survival rate among VLBW births in our study is dramatically low (66.6%. Not only attempts must be made to reduce the incidence and prevalence of this problem but also we need to work on the related factors of neonates' survival rate in this community.

  2. The Parkinson's disease death rate: carbidopa and vitamin B6

    Directory of Open Access Journals (Sweden)

    Hinz M

    2014-10-01

    Full Text Available Marty Hinz,1 Alvin Stein,2 Ted Cole31Clinical Research, NeuroResearch Clinics, Inc., Cape Coral, FL, USA; 2Stein Orthopedic Associates, Plantation, FL, USA; 3Cole Center for Healing, Cincinnati, OH, USAAbstract: The only indication for carbidopa and benserazide is the management of L-3,4-dihydroxyphenylalanine (L-dopa-induced nausea. Both drugs irreversibly bind to and permanently deactivate pyridoxal 5'-phosphate (PLP, the active form of vitamin B6, and PLP-dependent enzymes. PLP is required for the function of over 300 enzymes and proteins. Virtually every major system in the body is impacted directly or indirectly by PLP. The administration of carbidopa and benserazide potentially induces a nutritional catastrophe. During the first 15 years of prescribing L-dopa, a decreasing Parkinson's disease death rate was observed. Then, in 1976, 1 year after US Food and Drug Administration approved the original L-dopa/carbidopa combination drug, the Parkinson's disease death rate started increasing. This trend has continued to the present, for 38 years and counting. The previous literature documents this increasing death rate, but no hypothesis has been offered concerning this trend. Carbidopa is postulated to contribute to the increasing Parkinson's disease death rate and to the classification of Parkinson's as a progressive neurodegenerative disease. It may contribute to L-dopa tachyphylaxis.Keywords: L-dopa, levodopa, vitamin B6, pyridoxal 5'-phosphate

  3. High maternal and neonatal mortality rates in northern Nigeria: an 8-month observational study

    Directory of Open Access Journals (Sweden)

    Guerrier G

    2013-08-01

    Full Text Available Gilles Guerrier,1 Bukola Oluyide,2 Maria Keramarou,1 Rebecca Grais1 1Epicentre, Paris, France; 2Médecins Sans Frontières, Paris, France Background: Despite considerable efforts to reduce the maternal mortality ratio, numerous pregnant women continue to die in many developing countries, including Nigeria. We conducted a study to determine the incidence and causes of maternal mortality over an 8-month period in a rural-based secondary health facility located in Jahun, northern Nigeria. Methods: A retrospective observational study was performed in a 41-bed obstetric ward. From October 2010 to May 2011, demographic data, obstetric characteristics, and outcome were collected from all pregnant women admitted. The total number of live births during the study period was recorded in order to calculate the maternal mortality ratio. Results: There were 2,177 deliveries and 39 maternal deaths during the study period, with a maternal mortality ratio of 1,791/100,000 live births. The most common causes of maternal mortality were hemorrhage (26%, puerperal sepsis (19%, and obstructed labor (5%. No significant difference (P = 0.07 in mean time to reach the hospital was noted between fatal cases (1.9 hours, 95% confidence interval [CI] 1.1–2.6 and nonfatal cases (1.4 hours, 95% CI 1.4–1.5. Two hundred and sixty-six women were admitted presenting with stillbirth. Maternal mortality was higher for unbooked patients than for booked patients (odds ratio 5.1, 95% CI 3.5–6.2, P < 0.0001. The neonatal mortality rate was calculated at 46/1,000 live births. The main primary causes of neonatal deaths were prematurity (44% and birth asphyxia (22%. Conclusion: Maternal and neonatal mortality remains unacceptably high in this setting. Reducing unbooked emergencies should be a priority with continuous programs including orthodox practices in order to meet the fifth Millennium Development Goal. Keywords: fetal mortality, maternal mortality, Nigeria, antenatal care

  4. 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

    The aim of the study was to investigate whether deaths in term breech deliveries could have been avoided with improved care during pregnancy and delivery. All cases of intrapartum/early neonatal death of nonmalformed infants in breech presentation delivered at term in Denmark in the period 1982......-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......" was potentially avoidable. The majority thought that 42% of cases and 9% of the controls had died. Antenatal and intrapartum care was suboptimal respectively in 17% and 25% of cases and 4% and 26% of controls. The assumed death was found to have been potentially avoidable in 58% of cases and 17% of controls. Care...

  5. 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.

  6. 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.

  7. Insulin accelerates global and mitochondrial protein synthesis rates in neonatal muscle during sepsis

    Science.gov (United States)

    In neonatal pigs, sepsis decreases protein synthesis in skeletal muscle by decreasing translation initiation. However, insulin stimulates muscle protein synthesis despite persistent repression of translation initiation signaling. To determine whether the insulin-induced increase in global rates of m...

  8. Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot study.

    Science.gov (United States)

    Arízaga-Ballesteros, Víctor; Alcorta-García, Mario René; Lázaro-Martínez, Lizzeth Carolina; Amézquita-Gómez, Jesús Manuel; Alanís-Cajero, José Manuel; Villela, Luis; Castorena-Torres, Fabiola; Lara-Díaz, Víctor Javier

    2015-01-01

    The transmembrane glycoprotein TREM-1 triggers an inflammatory response. Its soluble fraction (sTREM-1) has been shown to have diagnostic accuracy for late-onset neonatal sepsis (LONS). Until now, the potential of sTREM-1 to predict septic shock and/or death in septic neonates has not been explored. This study obtained estimates of the incidence and prevalence of septic shock and/or death in septic neonates for future sample size calculations for confirmatory studies and evaluated the feasibility of using sTREM-1 as a predictor of septic shock and/or death in neonates with LONS criteria. A pilot study with a cross-sectional design was performed from May 1(st) to October 31(st), 2012. The participants were hospitalized neonates who, after three days of life, were diagnosed as having LONS. Plasma sTREM-1 was quantified by ELISA. The main outcome measurement was the development of septic shock and/or death. Of 71 eligible subjects, nine (12.7%) progressed to septic shock and/or death. In the LONS-Non-Shock group, the sTREM-1 median and interquartile range (IQR) plasma value were 10 (10 to 70) pg/mL. In the LONS & Shock/Death group, the values were 567 (260 to 649) pg/mL. These values were significantly different (Mann-Whitney's U test, p=0.001). A ROC curve for a proposed sTREM-1 cut-off value of 300 pg/mL exhibited an area under the curve of 0.884 (95% CI=0.73 to 1.0; pneonates with LONS, sTREM-1 has the potential to provide an excellent predictive value for septic shock/death. Larger sample sizes are needed to identify the optimal cut-off value of plasma sTREM-1 for this diagnosis and to provide diagnostic accuracy measures. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. 住院新生儿180例死亡原因分析%Analysis of 180 neonatal deaths in hospitalized patients

    Institute of Scientific and Technical Information of China (English)

    白小红; 熊英; 张德双; 陈娟

    2013-01-01

    目的 通过分析我院住院新生儿死亡原因,探讨降低住院新生儿病死率的有效措施.方法 回顾性分析2007-2011年我院新生儿科死亡病例的性别、胎龄、出生体重、母亲围产期高危因素、生后1 min及5 min Apgar评分、死亡日龄、死亡诊断及死亡原因.结果 2007-2011年共收治新生儿14909例,死亡180例,病死率1.2%;死亡新生儿男女性别比为1.34∶1;早产儿占死亡新生儿的64.4%,低出生体重儿占死亡新生儿的62.8%;73.3%在生后7天内死亡;新生儿呼吸窘迫综合征、新生儿肺炎、新生儿肺出血是早产儿死亡的主要原因,出生缺陷、肺炎、败血症是足月儿死亡的主要原因.结论 做好孕期保健和胎儿监测工作,减少早产、新生儿感染的发生,预防孕期并发症,是减少新生儿死亡的主要措施.%Objective To analyze the causes of death in hospitalized neonates and to find effective prevention and treatment measures to reduce infant mortalities. Methods Medical records of neonatal death from January 2007 to December 2011 were collected. Retrospective analysis were conducted on gender, gestational age, birth weight, perinatal risk factors, 1 min & 5 min APGAR scores, chronological age at death, final diagnosis and direct causes of death. Results Among the 14909 neonates hospitalized, 180 infants were deceased with mortality rate of 1. 2% and male to female ratio of 1.34:1. Premature infants accounted for 64. 4% and low birth weight infants consisted of 62. 8% of the deceased neonates. 73. 3% of all mortalities occurred within 7 days post partum. While neonatal hyaline membrane disease, pneumonia and neonatal pulmonary hemorrhage were the primary causes of mortality in premature infants, congenital defects ( especially congenital heart diseases ), pneumonia and sepsis were most commonly found conditions that had lead to term infant mortalities. Conclusions Emphasis on prenatal care and fetal monitoring; decrease the

  10. Variation in cesarean section rates is not related to maternal and neonatal outcomes.

    Science.gov (United States)

    Pallasmaa, Nanneli; Alanen, Anna; Ekblad, Ulla; Vahlberg, Tero; Koivisto, Mari; Raudaskoski, Tytti; Ulander, Veli-Matti; Uotila, Jukka

    2013-10-01

    The aim of this study was to compare the rate of cesarean sections in 12 delivery units in Finland, and to assess possible associations between cesarean section rates and maternal and neonatal complications. Prospective multicenter cohort study. The 12 largest delivery units in Finland. Total obstetric population between 1 January 2005 and 30 June 2005 (n = 19 764). Prospectively collected data on 2496 cesarean sections and data derived from the Finnish Birth Register on all deliveries in these units were compared. Cesarean section rates and maternal complication rates were adjusted for known risk factors. Cesarean section rate, maternal complications related to cesarean section, and neonatal asphyxia. The cesarean section rates varied significantly between the hospitals (12.9-25.1%, p cesarean section (13.0-36.5%, p cesarean section rate. The differences remained after adjusting for risk factors. Neonatal asphyxia rates varied between 0.14 and 2.8% (p cesarean section rates. The rates of cesarean section, maternal complications and neonatal asphyxia vary markedly between different delivery units. Good maternal and neonatal outcomes can be achieved with cesarean section rates <15%. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. N-Terminal Pro-B Type Natriuretic Peptide as a Marker of Bronchopulmonary Dysplasia or Death in Very Preterm Neonates

    DEFF Research Database (Denmark)

    Sellmer, Anna; Hjortdal, Vibeke Elisabeth; Bjerre, Jesper Vandborg

    2015-01-01

    three and bronchopulmonary dysplasia (BPD) or death and further to assess the impact of patent ductus arteriosus (PDA) on this association in neonates born before 32 gestational weeks. METHODS: A cohort study of 183 neonates born before 32 gestational weeks consecutively admitted to the Neonatal......-proBNP to be associated with BPD or death in very preterm neonates. This association was not only explained by the PDA. We speculate that NT-proBNP may help the identification of neonates at risk of BPD as early as postnatal day three....... Intensive Care Unit, Aarhus University Hospital, Denmark. On day three plasma samples were collected and echocardiography carried out. NT-proBNP was measured by routine immunoassays. The combined outcome BPD or death was assessed at 36 weeks of postmenstrual age. Receiver operator characteristic (ROC...

  12. Sudden infant death syndrome in Canada: trends in rates and risk factors, 1985-1998.

    Science.gov (United States)

    Rusen, I D; Liu, Shiliang; Sauve, Reg; Joseph, K S; Kramer, Michael S

    2004-01-01

    In Canada, sudden infant death syndrome (SIDS) remains the leading cause of postneonatal death. However, SIDS rates have been declining in many countries, including Canada. This decline has been largely attributed to recommendations to avoid placing infants to sleep in the prone position. We examined the postneonatal rate of mortality due to SIDS and to other causes in relation to the initial risk reduction campaign. The postneonatal mortality rate due to SIDS decreased from 0.97 to 0.54 per 1,000 neonatal survivors between 1985-1989 and 1994-1998 (relative risk [RR] = 0.56, 95% confidence interval [CI] 0.51-0.62). The rate of postneonatal mortality due to other causes also decreased during the same period, though to a smaller extent, from 1.19 to 0.86 (RR = 0.72, 95% CI 0.66-0.78). With the exception of seasonality, established risk factors for SIDS remained essentially unchanged between the two time periods. The observed reduction in postneonatal SIDS is consistent with a positive impact of the initial recommendations regarding risk reduction. However, the lack of reliable risk factor data limits the extent to which the decline can be attributed directly to the campaign.

  13. 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.

  14. NCHS - Age-adjusted Death Rates for the Top 10 Leading Causes of Death: United States, 2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — Age-adjusted death rates for the top 10 leading causes of death in the United States, including mortality patterns from 1999 through 2013, and by state of residence...

  15. Hypothermia at neonatal intensive care unit admission was not associated with respiratory disease or death in very preterm infants

    DEFF Research Database (Denmark)

    Jensen, C F; Ebbesen, F; Petersen, J P

    2017-01-01

    AIM: This study investigated the association between hypothermia and respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD) or death in very preterm infants admitted to a Danish neonatal intensive care unit (NICU). METHODS: We studied 675 infants born at Aalborg University Hospital...... before 32 weeks and admitted to the NICU from April 1997 to December 2011. Hypothermia was defined as a core temperature of less than 36.5°C on admission. The primary outcome was severe RDS or death within the first three days of life and the secondary outcome was BPD or death before 36 postmenstrual...... weeks. The multivariable logistic regression was adjusted for early onset infection, gestational age, Apgar score, sex, treatment year and birth weight. RESULTS: Infants with hypothermia had a two-fold increase (OR) in the odds for RDS or death (2.03), but the adjusted OR was not statistically...

  16. 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.

  17. Review of singleton fetal and neonatal deaths associated with cranial trauma and cephalic delivery during a national intrapartum-related confidential enquiry

    National Research Council Canada - National Science Library

    O'Mahony, Fidelma; Settatree, Ralph; Platt, Craig; Johanson, Richard

    2005-01-01

    Objective  To review delivery details of intrapartum-related fetal and neonatal deaths with singleton cephalic presentation and birthweight of 2500 g or more in which traumatic cranial or cervical spine injury...

  18. Comparison the effect of Quran and lullaby on heart rate changes of hospitalized neonates in Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Taheri L

    2015-08-01

    Full Text Available Background and Objective: Maintain a normal heart rate in newborns in intensive care unit is an important goal in neonatal care. Non-pharmaceutical interventions in this area are important. The current study was conducted aimed to determine the effect of Quran and lullaby on heart rate changes of hospitalized neonates in NICU.  Materials and Method: The current clinical trial study was done on 78 hospitalized newborns in neonatal intensive care unit in one of the hospitals in Jahrom in 2013-2014. Newborns were selected through convenience sampling and then were randomly allocated to three groups, Quran, Lullaby and control groups. The newborne in two intervention groups listened to lullaby or Quran via headphones during 3 days and daily for 20 minutes and in control group, headphone was laid without voice for newborns. The heart rate of newborns was recorded immediately before the interventuion, 10 and 20 minutes after the starting the intervention and finally 20 minutes after the completion of it. Data were analyzed through SPSS 19 using Greenhouse - Geisser test, ANOVA and repeated measures ANOVA.  Results: The mean of heart rate of neonates in lullaby group, Quran and control groups before the intervention was respectively 135.7 ± 6.15, 140.56 ± 14.97 and 132.21 ± 25.21 that the difference between them was not statistically significant, but the mean change of their heart rate was significantly lower in twentieth minute in the second day in lullaby group (126.67 ± 11.22 in compare with control group (134.31±18.31 and Quran group (138.81 ± 19.12 (P = 0.016.  Conclusion: With attention to the effect of lullaby in the second day on decreas the heart rate changes, this method can be used in the neonatal intensive care unit. Also, according to the healing effects of Quran, more research in this area is recommended.

  19. Coordinate activation of inflammatory gene networksalveolar destruction and neonatal death in AKNA deficient mice

    Institute of Scientific and Technical Information of China (English)

    Wenbin Ma; Woong-Kyung Suh; Hitoshi Okada; Tak W Mak; Yang Zhou; Michael R Blackburn; Hector Martinez-Valdez; Blanca Ortiz-Quintero; Roberto Rangel; Morgan R McKeller; Sara Herrera-Rodriguez; Eliseo F Castillo; Kimberly S Schluns; Mary Hall; Huiyuan Zhang

    2011-01-01

    Gene expression can be regulated by chromatin modifiers,transcription factors and proteins that modulate DNA architecture.Among the latter,AT-hook transcription factors have emerged as multifaceted regulators that can activate or repress broad A/T-rich gene networks.Thus,alterations of AT-hook genes could affect the transcription of multiple genes causing global cell dysfunction.Here we report that targeted deletions of mouse AKNA,a hypothetical AT-hook-like transcription factor,sensitize mice to pathogen-induced inflammation and cause sudden neonatal death.Compared with wild-type littermates,AKNA KO mice appeared weak,failedto thrive and most died by postnatal day 10.Systemic inflammation,predominantly in the lungs,was accompanied by enhanced leukocyte infiltration and alveolar destruction.Cytologic,immunohistochemical and molecular analyses revealed CD11b+Gr1+ neutrophils as major tissue infiltrators,neutrophilic granule protein,cathelin-related antimicrobial peptide and S100A8/9 as neutrophil-specific chemoattracting factors,interleukin-1β and interferon-γ as proinflammatory mediators,and matrix metalloprotease 9 as a plausible proteolytic trigger of alveolar damage.AKNA KO bone marrow transplants in wildtype recipients reproduced the severe pathogen-induced reactions and confirmed the involvement of neutrophils in acute inflammation.Moreover,promoter/reporter experiments showed that AKNA could act as a gene repressor.Our results support the concept of coordinated pathway-specific gene regulation functions modulating the intensity of inflammatory responses,reveal neutrophils as prominent mediators of acute inflammation and suggest mechanisms underlying the triggering of acute and potentially fatal immune reactions.

  20. A Neonate with Susceptibility to Long QT Syndrome Type 6 who Presented with Ventricular Fibrillation and Sudden Unexpected Infant Death.

    Science.gov (United States)

    Sauer, Charles W; Marc-Aurele, Krishelle L

    2016-07-28

    BACKGROUND This is a case of a neonate with susceptibility to long QT syndrome (LQTS) who presented with a sudden unexpected infant death. Experts continue to debate whether universal electrocardiogram (ECG) screening of all newborns is feasible, practical, and cost-effective. CASE REPORT A 19-day-old neonate was found unresponsive by her mother. ECG showed ventricular fibrillation and a combination of a lidocaine drip plus multiple defibrillations converted the rhythm to normal sinus. Unfortunately, MRI brain imaging showed multiple infarcts and EEG showed burst suppression pattern with frequent seizures; life supportive treatment was stopped and the infant died. Genetic testing revealed two mutations in the KCNE2 gene consistent with susceptibility to LQTS type 6. CONCLUSIONS We believe this case is the first to demonstrate both a precipitating electrocardiographic and genetic cause of death for an infant with LQTS, showing a cause-and-effect relationship between LQTS mutation, ventricular arrhythmia, and death. We wonder whether universal ECG newborn screening to prevent LQTS death could have saved this baby.

  1. 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.

  2. Rates and Correlates of Undetermined Deaths among African Americans: Results from the National Violent Death Reporting System

    Science.gov (United States)

    Huguet, Nathalie; Kaplan, Mark S.; McFarland, Bentson H.

    2012-01-01

    Little is known about the factors associated with undetermined death classifications among African Americans. In this study, the rates of undetermined deaths were assessed, the prevalence of missing information was estimated, and whether the circumstances preceding death differ by race were examined. Data were derived from the 2005-2008 National…

  3. Rates and Correlates of Undetermined Deaths among African Americans: Results from the National Violent Death Reporting System

    Science.gov (United States)

    Huguet, Nathalie; Kaplan, Mark S.; McFarland, Bentson H.

    2012-01-01

    Little is known about the factors associated with undetermined death classifications among African Americans. In this study, the rates of undetermined deaths were assessed, the prevalence of missing information was estimated, and whether the circumstances preceding death differ by race were examined. Data were derived from the 2005-2008 National…

  4. Trends in the neonatal mortality rate in the last decade with respect to demographic factors and health care resources.

    Science.gov (United States)

    Govande, Vinayak; Ballard, Amy R; Koneru, Madhavi; Beeram, Madhava

    2015-07-01

    To understand factors contributing to the neonatal mortality rate (NMR), we studied trends in the NMR during 2000 to 2009 with respect to demographic factors and health care resources. Birth- and death-linked mortality data for 14,168 neonatal deaths that occurred between 2000 and 2009 were obtained from the Texas Department of Health and Human Services. Demographic factors and health care resource data were analyzed using analysis of variance, chi-square tests, and linear regression analysis. The average NMR increased from 3.37 in 2000 to 3.77 in 2009. The NMR in blacks ranged from 6.57 to 8.97 during the study period. Among the babies who died, the mean birthweight decreased from 1505 to 1275 g (P < 0.001) and the mean gestational age decreased from 28.4 to 27.8 weeks (P < 0.001). Cesarean section deliveries increased from 32.7% to 44.9% (P < 0.001). The percentage of mothers receiving prenatal care increased from 81.4% to 86.6% (P < 0.001). Mothers with a college education increased from 8.8% to 20.5% (P < 0.001). The median household income increased from $41,047 to $49,189 (P < 0.001). The number of neonatal intensive care unit beds increased from 33.4 to 56 per 10,000 births, and the number of neonatologists increased from 0.27 to 0.40 per 10,000 women of 15 to 44 years of age. In conclusion, the NMR didn't improve despite improvements in demographic factors and health care resources. Racial disparities persist, with a high NMR in the black population. We speculate a possible genetic predisposition related to ethnicity, and a potentially higher rate of extreme prematurity might have contributed to a high NMR in the study population.

  5. The effect of changing patterns of obstetric care in Scotland (1980-2004 on rates of preterm birth and its neonatal consequences: perinatal database study.

    Directory of Open Access Journals (Sweden)

    Jane E Norman

    2009-09-01

    decision making behind the 34% increase in elective/induced preterm birth in these women. Although improvements in neonatal outcomes overall are welcome, preterm birth still accounts for over 66% of singleton stillbirths, 65% of singleton neonatal deaths, and 67% of infants whose stay in the neonatal unit is "prolonged," suggesting this condition remains a significant contributor to perinatal mortality and morbidity. CONCLUSIONS: In our population, increases in spontaneous and medically induced preterm births have made equal contributions to the rising rate of preterm birth. Despite improvements in related perinatal mortality, preterm birth remains a major obstetric and neonatal problem, and its frequency is increasing. Please see later in the article for the Editors' Summary.

  6. Fatores de risco para óbito em Unidade de Terapia Intensiva Neonatal Risk factors for death in the Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Luiz Fernando C. Nascimento

    2009-06-01

    Full Text Available OBJETIVO:Estimar fatores de risco para óbito durante internação em uma Unidade de Terapia Intensiva Neonatal (UTIN por modelo logístico hierarquizado. MÉTODOS: Trata-se de estudo observacional, analítico e longitudinal com recém-nascidos internados na UTIN de um hospital universitário, no período de janeiro/2000 a dezembro/2003. A variável dependente foi óbito intra-hospitalar e as independentes foram variáveis antenatais, perinatais e pós-natais. Criou-se um modelo hierarquizado em três níveis. Realizada a análise bivariada, foram incluídas no modelo as que apresentavam pOBJECTIVE:To estimate the risk factors for mortality during hospitalization in a Neonatal Intensive Care Unit (NICU using a hierarchical logistic model. METHODS:This longitudinal, observational and analytical study enrolled newborns admitted to the NICU from January/2001 to December/2003. The outcome analyzed was in-hospital death and the independent variables were prenatal, perinatal and postnatal factors. A hierarchical model with three levels was built. The variables with p<0.20 by bivariated analysis were included in the model and, after adjustment at the same level, variables with p<0.05 were maintained in the logistic model. Statistic analysis was performed by SPSS.10, software that estimated the accuracy of the model, adopting significance as p<0.05. RESULTS: Among 367 newborns included, 69 (18.8% died during hospital stay. The following risk factors comprised the hierarchical model of logistic regression and were significantly associated with death among the studied neonates: previous stillbirth, being first or second child, Apgar at five minutes below 7, preterm newborn and use of mechanical ventilation. This model had 86.9% of accuracy. CONCLUSIONS: The model obtained in this study has variables of the three hierarchical levels and might be used in Neonatal Intensive Care Units that share the same characteristic of the unit herein studied.

  7. Major Placenta Previa: Rate, Maternal and Neonatal Outcomes Experience at a Tertiary Maternity Hospital, Sohag, Egypt: A Prospective Study

    Science.gov (United States)

    Ahmed, Salah Roshdy; Aitallah, Abdusaeed; Abdelghafar, Hazem M.

    2015-01-01

    Introduction Major degree placenta is a serious health issue and is associated with high fetal-maternal morbidity and mortality. Literature from developing countries is scant. Aim To determine the prevalence and maternal and neonatal outcomes among women with major placenta previa (PP). Materials and Methods A prospective descriptive study of 52 singleton pregnancies with PP was evaluated in this study. The study was conducted at Sohag University Hospital, Egypt from January through June 2014. Outcome measures, including the prevalence of PP, maternal and neonatal outcomes, and case-fatality rate. Results The total number of deliveries performed during the study period was 3841, of them, 52 cases were placenta previa. Thus, the prevalence of PP was 1.3%. The mean of previous cesarean scars was 2.2±1.4. Of women with PP, 26.4% (n=14) had placenta accreta. In total, 15.1% (n=8) of women underwent an obstetric hysterectomy. From the total no. of babies, 13.2% (n=7) were delivered fresh stillborn babies. Of the surviving babies (n=45), 20% (n=9) required admission to NICU. The frequencies of bowel and bladder injuries were 3.8% (n=2) and 13.2% (n=7) respectively. There was no maternal death in this study. Conclusion The rate of PP is comparable to previous studies, however, the rate of placenta accreta is high. Also, there are high rates of neonatal mortality and intraoperative complications which can be explained by accreta. The study highlights the need to revise maternity and child health services. PMID:26674539

  8. Diferenças no padrão de ocorrência da mortalidade neonatal e pós-neonatal no Município de Goiânia, Brasil, 1992-1996: análise espacial para identificação das áreas de risco Differential patterns of neonatal and post-neonatal mortality rates in Goiânia, Brazil, 1992-1996: use of spatial analysis to identify high-risk areas

    Directory of Open Access Journals (Sweden)

    Otaliba Libânio de Morais Neto

    2001-10-01

    Full Text Available Este artigo refere-se à pesquisa acerca do padrão espacial dos componentes neonatal e pós-neonatal da mortalidade infantil em Goiânia, no Estado de Goiás, Brasil. A população do estudo foi a coorte de 101 mil nascidos vivos, residentes em Goiânia, de 1992 a 1996. As probabilidades de morte infantil foram estimadas mediante o cotejo dos arquivos de óbitos e de nascidos vivos. Para minimizar as flutuações aleatórias das taxas, empregou-se o método Bayesiano empírico. A unidade de análise do padrão espacial foi constituída pelos 65 distritos urbanos de planejamento. Para análise de autocorrelação espacial foram utilizados: Moran "global", Moran local e estatística Gi* local. Os componentes neonatal e pós-neonatal da mortalidade infantil evidenciaram autocorrelação espacial estatisticamente significativa. No período pós-neonatal, os distritos de risco concentram-se nas regiões periféricas do município. No período neonatal, o padrão de ocorrência é heterogêneo, havendo distritos de alto risco distribuídos em todas as regiões, inclusive na região Central de Goiânia.The aim of this study was to investigate the spatial pattern of neonatal and post-neonatal mortality in the city of Goiânia, Central Brazil. Analyses were based on linked birth and death certificates relating to 101,000 in-hospital live births from mothers residing in the city of Goiânia over the 1992-1996 period. Overall neonatal and post-neonatal mortality probabilities were calculated using the linked database. The empirical Bayes method was applied to smooth the estimated rates and minimize random fluctuation. Spatial units of analysis were 65 urban districts, corresponding to the urban planning sectors. The following exploratory spatial analyses were applied: "global" Moran's I statistic, local Moran LISA map, and Gi* local statistics. For both neonatal and post-neonatal mortality there was statistically significant spatial autocorrelation

  9. Sistema hospitalar como fonte de informações para estimar a mortalidade neonatal e a natimortalidade The Brazilian hospital system as a source of information to estimate stillbirth and neonatal mortality rates

    Directory of Open Access Journals (Sweden)

    Joyce MA Schramm

    2000-06-01

    new method to estimate the stillbirth and neonatal mortality rates is proposed. It was applied in a set of selected Brazilian states in the year of 1995. For comparative purposes, the Brazilian Death Information System was assessed to estimate the mortality rates under study, after adjusting the registered number of live births by using a demographic tool. RESULTS: By assessing the Hospital Information System a larger number of fetal and early neonatal deaths were observed when compared to data given by the death information system of the Northeastern states. Besides, in the Southern and Southeastern states, where death records are more thorough, the mortality rates calculated using both information sources were very similar. CONCLUSIONS: The results suggest that the proposed methodology could greatly contribute to the analysis of the spatial-time evolution of stillbirth and neonatal death rates in recent years in Brazil, as data on death registration in the majority of the Brazilian states are less thorough than those from the hospital information system.

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

    Directory of Open Access Journals (Sweden)

    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

  11. Analysis of neonatal death review in Xi'an city from 2010 to 2012%2010至2012年西安市新生儿死亡评审分析

    Institute of Scientific and Technical Information of China (English)

    相晓妹; 张水平; 于敏; 郑晶晶

    2013-01-01

    目的分析梳理西安市2010至2012年新生儿死亡监测信息、评审结论和建议,总结新生儿死亡评审工作经验,以进一步完善新生儿死亡评审工作,降低新生儿死亡率。方法本研究回顾了3年来西安市新生儿死亡监测及市、区(县)级评审资料,对相关数据进行分析,研究新生儿死亡率、死因顺位、就诊地点的变化情况、规律、评审结论和建议。结果西安市新生儿死亡率3年来较为平稳的维持在2.90‰~2.29‰左右,死亡原因集中在早产和低出生体重、出生窒息、先天性心脏病、肺炎及其它先天异常,就诊级别集中在县级和县级以上医疗机构,区县级占60.34%、市级占80.77%的评审病例结论为创造条件可避免死亡或可避免死亡。2011年市级和区县级评审结果差异无统计学意义( P=0.241>0.05);2012年市级和区县级评审结果差异有统计学意义(P=0.043<0.05)。结论新生儿死亡评审可从更高层面和更广角度对新生儿死亡进行全面分析,从而找出新生儿死亡的影响因素,提出干预措施。正确认识评审意义,资料完整、专家共享,有条件可进行尸检是做好评审工作的重要因素,评审建议的充分应用更是评审的最终目的。%Objective To analyze the monitoring information , review conclusions and recommendations on neonatal death in Xi'an City from 2010 to 2012, and summarize the experiences of the neonatal death review , so as to further improve the neonatal death review and reduce the neonatal mortality rate .Methods The study reviewed the data of the neonatal death monitoring and death review during last three years.The relevant data was analyzed and the research on neonatal mortality , rank order of death causes , change of places where doctors were visited, review conclusions and suggestions were done by using the SPSS 13.0.Results The neonatal mortality

  12. The Alteration of Neonatal Raphe Neurons by Prenatal-Perinatal Nicotine. Meaning for Sudden Infant Death Syndrome.

    Science.gov (United States)

    Cerpa, Verónica J; Aylwin, María de la Luz O; Beltrán-Castillo, Sebastián; Bravo, Eduardo U; Llona, Isabel R; Richerson, George B; Eugenín, Jaime L

    2015-10-01

    Nicotine may link maternal cigarette smoking with respiratory dysfunctions in sudden infant death syndrome (SIDS). Prenatal-perinatal nicotine exposure blunts ventilatory responses to hypercapnia and reduces central respiratory chemoreception in mouse neonates at Postnatal Days 0 (P0) to P3. This suggests that raphe neurons, which are altered in SIDS and contribute to central respiratory chemoreception, may be affected by nicotine. We therefore investigated whether prenatal-perinatal nicotine exposure affects the activity, electrical properties, and chemosensitivity of raphe obscurus (ROb) neurons in mouse neonates. Osmotic minipumps, implanted subcutaneously in 5- to 7-day-pregnant CF1 mice, delivered nicotine bitartrate (60 mg kg(-1) d(-1)) or saline (control) for up to 28 days. In neonates, ventilation was recorded by head-out plethysmography, c-Fos (neuronal activity marker), or serotonin autoreceptors (5HT1AR) were immunodetected using light microscopy, and patch-clamp recordings were made from raphe neurons in brainstem slices under normocarbia and hypercarbia. Prenatal-perinatal nicotine exposure decreased the hypercarbia-induced ventilatory responses at P1-P5, reduced both the number of c-Fos-positive ROb neurons during eucapnic normoxia at P1-P3 and their hypercapnia-induced recruitment at P3, increased 5HT1AR immunolabeling of ROb neurons at P3-P5, and reduced the spontaneous firing frequency of ROb neurons at P3 without affecting their CO2 sensitivity or their passive and active electrical properties. These findings reveal that prenatal-perinatal nicotine reduces the activity of neonatal ROb neurons, likely as a consequence of increased expression of 5HT1ARs. This hypoactivity may change the functional state of the respiratory neural network leading to breathing vulnerability and chemosensory failure as seen in SIDS.

  13. Pedi-cap color change precedes a significant increase in heart rate during neonatal resuscitation.

    Science.gov (United States)

    Blank, Doug; Rich, Wade; Leone, Tina; Garey, Donna; Finer, Neil

    2014-11-01

    Heart rate is the most important indicator of infant well-being during neonatal resuscitation. The Nellcor Pedi-Cap turns gold when exposed to exhaled gas with CO₂>15 mmHg. The aim of this study was to determine if Pedi-Cap gold color change during neonatal resuscitation precedes an increase in heart rate in babies with bradycardia receiving mask ventilation. This was a single-center retrospective review of video recordings and physiologic data of newborns with bradycardia receiving mask positive pressure ventilation during neonatal resuscitation. Subjects were included if the baby's HRCap gold color change compared to the HR after Pedi-Cap gold color change. Forty-one newborns during the study period had HRCap. The median heart rate 10s prior to Pedi-Cap gold color change was 75 BPM (IQR 62-85) and increased to 136 BPM (IQR 113-158) 30 s after gold color change (pCap gold color change to 52 ± 17% 30s after gold color change (p=0.001). Colorimetric CO₂ detection during mask positive pressure ventilation in neonatal resuscitation precedes a significant increase in heart rate and SpO₂. The Pedi-Cap can be easily applied during resuscitation, requires no electricity, provides immediate feedback and may be a useful, simple tool early in resuscitation and may be especially useful in resource limited settings. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. 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 (LBWkerosene - 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 (pkerosene (OR 2.30; 95% CI: 0.95-5.55). Biomass is associated with increased risk of neonatal death among infants born to women with no more than primary education (OR 7.56; 95% CI: 2.40-23.80). These results are consistent with a growing literature showing health impacts of household air pollution from these fuels. Copyright © 2012 Elsevier GmbH. 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

    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

  16. 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

  17. [The role of the psychologist with a death in neonatal and paediatric intensive care].

    Science.gov (United States)

    Birsan, Sandrine; Rodriguez, Marie-Pierre; Brissaud, Olivier

    2014-01-01

    The psychologist within a neonatal and paediatric intensive care unit intervenes in accordance with the condition of the patient and those at whom their services are aimed. The psychological practice in this particular context comprises certain specificities. As the child nears the end of life the psychologist must find his place within the unit and adapt his care to the needs expressed.

  18. 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 Survei

  19. Cause-specific neonatal deaths in rural Bangladesh, 1987-2005: Levels, trends and determinants

    NARCIS (Netherlands)

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

    2014-01-01

    This paper reports on an analysis of neonatal mortality from communicable and non-communicable diseases in Bangladesh. The competing-risks model employed incorporated both observed and unobserved heterogeneity and allowed the two heterogeneity terms to be correlated. The data used came from the

  20. Congenital isolated adrenocorticotropin deficiency: an underestimated cause of neonatal death, explained by TPIT gene mutations.

    NARCIS (Netherlands)

    Vallette-Kasic, S.; Brue, T.; Pulichino, A.M.; Gueydan, M.; Barlier, A.; David, M.; Nicolino, M.; Malpuech, G.; Dechelotte, P.; Deal, C.; Vliet, G. van; Vroede, M.A. de; Riepe, F.G.; Partsch, C.J.; Sippell, W.G.; Berberoglu, M.; Atasay, B.; Zegher, F. de; Beckers, D.; Kyllo, J.; Donohoue, P.; Fassnacht, M.; Hahner, S.; Allolio, B.; Noordam, C.; Dunkel, L.; Hero, M.; Pigeon, B.; Weill, J.; Yigit, S.; Brauner, R.; Heinrich, J.J.; Cummings, E.; Riddell, C.; Enjalbert, A.; Drouin, J.

    2005-01-01

    Tpit is a T box transcription factor important for terminal differentiation of pituitary proopiomelanocortin-expressing cells. We demonstrated that human and mouse mutations of the TPIT gene cause a neonatal-onset form of congenital isolated ACTH deficiency (IAD). In the absence of glucocorticoid

  1. Differential Neonatal and Postneonatal Infant Mortality Rates across US Counties: The Role of Socioeconomic Conditions and Rurality

    Science.gov (United States)

    Sparks, P. Johnelle; McLaughlin, Diane K.; Stokes, C. Shannon

    2009-01-01

    Purpose: To examine differences in correlates of neonatal and postneonatal infant mortality rates, across counties, by degree of rurality. Methods: Neonatal and postneonatal mortality rates were calculated from the 1998 to 2002 Compressed Mortality Files from the National Center for Health Statistics. Bivariate analyses assessed the relationship…

  2. N-Terminal Pro-B Type Natriuretic Peptide as a Marker of Bronchopulmonary Dysplasia or Death in Very Preterm Neonates: A Cohort Study.

    Directory of Open Access Journals (Sweden)

    Anna Sellmer

    Full Text Available Bronchopulmonary dysplasia (BPD is a serious complication of preterm birth. Plasma N-terminal pro-B type natriuretic peptide (NT-proBNP has been suggested as a marker that may predict BPD within a few days after birth.To investigate the association between NT-proBNP day three and bronchopulmonary dysplasia (BPD or death and further to assess the impact of patent ductus arteriosus (PDA on this association in neonates born before 32 gestational weeks.A cohort study of 183 neonates born before 32 gestational weeks consecutively admitted to the Neonatal Intensive Care Unit, Aarhus University Hospital, Denmark. On day three plasma samples were collected and echocardiography carried out. NT-proBNP was measured by routine immunoassays. The combined outcome BPD or death was assessed at 36 weeks of postmenstrual age. Receiver operator characteristic (ROC analysis was performed to determine the discrimination ability of NT-proBNP by the natural log continuous measure to recognize BPD or death. The association of BPD or death was assessed in relation to natural log NT-proBNP levels day three.The risk of BPD or death increased 1.7-fold with one unit increase of natural log NT-proBNP day three when adjusted for gestational age at birth (OR = 1.7, 95% CI 1.3; 2.3. The association was found both in neonates with and without a PDA. Adjusting for GA, PDA diameter, LA:Ao-ratio, or early onset sepsis did not change the estimate.We found NT-proBNP to be associated with BPD or death in very preterm neonates. This association was not only explained by the PDA. We speculate that NT-proBNP may help the identification of neonates at risk of BPD as early as postnatal day three.

  3. Causes Of Neonatal Mortality : A Community Based Study using Verbal Autopsy Tool

    Directory of Open Access Journals (Sweden)

    Yashpal Jain, Madhav Bansal, Rajesh Tiwari, Pradeep Kumar Kasar

    2013-01-01

    Full Text Available Introduction: Neonatal mortality is increasingly important be-cause the proportion of under-five deaths that occur during the neonatal period is increasing as under-five mortality declines. Because declines in the neonatal mortality rate are slower the share of neonatal deaths among under-five deaths increased from about 36 percent in 1990 to about 43 percent in 2011. There is a need to identify and address the causes of neonatal mortality to achieve the MDG of 31 under five deaths per 1000 live births per year. Objective: To ascertain the causes of neonatal mortality in the area covered by CHC Natwara (Shahpura Block of Jabalpur district using verbal autopsy method. Materials and Methods: Neonatal deaths registered during the period of 1st April 2005 to 31st March 2006 at CHC Natwara of District Jabalpur of MP were studied. Total 69 neonatal deaths were studied using standard verbal autopsy questionnaire. Causes of deaths were ascertained from the filled in VA questionnaire taking the help of a pediatrician. Results: Mother was main respondent in 50.72% cases followed by father (23.1%. Sepsis was the most important cause of death particularly in the late neonatal period. Birth asphyxia, pneumonia and RDS were the other important causes of death contributing predominantly to the early neonatal deaths. The most important predisposing cause of death was LBW/prematurity. Conclusion: Most of the deaths are directly or indirectly related to infection and nutrition and are therefore amenable to prevention.

  4. 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...... suggest a reduced rate of death from any cause, but the trials have been small and have varied in quality....

  5. Trend in rates for deaths with mention of schizophrenia on death certificates of US residents, 1999-2010.

    Science.gov (United States)

    Polednak, Anthony P

    2014-07-01

    Trends in mortality rates for schizophrenia using multiple causes of death (including contributory causes) coded on death certificates in the US resident population apparently have not been reported. Age-standardized rates for deaths per 100,000 in 1999-2010 at age 15+ years (and for 15-64 and 65+ years) with mention of schizophrenia were examined for the US resident population, including variation by age, gender, race (blacks/African Americans and whites) and region. Deaths at age 15+ years coded with schizophrenia as underlying cause were only 12 % of all deaths with mention of schizophrenia, for which the rate declined from 1.58 in 1999 (3,407 deaths) to 1.32 in 2010 (3,422 deaths) (percentage change or PC = -16 %). Declines were larger in females than males, in whites than blacks, and occurred in the Northeast, Midwest and South but not the West. The rate increased for age 15-64 years (PC = +28 %) (mainly in males), however, while declining for age 65+ years (PC = -35 %). For deaths at age 15-64 years with schizophrenia coded as other than the underlying cause, the largest continuous increase was for endocrine-metabolic diseases (predominantly diabetes mellitus) as underlying cause, with smaller increases in males for cardiovascular diseases, external causes and neoplasms. Trends in the US rate for deaths with mention of schizophrenia varied among the sociodemographic groups examined. The lack of decline for age 15-64 years requires further study especially with regard to mediators (e.g., obesity) of excess mortality in schizophrenia identified from cohort studies.

  6. 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

    (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...

  7. Rates of TBI-related Deaths by Age Group — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — Changes in the rates of TBI-related deaths vary depending on age. For persons 44 years of age and younger, TBI-related deaths decreased between the periods of...

  8. Neonatal tetanus mortality in coastal Kenya

    DEFF Research Database (Denmark)

    Bjerregaard, P; Steinglass, R; Mutie, D M

    1993-01-01

    livebirths. The neonatal and NNT mortality rates were higher in boys than in girls. Neonatal tetanus was not associated with mother's age, parity, or history of previous child death. The majority of the children (72%) were adequately protected at birth against NNT; in those with documented protection NNT...

  9. Short-Term Variation of the Fetal Heart Rate for Predicting Neonatal Acidosis in Preeclampsia.

    Science.gov (United States)

    Aernout, Eva Marie; Devos, Patrick; Deruelle, Philippe; Houfflin-Debarge, Véronique; Subtil, Damien

    2015-01-01

    The aim of this study was to measure the performance of short-term variation (STV) in predicting the onset of neonatal acidosis in fetuses at risk due to maternal preeclampsia. This retrospective study examined data from a series of 159 women with singleton pregnancies, hospitalized for preeclampsia in a level 3 reference maternity hospital in northern France, with an STV measurement in the 24 h preceding cesarean delivery and a measurement of the newborn's arterial cord pH at birth. The main outcome was determined by a correlation between STV and neonatal pH. The last computerized fetal heart rate analysis took place a mean of 7.9 ± 6.3 h before birth, and neonatal acidosis was diagnosed in 38 newborns (23.9%). Although STV and umbilical artery pH at birth were significantly correlated (x03C1; = 0.16, p acidosis was poor, with an area under the ROC curve of 0.63. The sensitivity reached only 50.0% and the specificity 71.9% at the best STV threshold for predicting acidosis. The performance of STV for screening for neonatal acidosis is poor in women with preeclampsia. The divergent results between studies are probably due to the variable intervals between STV measurement and birth. © 2015 S. Karger AG, Basel.

  10. Heart rate characteristics: physiomarkers for detection of late-onset neonatal sepsis.

    Science.gov (United States)

    Fairchild, Karen D; O'Shea, T Michael

    2010-09-01

    Early detection of late-onset neonatal sepsis, before the onset of obvious and potentially catastrophic clinical signs, is an important goal in neonatal medicine. Sepsis causes a well-known series of physiologic changes including abnormalities of blood pressure, respiration, temperature, and heart rate, and less well-known changes in heart rate variability. Although vital signs are frequently or continuously monitored in patients in the neonatal intensive care unit (NICU), changes in these parameters are subtle in the early phase of sepsis and difficult to interpret using traditional NICU monitoring tools. A new tool, continuous monitoring of heart rate characteristics (HRC), is now available for clinical use. Recent research has established that 2 abnormalities of HRC that have long been used by obstetricians to identify fetal compromise, reduced heart rate variability and transient decelerations, occur early in the course of sepsis in patients in the NICU, often before clinical signs of illness. Through mathematical modeling of electrocardiogram data from hundreds of patients in the NICU, an HRC index that represents the fold increase in risk that a neonate will be diagnosed with clinical or culture-proven sepsis within the next 24 hours was derived. The effect of continuous HRC monitoring on outcomes in preterm very low birth weight infants is the subject of a multicenter randomized clinical trial of 3000 patients, which will be complete in 2010. Further research into mechanisms of abnormal HRC and regulation of autonomic nervous system function in sepsis and other disease processes will shed light on additional applications of this exciting new technology. (c) 2010 Elsevier Inc. All rights reserved.

  11. Prostanoid receptors involved in regulation of the beating rate of neonatal rat cardiomyocytes.

    Directory of Open Access Journals (Sweden)

    Hakima Mechiche

    Full Text Available Although prostanoids are known to be involved in regulation of the spontaneous beating rate of cultured neonatal rat cardiomyocytes, the various subtypes of prostanoid receptors have not been investigated in detail. In our experiments, prostaglandin (PGF(2α and prostanoid FP receptor agonists (fluprostenol, latanoprost and cloprostenol produced a decrease in the beating rate. Two prostanoid IP receptor agonists (iloprost and beraprost induced first a marked drop in the beating rate and then definitive abrogation of beating. In contrast, the prostanoid DP receptor agonists (PGD(2 and BW245C and TP receptor agonists (U-46619 produced increases in the beating rate. Sulprostone (a prostanoid EP(1 and EP(3 receptor agonist induced marked increases in the beating rate, which were suppressed by SC-19220 (a selective prostanoid EP(1 antagonist. Butaprost (a selective prostanoid EP(2 receptor agonist, misoprostol (a prostanoid EP(2 and EP(3 receptor agonist, 11-deoxy-PGE(1 (a prostanoid EP(2, EP(3 and EP(4 receptor agonist did not alter the beating rate. Our results strongly suggest that prostanoid EP(1 receptors are involved in positive regulation of the beating rate. Prostanoid EP(1 receptor expression was confirmed by western blotting with a selective antibody. Hence, neonatal rat cardiomyocytes express both prostanoid IP and FP receptors (which negatively regulate the spontaneous beating rate and prostanoid TP, DP(1 and EP(1 receptors (which positively regulate the spontaneous beating rate.

  12. Valor preditivo do "Clinical Risk Index for Babies" para o risco de mortalidade neonatal Predictive value of the "Clinical Risk Index for Babies" for the risk of neonatal death

    Directory of Open Access Journals (Sweden)

    Oscar T. Matsuoka

    1998-12-01

    Full Text Available OBJETIVO: Comparar o valor preditivo do CRIB (Clinical Risk Index for Babies para o risco de mortalidade neonatal ao peso de nascimento (PN e idade gestacional (IG. MÉTODO: Numa coorte prospectiva foram estudados, durante o ano de 1996, 71 recém-nascidos admitidos na unidade de terapia intensiva, com PN 10 foi de 100%. CONCLUSÕES: O escore de CRIB > 10 correspondeu a maiores especificidade e valor preditivo positivo em relação aos demais parâmetros. A área determinada pela "receiver operating characteristic" relativa ao CRIB também foi superior. O CRIB mostrou-se um marcador mais acurado na previsão de risco de mortalidade quando comparado ao PN ou IG isoladamente.OBJECTIVE: Several indicators, mainly birthweight and gestational age, have been used to predict the mortality risk in neonatal intensive care units. In order to assess the potential value of CRIB in predicting neonatal mortality, the score was used over the first 12 hours of life of the newborns admitted to this unit, during the year of 1996. METHOD: The inclusion criteria consisted of all infants without inevitably lethal congenital malformations, birthweight below 1,500g and/or gestational age less than 31 weeks. Newborn children who died within 12 hours after delivery were excluded. The CRIB score covers birth weight, gestational age, the presence of congenital malformations (not inevitably lethal and three indexes of physiological status during first 12 hours after birth - maximum and minimum appropriate fraction of inspired oxygen and maximum (most acidotic base excess. RESULTS: In a prospective cohort, seventy one newborn children were studied. The birthweight (average was 1,119 ± 275.6 g, gestational age 30 weeks 4/7 ±2 weeks 3/7; male (57%; Apgar 1° min. score <=3 ( 36.2% and Apgar 5° min. score < 5 (5.8%. The mortality rate was 29.6% (gold standard. But mortality rate by birthweight less than 1,000 gr. or gestational age lower than 29 weeks was 60.0% and for the

  13. Customized spectral band analysis compared with conventional Fourier analysis of heart rate variability in neonates.

    Science.gov (United States)

    de Beer, N A M; Andriessen, P; Berendsen, R C M; Oei, S G; Wijn, P F F; Oetomo, S Bambang

    2004-12-01

    A customized filtering technique is introduced and compared with fast Fourier transformation (FFT) for analyzing heart rate variability (HRV) in neonates from short-term recordings. FFT is classically the most commonly used spectral technique to investigate cardiovascular fluctuations. FFT requires stability of the physiological signal within a 300 s time window that is usually analyzed in adults. Preterm infants, however, show characteristics of rapidly fluctuating heart rate and blood pressure due to an immature autonomic regulation, resulting in non-stationarity of these signals. Therefore neonatal studies use (half-overlapping or moving) windows of 64 s length within a recording time of 2-5 min. The proposed filtering technique performs a filtering operation in the frequency range of interest before calculating the spectrum, which allows it to perform an analysis of shorter periods of only 42 s. The frequency bands of interest are 0.04-0.15 Hz (low frequency, LF) and 0.4-1.5 Hz (high frequency, HF). Although conventional FFT analysis as well as the proposed alternative technique result in errors in the estimation of LF power, due to spectral leakage from the very low frequencies, FFT analysis is more sensitive to this effect. The response times show comparable behavior for both the techniques. Applying both the methods to heart rate data obtained from a neonate before and after atropine administration (inducing a wide range of HRV), shows a very significant correlation between the two methods in estimating LF and HF power. We conclude that a customized filtering technique might be beneficial for analyzing HRV in neonates because it reduces the necessary time window for signal stability.

  14. Island colonisation and the evolutionary rates of body size in insular neonate snakes

    Science.gov (United States)

    Aubret, F

    2015-01-01

    Island colonisation by animal populations is often associated with dramatic shifts in body size. However, little is known about the rates at which these evolutionary shifts occur, under what precise selective pressures and the putative role played by adaptive plasticity on driving such changes. Isolation time played a significant role in the evolution of body size in island Tiger snake populations, where adaptive phenotypic plasticity followed by genetic assimilation fine-tuned neonate body and head size (hence swallowing performance) to prey size. Here I show that in long isolated islands (>6000 years old) and mainland populations, neonate body mass and snout-vent length are tightly correlated with the average prey body mass available at each site. Regression line equations were used to calculate body size values to match prey size in four recently isolated populations of Tiger snakes. Rates of evolution in body mass and snout-vent length, calculated for seven island snake populations, were significantly correlated with isolation time. Finally, rates of evolution in body mass per generation were significantly correlated with levels of plasticity in head growth rates. This study shows that body size evolution occurs at a faster pace in recently isolated populations and suggests that the level of adaptive plasticity for swallowing abilities may correlate with rates of body mass evolution. I hypothesise that, in the early stages of colonisation, adaptive plasticity and directional selection may combine and generate accelerated evolution towards an ‘optimal' phenotype. PMID:25074570

  15. Island colonisation and the evolutionary rates of body size in insular neonate snakes.

    Science.gov (United States)

    Aubret, F

    2015-10-01

    Island colonisation by animal populations is often associated with dramatic shifts in body size. However, little is known about the rates at which these evolutionary shifts occur, under what precise selective pressures and the putative role played by adaptive plasticity on driving such changes. Isolation time played a significant role in the evolution of body size in island Tiger snake populations, where adaptive phenotypic plasticity followed by genetic assimilation fine-tuned neonate body and head size (hence swallowing performance) to prey size. Here I show that in long isolated islands (>6000 years old) and mainland populations, neonate body mass and snout-vent length are tightly correlated with the average prey body mass available at each site. Regression line equations were used to calculate body size values to match prey size in four recently isolated populations of Tiger snakes. Rates of evolution in body mass and snout-vent length, calculated for seven island snake populations, were significantly correlated with isolation time. Finally, rates of evolution in body mass per generation were significantly correlated with levels of plasticity in head growth rates. This study shows that body size evolution occurs at a faster pace in recently isolated populations and suggests that the level of adaptive plasticity for swallowing abilities may correlate with rates of body mass evolution. I hypothesise that, in the early stages of colonisation, adaptive plasticity and directional selection may combine and generate accelerated evolution towards an 'optimal' phenotype.

  16. Neonatal death and parents' grief. Experience, behaviour and attitudes of Swedish nurses.

    Science.gov (United States)

    Lundqvist, A; Nilstun, T

    1998-01-01

    The aim of the present study was to survey the experience, behaviour and attitudes of nurses in Swedish neonatal wards towards parents who refuse or are reluctant to see, touch or hold their dying or dead baby. A questionnaire was distributed to 173 nurses, of whom 144 responded. The questionnaire contained questions about the nurses' own experience of such situations, their behaviour, and their attitude towards influencing the parents. Seventy-four percent answered that they had experience of such situations, 59% that they often tried to persuade or in other ways influence the parents to change their mind, and 60% were of the opinion that the parents mourning-process is always facilitated when they touch or hold their dead baby. Most nurses (83%) were of the opinion that the conflict between beneficence and autonomy was difficult but not impossible to solve. A majority of the nurses were inclined to give priority to the principle of beneficence. But is this inclination ethically justified? A well-founded answer to this question requires more knowledge about the experiences of parents who have lived through such traumatic situations.

  17. Husbandry and growth rates of neonate epaulette sharks, Hemiscyllium ocellatum in captivity.

    Science.gov (United States)

    Payne, Eric J; Rufo, Kimberly S

    2012-01-01

    In this report, I describe husbandry techniques that are used to successfully hatch and raise epaulette sharks, Hemiscyllium ocellatum, in captivity. Egg cases and hatchlings were held in floating baskets within a 1,306-L tank, at water temperatures of 24.4-25.5°C. From 56 egg cases, 27 neonates successfully hatched, and 22 survived. Based on seven tagged egg cases, the average gestation time was 140.3 ± 4.6 days with a range of 134 and 148 days. Upon hatching, neonate length was 16.2 ± 0.522 cm, with a range of 15.24-17.30 cm, and weight was 19.9 ± 2.06 g, with a range of 16.50-24.5 g. Growth rates of four individuals were recorded over time. Finely chopped capelin, Mallotus villosus, fillets, supplemented with a multivitamin were the primary food items accepted by neonates. The success in rearing H. ocellatum can likely be attributed to a low stress environment, limited disruption, an easy to consume diet, multivitamin supplementation, and excellent water quality. © 2011 Wiley Periodicals, Inc.

  18. High death rate in mice treated topically with diclofenac

    DEFF Research Database (Denmark)

    Lerche, Catharina M; Philipsen, Peter A; Poulsen, Thomas

    2011-01-01

    Recently, 3% diclofenacnatrium gel (diclofenac) was introduced for the treatment of actinic keratoses. Data on photocarcinogenesis of topical diclofenac are limited, and we wished to investigate whether topical diclofenac can accelerate photocarcinogenesis using simulated solar radiation (SSR......). Diclofenac was applied topically on the backs of hairless, female, C3.Cg/TifBomTac immunocompetent mice three times weekly followed by ultraviolet radiation (2, 3, or 4 Standard Erythema Dose) until death. There was a significant difference in survival between diclofenac-treated groups and control groups (P...

  19. 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

    2008-02-01

    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

  20. 新生儿死亡高危因素分析——附79例死亡病例报道%Analyze risk factors of neonatal deaths in NICU

    Institute of Scientific and Technical Information of China (English)

    管利荣; 余静; 任丹; 胡煜; 吴翼君; 张春华; 魏丽蓉; 侯怡; 邱云

    2012-01-01

      Objectives:Through analyzing the risk factors of neonatal death in NICU to improve the Diagnosis and prevention and treatment skils. Methods: There were 79 neonatal died in NICU from January 2000 to May 2010, we made a retrospective analysis to find the risk factors of neonatal death, The cause of deaths and the relationship of deaths and Original diseases, organs damage, age and conditions of Production hospital. Results: High mortality rate focus in age < 3days, Main risk factors were Respiratory disease, Choking, premature birth, low birth weight, Not timely referral .Conclusion: Prevent premature birth、Chocking, effective cardiopulmonary resuscitation(CPR) and Do airway management were key methods to reduce mortality.%  目的通过对新生儿死亡因素进行分析,提高防治诊疗水平。方法对我院2000年1月---2010年5月期间79例住院新生儿死亡因素进行回顾性分析,总结死亡原因,死亡与原发病、脏器功能受损情况、就诊日龄及产院条件等的关系。结果死亡日龄高峰<3天,死亡原因主要是以呼吸道疾病为主的多脏器功能衰竭,窒息、早产、低出生体重、未及时地转诊是死亡的高危因素。结论预防早产、窒息,有效复苏,做好气道管理,及时恰当地转诊,是降低病死率的关键。

  1. Rural-urban differentials in the rates and factors associated with post-neonatal mortality in Nigeria: Evidence from the 2013 national household survey.

    Science.gov (United States)

    Adewuyi, Emmanuel Olorunleke; Adama, Samuel John; Adefemi, Kazeem; Akintunde, Olufemi Abayomi; Bulndi, Lydia Babatunde

    2017-07-26

    The burden of post-neonatal mortality remains considerably high in Nigeria. This study examines the rural-urban differences in post-neonatal mortality rates (PNMR) and associated factors in Nigeria. Dataset from the 2013 Nigeria demographic and health survey, disaggregated by rural-urban residence, was analyzed. PNMR was reported using frequency tabulation, whereas, factors associated were first evaluated using Chi-Square test and further examined using multivariable logistic regression analysis. A total of 30384 singleton livebirths (20449 in rural and 9935 in urban residences) in the five years preceding the survey was included in this study. PNMR in rural and urban residences were 34 (95%CI: 31 - 38) and 22 (95%CI: 18 - 26) deaths per 1000 live births (Purban residence, poor wealth index (AOR: 1.660, 95%CI: 1.024 - 2.689), living in the South-East region (AOR: 2.902, 95%CI: 1.470 - 5.726), and home delivery (AOR: 1.539, 95%CI: 1.016 - 2.330) increased the odds of post-neonatal mortality. Regardless of residence, the use of solid cooking-fuels (Rural: AOR: 2.394, 95%CI: 1.211 - 4.734; Urban: AOR: 1.912, 95%CI: 1.206 - 3.030), birth interval Urban: AOR: 1.630, 95%CI: 1.042 - 2.550) and lack of breastfeeding (Rural: AOR: 2.547, 95%CI: 2.089 - 3.105; Urban: AOR: 2.152, 95%CI: 1.496 - 3.096) increased the odds of post-neonatal mortality. PNMR and associated factors differ in rural and urban Nigeria. Post-neonates in urban areas had better survival chances. Intervention efforts would need to prioritize findings in this study. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Lipotoxic Palmitate Impairs the Rate of β-Oxidation and Citric Acid Cycle Flux in Rat Neonatal Cardiomyocytes.

    Science.gov (United States)

    Haffar, Taha; Akoumi, Ali; Bousette, Nicolas

    2016-01-01

    Diabetic hearts exhibit intracellular lipid accumulation. This suggests that the degree of fatty acid oxidation (FAO) in these hearts is insufficient to handle the elevated lipid uptake. We previously showed that palmitate impaired the rate of FAO in primary rat neonatal cardiomyocytes. Here we were interested in characterizing the site of FAO impairment induced by palmitate since it may shed light on the metabolic dysfunction that leads to lipid accumulation in diabetic hearts. We measured fatty acid oxidation, acetyl-CoA oxidation, and carnitine palmitoyl transferase (Cpt1b) activity. We measured both forward and reverse aconitase activity, as well as NAD+ dependent isocitrate dehydrogenase activity. We also measured reactive oxygen species using the 2', 7'-Dichlorofluorescin Diacetate (DCFDA) assay. Finally we used thin layer chromatography to assess diacylglycerol (DAG) levels. We found that palmitate significantly impaired mitochondrial β-oxidation as well as citric acid cycle flux, but not Cpt1b activity. Palmitate negatively affected net aconitase activity and isocitrate dehydrogenase activity. The impaired enzyme activities were not due to oxidative stress but may be due to DAG mediated PKC activation. This work demonstrates that palmitate, a highly abundant fatty acid in human diets, causes impaired β-oxidation and citric acid cycle flux in primary neonatal cardiomyocytes. This metabolic defect occurs prior to cell death suggesting that it is a cause, rather than a consequence of palmitate mediated lipotoxicity. This impaired mitochondrial metabolism can have important implications for metabolic diseases such as diabetes and obesity. © 2016 The Author(s) Published by S. Karger AG, Basel.

  3. Lipotoxic Palmitate Impairs the Rate of β-Oxidation and Citric Acid Cycle Flux in Rat Neonatal Cardiomyocytes

    Directory of Open Access Journals (Sweden)

    Taha Haffar

    2016-12-01

    Full Text Available Background/Aims: Diabetic hearts exhibit intracellular lipid accumulation. This suggests that the degree of fatty acid oxidation (FAO in these hearts is insufficient to handle the elevated lipid uptake. We previously showed that palmitate impaired the rate of FAO in primary rat neonatal cardiomyocytes. Here we were interested in characterizing the site of FAO impairment induced by palmitate since it may shed light on the metabolic dysfunction that leads to lipid accumulation in diabetic hearts. Methods: We measured fatty acid oxidation, acetyl-CoA oxidation, and carnitine palmitoyl transferase (Cpt1b activity. We measured both forward and reverse aconitase activity, as well as NAD+ dependent isocitrate dehydrogenase activity. We also measured reactive oxygen species using the 2', 7'-Dichlorofluorescin Diacetate (DCFDA assay. Finally we used thin layer chromatography to assess diacylglycerol (DAG levels. Results: We found that palmitate significantly impaired mitochondrial β-oxidation as well as citric acid cycle flux, but not Cpt1b activity. Palmitate negatively affected net aconitase activity and isocitrate dehydrogenase activity. The impaired enzyme activities were not due to oxidative stress but may be due to DAG mediated PKC activation. Conclusion: This work demonstrates that palmitate, a highly abundant fatty acid in human diets, causes impaired β-oxidation and citric acid cycle flux in primary neonatal cardiomyocytes. This metabolic defect occurs prior to cell death suggesting that it is a cause, rather than a consequence of palmitate mediated lipotoxicity. This impaired mitochondrial metabolism can have important implications for metabolic diseases such as diabetes and obesity.

  4. Preterm premature rupture of membranes and the rate of neonatal sepsis after two courses of antenatal corticosteroids.

    Science.gov (United States)

    Gyamfi-Bannerman, Cynthia; Son, Moeun

    2014-11-01

    To evaluate whether a second antenatal corticosteroid course is associated with an increased risk of neonatal sepsis after preterm premature rupture of membranes (PROM). This secondary analysis is a cohort study with data from the Maternal-Fetal Medicine Units study on magnesium for neuroprotection. Women with singleton gestations and preterm PROM were eligible. The primary exposure was one compared with two antenatal corticosteroid courses. The primary outcome, neonatal sepsis, was compared between exposed groups. Patient characteristics were analyzed by χ2 for categorical variables and Student t test or Wilcoxon rank-sum for continuous variables where appropriate. Predictors of neonatal sepsis were analyzed by multivariable logistic regression. One thousand six hundred forty-one patients were eligible. Neonatal sepsis was similar among neonates born to mothers who received one or two antenatal corticosteroid courses (16.2% compared with 17.2%, P=.756, respectively). Adjusting for confounders, the factors associated with neonatal sepsis were length of time from membrane rupture to delivery (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.02-2.26), respiratory distress syndrome (OR 2.11, 95% CI 1.45-3.07), gestational age at delivery in days (OR 0.98, 95% CI 0.95-0.99) and birth weight per 100 g (OR 0.85, 95% CI 0.77-0.94). A second maternal antenatal corticosteroid course was not associated with an increased rate neonatal sepsis.

  5. 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.

  6. Rates of 47, + 13 amd 46 translocation D/13 Patau syndrome in live births and comparison with rates in fetal deaths and at amniocentesis.

    Science.gov (United States)

    Hook, E B

    1980-11-01

    Trisomy 13 (Patau syndrome) is rare in newborns. Data on rates in 167,774 live births from 17 separate studies are reviewed, and the following pooled rates found for: (1) 47,trisomy 13, 8.3 X 10(-5) (1/12,000); and (2) 46, (D/13 Robertsonian translocations), 4.2 X 10(-5) (1/24,000)--mutants, 1.2 X 10(-5) (1/80,000) to 1.8 X 10(-5) (1/56,000); and familial cases, 2.4 X 10(-5) (1/42,000) to 3.0 X 10(-5) (1/33,000). The rate of trisomy 13 (47, + 13) in liveborns (ignoring possible biases in studies and heterogeneity in rates) is, with 95% confidence, between 4.6 X 10(-5) (1/21,700) and 14.0 X 10(-5) (1/7,000), with the most likely figure close to 8 X 10(-5) (1/12,000). Numbers are insufficient to construct a comparably narrow confidence interval for translocation cases. The rates of 47, + 13 may be estimated in (1) spontaneous abortuses, about 0.8%--1.0% (100-fold greater than in liveborns); (2) early neonatal deaths, about 0.4% (50-fold greater than in liveborns); and (3) amniocentesis, higher than in liveborns, at least for mothers 40 years and over.

  7. Rate of teenage pregnancy in Jordan and its impact on maternal and neonatal outcomes.

    Science.gov (United States)

    Khader, Yousef S; Batieha, Anwar; Al Fursan, Rana Kareem; Al-Hader, Rami; Hijazi, Sa'ad S

    2017-07-26

    Objective Research regarding the adverse outcomes of adolescent childbearing has suffered from many limitations such as a small sample size and non-representative samples. This study was conducted to determine the rate of teenage pregnancy among Jordanian adolescents and its associated adverse maternal and neonatal outcomes. Methods The study is a part of a comprehensive national study of perinatal mortality that was conducted between 2011 and 2012 in Jordan. All women who gave birth after 20 weeks of gestation in 18 maternity hospitals in Jordan between 2011 and 2012 were invited to participate in the study. Consenting women were interviewed by the trained midwives in these hospitals using a structured questionnaire prepared for the purpose of this study. Additional information was also collected based on the physical examination by the midwife and the obstetrician at admission and at discharge. Data on the newborn were also collected by the pediatric nurses and the neonatologists in these hospitals. Results The overall rate of teenage pregnancy [95% confidence interval (CI) was 6.2% (5.9%, 6.5%)]. Of the studied maternal and neonatal outcomes, women aged Teenage pregnancy was associated with increased risk of premature delivery, apart from the effects of socioeconomic factors.

  8. Heart rate variability analysis is more sensitive at identifying neonatal sepsis than conventional vital signs.

    Science.gov (United States)

    Bohanon, Fredrick J; Mrazek, Amy A; Shabana, Mohamed T; Mims, Sarah; Radhakrishnan, Geetha L; Kramer, George C; Radhakrishnan, Ravi S

    2015-10-01

    Sepsis remains the largest preventable source of neonatal mortality in the world. Heart rate variability (HRV) analysis and noninvasive cardiac output have been shown to be useful adjuncts to sepsis detection in many patient groups. With Institutional Review Board approval, 4 septic and 6 nonseptic extremely low birth weight patients were enrolled. Data from septic and healthy patients were collected for 5 hours. Electrocardiogram waveform and traditional vital signs were collected and the RR intervals were calculated; then HRV analysis was performed in both the time and frequency domain. HRV measurements in time domain, heart rate, and pulse oximetry (SpO2) were significantly different in septic patients vs nonseptic controls. These results indicate that nonconventional vital signs such as HRV are more sensitive than traditionally used vital signs, such as cardiac output and mean arterial pressure, in the confirmation of sepsis in extremely low birth weight neonates. HRV may allow for earlier identification of septic physiology. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Genomic Imbalances in Neonates With Birth Defects: High Detection Rates by Using Chromosomal Microarray Analysis

    Science.gov (United States)

    Lu, Xin-Yan; Phung, Mai T.; Shaw, Chad A.; Pham, Kim; Neil, Sarah E.; Patel, Ankita; Sahoo, Trilochan; Bacino, Carlos A.; Stankiewicz, Pawel; Lee Kang, Sung-Hae; Lalani, Seema; Chinault, A. Craig; Lupski, James R.; Cheung, Sau W.; Beaudet, Arthur L.

    2009-01-01

    OBJECTIVES Our aim was to determine the frequency of genomic imbalances in neonates with birth defects by using targeted array-based comparative genomic hybridization, also known as chromosomal microarray analysis. METHODS Between March 2006 and September 2007, 638 neonates with various birth defects were referred for chromosomal microarray analysis. Three consecutive chromosomal microarray analysis versions were used: bacterial artificial chromosome-based versions V5 and V6 and bacterial artificial chromosome emulated oligonucleotide-based version V6 Oligo. Each version had targeted but increasingly extensive genomic coverage and interrogated >150 disease loci with enhanced coverage in genomic rearrangement-prone pericentromeric and subtelomeric regions. RESULTS Overall, 109 (17.1%) patients were identified with clinically significant abnormalities with detection rates of 13.7%, 16.6%, and 19.9% on V5, V6, and V6 Oligo, respectively. The majority of these abnormalities would not be defined by using karyotype analysis. The clinically significant detection rates by use of chromosomal microarray analysis for various clinical indications were 66.7% for “possible chromosomal abnormality” ± “others” (other clinical indications), 33.3% for ambiguous genitalia ± others, 27.1% for dysmorphic features + multiple congenital anomalies ± others, 24.6% for dysmorphic features ± others, 21.8% for congenital heart disease ± others, 17.9% for multiple congenital anomalies ± others, and 9.5% for the patients referred for others that were different from the groups defined. In all, 16 (2.5%) patients had chromosomal aneuploidies, and 81 (12.7%) patients had segmental aneusomies including common microdeletion or microduplication syndromes and other genomic disorders. Chromosomal mosaicism was found in 12 (1.9%) neonates. CONCLUSIONS Chromosomal microarray analysis is a valuable clinical diagnostic tool that allows precise and rapid identification of genomic imbalances

  10. Rates of intentionally caused and road crash deaths of US citizens abroad.

    Science.gov (United States)

    Sherry, Melissa K; Mossallam, Mahmoud; Mulligan, Matthew; Hyder, Adnan A; Bishai, David

    2015-04-01

    Currently, little is known about rates of death by cause and country among US travellers. Understanding the risk by cause and country is imperative to risk communication and the development of risk reduction strategies. Publicly available data on non-natural deaths of US citizens abroad were gathered from January 2003 to December 2009 from the US Department of State's Department Bureau of Consular Affairs. Traveller information was gathered from the US Department of Commerce Office of Travel and Tourism for the same time period. Rates of death were calculated by dividing the number of non-natural deaths of US citizens abroad by the number of US outbound visits for each country. A total of 5417 non-natural death events were retrieved between 2003 and 2009 from the US State Department. Intentionally caused death rates ranged from 21.44 per 1 000 000 visits in the Philippines to 0 per 1 000 000 visits in several countries; the majority of countries had fewer than five intentionally caused deaths per 1 000 000 visits. Rates of road traffic crashes were higher than rates of intentionally caused deaths in almost every instance. Thailand had the highest rate of deaths due to road traffic crashes (16.49 per 1 000 000), followed by Vietnam, Morocco and South Africa (15.12 per 1 000 000, 11.96 per 1 000 000 and 10.90 per 1 000 000, respectively). Motorcycle deaths account for most of the heightened risk observed in Thailand and Vietnam. The leading cause of non-natural deaths in US travellers abroad was road crashes, which exceeds intentional injury as the leading cause of non-natural deaths in almost every country where US citizens travel. Southeast Asia had the highest unintentional injury death rates for US citizens abroad due to the high rates of deaths from motorcycle crashes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. High death rates in health care workers and teachers in Malawi.

    Science.gov (United States)

    Harries, A D; Hargreaves, N J; Gausi, F; Kwanjana, J H; Salaniponi, F M

    2002-01-01

    High death rates are reported in health care workers (HCWs) and teachers in urban areas of Malawi. The present study was carried out to determine the annual death rate in HCWs and primary school teachers working in semi-urban and rural areas of Malawi, and to try to ascertain the main causes of death. Forty district and mission hospitals in Malawi were visited. A record was made of the number of clinical and nursing-based HCWs in each hospital in 1999, the number of deaths in that calendar year and reported causes of death. A record was also made of the number of teachers working in 4 primary schools nearest to each hospital in 1999, the number of deaths in that calendar year and reported causes of death. There were 2979 HCWs, of whom 60 (2.0%) died. There were 4367 teachers of whom 101 (2.3%) died. Annual death rates, calculated per 100,000 people, were significantly higher in male HCWs compared with female HCWs (2495 versus 1770, RR 1.17, 95% CI 1.14-1.20, P < 0.001), and significantly higher in female teachers compared with male teachers (2521 versus 1934, RR 1.14, 95% CI 1.11-1.17, P < 0.001). In male HCWs and teachers the highest death rates were in those aged 35-44 years. In female HCWs and teachers, the highest death rates were in those aged 25-34 years and 35-44 years, respectively. Reported causes of death in HCWs were tuberculosis (TB) in 47%, chronic illness in 45% and acute illness in the remainder, while in teachers the causes were TB in 27%, chronic illness in 49% and acute illness in 25%. Chronic illness, thought to be due to AIDS, and TB were the common causes of death. The current high death rates from AIDS and TB will have a crippling toll on the health and education sectors, and effective ways of reducing these death rates must be found.

  12. Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect

    Science.gov (United States)

    2011-01-01

    Background Annually over 520,000 newborns die from neonatal sepsis, and 60,000 more from tetanus. Estimates of the effect of clean birth and postnatal care practices are required for evidence-based program planning. Objective To review the evidence for clean birth and postnatal care practices and estimate the effect on neonatal mortality from sepsis and tetanus for the Lives Saved Tool (LiST). Methods We conducted a systematic review of multiple databases. Data were abstracted into standard tables and assessed by GRADE criteria. Where appropriate, meta-analyses were undertaken. For interventions with low quality evidence but a strong GRADE recommendation, a Delphi process was conducted. Results Low quality evidence supports a reduction in all-cause neonatal mortality (19% (95% c.i. 1–34%)), cord infection (30% (95% c.i. 20–39%)) and neonatal tetanus (49% (95% c.i. 35–62%)) with birth attendant handwashing. Very low quality evidence supports a reduction in neonatal tetanus mortality with a clean birth surface (93% (95% c.i. 77-100%)) and no relationship between a clean perineum and tetanus. Low quality evidence supports a reduction of neonatal tetanus with facility birth (68% (95% c.i. 47-88%). No relationship was found between birth place and cord infections or sepsis mortality. For postnatal clean practices, all-cause mortality is reduced with chlorhexidine cord applications in the first 24 hours of life (34% (95% c.i. 5–54%, moderate quality evidence) and antimicrobial cord applications (63% (95% c.i. 41–86%, low quality evidence). One study of postnatal maternal handwashing reported reductions in all-cause mortality (44% (95% c.i. 18–62%)) and cord infection ((24% (95% c.i. 5-40%)). Given the low quality of evidence, a Delphi expert opinion process was undertaken. Thirty experts reached consensus regarding reduction of neonatal sepsis deaths by clean birth practices at home (15% (IQR 10–20)) or in a facility (27% IQR 24–36)), and by clean

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

  2. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 5 - Chicago

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

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

    Data.gov (United States)

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

  4. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 7 - Kansas City

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

  5. Comparison of hurricane exposure methods and associations with county fetal death rates, adjusting for environmental quality

    Science.gov (United States)

    Adverse effects of hurricanes are increasing as coastal populations grow and events become more severe. Hurricane exposure during pregnancy can influence fetal death rates through mechanisms related to healthcare, infrastructure disruption, nutrition, and injury. Estimation of hu...

  6. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 4 - Atlanta

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

  7. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 2 - New York

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

  8. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 10 - Seattle

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

  9. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, All States

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012. 2012 Source: Fatality Analysis...

  10. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 3 - Philadelphia

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

  11. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 8 - Denver

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

  12. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 1 - Boston

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

  13. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 6 - Dallas

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

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

    Data.gov (United States)

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

  15. Impaired Driving Death Rate, by Age and Gender, 2012 & 2014, Region 9 - San Francisco

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for people killed in crashes involving a driver with BAC =>0.08%, 2012, 2014. 2012 Source: Fatality Analysis...

  16. 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

  17. A Change of Possible Neurological and Psychological Significance Within the First Week of Neonate Life: Sleeping REM Rate.

    Science.gov (United States)

    Minard, James; And Others

    The percentage of rapid eye movement (REM) during sleep is substantially greater in neonates (infants in first month after birth) than in other children or adults. It was hypothesized that REM rate may decline as rates of many response sequences do when repeatedly elicited. Electrical recordings of eye movements were obtained from a 3-day-old male…

  18. An international comparison of the effect of policy shifts to organ donation following cardiocirculatory death (DCD on donation rates after brain death (DBD and transplantation rates.

    Directory of Open Access Journals (Sweden)

    Aric Bendorf

    Full Text Available During the past decade an increasing number of countries have adopted policies that emphasize donation after cardiocirculatory death (DCD in an attempt to address the widening gap between the demand for transplantable organs and the availability of organs from donation after brain death (DBD donors. In order to examine how these policy shifts have affected overall deceased organ donor (DD and DBD rates, we analyzed deceased donation rates from 82 countries from 2000-2010. On average, overall DD, DBD and DCD rates have increased over time, with the proportion of DCD increasing 0.3% per year (p = 0.01. Countries with higher DCD rates have, on average, lower DBD rates. For every one-per million population (pmp increase in the DCD rate, the average DBD rate decreased by 1.02 pmp (95% CI: 0.73, 1.32; p<0.0001. We also found that the number of organs transplanted per donor was significantly lower in DCD when compared to DBD donors with 1.51 less transplants per DCD compared to DBD (95% CI: 1.23, 1.79; p<0.001. Whilst the results do not infer a causal relationship between increased DCD and decreased DBD rates, the significant correlation between higher DCD and lower DBD rates coupled with the reduced number of organs transplanted per DCD donor suggests that a national policy focus on DCD may lead to an overall reduction in the number of transplants performed.

  19. An international comparison of the effect of policy shifts to organ donation following cardiocirculatory death (DCD) on donation rates after brain death (DBD) and transplantation rates.

    Science.gov (United States)

    Bendorf, Aric; Kelly, Patrick J; Kerridge, Ian H; McCaughan, Geoffrey W; Myerson, Brian; Stewart, Cameron; Pussell, Bruce A

    2013-01-01

    During the past decade an increasing number of countries have adopted policies that emphasize donation after cardiocirculatory death (DCD) in an attempt to address the widening gap between the demand for transplantable organs and the availability of organs from donation after brain death (DBD) donors. In order to examine how these policy shifts have affected overall deceased organ donor (DD) and DBD rates, we analyzed deceased donation rates from 82 countries from 2000-2010. On average, overall DD, DBD and DCD rates have increased over time, with the proportion of DCD increasing 0.3% per year (p = 0.01). Countries with higher DCD rates have, on average, lower DBD rates. For every one-per million population (pmp) increase in the DCD rate, the average DBD rate decreased by 1.02 pmp (95% CI: 0.73, 1.32; pDBD donors with 1.51 less transplants per DCD compared to DBD (95% CI: 1.23, 1.79; pDBD rates, the significant correlation between higher DCD and lower DBD rates coupled with the reduced number of organs transplanted per DCD donor suggests that a national policy focus on DCD may lead to an overall reduction in the number of transplants performed.

  20. Cardioprotective activity of urocortin by preventing caspase-independent, non-apoptotic death in cultured neonatal rat cardiomyocytes exposed to ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Takatani-Nakase, Tomoka, E-mail: nakase@mukogawa-u.ac.jp [Department of Pharmaceutics, School of Pharmaceutical Sciences, Mukogawa Women' s University, 11-68, Koshien, Nishinomiya, Hyogo 663-8179 (Japan); Takahashi, Koichi, E-mail: koichi@mukogawa-u.ac.jp [Department of Pharmaceutics, School of Pharmaceutical Sciences, Mukogawa Women' s University, 11-68, Koshien, Nishinomiya, Hyogo 663-8179 (Japan)

    2010-11-12

    Research highlights: {yields} Ischemia induces high level of iPLA{sub 2} resulting in caspase-independent myocyte death. {yields} Urocortin causes iPLA{sub 2} down-regulation leading to avoidance of non-apoptotic death. {yields} The survival-promoting effect of urocortin is abrogated by CRH receptor antagonist. -- Abstract: Caspase-independent, non-apoptotic cell death in ischemic heart disease is considered to be one of the important therapeutic targets, however, the detailed mechanisms of this cell death process are not clear. In this study, we investigated the mechanisms of non-apoptotic cell death in cultured neonatal rat cardiomyocytes during ischemia, and the cardioprotection by preventing the mechanisms. We found that ischemia caused elevation of the phospholipase A{sub 2} (iPLA{sub 2}) expression in the myocytes, leading to distinctive non-apoptotic nuclear shrinkage, and cell death. Moreover, we investigated whether the potent cardioprotective corticotropin-releasing hormone (CRH), urocortin, which had been less focused on non-apoptotic cell death, inhibits the ischemic myocyte death. Ischemia-augmented nuclear shrinkage of the myocytes was suppressed by the pretreatment of {approx}10 nM urocortin before the cells were exposed to ischemia. Urocortin could significantly suppress the expression and activity of iPLA{sub 2}, resulting in preventing the ischemia-induced cell death. The survival-promoting effect of urocortin was abrogated by the CRH receptor antagonist astressin. These findings provide the first evidence linking the targets of the urocortin-mediated cardioprotection to the suppression of the caspase-independent, non-apoptotic death in cardiac myocytes exposed to ischemia.

  1. 新生儿新法复苏术的临床应用%Clinical Practice in a New Method of Neonatal Resurrection

    Institute of Scientific and Technical Information of China (English)

    王侃清; 顾伟芳; 贾丽敏

    2003-01-01

    Objective Increase successful rate of neonatal resurrection. Methods With reference to "The Course ofNeonatal Resurrection", we designed the process of resurrection. Equipped with qualified medical staff. Implementing neonatalresurrection managenent. The results will be compared with the traditional neonatal resurrection. Results Compare with twogroups: There are significant differences between the two groups. The trachea insert rate of the study group is decreased by 60.69% .The death - rate of neonatal is decreased by 69.60%. The successful rate of resurrection is increased by 9.75%.Conclusion The new way of neonatal resurrection is superior to the traditional neonatal resurrection.

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

    Science.gov (United States)

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

  3. Verbal autopsy completion rate and factors associated with undetermined cause of death in a rural resource-poor setting of Tanzania

    Directory of Open Access Journals (Sweden)

    Maliti Deodatus V

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy (VA is a widely used tool to assign probable cause of death in areas with inadequate vital registration systems. Its uses in priority setting and health planning are well documented in sub-Saharan Africa (SSA and Asia. However, there is a lack of data related to VA processing and completion rates in assigning causes of death in a community. There is also a lack of data on factors associated with undetermined causes of death documented in SSA. There is a need for such information for understanding the gaps in VA processing and better estimating disease burden. Objective The study's intent was to determine the completion rate of VA and factors associated with assigning undetermined causes of death in rural Tanzania. Methods A database of deaths reported from the Ifakara Health and Demographic Surveillance System from 2002 to 2007 was used. Completion rates were determined at the following stages of processing: 1 death identified; 2 VA interviews conducted; 3 VA forms submitted to physicians; 4 coding and assigning of cause of death. Logistic regression was used to determine factors associated with deaths coded as "undetermined." Results The completion rate of VA after identification of death and the VA interview ranged from 83% in 2002 and 89% in 2007. Ninety-four percent of deaths submitted to physicians were assigned a specific cause, with 31% of the causes coded as undetermined. Neonates and child deaths that occurred outside health facilities were associated with a high rate of undetermined classification (33%, odds ratio [OR] = 1.33, 95% confidence interval [CI] (1.05, 1.67, p = 0.016. Respondents reporting high education levels were less likely to be associated with deaths that were classified as undetermined (24%, OR = 0.76, 95% CI (0.60, -0.96, p = 0.023. Being a child of the deceased compared to a partner (husband or wife was more likely to be associated with undetermined cause of death classification

  4. Verbal autopsy completion rate and factors associated with undetermined cause of death in a rural resource-poor setting of Tanzania.

    Science.gov (United States)

    Mwanyangala, Mathew A; Urassa, Honorathy M; Rutashobya, Jensen C; Mahutanga, Chrisostom C; Lutambi, Angelina M; Maliti, Deodatus V; Masanja, Honorati M; Abdulla, Salim K; Lema, Rose N

    2011-08-05

    Verbal autopsy (VA) is a widely used tool to assign probable cause of death in areas with inadequate vital registration systems. Its uses in priority setting and health planning are well documented in sub-Saharan Africa (SSA) and Asia. However, there is a lack of data related to VA processing and completion rates in assigning causes of death in a community. There is also a lack of data on factors associated with undetermined causes of death documented in SSA. There is a need for such information for understanding the gaps in VA processing and better estimating disease burden. The study's intent was to determine the completion rate of VA and factors associated with assigning undetermined causes of death in rural Tanzania. A database of deaths reported from the Ifakara Health and Demographic Surveillance System from 2002 to 2007 was used. Completion rates were determined at the following stages of processing: 1) death identified; 2) VA interviews conducted; 3) VA forms submitted to physicians; 4) coding and assigning of cause of death. Logistic regression was used to determine factors associated with deaths coded as "undetermined." The completion rate of VA after identification of death and the VA interview ranged from 83% in 2002 and 89% in 2007. Ninety-four percent of deaths submitted to physicians were assigned a specific cause, with 31% of the causes coded as undetermined. Neonates and child deaths that occurred outside health facilities were associated with a high rate of undetermined classification (33%, odds ratio [OR] = 1.33, 95% confidence interval [CI] (1.05, 1.67), p = 0.016). Respondents reporting high education levels were less likely to be associated with deaths that were classified as undetermined (24%, OR = 0.76, 95% CI (0.60, -0.96), p = 0.023). Being a child of the deceased compared to a partner (husband or wife) was more likely to be associated with undetermined cause of death classification (OR = 1.35, 95% CI (1.04, 1.75), p = 0.023). Every year

  5. Neonatal Sucking: Effects of Quantity of the Response-Contingent Fluid upon Sucking Rhythm and Heart Rate

    Science.gov (United States)

    Crook, C. K.

    1976-01-01

    The temporal organization of neonatal nutritive sucking and heart rate were studied in two consecutive 4-minute periods to analyze the effects of two quantities of response-contingent fluid. Results are discussed in relation to the distinction between nutritive and nonnutritive sucking and effects of fluid sweetness. (Author/SB)

  6. Profile of neonatal mortality in Iran in 1391

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Heidarnia

    2016-10-01

    Full Text Available Background: The first duty of any government is to ensure the health of its children and neonates. Today's countries are classified as declining mortality in this group. To increase neonatal survival rate, classified causes of newborn mortality are the core strategy and policies. This study was aimed to determine the classification of causes of neonatal death in Iran. Methods: Neonatal mortality refers to deaths of young children. It is measured by the neonatal mortality rate (NMR, which is the number of deaths of neonates per 1000 live births. This study was used data from 11693 neonatal deaths (from 22 weeks gestational age to neonatal death less than 30 days, in Iran's hospitals in 2012 that registered in the perinatal mortality surveillance system (hospital-based system. Demographic characteristics and other factors associated with neonatal death were investigated. To aid in cause of death analysis, burden of disease analysis, and comparative risk assessment we classified the causes of death according to international statistical classification of diseases version 10 (ICD 10, divided into three cause mortality strata. Results: Results showed the most common cause of neonatal mortality was "certain conditions originating in the perinatal period" (77.92% with the highest incidence of "disorders related to length of gestation and fetal growth" (37.7% in this group. Also it shows that 20.82% of deaths caused by "congenital malformations, deformations and chromosomal abnormalities" and 1.26% cases had occurred as a result of "accidents and injuries". The greatest cause of death in the neonates with weight over one thousand grams was "certain conditions originating in the perinatal period" (71.29%, with the highest percentage in the disorders related to "length of gestation and fetal growth" (29.65%. Conclusion: According to this study the "certain conditions originating in the perinatal period" special "disorders related to length of gestation

  7. Trend and forecasting rate of cancer deaths at a public university hospital using univariate modeling

    Science.gov (United States)

    Ismail, A.; Hassan, Noor I.

    2013-09-01

    Cancer is one of the principal causes of death in Malaysia. This study was performed to determine the pattern of rate of cancer deaths at a public hospital in Malaysia over an 11 year period from year 2001 to 2011, to determine the best fitted model of forecasting the rate of cancer deaths using Univariate Modeling and to forecast the rates for the next two years (2012 to 2013). The medical records of the death of patients with cancer admitted at this Hospital over 11 year's period were reviewed, with a total of 663 cases. The cancers were classified according to 10th Revision International Classification of Diseases (ICD-10). Data collected include socio-demographic background of patients such as registration number, age, gender, ethnicity, ward and diagnosis. Data entry and analysis was accomplished using SPSS 19.0 and Minitab 16.0. The five Univariate Models used were Naïve with Trend Model, Average Percent Change Model (ACPM), Single Exponential Smoothing, Double Exponential Smoothing and Holt's Method. The overall 11 years rate of cancer deaths showed that at this hospital, Malay patients have the highest percentage (88.10%) compared to other ethnic groups with males (51.30%) higher than females. Lung and breast cancer have the most number of cancer deaths among gender. About 29.60% of the patients who died due to cancer were aged 61 years old and above. The best Univariate Model used for forecasting the rate of cancer deaths is Single Exponential Smoothing Technique with alpha of 0.10. The forecast for the rate of cancer deaths shows a horizontally or flat value. The forecasted mortality trend remains at 6.84% from January 2012 to December 2013. All the government and private sectors and non-governmental organizations need to highlight issues on cancer especially lung and breast cancers to the public through campaigns using mass media, media electronics, posters and pamphlets in the attempt to decrease the rate of cancer deaths in Malaysia.

  8. Falling Plasmodium knowlesi Malaria Death Rate among Adults despite Rising Incidence, Sabah, Malaysia, 2010-2014.

    Science.gov (United States)

    Rajahram, Giri S; Barber, Bridget E; William, Timothy; Grigg, Matthew J; Menon, Jayaram; Yeo, Tsin W; Anstey, Nicholas M

    2016-01-01

    Deaths from Plasmodium knowlesi malaria have been linked to delayed parenteral treatment. In Malaysia, early intravenous artesunate is now recommended for all severe malaria cases. We describe P. knowlesi fatalities in Sabah, Malaysia, during 2012-2014 and report species-specific fatality rates based on 2010-2014 case notifications. Sixteen malaria-associated deaths (caused by PCR-confirmed P. knowlesi [7], P. falciparum [7], and P. vivax [1] and microscopy-diagnosed "P. malariae" [1]) were reported during 2012-2014. Six patients with severe P. knowlesi malaria received intravenous artesunate at hospital admission. For persons ≥15 years of age, overall fatality rates during 2010-2014 were 3.4, 4.2, and 1.0 deaths/1,000 P. knowlesi, P. falciparum, and P. vivax notifications, respectively; P. knowlesi-associated fatality rates fell from 9.2 to 1.6 deaths/1,000 notifications. No P. knowlesi-associated deaths occurred among children, despite 373 notified cases. Although P. knowlesi malaria incidence is rising, the notification-fatality rate has decreased, likely due to improved use of intravenous artesunate.

  9. 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

  10. Cholestasis sepsis at neonatology ward and neonatal Intensive Care Unit Cipto Mangunkusumo Hospital 2007 : incidence, mortality rate and associated risk factors

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    Kadim S. Bachtiar

    2008-06-01

    Full Text Available Cholestatic jaundice represents serious pathological condition. Septic-cholestasis is a kind of hepato-cellular cholestasis that occured during or after sepsis caused by biliary flow obstruction. This is a cohort study from February to June 2007 on neonatal sepsis patients at Neonatology ward Department of Child Health Faculty of Medicine University of Indonesia-Cipto Mangunkusumo General National Hospital. Aim of this study is to find out the incidence of intrahepatic cholestasis in neonatal sepsis, associated risk factors, and mortality rate in neonatal cholestasis-sepsis. From 138 neonatal sepsis patients, the incidence of intrahepatic cholestasis is 65.9%. None of the risk factors tested in this study showed statistically significant result. Mortality rate of neonatal cholestasis-sepsis is 52.8%. (Med J Indones 2008; 17: 107-13Keywords: cholestasis intrahepatic, neonatal sepsis, cholestasis sepsis, conjugated hyperbilirubinemia

  11. Time-Frequency Analysis of Heart Rate Variability for Neonatal Seizure Detection

    Science.gov (United States)

    Malarvili, M. B.; Mesbah, Mostefa; Boashash, Boualem

    2007-12-01

    There are a number of automatic techniques available for detecting epileptic seizures using solely electroencephalogram (EEG), which has been the primary diagnosis tool in newborns. The electrocardiogram (ECG) has been much neglected in automatic seizure detection. Changes in heart rate and ECG rhythm were previously linked to seizure in case of adult humans and animals. However, little is known about heart rate variability (HRV) changes in human neonate during seizure. In this paper, we assess the suitability of HRV as a tool for seizure detection in newborns. The features of HRV in the low-frequency band (LF: 0.03-0.07 Hz), mid-frequency band (MF: 0.07-0.15 Hz), and high-frequency band (HF: 0.15-0.6 Hz) have been obtained by means of the time-frequency distribution (TFD). Results of ongoing time-frequency (TF) research are presented. Based on our preliminary results, the first conditional moment of HRV which is the mean/central frequency in the LF band and the variance in the HF band can be used as a good feature to discriminate the newborn seizure from the nonseizure.

  12. Time-Frequency Analysis of Heart Rate Variability for Neonatal Seizure Detection

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    Boualem Boashash

    2007-01-01

    Full Text Available There are a number of automatic techniques available for detecting epileptic seizures using solely electroencephalogram (EEG, which has been the primary diagnosis tool in newborns. The electrocardiogram (ECG has been much neglected in automatic seizure detection. Changes in heart rate and ECG rhythm were previously linked to seizure in case of adult humans and animals. However, little is known about heart rate variability (HRV changes in human neonate during seizure. In this paper, we assess the suitability of HRV as a tool for seizure detection in newborns. The features of HRV in the low-frequency band (LF: 0.03–0.07 Hz, mid-frequency band (MF: 0.07–0.15 Hz, and high-frequency band (HF: 0.15–0.6 Hz have been obtained by means of the time-frequency distribution (TFD. Results of ongoing time-frequency (TF research are presented. Based on our preliminary results, the first conditional moment of HRV which is the mean/central frequency in the LF band and the variance in the HF band can be used as a good feature to discriminate the newborn seizure from the nonseizure.

  13. Óbitos neonatais precoces: análise de causas múltiplas de morte pelo método Grade of Membership Early neonatal mortality: an analysis of multiple causes of death by the Grade of Membership method

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    Eliane de Freitas Drumond

    2007-01-01

    Full Text Available Estudo de base populacional para determinar perfis de óbitos neonatais precoces ocorridos em Belo Horizonte, Minas Gerais, Brasil, de 2000 a 2003. A defini��ão dos perfis de causas amplia possibilidade de análise sob enfoque de evitabilidade, justificada pela persistência de altas taxas de mortalidade neonatal precoce. Três perfis foram gerados, a partir do enfoque de causas múltiplas, sob a perspectiva dos conjuntos nebulosos ("fuzzy sets", utilizando-se técnica Grade of Membership. Relacionaram-se esses perfis ao peso de nascimento e a natureza jurídica do hospital de ocorrência do óbito. Nos hospitais da rede privada ocorreram "óbitos dificilmente preveníveis, com menção de malformação congênita" (perfil 2. Aos hospitais do Sistema Único de Saúde (SUS associaram-se dois perfis distintos. Nos hospitais contratados/conveniados ocorreram os "óbitos passíveis de prevenção" (perfil 1 e na rede própria os "óbitos de prematuros" (perfil 3. A tipologia observada aponta para necessidade de adoção de políticas diferenciadas na rede SUS: prioritariamente, na rede contratada/conveniada, ações voltadas para credenciamento e avaliação da qualidade da assistência; e, em toda rede, adoção rotineira de protocolos assistenciais e medidas profiláticas, redutores da morbimortalidade neonatal.This population-based study aimed to determine the profile of early neonatal deaths in Belo Horizonte, Minas Gerais, Brazil, from 2000 to 2003. Profiles were analyzed from the perspective of avoidability, justified by persistently high early neonatal mortality rates in the city. Three profiles were generated for multiple causes of death from the perspective of fuzzy sets, using the Grade of Membership method. Birth weight and the hospital's corporate status were also related to the three profiles. Private hospitals were characterized by so-called "difficult-to-prevent deaths, with mention of congenital malformations" (profile 2. The

  14. US County-Level Trends in Mortality Rates for Major Causes of Death, 1980–2014

    Science.gov (United States)

    Dwyer-Lindgren, Laura; Bertozzi-Villa, Amelia; Stubbs, Rebecca W.; Morozoff, Chloe; Kutz, Michael J.; Huynh, Chantal; Barber, Ryan M.; Shackelford, Katya A.; Mackenbach, Johan P.; van Lenthe, Frank J.; Flaxman, Abraham D.; Naghavi, Mohsen; Mokdad, Ali H.; Murray, Christopher J. L.

    2017-01-01

    IMPORTANCE County-level patterns in mortality rates by cause have not been systematically described but are potentially useful for public health officials, clinicians, and researchers seeking to improve health and reduce geographic disparities. OBJECTIVES To demonstrate the use of a novel method for county-level estimation and to estimate annual mortality rates by US county for 21 mutually exclusive causes of death from 1980 through 2014. DESIGN, SETTING, AND PARTICIPANTS Redistribution methods for garbage codes (implausible or insufficiently specific cause of death codes) and small area estimation methods (statistical methods for estimating rates in small subpopulations) were applied to death registration data from the National Vital Statistics System to estimate annual county-level mortality rates for 21 causes of death. These estimates were raked (scaled along multiple dimensions) to ensure consistency between causes and with existing national-level estimates. Geographic patterns in the age-standardized mortality rates in 2014 and in the change in the age-standardized mortality rates between 1980 and 2014 for the 10 highest-burden causes were determined. EXPOSURE County of residence. MAIN OUTCOMES AND MEASURES Cause-specific age-standardized mortality rates. RESULTS A total of 80 412 524 deaths were recorded from January 1, 1980, through December 31, 2014, in the United States. Of these, 19.4 million deaths were assigned garbage codes. Mortality rates were analyzed for 3110 counties or groups of counties. Large between-county disparities were evident for every cause, with the gap in age-standardized mortality rates between counties in the 90th and 10th percentiles varying from 14.0 deaths per 100 000 population (cirrhosis and chronic liver diseases) to 147.0 deaths per 100 000 population (cardiovascular diseases). Geographic regions with elevated mortality rates differed among causes: for example, cardiovascular disease mortality tended to be highest along the

  15. Neonatal survival rate and its related causes in NICU of private and governmental hospitals in Sari by survival analysis technique during 2005-2007

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    R. Sabaghi, Bs.

    2008-01-01

    Full Text Available AbstractBackground and Purpose: Many children younger than 1 year old (about 4/000/000 are dying annually around the world, that three quarters of this mortality is related to neonatal period (4 weeks after birth. Several factors such as environmental conditions, social and genetic factors are causes of decreasing neonatal mortality. The aim of this study was to determine the neonatal survival rate and its related causes in NICU of private and governmental hospitals in Sari.Materials and Methods: This survival analysis was a descriptive study of 500 neonates who were admitted into NICU of private and governmental hospitals (Booali Sina, Nimeyeh Shaban, Amir-Mazandarani, and Shafa Hospitals in Sari during 2005 to 2007. Data was gathered by using Self-making Informational Form (validity and availability was confirmed by content validity and α- kronbach. Information were obtained by interview with mothers, study of patient's chart, observation of the neonates, or phone interviews, after being discharged from the hospital. Statistical analysis of data was done by using Kaplan-Mayer survival analysis technique, and survival tables. Furthermore, risk factors were determined by logistic regression.Results: Three-hundred twenty six neonates (65.2% were the first rank of birth. Sixty-three mothers (12.6% experienced previous neonatal mortality. 217 of mothers (43.4% were illiterate and 85 (17% had diplomas or higher education. 119 neonates (23.85 died within 28 days of life. There was a relationship between higher education level of mothers, polyhydraminous (over production of amniotic fluid according to sonography report, and delivery method, neonatal weight at birth, congenital anomalies, and neonatal survival rate. Eighty-seven expired neonates (73.1% had birth weight lower than 2500gr, and 21 (16.8% had gestational age lower than 36 weeks. The survival rate was higher among neonates within 21 and 22 days of life. The mortality rate among neonates

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

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    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.

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

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    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

  18. Ca²⁺/calmodulin-dependent protein kinase II contributes to hypoxic ischemic cell death in neonatal hippocampal slice cultures.

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    Qing Lu

    Full Text Available We have recently shown that p38MAP kinase (p38MAPK stimulates ROS generation via the activation of NADPH oxidase during neonatal hypoxia-ischemia (HI brain injury. However, how p38MAPK is activated during HI remains unresolved and was the focus of this study. Ca²⁺/calmodulin-dependent protein kinase II (CaMKII plays a key role in brain synapse development, neural transduction and synaptic plasticity. Here we show that CaMKII activity is stimulated in rat hippocampal slice culture exposed to oxygen glucose deprivation (OGD to mimic the condition of HI. Further, the elevation of CaMKII activity, correlated with enhanced p38MAPK activity, increased superoxide generation from NADPH oxidase as well as necrotic and apoptotic cell death. All of these events were prevented when CaMKII activity was inhibited with KN93. In a neonatal rat model of HI, KN93 also reduced brain injury. Our results suggest that CaMKII activation contributes to the oxidative stress associated with neural cell death after HI.

  19. Familial very long chain acyl-CoA dehydrogenase deficiency as a cause of neonatal sudden infant death: improved survival by prompt diagnosis.

    Science.gov (United States)

    Scalais, Emmanuel; Bottu, Jean; Wanders, Ronald J A; Ferdinandusse, Sacha; Waterham, Hans R; De Meirleir, Linda

    2015-01-01

    In neonates, very long chain acyl-CoA dehydrogenase (VLCAD) deficiency is often characterized by cardiomyopathy, hepatic encephalopathy, or severe hypoketotic hypoglycemia, or a combination thereof. The purpose of this study was to further elucidate a familial VLCAD deficiency in three patients, two of whom died in the neonatal period. We report on a family with VLCAD deficiency. Acyl-carnitine profiles were obtained from dried blood spot and/or from oxidation of (13) C-palmitate by cultured skin fibroblasts. In the index patient, VLCAD deficiency was ascertained by enzyme activity measurement in fibroblasts and by molecular analysis of ACADVL. At 30 hr of life, the proband was diagnosed with hypoglycemia (1.77 mmol/L), rhabdomyolysis (CK: 12966 IU/L) and hyperlactacidemia (10.6 mmol/L). Acylcarnitine profile performed at 31 hr of life was consistent with VLCAD deficiency and confirmed by cultured skin fibroblast enzyme activity measurement. Molecular analysis of ACADVL revealed a homozygous splice-site mutation (1077 + 2T>C). The acyl-carnitine profile obtained from the sibling's original newborn screening cards demonstrated a similar, but less pronounced abnormal profile. In the proband, the initial metabolic crisis was controlled with 10% dextrose solution and oral riboflavin followed by specific diet (Basic-F and medium chain triglyceride (MCT). This clinical report demonstrates a familial history of repeated neonatal deaths explained by VLCAD deficiency, and the clinical evolution of the latest affected, surviving sibling. It shows that very early metabolic screening is an effective approach to avoid sudden unexpected death.

  20. Fatores preditores para o óbito neonatal em gestações com diástole zero ou reversa na doplervelocimetria da artéria umbilical Predictor parameters of neonatal death in gestations with absent or reverse end-diastolic flow in the umbilical artery doppler velocimetry

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    Manoel Martins Neto

    2010-07-01

    -sectional retrospective study based on data from 48 medical records of singleton pregnancies with DZ or DR, and gestational age of 24 to 34 weeks, at a maternity in the Brazilian Northeast. Mean age was 27.3 (SD: 7.9 years. Twenty (41.7% patients were primiparas. Hypertensive disorders were found in 44 (91.7% cases. Thirty-five women (72.9% had DZ and 13 (27.1% had DR. Univariate analysis was firstly done (Student's t-test and Fisher's exact test correlating the parameters with the assessed outcome (neonatal death. Variables that showed significant association were included in the logistic regression model (Wald statistics. The level of significance was set at 5%. RESULTS: The perinatal mortality rate was 64.6% (31/48. There were five stillbirths and 26 neonatal deaths. The mean gestational age at diagnosis was 27.9 (SD: 2.8 weeks. Deliveries before 24 hours after diagnosis occurred in 52.1% of the cases. Cesarean section was performed in 85.4% of the sample. The newborns weighed 975.9 g on average (SD: 457.5. Twenty-four (57.1% presented Apgar scores below 7 in the first minute and 21.4% in the fifth minute. Gestational age at diagnosis, birth weight and Apgar of the first minute proved to be variables significantly related to neonatal death (p values were: 0.008, 0.004, and 0.020, respectively. The Odds Ratio was 6.6, 25.3 and 13.8 for neonatal death, when the diagnosis was established at the 28th week, weight was <1000 g and first minute Apgar score was <7, respectively. CONCLUSIONS: gestational age at diagnosis, birth weight and Apgar score at the first minute were factors that could predict neonatal death in pregnancies with DV or DR determined by umbilical artery Doppler velocimetry.

  1. 新生儿重症监护室五年死亡病例分析%Analysis of neonatal death in NICU during the latest 5 years

    Institute of Scientific and Technical Information of China (English)

    康文清; 刘大鹏; 陈宇辉; 孙慧清; 熊虹

    2009-01-01

    目的 了解新生儿重症监护室5年新生儿死亡原因及变迁,探讨预防措施,降低病死率.方法 对新生儿重症监护室2004年1月至2008年12月5年间死亡的69例病例进行回顾性分析.结果 (1)男女比例1.7:1,早产儿占34.8%,胎龄≤32周的早产儿占早产儿死亡病例的70.8%;(2)以早期新生儿死亡为主,占59.4%,住院3 d内死亡占69.6%;(3)早产儿前三位死亡原因为呼吸窘迫综合征、败血症、硬肿症,占早产儿死亡数的70.8%;足月儿前三位死亡原因为败血症、重度窒息、肺炎,占足月儿死亡数的77.1%;(4)呼吸窘迫综合征病死率逐年下降,败血症、重度窒息病死率无下降趋势.结论 要降低我省新生儿的病死率,必须加强围生期保健,减少早产儿的出生,深入推广新生儿新法复苏,积极控制感染.%Objective To analyze the cause and change of neonatal death during the latest 5 years,to discuss the ways to decrease the mortality.Methods A retrospective analysis of 69 cases in NICU were performed from Jan 2004 to Dec 2008.Results(1)The sex ratio of male to female was 1.7:1.The preterm infants accounted for 34.8%,preterm infants with gestational ages of less than 32 weeks accounted for 70.8% of the total premature deaths.(2)59.4% of the deaths in newborn infants occurred in the first 7days of life.69.6% occurred within 3 days after admission.(3)The three leading causes of premature infant death were RDS,sepsis and scleredema neonatorum,accounted for 75% of premature death.The three leading canses of full term death were sepsis,neonate severe asphyxia and pneumonia,accounted for 71.1% of all full term death.(4)The newborn who died of RDS were gradually decreasing.Those who died of sepsis and severe asphyxia weren't changing.Condusion Heath care during the perinatal period should be strengthened to decrease the premature birth and asphyxia.The neonatal new resuscitation technique should be widely adovocated and neonatal sepsis should

  2. Death rate due to horseshoe crab poisoning:summarization on Thai reports

    Institute of Scientific and Technical Information of China (English)

    Beuy Joob; Viroj Wiwanitkit

    2015-01-01

    Horseshoe crab can be poisonous and intoxication due to intake of horseshoe crab is possible. Horseshoe crab intoxication can be seen in many countries with seacoasts including Thailand. Here, the authors summarized the death rate due to horseshoe crab poisoning in Thailand.

  3. L2-Algebraic Decay Rate for Transient Birth-Death Processes

    Institute of Scientific and Technical Information of China (English)

    Lijuan CHENG; Yingzhe WANG

    2012-01-01

    This paper is a continuation of the study of the algebraic speed for Markov processes.The authors concentrate on algebraic decay rate for the transient birth-death processes.According to the classification of the boundaries,a series of the sufficient conditions for algebraic decay is presented.To illustrate the power of the results,some examples are included.

  4. Complete Genome Sequence of Cronobacter turicensis LMG 23827, a Food-Borne Pathogen Causing Deaths in Neonates

    OpenAIRE

    2010-01-01

    Here, we report the complete and annotated genome sequence of Cronobacter turicensis, an opportunistic food-borne pathogen, which is known as a rare but important cause of life-threatening neonatal infections. Among all proteins of C. turicensis, 223 have been annotated as virulence- and disease-related proteins.

  5. Complete genome sequence of Cronobacter turicensis LMG 23827, a food-borne pathogen causing deaths in neonates.

    Science.gov (United States)

    Stephan, Roger; Lehner, Angelika; Tischler, Patrick; Rattei, Thomas

    2011-01-01

    Here, we report the complete and annotated genome sequence of Cronobacter turicensis, an opportunistic food-borne pathogen, which is known as a rare but important cause of life-threatening neonatal infections. Among all proteins of C. turicensis, 223 have been annotated as virulence- and disease-related proteins.

  6. Nationwide population-based study of cause-specific death rates in patients with psoriasis

    DEFF Research Database (Denmark)

    Salahadeen, E; Torp-Pedersen, C; Gislason, G;

    2015-01-01

    with severe psoriasis. The age at time of death varied by psoriasis status, i.e. 76.5 ± 14.0, 74.4 ± 12.8 and 72.0 ± 13.4 years, for the general population, mild psoriasis and severe psoriasis respectively. In general, the highest death rates were observed in patients with severe psoriasis. Overall death...... and nationwide data have not been presented previously. METHODS: In a nationwide population-based cohort we evaluated all-cause and cause-specific death rates in patients with psoriasis as compared to the general population. RESULTS: The entire Danish population aged 18 and above, corresponding to a total of 5......,458,627 individuals (50.7% female, 40.9 years ± 19.7), including 94,069 with mild psoriasis (53% female, 42.0 ± 17.0 years) and 28,253 with severe psoriasis (53.4% female, 43.0 ± 16.5 years), was included. A total of 884,661 deaths were recorded, including 10 916 in patients with mild psoriasis and 3699 in patients...

  7. To explore the neonatal nurses' beliefs and attitudes towards caring for dying neonates in Taiwan.

    Science.gov (United States)

    Chen, Chao-Huei; Huang, Li-Chi; Liu, Hsin-Li; Lee, Ho-Yu; Wu, Shu-Ya; Chang, Yue-Cune; Peng, Niang-Huei

    2013-12-01

    (1) To explore attitudes and beliefs of neonatal nurses toward nursing care for dying neonates; (2) to estimate the influence of neonatal nurses' personal and professional characteristics on their attitudes towards end-of life care for dying infants. A cross-sectional design was used. A questionnaire was used to collect data from 80 neonatal nurses. Research setting was four level III NICUs at four medical centers around the central region of Taiwan. Research participants were neonatal nurses who had worked for at least 1 year in one of level III NICUs and had been directly involved with the care of dying infants. Research participants were 80 neonatal nurses (response rate 100 %). Research findings identified eight barriers hindering neonatal palliative care practice. These barriers were insufficient communication due to the lack of an in-service educational program; the lack of available counseling help for neonatal clinicians; inability to express personal opinions, values and beliefs towards neonatal palliative care; insufficient staffing; the lack of unit policies/guidelines for supporting palliative care; the technological imperative; parental demands and personal beliefs about death and previous experience caring for dying infants. Further studies are needed to explore each barrier and to provide in-service neonatal palliative care educational programs that are needed to decrease these barriers.

  8. 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

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    Maria Fernanda Branco de Almeida

    2008-08-01

    -1,500 g and 23-33 weeks of gestational age (GA, without malformations, who were born alive at eight public university tertiary hospitals in Brazil between June of 2004 and May of 2005. Infants who died within their first 6 days of life were compared with those who did not regarding maternal and neonatal characteristics and morbidity during the first 72 hours of life. Variables associated with the early deaths were identified by stepwise logistic regression. RESULTS: A total of 579 live births met the inclusion criteria. Early deaths occurred in 92 (16% cases, varying between centers from 5 to 31%, and these differences persisted after controlling for newborn illness severity and mortality risk score (SNAPPE-II. According to the multivariate analysis, the following factors were associated with early intrahospital neonatal deaths: gestational age of 23-27 weeks (odds ratio - OR = 5.0; 95%CI 2.7-9.4, absence of maternal hypertension (OR = 1.9; 95%CI 1.0-3.7, 5th minute Apgar 0-6 (OR = 2.8; 95%CI 1.4-5.4, presence of respiratory distress syndrome (OR = 3.1; 95%CI 1.4-6.6, and network center of birth. CONCLUSION: Important perinatal factors that are associated with early neonatal deaths in very low birth weight preterm infants can be modified by interventions such as improving fetal vitality at birth and reducing the incidence and severity of respiratory distress syndrome. The heterogeneity of early neonatal rates across the different centers studied indicates that best clinical practices should be identified and disseminated throughout the country.

  9. Exchange Transfusion in the Treatment of Neonatal Septic Shock: A Ten-Year Experience in a Neonatal Intensive Care Unit

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    Lorenza Pugni

    2016-05-01

    Full Text Available Septic shock, occurring in about 1% of neonates hospitalized in neonatal intensive care unit (NICU, is a major cause of death in the neonatal period. In the 1980s and 90s, exchange transfusion (ET was reported by some authors to be effective in the treatment of neonatal sepsis and septic shock. The main aim of this retrospective study was to compare the mortality rate of neonates with septic shock treated only with standard care therapy (ScT group with the mortality rate of those treated with ScT and ET (ET group. All neonates with septic shock admitted to our NICU from 2005 to 2015 were included in the study. Overall, 101/9030 (1.1% neonates had septic shock. Fifty neonates out of 101 (49.5% received one or more ETs. The mortality rate was 36% in the ET group and 51% in the ScT group (p = 0.16. At multivariate logistic regression analysis, controlling for potentially confounding factors significantly associated with death (gestational age, serum lactate, inotropic drugs, oligoanuria, ET showed a marked protective effect (Odds Ratio 0.21, 95% Confidence Interval: 0.06–0.71; p = 0.01. The lack of observed adverse events should encourage the use of this procedure in the treatment of neonates with septic shock.

  10. Reduced heart rate volatility: an early predictor of death in trauma patients.

    Science.gov (United States)

    Grogan, Eric L; Morris, John A; Norris, Patrick R; France, Daniel J; Ozdas, Asli; Stiles, Renée A; Harris, Paul A; Dawant, Benoit M; Speroff, Theodore

    2004-09-01

    To determine if using dense data capture to measure heart rate volatility (standard deviation) measured in 5-minute intervals predicts death. Fundamental approaches to assessing vital signs in the critically ill have changed little since the early 1900s. Our prior work in this area has demonstrated the utility of densely sampled data and, in particular, heart rate volatility over the entire patient stay, for predicting death and prolonged ventilation. Approximately 120 million heart rate data points were prospectively collected and archived from 1316 trauma ICU patients over 30 months. Data were sampled every 1 to 4 seconds, stored in a relational database, linked to outcome data, and de-identified. HR standard deviation was continuously computed over 5-minute intervals (CVRD, cardiac volatility-related dysfunction). Logistic regression models incorporating age and injury severity score were developed on a test set of patients (N = 923), and prospectively analyzed in a distinct validation set (N = 393) for the first 24 hours of ICU data. Distribution of CVRD varied by survival in the test set. Prospective evaluation of the model in the validation set gave an area in the receiver operating curve of 0.81 with a sensitivity and specificity of 70.1 and 80.0, respectively. CVRD predict death as early as 24 hours in the validation set. CVRD identifies a subgroup of patients with a high probability of dying. Death is predicted within first 24 hours of stay. We hypothesize CVRD is a surrogate for autonomic nervous system dysfunction.

  11. Impact of neonatal intensive care bed configuration on rates of late-onset bacterial sepsis and methicillin-resistant Staphylococcus aureus colonization.

    Science.gov (United States)

    Julian, Samuel; Burnham, Carey-Ann D; Sellenriek, Patricia; Shannon, William D; Hamvas, Aaron; Tarr, Phillip I; Warner, Barbara B

    2015-10-01

    Infections cause morbidity and mortality in neonatal intensive care units (NICUs). The association between nursery design and nosocomial infections is unclear. To determine whether rates of colonization by methicillin-resistant Staphylococcus aureus (MRSA), late-onset sepsis, and mortality are reduced in single-patient rooms. DESIGN Retrospective cohort study. NICU in a tertiary referral center. Our NICU is organized into single-patient and open-unit rooms. Clinical data sets including bed location and microbiology results were examined over 29 months. Differences in outcomes between bed configurations were determined by χ2 and Cox regression. All NICU patients. Among 1,823 patients representing 55,166 patient-days, single-patient and open-unit models had similar incidences of MRSA colonization and MRSA colonization-free survival times. Average daily census was associated with MRSA colonization rates only in single-patient rooms (hazard ratio, 1.31; P=.039), whereas hand hygiene compliance on room entry and exit was associated with lower colonization rates independent of bed configuration (hazard ratios, 0.834 and 0.719 per 1% higher compliance, respectively). Late-onset sepsis rates were similar in single-patient and open-unit models as were sepsis-free survival and the combined outcome of sepsis or death. After controlling for demographic, clinical, and unit-based variables, multivariate Cox regression demonstrated that bed configuration had no effect on MRSA colonization, late-onset sepsis, or mortality. MRSA colonization rate was impacted by hand hygiene compliance, regardless of room configuration, whereas average daily census affected only infants in single-patient rooms. Single-patient rooms did not reduce the rates of MRSA colonization, late-onset sepsis, or death.

  12. Impact of neonatal intensive care bed configuration on rates of late-onset bacterial sepsis and methicillin-resistant Staphylococcus aureus colonization

    Science.gov (United States)

    Julian, Samuel; Burnham, Carey-Ann D.; Sellenriek, Patricia; Shannon, William D.; Hamvas, Aaron; Tarr, Phillip I.; Warner, Barbara B.

    2016-01-01

    Objectives Infections cause significant morbidity and mortality in neonatal intensive care units (NICUs). The association between nursery design and nosocomial infections has not been delineated. We hypothesized that rates of colonization by methicillin-resistant Staphylococcus aureus (MRSA), late-onset sepsis, and mortality are reduced in single-patient rooms. Design Retrospective cohort study. Setting NICU in a tertiary referral center. Methods Our NICU is organized into single-patient and open-unit rooms. Clinical datasets including bed location and microbiology results were examined over a 29-month period. Differences in outcomes between bed configurations were determined by Chi-square and Cox regression. Patients All NICU patients. Results Among 1823 patients representing 55,166 patient-days, single-patient and open-unit models had similar incidences of MRSA colonization and MRSA colonization-free survival times. Average daily census was associated with MRSA colonization rates only in single-patient rooms (hazard ratio 1.31, p=0.039), while hand hygiene compliance on room entry and exit was associated with lower colonization rates independent of bed configuration (hazard ratios 0.834 and 0.719 per 1% higher compliance, respectively). Late-onset sepsis rates were similar in single-patient and open-unit models as were sepsis-free survival and the combined outcome of sepsis or death. After controlling for demographic, clinical and unit-based variables, multivariate Cox regression demonstrated that bed configuration had no effect on MRSA colonization, late-onset sepsis, or mortality. Conclusions MRSA colonization rate was impacted by hand hygiene compliance, regardless of room configuration, while average daily census only affected infants in single-patient rooms. Single-patient rooms did not reduce the rates of MRSA colonization, late-onset sepsis or death. PMID:26108888

  13. Normal overall mortality rate in Addison's disease, but young patients are at risk of premature death.

    Science.gov (United States)

    Erichsen, Martina M; Løvås, Kristian; Fougner, Kristian J; Svartberg, Johan; Hauge, Erik R; Bollerslev, Jens; Berg, Jens P; Mella, Bjarne; Husebye, Eystein S

    2009-02-01

    Primary adrenal insufficiency (Addison's disease) is a rare autoimmune disease. Until recently, life expectancy in Addison's disease patients was considered normal. To determine the mortality rate in Addison's disease patients. i) Patients registered with Addison's disease in Norway during 1943-2005 were identified through search in hospital diagnosis registries. Scrutiny of the medical records provided diagnostic accuracy and age at diagnosis. ii) The patients who had died were identified from the National Directory of Residents. iii) Background mortality data were obtained from Statistics Norway, and standard mortality rate (SMR) calculated. iv) Death diagnoses were obtained from the Norwegian Death Cause Registry. Totally 811 patients with Addison's disease were identified, of whom 147 were deceased. Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). Acute adrenal failure was a major cause of death; infection and sudden death were more common than in the general population. The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. Addison's disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison's disease.

  14. Platelet counts, MPV and PDW in culture proven and probable neonatal sepsis and association of platelet counts with mortality rate.

    Science.gov (United States)

    Ahmad, Mirza Sultan; Waheed, Abdul

    2014-05-01

    To determine frequency of thrombocytopenia and thrombocytosis, the MPV (mean platelet volume) and PDW (platelet distribution width) in patients with probable and culture proven neonatal sepsis and determine any association between platelet counts and mortality rate. Descriptive analytical study. NICU, Fazle Omar Hospital, from January 2011 to December 2012. Cases of culture proven and probable neonatal sepsis, admitted in Fazle Omar Hospital, Rabwah, were included in the study. Platelet counts, MPV and PDW of the cases were recorded. Mortality was documented. Frequencies of thrombocytopenia ( 450000/mm3) were ascertained. Mortality rates in different groups according to platelet counts were calculated and compared by chi-square test to check association. Four hundred and sixty nine patients were included; 68 (14.5%) of them died. One hundred and thirty six (29%) had culture proven sepsis, and 333 (71%) were categorized as probable sepsis. Thrombocytopenia was present in 116 (24.7%), and thrombocytosis was present in 36 (7.7%) cases. Median platelet count was 213.0/mm3. Twenty eight (27.7%) patients with thrombocytopenia, and 40 (12.1%) cases with normal or raised platelet counts died (p neonatal sepsis. Those with thrombocytopenia have higher mortality rate. No significant difference was present between PDW and MPV of the cases who survived and died.

  15. Long-term dynamics of death rates of emphysema, asthma, and pneumonia and improving air quality

    Directory of Open Access Journals (Sweden)

    Kravchenko J

    2014-06-01

    Full Text Available Julia Kravchenko,1 Igor Akushevich,2 Amy P Abernethy,3 Sheila Holman,4 William G Ross Jr,5 H Kim Lyerly1,6 1Department of Surgery, 2Center for Population Health and Aging, 3Duke Clinical Research Institute, Duke University Medical Center, Duke University, Durham, 4Division of Air Quality, North Carolina Department of Environment and Natural Resources, Raleigh, 5Nicholas School of the Environment, 6Department of Pathology, Duke University Medical Center, Duke University, Durham, NC, USA Background: The respiratory tract is a major target of exposure to air pollutants, and respiratory diseases are associated with both short- and long-term exposures. We hypothesized that improved air quality in North Carolina was associated with reduced rates of death from respiratory diseases in local populations. Materials and methods: We analyzed the trends of emphysema, asthma, and pneumonia mortality and changes of the levels of ozone, sulfur dioxide (SO2, nitrogen dioxide (NO2, carbon monoxide (CO, and particulate matters (PM2.5 and PM10 using monthly data measurements from air-monitoring stations in North Carolina in 1993–2010. The log-linear model was used to evaluate associations between air-pollutant levels and age-adjusted death rates (per 100,000 of population calculated for 5-year age-groups and for standard 2000 North Carolina population. The studied associations were adjusted by age group-specific smoking prevalence and seasonal fluctuations of disease-specific respiratory deaths. Results: Decline in emphysema deaths was associated with decreasing levels of SO2 and CO in the air, decline in asthma deaths–with lower SO2, CO, and PM10 levels, and decline in pneumonia deaths–with lower levels of SO2. Sensitivity analyses were performed to study potential effects of the change from International Classification of Diseases (ICD-9 to ICD-10 codes, the effects of air pollutants on mortality during summer and winter, the impact of approach when only

  16. Heart rate variability regression and risk of sudden unexpected death in epilepsy.

    Science.gov (United States)

    Galli, Alessio; Lombardi, Federico

    2017-02-01

    The exact mechanisms of sudden unexpected death in epilepsy remain elusive, despite there is consensus that SUDEP is associated with severe derangements in the autonomic control to vital functions as breathing and heart rate regulation. Heart rate variability (HRV) has been advocated as biomarker of autonomic control to the heart. Cardiac dysautonomia has been found in diseases where other branches of the autonomous nervous system are damaged, as Parkinson disease and multiple system atrophy. In this perspective, an impaired HRV not only is a risk factor for sudden cardiac death mediated by arrhythmias, but also a potential biomarker for monitoring a progressive decline of the autonomous nervous system. This slope may lead to an acute imbalance of the regulatory pathways of vital functions after seizure and then to SUDEP. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Mortality Rates and Causes of Death of Convicted Dutch Criminals 25 Years Later

    OpenAIRE

    Nieuwbeerta, Paul; PIQUERO, ALEX R.

    2008-01-01

    Extant theory hypothesizes that offenders have greater risk of premature and unnatural death than nonoffenders, but few studies have assessed this hypothesis; those doing so have relied on U.S. samples of male offenders typically followed until midlife. This article examines the relation between criminal conduct and mortality rates in the Netherlands using data from the Criminal Careers and Life Course Study, which traces the life course and criminal careers of 4,615 males and females convict...

  18. Heart Rate Distribution and Cause-specific Death in General Population of South China

    Institute of Scientific and Technical Information of China (English)

    Liu Xiaoqing; Rao Xuxu; Mai Jinzhuang; Wu Yong; Guo Chenye; Shi Meiling; Gao Xiangmin; Deng Mulan; Lian Zibing

    2005-01-01

    Objectives To analyses heart rate (HR) distribution of healthy adults in the south China community and evaluate relative risk of HR to total cause of death and cardiac cerebral vascular death. Methods Analytical data come from the baseline survey and follow-up visits in the PRC-USA Collaborative Study of Cardiovascular Epidemiology in urban and rural samples of Guangzhou. The baseline survey was initiated in 1983 and 1984, and rescanned in 1987 and 1988. Since 1991 Follow-up visits for endpoint events were carried once every two years.Average follow-up year was 16.2 from baseline to 2000.People excluded from cardiac cerebral vascular disease, diabetes and other various chronic diseases were regarded as "healthy adults". Heart rates of these subjects were measured on resting electrocardiogram.Endpoint evens include: total cause of death, first attack of coronary disease and cerebral vascular events.SAS software was used for analysis. Cox Proportional Hazards model was used to evaluate the impact of HR on total death and cardiac cerebral vascular disease.Results A total of 4570 men and women aged 35-55years from urban and rural Guangzhou were investigated. 3493 healthy subjects were enrolled in the analysis, including 1694 men and 1799 women. Mean of theHRis (67.9±10.6) beats/min (bpm) in the whole population, ( 66.3 ± 10.7 ) bpm in men and (69.3 ±10.4) in women. The 5th percentile of the HR was 51 in men and 54 in women. The 95th percentile of the HR was 85 in men and 88 in women. Single correlation analysis showed there was negative relationship between age and HR, but it was only statistical significant in female. Analysis with Cox Proportional Hazards model show that HR < 50 bpm tops the risk of total causes of death (1.725)and HR 50-59 bpm decreased the risk of total causes of death (0.843).Relative risk of cardiac cerebral vascular events exceeds 1 when HR < 50 and >90 bpm (1.486 and 7.008 respectively). It was less than 1 in other groups but there was

  19. Death rate in a small air-lift loop reactor of vero cells grown on solid microcarriers and in macroporous microcarriers

    NARCIS (Netherlands)

    Martens, D E; Nollen, E A; Hardeveld, M; Velden-de Groot, C A; Gooijer, C D; Beuvery, E C; Tramper, J

    The death rate of Vero cells grown on Cytodex-3 microcarrierswas studied as a function of the gas flow rate in a smallair-lift loop reactor. The death rate may be described byfirst-order death-rate kinetics. The first-order death-rateconstant as calculated from the decrease in viable cells,

  20. Heart rate turbulence predicts all-cause mortality and sudden death in congestive heart failure patients.

    Science.gov (United States)

    Cygankiewicz, Iwona; Zareba, Wojciech; Vazquez, Rafael; Vallverdu, Montserrat; Gonzalez-Juanatey, Jose R; Valdes, Mariano; Almendral, Jesus; Cinca, Juan; Caminal, Pere; de Luna, Antoni Bayes

    2008-08-01

    Abnormal heart rate turbulence (HRT) has been documented as a strong predictor of total mortality and sudden death in postinfarction patients, but data in patients with congestive heart failure (CHF) are limited. The aim of this study was to evaluate the prognostic significance of HRT for predicting mortality in CHF patients in New York Heart Association (NYHA) class II-III. In 651 CHF patients with sinus rhythm enrolled into the MUSIC (Muerte Subita en Insuficiencia Cardiaca) study, the standard HRT parameters turbulence onset (TO) and slope (TS), as well as HRT categories, were assessed for predicting total mortality and sudden death. HRT was analyzable in 607 patients, mean age 63 years (434 male), 50% of ischemic etiology. During a median follow up of 44 months, 129 patients died, 52 from sudden death. Abnormal TS and HRT category 2 (HRT2) were independently associated with increased all-cause mortality (HR: 2.10, CI: 1.41 to 3.12, P 120 ms. HRT is a potent risk predictor for both heart failure and arrhythmic death in patients with class II and III CHF.

  1. High mortality among children with gastroschisis after the neonatal period

    DEFF Research Database (Denmark)

    Risby, Kirsten; Husby, Steffen; Qvist, Niels

    2017-01-01

    BACKGROUND: During the last decades neonatal outcomes for children born with gastroschisis have improved significantly. Survival rates >90% have been reported. Early prenatal diagnosis and increased survival enforce the need for valid data for long-term outcome in the pre- and postnatal counseling...... of parents with a child with gastroschisis. METHODS: Long-term follow-up on all newborns with gastroschisis at Odense University Hospital (OUH) from January 1 1997-December 31 2009. Follow-up included neonatal chart review for neonatal background factors, including whether a GORE(®)DUALMESH was used...... the neonatal period and four died after the neonatal period. Parenteral nutrition (PN) induced liver failure and suspected adhesive small bowel obstruction were the causes of deaths after the neonatal period. Overall mortality was high in the "complex" group compared to the simple group (3/7 (42.9%) vs 4/64 (6...

  2. Setting the speed limit: a pilot study of the rate of serum creatinine decrease after endoscopic valve ablation in neonates.

    Science.gov (United States)

    Deshpande, A V; Alsaywid, B S; Smith, G H H

    2011-06-01

    In neonates with a posterior urethral valve serum creatinine is increased. It decreases after successful relief of obstruction. Clinicians consider urinary diversion if serum creatinine remains increased. However, the optimal rate of decrease of serum creatinine is not defined. We generated useful data on the rate of serum creatinine decrease in neonates with a posterior urethral valve by introducing the idea of a prediction curve. We reviewed the medical charts of 15 consecutive children treated for a posterior urethral valve in the neonatal period at our institute between 2002 and 2007. The 11 children with a delayed diagnosis of a posterior urethral valve were excluded from analysis. Serial serum creatinine levels in the cohort of 15 patients were analyzed to estimate 1) the rate of decrease after valve ablation and 2) the time needed to achieve a nadir. One child died of renal insufficiency on day 10 of life and was excluded from study. Serum creatinine attained a nadir at about age 6 months but 73% of the total decrease occurred within the first 2 months of life, which was also equal to a 45% decrease from the peak values recorded soon after birth. The rate of decrease did not appear to be influenced by the peak values. Children with normal peak creatinine or intercurrent problems did not follow the trend. The rate of decrease in serum creatinine in the first few months of life may provide useful information on the adequacy of valve ablation. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Epidemiology of early neonatal mortality.

    Science.gov (United States)

    Tyagi, N K; Bharambe, M S; Garg, B S; Mathur, J S; Goswami, K

    1994-01-01

    During 1981-1991 at a rural teaching hospital (Kasturba Hospital) of Mahatma Gandhi Institute of Medical Sciences in Sevagram, Wardha, India, 454 of 13,939 newborns died during the early neonatal period for an early neonatal mortality rate (ENMR) of 33.7/1000 live births. The ENMR for boys was not significantly different from that for girls (36.1 vs. 28.6). Community medicine specialists analyzed data on these early neonatal deaths to examine distribution of early neonatal mortality, especially its relationship with prematurity, low birth weight, birth order, and by sex. They calculated average percent deaths (APD) per hour to examine the dynamics in early neonatal mortality. The mean age at death was lower among newborns of birth order greater than 2 than those of birth order less than 2 (23.47 vs. 26.85 hours; p 0.001). ENMR was higher for newborns of birth order greater than 2 than those of birth order less than 2 (41.74% vs. 27.35%; P 0.001). The mean age at death increased as gestation increased (10.34 for 28 weeks; 24.27 for 28-33 weeks, 31.53 for 33-37 weeks, and 34.43 for 37 weeks; p 0.001). ENMR decreased as gestation increased (850 for 28 weeks; 375 for 28-33 weeks, 147.02 for 33-37 weeks, and 8.77 for 37 weeks; p 0.001). The mean age at death increased as birth weight increased for newborns weighing less than 1500 gms through 2000-2500 gms (23.36-37.13 hours; p 0.001). It was lowest among those weighing more 3000 gms (11.55 gms). ENMR fell as birth weight increased (614.33 for 1500 gms, 116.19 for 1500-2000 gms, 19.38 for 2000-2500 gms, 10.99 for 2500-3000 gms, and 5.41 for 3000 gms; p 0.001). The APD/hour for the first hour of life was 3.74% for a relative risk of 12.9. It decreased steadily as the hours of life increased (3.08% for 1-6 hours, 1.19% for 6-24 hours, 0.67% for 24-72 hours, and 0.29% for 72-168 hours). Knowledge of time of likely death can help providers know where they need to focus their attention to prevent early neonatal deaths.

  4. Impact of leukapheresis on early death rate in adult acute myeloid leukemia presenting with hyperleukocytosis.

    Science.gov (United States)

    Bug, Gesine; Anargyrou, Konstantinos; Tonn, Torsten; Bialleck, Heike; Seifried, Erhard; Hoelzer, Dieter; Ottmann, Oliver G

    2007-10-01

    Patients with acute myeloid leukemia (AML) with hyperleukocytosis of at least 100 x 10(9) per L are at high risk of early death due to pulmonary or cerebral leukostasis. Although the efficacy of leukapheresis in terms of prompt cytoreduction is generally accepted, published data regarding the clinical value of immediate therapeutic leukapheresis are limited and conflicting. To determine whether leukapheresis has a favorable impact on early mortality, the clinical course of 53 newly diagnosed patients with AML and hyperleukocytosis admitted between 1995 and 2005 was analyzed retrospectively. Before August 2001, 28 patients received chemotherapy without leukoreduction (Cohort A). Thereafter, all AML patients with hyperleukocytosis were scheduled to receive leukapheresis, which was performed in 25 patients (Cohort B). There were no procedure-related adverse events. By Day 21 of therapy, 13 of 53 patients had died, resulting in an overall early death rate of 25 percent. In a multivariate logistic regression model, patients in Cohort B had a significantly lower risk of early death than patients in Cohort A (16% vs. 32%, respectively; p = 0.015). Dyspnea (p = 0.005), elevated creatinine (p = 0.028), and higher lactate dehydrogenase serum levels (p = 0.021) were independent risk factors for early death. With a median follow-up of 24.2 months, the overall survival was similar in both cohorts (Cohort A, 7.5; Cohort B, 6.5 months). Thus, leukapheresis had no impact on patients' long-term survivals. Our experience suggests that AML patients with hyperleukocytosis receiving leukapheresis had a significantly lower risk for early death by Day 21 than patients treated without leukapheresis. We therefore have adopted leukapheresis as a standard procedure in our department.

  5. 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.

  6. Occurrence of fetal macrosomia rate and its maternal and neonatal complications: a 5-year cohort study.

    Science.gov (United States)

    Najafian, Mahin; Cheraghi, Maria

    2012-01-01

    Background. Macrosomia is defined as an infant's birth weight of more than 4000 g at term which is to different maternal and neonatal complications. Several studies have been done on factors influencing risk of macrosomia, but there is lack of information and study in our country regarding macrosomia complications. Objective. The aim of this study was to determine the prevalence of macrosomia and its complications. Method. A cohort study was conducted from 2007 to 2011 at Obstetrics and Gynecology Department, Razi Hospital in Ahvaz city, Iran. All pregnant mothers who were referred to Obstetrics and Gynecology Department for delivery were included in this study. The total number of 201,102 pregnant mothers was recruited and divided into case and control groups after delivery (macrosomia (case) and normal weight infants (control) groups). Results. Out of total deliveries (201,102), there were 1800 macrosomia, (9%). Gestational diabetes, maternal obesity (BMI), maternal aged and positive history of previous macrosomia were the major risk factors for macrosomia which were compared with the normal weight infant groups (P macrosomia included humerus-clavicle fractures and arm-brachial plexus injury which were significant compared to the control group (P macrosomia is potentially dangerous for the mother and the neonate. It is important to recognize the suspected fetal macrosomia to prevent its risk factors and complications. There is a need to provide all delivery facilities and care services to prevent and reduce the maternal and neonatal macrosomia complications.

  7. Uso da regressão de Cox para estimar fatores associados a óbito neonatal em UTI privada Uso de la regresión de Cox para estimar factores asociados a óbito neonatal en UTI privada The use of Cox regression to estimate the risk factors of neonatal death in a private NICU

    Directory of Open Access Journals (Sweden)

    Lívia Maria M. M. Lanfranchi

    2011-06-01

    medio de la regresión de Cox para verificar la asociación de factores maternos y neonatales al desfecho primario. RESULTADOS: Entraron en el estudio 185 neonatos, sien-do que 10,5% fueron a óbito antes del 28º día de vida. Las variables que se asociaron de modo significativo al óbito en el Modelo de Cox fueron: peso OBJECTIVE: To estimate the risk factors associated with neonatal deaths in a Neonatal Intensive Care Unit of a pri-vate hospital in the city of Taubaté (SP, Brazil, from 2005 to 2007, using the Cox regression analysis. METHODS: Longitudinal epidemiological study with data retrieved from medical records of all newborn admitted to a private Neonatal Intensive Care Unit from January 2005 to December 2007. The primary outcome was the neonatal mortality and independent variables were those concerning maternal and neonatal characteristics. Univariate analysis included chisquare test, relative risk and the Kaplan-Meier survival plot for each variable. Multivariate analysis to test association of independent variables with neonatal mortal-ity was performed by Cox regression analysis. RESULTS: 185 neonates were enrolled in the study and 10.5% died before the 28th day of life. Variables that were significantly associated to neonatal death by the Cox regression analysis model were birthweight <1500g, 5th minute Apgar score <7, mechanical ventilation and previous stillbirth. CONCLUSIONS: The variables with good adjustment in the Cox model for neonatal death are those associated to pre-natal maternal care and the quality of infant's care in the Neonatal Intensive Care Unit.

  8. Neonatal hearing screening of high-risk infants using automated auditory brainstem response: a retrospective analysis of referral rates.

    LENUS (Irish Health Repository)

    McGurgan, I J

    2013-10-07

    The past decade has seen the widespread introduction of universal neonatal hearing screening (UNHS) programmes worldwide. Regrettably, such a programme is only now in the process of nationwide implementation in the Republic of Ireland and has been largely restricted to one screening modality for initial testing; namely transient evoked otoacoustic emissions (TEOAE). The aim of this study is to analyse the effects of employing a different screening protocol which utilises an alternative initial test, automated auditory brainstem response (AABR), on referral rates to specialist audiology services.

  9. Optimal Chest Compression Rate and Compression to Ventilation Ratio in Delivery Room Resuscitation: Evidence from Newborn Piglets and Neonatal Manikins

    Science.gov (United States)

    Solevåg, Anne Lee; Schmölzer, Georg M.

    2017-01-01

    Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider. Thus, provider performance should be taken into account. Neonatal resuscitation guidelines recommend a 3:1 C:V ratio. CCs should be delivered at a rate of 90/min synchronized with ventilations at a rate of 30/min to achieve a total of 120 events/min. Despite a lack of scientific evidence supporting this, the investigation of alternative CC interventions in human neonates is ethically challenging. Also, the infrequent occurrence of extensive CPR measures in the DR make randomized controlled trials difficult to perform. Thus, many biomechanical aspects of CC have been investigated in animal and manikin models. Despite mathematical and physiological rationales that higher rates and uninterrupted CC improve CPR hemodynamics, studies indicate that provider fatigue is more pronounced when CC are performed continuously compared to when a pause is inserted after every third CC as currently recommended. A higher rate (e.g., 120/min) is also more fatiguing, which affects CC quality. In post-transitional piglets with asphyxia-induced cardiac arrest, there was no benefit of performing continuous CC at a rate of 90/min. Not only rate but duty cycle, i.e., the duration of CC/total cycle time, is a known determinant of CC effectiveness. However, duty cycle cannot be controlled with manual CC. Mechanical/automated CC in neonatal CPR has not been explored, and feedback systems are under-investigated in this

  10. Increased Rate of Adenoma Detection Associates With Reduced Risk of Colorectal Cancer and Death.

    Science.gov (United States)

    Kaminski, Michal F; Wieszczy, Paulina; Rupinski, Maciej; Wojciechowska, Urszula; Didkowska, Joanna; Kraszewska, Ewa; Kobiela, Jaroslaw; Franczyk, Robert; Rupinska, Maria; Kocot, Bartlomiej; Chaber-Ciopinska, Anna; Pachlewski, Jacek; Polkowski, Marcin; Regula, Jaroslaw

    2017-07-01

    The quality of endoscopists' colonoscopy performance is measured by adenoma detection rate (ADR). Although ADR is associated inversely with interval colorectal cancer and colorectal cancer death, the effects of an increasing ADR have not been shown. We investigated whether increasing ADRs from individual endoscopists is associated with reduced risks of interval colorectal cancer and subsequent death. We performed a prospective cohort study of individuals who underwent a screening colonoscopy within the National Colorectal Cancer Screening Program in Poland, from January 1, 2004, through December 31, 2008. We collected data from 146,860 colonoscopies performed by 294 endoscopists, with each endoscopist having participated at least twice in annual editions of primary colonoscopy screening. We used annual feedback and quality benchmark indicators to improve colonoscopy performance. We used ADR quintiles in the whole data set to categorize the annual ADRs for each endoscopist. An increased ADR was defined as an increase by at least 1 quintile category, or the maintenance of the highest category in subsequent screening years. Multivariate frailty models were used to evaluate the effects of increased ADR on the risk of interval colorectal cancer and death. Throughout the enrollment period, 219 endoscopists (74.5%) increased their annual ADR category. During 895,916 person-years of follow-up evaluation through the National Cancer Registry, we identified 168 interval colorectal cancers and 44 interval cancer deaths. An increased ADR was associated with an adjusted hazard ratio for interval colorectal cancer of 0.63 (95% confidence interval [CI], 0.45-0.88; P = .006), and for cancer death of 0.50 (95% CI, 0.27-0.95; P = .035). Compared with no increase in ADR, reaching or maintaining the highest quintile ADR category (such as an ADR > 24.56%) decreased the adjusted hazard ratios for interval colorectal cancer to 0.27 (95% CI, 0.12-0.63; P = .003), and 0.18 (95% CI, 0

  11. 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.

  12. Rate of change in kidney function and the risk of death: the case for incorporating the rate of kidney function decline into the CKD staging system.

    Science.gov (United States)

    Al-Aly, Ziyad; Cepeda, Oscar

    2011-01-01

    Chronic kidney disease (CKD) is associated with increased risk of death. A wave of recent studies used longitudinal data to examine the effect of the rate of decline of kidney function on the risk of death. The results from these studies show that there is an independent and graded association between the rate of kidney function decline and the risk of death. There is a need to incorporate the rate of decline in the definition of CKD. This redefinition of CKD will transform a static definition into a dynamic one that more accurately describes the disease state in an individual patient.

  13. Excessive heart rate increase during mild mental stress in preparation for exercise predicts sudden death in the general population.

    Science.gov (United States)

    Jouven, Xavier; Schwartz, Peter J; Escolano, Sylvie; Straczek, Céline; Tafflet, Muriel; Desnos, Michel; Empana, Jean Philippe; Ducimetière, Pierre

    2009-07-01

    The aim of this study involves the early identification, among apparently healthy individuals, of those at high risk for sudden cardiac death. We tested the hypothesis that individuals who respond to mild mental stress in preparation for exercise test with the largest heart rate increases might be at highest risk. Data from 7746 civil servants participating in the Paris Prospective Study I, followed-up for 23 years, allowed to compare heart rate changes between rest and mild mental stress (preparation prior to an exercise test) between subjects who suffered sudden cardiac death (n = 81), non-sudden (n = 129) coronary death, or death from any cause (n = 1306). The mean heart rate increase during mild mental stress was 8.9 +/- 10.8 b.p.m. Risk of sudden cardiac death increased progressively with heart rate increase during mental stress and the relative risk of the third vs. the first tertile was 2.09 (95% confidence interval, 1.13-3.86) after adjustment for confounders. This relationship was not observed for non-sudden coronary death. An important heart rate increase produced by a mild mental stress predicts long-term risk for sudden cardiac death. Heart rate changes before an exercise test may provide a simple tool for risk stratification.

  14. Impact of Place of Delivery on Neonatal Mortality in Rural Tanzania

    Directory of Open Access Journals (Sweden)

    Justice Ajaari, MSc

    2012-11-01

    Full Text Available Objectives:Studies on factors affecting neonatal mortality have rarely considered the impact of place of delivery on neonatal mortality. This study provides epidemiological information regarding the impact of place of delivery on neonatal deaths.Methods:We analyzed data from the Rufiji Health and Demographic Surveillance System (RHDSS in Tanzania. A total of 5,124 live births and 166 neonatal deaths were recorded from January 2005 to December 2006. The place of delivery was categorized as either in a health facility or outside, and the neonatal mortality rate (NMR was calculated as the number of neonatal deaths per 1,000 live births. Univariate and multivariate logistic regression models were used to assess the association between neonatal mortality and place of delivery and other maternal risk factors while adjusting for potential confounders.Results:Approximately 67% (111 of neonatal deaths occurred during the first week of life. There were more neonatal deaths among deliveries outside health facilities (NMR = 43.4 per 1,000 live births than among deliveries within health facilities (NMR = 27.0 per 1,000 live births. The overall NMR was 32.4 per 1,000 live births. Mothers who delivered outside a health facility experienced 1.85 times higher odds of experiencing neonatal deaths (adjusted odds ratio = 1.85; 95% confidence interval = 1.33–2.58 than those who delivered in a health facility.Conclusions and Public Health Implications:Place of delivery is a significant predictor of neonatal mortality. Pregnant women need to be encouraged to deliver at health facilities and this should be done by intensifying education on where to deliver. Infrastructure, such as emergency transport, to facilitate health facility deliveries also requires urgent attention.

  15. Effect of marital status on death rates. Part 2: Transient mortality spikes

    CERN Document Server

    Richmond, Peter

    2015-01-01

    We examine what happens in a population when it experiences an abrupt change in surrounding conditions. Several cases of such "abrupt transitions" for both physical and living social systems are analyzed from which it can be seen that all share a common pattern. First, a steep rising death rate followed by a much slower relaxation process during which the death rate decreases as a power law (with an exponent close to 0.7). This leads us to propose a general principle which can be summarized as follows: "ANY abrupt change in living conditions generates a mortality spike which acts as a kind of selection process." This we term the Transient Shock conjecture. It provides a qualitative model which leads to testable predictions. For example, marriage certainly brings about a major change in environmental and social conditions and according to our conjecture one would expect a mortality spike in the months following marriage. At first sight this may seem an unlikely proposition but we demonstrate (by three differen...

  16. Phenomenology of infant death rates. Identification of the peaks of viral and bacterial diseases

    CERN Document Server

    Richmond, Peter

    2016-01-01

    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 t_c, for all mammals the death rate decreases with age as an hyperbolic function. For humans t_c is equal to 10 years. At some ages the hyperbolic fall displays 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 about 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 currently, it is possible to get a magnified view of these peaks which in turn may give us useful information about how a...

  17. Air Temperature and Death Rates in the Continental U.S., 1968–2013

    Directory of Open Access Journals (Sweden)

    John Hart

    2015-06-01

    Full Text Available A previous test of global warming theory, on a local level, for Texas revealed inverse correlations between air temperature and death rates. The present study expands the test field to the continental U.S. Using an ecological design, mean daily maximum air temperature (“temperature” in the 48 contiguous states plus the District of Columbia by year from 1968–2013 was compared to age-adjusted all-cause mortality (“deaths” in these same jurisdictions for the same years using Pearson correlation (n = 46 years. The comparison was made for three race categories, white, black, and all races, where each category included all ages and both genders. There was 5.0 degree F range for the years studied (62.7–67.7 degrees F. Correlations were moderate strength, inverse, and statistically significant, as follows. Whites: r = −0.576, p < 0.0001; Blacks: r = −0.556, p = 0.0001; and all races: r = −0.577, p < 0.0001. These correlations are consistent with the Texas study, both of which indicated that warmer years tended to correlate with decreased death rates. A limitation to this research is its (ecological design, but is an initial step towards further investigation.

  18. High firing rate of neonatal hippocampal interneurons is caused by attenuation of afterhyperpolarizing potassium currents by tonically active kainate receptors.

    Science.gov (United States)

    Segerstråle, Mikael; Juuri, Juuso; Lanore, Frédéric; Piepponen, Petteri; Lauri, Sari E; Mulle, Christophe; Taira, Tomi

    2010-05-12

    In the neonatal hippocampus, the activity of interneurons shapes early network bursts that are important for the establishment of neuronal connectivity. However, mechanisms controlling the firing of immature interneurons remain elusive. We now show that the spontaneous firing rate of CA3 stratum lucidum interneurons markedly decreases during early postnatal development because of changes in the properties of GluK1 (formerly known as GluR5) subunit-containing kainate receptors (KARs). In the neonate, activation of KARs by ambient glutamate exerts a tonic inhibition of the medium-duration afterhyperpolarization (mAHP) by a G-protein-dependent mechanism, permitting a high interneuronal firing rate. During development, the amplitude of the apamine-sensitive K+ currents responsible for the mAHP increases dramatically because of decoupling between KAR activation and mAHP modulation, leading to decreased interneuronal firing. The developmental shift in the KAR function and its consequences on interneuronal activity are likely to have a fundamental role in the maturation of the synchronous neuronal oscillations typical for adult hippocampal circuitry.

  19. Routine neonatal circumcision?

    OpenAIRE

    Tran, P. T.; Giacomantonio, M.

    1996-01-01

    Routine neonatal circumcision is still a controversial procedure. This article attempts to clarify some of the advantages and disadvantages of neonatal circumcision. The increased rate of penile cancer among uncircumcised men appears to justify the procedure, but that alone is not sufficient justification. The final decision on neonatal circumcision should be made by parents with balanced counsel from attending physicians.

  20. Scaling in Rate-Changeable Birth and Death Processes with Random Removals

    Institute of Scientific and Technical Information of China (English)

    KE Jian-Hong; LIN Zhen-Quan; CHEN Xiao-Shuang

    2009-01-01

    We propose a monomer birth-death model with random removals, in which an aggregate of size k can produce a new monomer at a time-dependent rate I(t)k or lose one monomer at a rate J(t)k, and with a probability P(t) an aggregate of any size is randomly removed. We then analytically investigate the kinetic evolution of the model by means of the rate equation. The results show that the scaling behavior of the aggregate size distribution is dependent crucially on the net birth rate I(t)-J(t) as well as the birth rate I(t). The aggregate size distribution can approach a standard or modified scaling form in some cases, but it may take a scale-free form in other cases. Moreover, the species can survive finally only if either I(t) - J(t) ≥ P(t) or [J(t) + P(t) - I(t)]t (≌) 0 at t > 1; otherwise, it will become extinct.

  1. Changes in causes of death and mortality rates among children in Greenland from 1987 - 91 to 1992 - 99

    DEFF Research Database (Denmark)

    Aaen-Larsen, Birger; Bjerregaard, Peter

    2003-01-01

    This study analysed the spontaneous trends in mortality among children in Greenland from 1987 - 91 to 1992 - 99 and describes the changes in the causes of death, mortality rates, and variation between regions....

  2. Rates of TBI-related Emergency Department Visits, Hospitalizations, and Deaths — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — In general, total combined rates for traumatic brain injury (TBI)-related emergency department (ED) visits, hospitalizations and deaths have increased over the past...

  3. Fatores de risco para óbito neonatal obtidos pelo modelo de regressão multivariado de Cox Factores de riesgo para óbito neonatal obtenidos por el modelo de regresión multivariante de Cox Risk factors for neonatal death obtained by Cox multivariate regression analysis

    Directory of Open Access Journals (Sweden)

    Susana de Paula Risso

    2011-06-01

    Full Text Available OBJETIVO: Identificar os fatores associados ao óbito neonatal em São José dos Campos (SP. MÉTODOS: Estudo epidemiológico do tipo longitudinal para o qual foi construído um banco de dados com informações do recém-nascido e da mãe obtidas a partir das Declarações de Nascido Vivo e de Óbito de neonatos de mães residentes em São José dos Campos, nos anos de 2003 e 2004. Definiu-se como variável dependente o óbito até o 28º dia após o nascimento. A análise multivariada, utilizando o modelo de Cox, foi aplicada para verificar a associação entre o óbito neonatal e as seguintes variáveis independentes: sexo, peso ao nascer, duração da gestação, Apgar no 1º e 5º minuto, idade materna, nível de instrução da mãe, número de óbitos fetais e de filhos vivos prévio, tipo de parto e gestação única ou múltipla. O nível de significância adotado foi pOBJETIVO: Identificar los factores asociados al óbito neonatal en São José dos Campos. MÉTODOS: Se trata de estudio epistemológico de tipo longi-tudinal para el que se construyó una base de datos con informa-ciones del recién-nacido y de la madre, obtenidos a partir de las Declaraciones de Nacido Vivo y de óbito de neonatos y de madres residentes en São José dos Campos (São Paulo, Brasil, en los años de 2003 y 2004. Se definió como variable dependiente el óbito hasta el 28º día después del nacimiento. El análisis multivaria-do, utilizando el modelo de Cox, fue aplicado para verificar la asociación entre el óbito neonatal y las siguientes variables inde-pendientes: sexo, peso al nacer, duración de la gestación, Apgar en el 1er y 3er minuto, edad materna, nivel de instrucción de la madre, número de óbitos fetales y de hijos vivos previo, tipo de parto y gestación única o múltiple. El nivel de significancia adoptado fue pOBJECTIVE: To identify the risk factors for neonatal death in São José dos Campos (SP Brazil. METHODS: This longitudinal study

  4. 儿童医院住院早期新生儿134例死亡原因分析%Analysis on causes of 134 early neonatal death in children s hospital

    Institute of Scientific and Technical Information of China (English)

    李敏; 沈云琳; 刘万红; 刘霞; 龚小慧

    2011-01-01

    目的:回顾性总结并分析上海市儿童医院住院早期新生儿死亡病例的主要死因.方法:调查上海市儿童医院1997年1月~2009年12月死亡住院新生儿的病历资料,分析住院早期新生儿死亡病例的临床情况及其主要死因.结果:1997年1月~2009年12月共收治住院新生儿18061例,其中死亡201例.医治无效死亡的生后1周内早期新生儿134例,其中早产A 59例,足月儿75例,占新生儿死亡66.67%,多数在出生后3天内死亡,在生后<24 h,24~72 h,4~7天,早产儿和足月儿死亡分别为27例(45.76%)、18例(30.51%)、14例(23.73%);35例(46.67%)、16例(21.33%)、24例(32.00%).早期新生儿主要死因前三位:早产儿为呼吸窘迫综合征、极低或超低出生体重儿并发肺炎和重度围产期窒息,足月儿为先天畸形、重度围产期窒息和败血症.结论:为降低住院新生儿的病死率,新生儿科医生应尽早识别出危重新生儿,按各种疾病的高度危险期积极救治,并提高早产儿的监护和治疗水平.%Objective: To summarize and analyze the main causes of early neonatal death in Shanghai children ' s hospital. Methods; The medical records of early neonatal death in the hospital from January 1997 to December 2009 were investigated, the clinical conditions and the main causes of the early neonatal death were analyzed. Results; 18 061 neonates hospitalized in the hospital from January 1997 to December 2009, and 201 of them died. The proportion of early neonatal death within one week after birth was 66. 67% (134 cases) , including 59 premature infants and 75 mature infants, most of the neonates died within 3 days after birth; the mortalities of prema-ture infants within 24 hours, 24-72 hours and 4-7 days after birth were 45. 76% (27 cases) , 30. 51% ( 18 cases) , 23.73% ( 14 cases) , respectively; and the mortalities of mature infants within 24 hours, 24 ~ 72 hours and 4-7 days after birth were 46. 67% (35 cases) , 21. 33% (16 cases

  5. Fetal death and reduced birth rates associated with exposure to lead-contaminated drinking water.

    Science.gov (United States)

    Edwards, Marc

    2014-01-01

    This ecologic study notes that fetal death rates (FDR) during the Washington DC drinking water "lead crisis" (2000-2004) peaked in 2001 when water lead levels (WLLs) were highest, and were minimized in 2004 after public health interventions were implemented to protect pregnant women. Changes in the DC FDR vs neighboring Baltimore City were correlated to DC WLL (R(2) = 0.72). Birth rates in DC also increased versus Baltimore City and versus the United States in 2004-2006, when consumers were protected from high WLLs. The increased births in DC neighborhoods comparing 2004 versus 2001 was correlated to the incidence of lead pipes (R(2) = 0.60). DC birth rates from 1999 to 2007 correlated with proxies for maternal blood lead including the geometric mean blood lead in DC children (R(2) = 0.68) and the incidence of lead poisoning in children under age 1.3 years (R(2) = 0.64). After public health protections were removed in 2006, DC FDR spiked in 2007-2009 versus 2004-2006 (p lead service line replacements, and DC FDR dropped to historically low levels in 2010-2011 after consumers were protected and the PSLR program was terminated. Re-evaluation of a historic construction-related miscarriage cluster in the USA Today Building (1987-1988), demonstrates that high WLLs from disturbed plumbing were a possible cause. Overall results are consistent with prior research linking increased lead exposure to higher incidence of miscarriages and fetal death, even at blood lead elevations (≈5 μg/dL) once considered relatively low.

  6. Heart rate turbulence to guide treatment for prevention of sudden death.

    Science.gov (United States)

    Bauer, Axel; Zürn, Christine S; Schmidt, Georg

    2010-06-01

    Heart rate turbulence (HRT) denotes the baroreflex-mediated short-term oscillation of cardiac cycle lengths after spontaneous ventricular premature complexes. The physiological pattern of HRT consists of brief heart rate acceleration followed by more gradual heart rate deceleration before the heart rate returns to baseline. Physiological mechanisms of HRT are complex and require an intact interplay between both sympathetic and parasympathetic nervous systems. The strong and independent prognostic value of HRT in identifying postinfarction patients at high risk for death has been validated in six retrospective and three prospective studies together enrolling more than 8000 patients. This evidence qualifies HRT as a promising tool for selection of patients who might benefit from implantation of a cardioverter-defibrillator. Moreover, HRT predicts poor outcome in patients with heart failure. It is not only correlated with a patient's clinical status, but also recovers when heart failure treatment, including beta-blockers, angiotensin-converting enzyme inhibitors, or cardiac resynchronization therapy, is effective. Therefore, HRT might also be used as a treatment target to guide pharmacotherapy of heart failure.

  7. Evaluation of Heart Rate Assessment Timing, Communication, Accuracy, and Clinical Decision-Making during High Fidelity Simulation of Neonatal Resuscitation

    Directory of Open Access Journals (Sweden)

    Win Boon

    2014-01-01

    Full Text Available Objective. Accurate heart rate (HR determination during neonatal resuscitation (NR informs subsequent NR actions. This study’s objective was to evaluate HR determination timeliness, communication, and accuracy during high fidelity NR simulations that house officers completed during neonatal intensive care unit (NICU rotations. Methods. In 2010, house officers in NICU rotations completed high fidelity NR simulation. We reviewed 80 house officers’ videotaped performance on their initial high fidelity simulation session, prior to training and performance debriefing. We calculated the proportion of cases congruent with NR guidelines, using chi square analysis to evaluate performance across HR ranges relevant to NR decision-making: <60, 60–99, and ≥100 beats per minute (bpm. Results. 87% used umbilical cord palpation, 57% initiated HR assessment within 30 seconds, 70% were accurate, and 74% were communicated appropriately. HR determination accuracy varied significantly across HR ranges, with 87%, 57%, and 68% for HR <60, 60–99, and ≥100 bpm, respectively (P<0.001. Conclusions. Timeliness, communication, and accuracy of house officers’ HR determination are suboptimal, particularly for HR 60–100 bpm, which might lead to inappropriate decision-making and NR care. Training implications include emphasizing more accurate HR determination methods, better communication, and improved HR interpretation during NR.

  8. Ethnic-specific splicing mutation of the carnitine-acylcarnitine translocase gene in a Chinese neonate presenting with sudden unexpected death

    Institute of Scientific and Technical Information of China (English)

    林青云; 赖志刚; 周镇邦; 汤瑞芳; 袁月冰; 麦婉芳; 陈恩和

    2003-01-01

    Carnitine-acylcarnitine translocase (CACT) deficiency (OMIM 212138) is an autosomal recessive disease caused by mutations of the SLC25A20 gene [solute carrier family 25 (carnitine/acylcarnitine translocase), member 20]. The gene has an open reading frame of 903 bp,1 mapped to chromosome 3p21.31 by in situ hybridization,2 and encodes a protein having three repeated homologous domains, each about 100 amino acids in length-a characteristic feature of mitochondrial transport proteins.3,4 CACT is essential in long-chain fatty acid oxidation because CACT is located in the inner side of the inner mitochondrial membrane, shuttling long-chain acylcarnitines in the intermembranous space against carnitine in the mitochondrial matrix. The first patient with CACT deficiency reported in the United States,5 and the first patient reported in the United Kingdom6 are both of mixed ethnicity with one of the parents being Chinese. Intriguingly, there is no single case of CACT deficiency reported in Chinese populations, suggesting that this disease may be underdiagnosed in Chinese populations. In this study, we have confirmed that CACT deficiency can be a cause of sudden neonatal death in Chinese.

  9. 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

    and the trial was halted immediately with 232 boys enrolled. The VAS group had significantly higher mortality than the OPV0 group in the rainy season (HR: 9.91 (1.23 - 80)). All deaths had had contact with the neonatal nursery; of seven VAS boys enrolled during one week in September, six died within two months......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...... measurements to the 2006 WHO growth reference. We compared differences in z-scores by linear regression. Relative risks (RR) of being stunted or underweight were calculated in Poisson regression models with robust standard errors. RESULTS: In the rainy season we detected a cluster of deaths in the VAS group...

  10. 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.

  11. 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

    in the context of routine practice. The primary endpoint is the proportion of pregnancies in women treated with insulin detemir, compared with other basal insulin regimens, which do not result in any of the following events: major congenital malformations, perinatal death or neonatal death. A sample size of 3075...... pregnancies was calculated to provide an 80% power to detect a difference of 3.5% between groups in the primary endpoint at a 5% level. DISCUSSION: The study will also examine other important maternal endpoints (e.g., incidences of severe hypoglycaemia and pre-eclampsia) and perinatal outcomes...

  12. Effects of Breast Milk and Vanilla Odors on Premature Neonate's Heart Rate and Blood Oxygen Saturation During and After Venipuncture.

    Science.gov (United States)

    Neshat, Hanieh; Jebreili, Mahnaz; Seyyedrasouli, Aleheh; Ghojazade, Morteza; Hosseini, Mohammad Bagher; Hamishehkar, Hamed

    2016-06-01

    Different studies have shown that the use of olfactory stimuli during painful medical procedures reduces infants' response to pain. The main purpose of the current study was to investigate the effect of breast milk odor and vanilla odor on premature infants' vital signs including heart rate and blood oxygen saturation during and after venipuncture. A total of 135 preterm infants were randomly selected and divided into three groups of control, vanilla odor, and breast milk odor. Infants in the breast milk group and the vanilla group were exposed to breast milk odor and vanilla odor from 5 minutes prior to sampling until 30 seconds after sampling. The results showed that breast milk odor has a significant effect on the changes of neonatal heart rate and blood oxygen saturation during and after venipuncture and decreased the variability of premature infants' heart rate and blood oxygen saturation. Vanilla odor has no significant effect on premature infants' heart rate and blood oxygen saturation. Breast milk odor can decrease the variability of premature infants' heart rate and blood oxygen saturation during and after venipuncture. Copyright © 2015. Published by Elsevier B.V.

  13. Comparison of total and cardiovascular death rates in the same city during a losing versus winning super bowl championship.

    Science.gov (United States)

    Kloner, Robert A; McDonald, Scott; Leeka, Justin; Poole, W Kenneth

    2009-06-15

    The purpose of this study was to determine whether there were changes in death rates when a local football team participated in the Super Bowl. Los Angeles (LA) played in the Super Bowl twice: on January 20, 1980 (LA Rams vs Pittsburgh Steelers, which LA lost), and on January 22, 1984 (LA Raiders vs Washington Redskins, which LA won). Data from LA County were analyzed for all-cause and circulatory death rates for the Super Bowl and the following 14 days when LA played (Super Bowl-related days) and control days (from January 15 to the end of February for 1980 to 1983 and 1984 to 1988). The Super Bowl-related days during LA's losing 1980 game were associated with higher daily death rates in LA County (per 100,000 population) for all deaths (2.4482 vs 2.0968 for control days, p Super Bowl-related days during the winning 1984 game were associated with a lower rate of all-cause death (2.1870 vs 2.3205 for control days, p = 0.0302). In conclusion, the emotional stress of loss and/or the intensity of a game played by a sports team in a highly publicized rivalry such as the Super Bowl can trigger total and cardiovascular deaths.

  14. Detection of anomalous diffusion using confidence intervals of the scaling exponent with application to preterm neonatal heart rate variability

    Science.gov (United States)

    Bickel, David R.; Verklan, M. Terese; Moon, Jon

    1998-11-01

    The scaling exponent of the root mean square (rms) displacement quantifies the roughness of fractal or multifractal time series; it is equivalent to other second-order measures of scaling, such as the power-law exponents of the spectral density and autocorrelation function. For self-similar time series, the rms scaling exponent equals the Hurst parameter, which is related to the fractal dimension. A scaling exponent of 0.5 implies that the process is normal diffusion, which is equivalent to an uncorrelated random walk; otherwise, the process can be modeled as anomalous diffusion. Higher exponents indicate that the increments of the signal have positive correlations, while exponents below 0.5 imply that they have negative correlations. Scaling exponent estimates of successive segments of the increments of a signal are used to test the null hypothesis that the signal is normal diffusion, with the alternate hypothesis that the diffusion is anomalous. Dispersional analysis, a simple technique which does not require long signals, is used to estimate the scaling exponent from the slope of the linear regression of the logarithm of the standard deviation of binned data points on the logarithm of the number of points per bin. Computing the standard error of the scaling exponent using successive segments of the signal is superior to previous methods of obtaining the standard error, such as that based on the sum of squared errors used in the regression; the regression error is more of a measure of the deviation from power-law scaling than of the uncertainty of the scaling exponent estimate. Applying this test to preterm neonate heart rate data, it is found that time intervals between heart beats can be modeled as anomalous diffusion with negatively correlated increments. This corresponds to power spectra between 1/f2 and 1/f, whereas healthy adults are usually reported to have 1/f spectra, suggesting that the immaturity of the neonatal nervous system affects the scaling

  15. Neonatal sepsis: progress towards improved outcomes.

    Science.gov (United States)

    Shane, Andi L; Stoll, Barbara J

    2014-01-01

    Neonates are predisposed to infections during the perinatal period due to multiple exposures and a relatively compromised immune system. The burden of disease attributed to neonatal infections varies by geographic region and maternal and neonatal risk factors. Worldwide, it is estimated that more than 1.4 million neonatal deaths annually are the consequence of invasive infections. Risk factors for early-onset neonatal sepsis (EOS) include prematurity, immunologic immaturity, maternal Group B streptococcal colonization, prolonged rupture of membranes, and maternal intra-amniotic infection. Intrapartum antimicrobial prophylaxis administered to GBS-colonized women has reduced the burden of disease associated with early onset GBS invasive infections. Active surveillance has identified Gram-negative pathogens as an emerging etiology of early-onset invasive infections. Late-onset neonatal sepsis (LOS) attributable to Gram-positive organisms, including coagulase negative Staphylococci and Staphylococcus aureus, is associated with increased morbidity and mortality among premature infants. Invasive candidiasis is an emerging cause of late-onset sepsis, especially among infants who receive broad spectrum antimicrobial agents. Prophylactic fluconazole administration to very low birthweight (VLBW) neonates during the first 6 weeks of life reduces invasive candidiasis in neonatal intensive care units with high rates of fungal infection. Prevention of healthcare associated infections through antimicrobial stewardship, limited steroid use, early enteral feeding, limited use of invasive devices and standardization of catheter care practices, and meticulous hand hygiene are important and cost-effective strategies for reducing the burden of late-onset neonatal sepsis. Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  16. Heart rate variability in conscious neonatal swine: spectral features and responses to short-term intermittent hypoxia

    Directory of Open Access Journals (Sweden)

    Zhao Ning

    2006-06-01

    Full Text Available Abstract Background Spectral analysis of the cardiac time series has been used as a tool for assessing levels of parasympathetic and sympathetic modulation of the sinoatrial node. In the present investigation we evaluated daily changes in heart rate variability spectra in conscious neonatal piglets that were either neurally intact (n = 5 or had undergone right stellate ganglionectomy (n = 5. The partial stellectomized animals and their intact litter mates were exposed to four days of intermittent hypoxia, each day comprising nine episodes of hypoxia alternating with nine episodes of normoxia. A time control group (n = 7 comprised animals from different litters that were not exposed to intermittent hypoxia. We hypothesized that exposure to intermittent hypoxia would increase sympathetic efferent neuronal modulation of heart rate variability spectra in neurally intact animals and in those with right stellate ganglionectomy, and that his effect would be observed in heart rate variability spectra computed from baseline recordings. Results Overall, heart rate variability spectra during baseline conditions were dominated by high frequency activity, a reflection of parasympathetic efferent neuronal innervation and linkage to the ventilatory cycle manifested as respiratory sinus arrhythmia. Exposure to intermittent hypoxia did not alter daily baseline spectral features that would indicate an increase of sympathetic cardiac activity: low frequency (0.05 – 0.15 Hz activity was unaffected and the ratio of low- to -high frequency activity remained less than unity indicating a predominance of high frequency activity. The resultant spectra were remarkably similar despite differences in cardiac sympathetic efferent neuronal innervation and experimental treatment. When spectra were computed from cardiac time series during representative hypoxic episodes, significant increases in activity across the low frequency region (0.05 – 0.15 Hz of heart rate

  17. Prediction of road traffic death rate using neural networks optimised by genetic algorithm.

    Science.gov (United States)

    Jafari, Seyed Ali; Jahandideh, Sepideh; Jahandideh, Mina; Asadabadi, Ebrahim Barzegari

    2015-01-01

    Road traffic injuries (RTIs) are realised as a main cause of public health problems at global, regional and national levels. Therefore, prediction of road traffic death rate will be helpful in its management. Based on this fact, we used an artificial neural network model optimised through Genetic algorithm to predict mortality. In this study, a five-fold cross-validation procedure on a data set containing total of 178 countries was used to verify the performance of models. The best-fit model was selected according to the root mean square errors (RMSE). Genetic algorithm, as a powerful model which has not been introduced in prediction of mortality to this extent in previous studies, showed high performance. The lowest RMSE obtained was 0.0808. Such satisfactory results could be attributed to the use of Genetic algorithm as a powerful optimiser which selects the best input feature set to be fed into the neural networks. Seven factors have been known as the most effective factors on the road traffic mortality rate by high accuracy. The gained results displayed that our model is very promising and may play a useful role in developing a better method for assessing the influence of road traffic mortality risk factors.

  18. 新生儿重症监护室10年早期新生儿死亡分析%Analysis of 10-year early neonatal death in the NICU

    Institute of Scientific and Technical Information of China (English)

    杨燕玲; 蒋裕蕊; 崔兆芳; 崔凤静; 单若冰

    2014-01-01

    目的:对青岛市妇女儿童医院新生儿重症监护室近10年早期新生儿死亡特征进行分析,探索早期新生儿死亡的原因及相应干预措施。方法收集青岛市妇女儿童医院2002年1月至2011年12月10年间新生儿重症监护室死亡新生儿病例资料,对住院早期新生儿死亡病例临床情况及主要死因进行回顾性分析。结果10年间青岛市妇女儿童医院共入院16314例新生儿,共死亡525例,生后1周内早期新生儿死亡408例,包括214例早产儿,194例足月儿,占新生儿死亡的77.71%。前后5年比较,病死率明显下降(P<0.05)。生后1 d内、~3 d、~7 d分别死亡110例(27.00%)、192例(47.06%)、106例(25.98%),多数病例为生后3 d内死亡,且1 d内死亡患儿疾病危重度高于其他两组(P<0.01)。10年内早期新生儿主要死因依次为:早产相关因素(97例,23.78%),重度窒息(91例,22.3%),先天畸形(66例,16.2%)等。2002-2006年早期新生儿死因前3位为重度窒息、先天畸形、呼吸窘迫综合征(RDS),2007-2011年为呼吸窘迫综合征(RDS)、重度窒息、先天畸形。早产儿死亡主要集中在32周以内(26.72%)。结论青岛市妇女儿童医院10年早期新生儿病死率逐年下降,死亡病例以3 d内最多,早产儿死亡主要集中在32周以内;早期新生儿总体死因顺位为早产、重度窒息、先天畸形,且前后五年死因顺位不同。%Objective To analyze the main causes of early neonatal death in Qingdao Women &Children's Hospital in the latest 10 years.Methods The medical records of early neonatal death in the Qingdao Women&Children’s Hospital from January 2002 through December 201 1 were analyzed.Results A total of 16 314 neonates were available to study,and 525 of them died.The mortality of early neonatal death within a week after birth was 77.71% (408 cases),including 214 premature

  19. Prediction of Trend between Water Environment Pollution of D Lake and Death Rate of Malignancy in Population

    Institute of Scientific and Technical Information of China (English)

    李龙; 吴春松

    2003-01-01

    Grey system analysis method was used to study the correlation between water pollution in D Lake area and death rate of malignancy with death rate of malignancy as effect sequence and a variety of water pollution index as factor sequence. On the basis of grey correlation analysis, grey system predication model was established for death rate of malignancy in population in D Lake area including GM(1.N) model for death rate of malignancy [ MR(t+1) = (9.9987E1 ± 5. 0001E2 + 10.8994E3+1. 1114E4+165.1029) · e-0.0070t -9. 9987E1 - 5. 0001E2 - 10. 8994E3 - 1. 1114E4] and GM(1,1) model for related factors [ E1(t+1) =52. 1214-46. 9468e -0. 0058t, E2(t+1)=4. 6114-4.5664e0.0015t, E3(t+1)=1.1389-1. 1212e0.0065t, E4(t+1 = 554. 5867-549. 8006e0.0016t], and the trend of death rate of malignancy from 2000 to 2010 was predicted.

  20. 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

  1. ANALISIS PERBEDAAN ANTAR PARITAS IBU DENGAN KEMATIAN NEONATAL

    Directory of Open Access Journals (Sweden)

    Mugeni Sugiharto

    2012-12-01

    Full Text Available Background: Neonatal mortality are still high, in Indonesia that was 25 per thousand live births. Baby’s health can not be separated from the mother’s health. Meanwhile primigravid mother and a grande is a high risk of pregnancy and childbirth. To find out whether there are differences between mothers with parity of neonatal death, it is necessary to do this research. The aim is to tell the difference between maternal parity with the neonatal mortality rates. Methods: This study is cross sectional using Riskesdas 2007 data and analyzed by difference 2 free sample test “Mann Whitney”. Results: Most neonatal deaths in rural areas (75.7% at the age of 0–6 days for 77.38%, primarily male (62.3%. Mann Whitney test results is mothers primigravid parity differ with grande, because p = 0.01 < α (0.05, And also primigravid parity differ with three parity, because p = 0.04 < a, but no different between primigravid parity with two parity, because p = 0505 > a. Conclusion: Mann-Whitney test demonstrated that primigravid mothers significanty have differences with the three and grande, while the parity to the two did not differ with parity primigravid of neonatal death. Key words: Neonate mortality, parity, Mann-Whitney

  2. Role of climate variability in the heatstroke death rates of Kanto region in Japan.

    Science.gov (United States)

    Akihiko, Takaya; Morioka, Yushi; Behera, Swadhin K

    2014-07-10

    The death toll by heatstroke in Japan, especially in Kanto region, has sharply increased since 1994 together with large interannual variability. The surface air temperature and humidity observed during boreal summers of 1980-2010 were examined to understand the role of climate in the death toll. The extremely hot days, when the daily maximum temperature exceeds 35 °C, are more strongly associated with the death toll than the conventional Wet Bulb Globe Temperature index. The extremely hot days tend to be associated with El Niño/Southern Oscillation or the Indian Ocean Dipole, suggesting a potential link with tropical climate variability to the heatstroke related deaths. Also, the influence of these climate modes on the death toll has strengthened since 1994 probably related to global warming. It is possible to develop early warning systems based on seasonal climate predictions since recent climate models show excellent predictability skills for those climate modes.

  3. NCHS - Age-adjusted death rates and life-expectancy at birth, (All Races, Both Sexes): United States, 1900-2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — Age-adjusted death rates (deaths per 100,000) are based on the 2000 U.S. standard population. Populations used for computing death rates for 2011–2013 are...

  4. Gestational Age Patterns of Fetal and Neonatal Mortality Rates: The Euro Peristat Project

    NARCIS (Netherlands)

    Mohangoo, A.; Buitendijk, S.; Zeitling, J.

    2010-01-01

    Background: The recently published European Perinatal Health Report showed wide variability in perinatal mortality rates between European countries. We investigated the gestational age patterns of mortality in order to better understand differences between low versus high mortality countries.

  5. RISK FACTORS OF MORTALITY IN NEONATAL ILLNESS

    Directory of Open Access Journals (Sweden)

    Jeyanthi

    2016-03-01

    Full Text Available BACKGROUND Infant Mortality Rate (IMR is high in India. Identification of risk factors of mortality in neonatal illness is essential to reduce Neonatal Mortality Rate (NMR and ultimately the IMR. AIM To identify the risk factors of mortality in neonatal illness. SETTING AND DESIGN It was a nested case control study done at the sick neonatal unit of urban tertiary referral centre. METHODS AND MATERIALS After obtaining ethical committee approval, retrospective analysis of 150 out born neonatal case records of babies admitted during the period from October 2015 to December 2015 was done. Data such as demographic features, maternal details, referral details, perinatal events, clinical features, laboratory reports and outcome were recorded. STATISTICAL ANALYSIS These risk factors were subjected to univariate and multivariate logistic regression analysis and P value calculated for the same to find out significant risk factors of mortality in neonatal illness. RESULTS Neonatal mortality rate was 22%. Male-to-female ratio was 2:1, death occurred more commonly in female neonates (23.1%. Home deliveries carried more risk of mortality. Birth order 4 and above had 25% mortality. Neonates of mother who had primary education and below had higher mortality. Perinatal asphyxia and sepsis were the most common causes of neonatal mortality. By univariate analysis, preterms had 4.9 times increased risk of mortality than term babies. Apnoeic spells, chest retractions and shock had 8 times, 3 times and 3.6 times increased risk of mortality respectively. By multivariate analysis, birth weight below 2 kilograms (kg carried 11.8 times more risk of mortality with a p value 0.00 (95% C.I 3.2, 30.4 and poor maternal intake of iron and folic acid tablets was 3.9 times more risk p value 0.003 (95% C.I 1.6, 9.6, apnoeic spells were 5.8 times more risk of mortality with p value 0.02 (95% C.I 1.3, 26.2. CONCLUSION Birth weight below 2 kg, poor maternal intake of iron and folic

  6. Studies in Early Infant Learning: Classical Conditioning of the Neonatal Heart Rate

    Science.gov (United States)

    Crowell, David H.; And Others

    1976-01-01

    In three experiments, it was demonstrated that human newborn heart rate level can be reliably modified through classical conditioning procedures. Findings support the idea that early learning may occur under a variety of conditions and different theories may account for the results. (Author/SB)

  7. Growth rates and post-release survival of captive neonate timber rattlesnakes Crotalus horridus

    Science.gov (United States)

    Richard N. Conner; D. Craig Rudolph; Daniel Saenz; Richard R. Schaefer; Shirley J. Burgdorf

    2003-01-01

    The need for conservation and management of rare species is becoming increasingly important as wildlife species and their habitat continue to decline. Translocation of wild captured adults to augment and reintroduce populations has been successfully used for some endangered avian species (see Carrie et al. 1999; Rudolph et al. 1992). In general, success rates for...

  8. 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

  9. Correlation of Alzheimer's disease death rates with historical per capita personal income in the USA.

    Science.gov (United States)

    Stępkowski, Dariusz; Woźniak, Grażyna; Studnicki, Marcin

    2015-01-01

    Alzheimer's disease (AD) is a progressive degenerating disease of complex etiology. A variety of risk factors contribute to the chance of developing AD. Lifestyle factors, such as physical, mental and social activity, education, and diet all affect the susceptibility to developing AD. These factors are in turn related to the level of personal income. Lower income usually coincides with lower level of education, lesser mental, leisure-social and physical activity, and poorer diet. In the present paper, we have analyzed the correlation of historical (1929-2011) per capita personal income (PCPI) for all states of the USA with corresponding age-adjusted AD death rates (AADR) for years 2000, 2005 and 2008. We found negative correlations in all cases, the highest one (R ≈ -0.65) for the PCPIs in the year 1970 correlated against the AADRs in 2005. From 1929 to 2005 the R value varies in an oscillatory manner, with the strongest correlations in 1929, 1970, 1990 and the weakest in 1950, 1980, 1998. Further analysis indicated that this oscillatory behavior of R is not artificially related to the economic factors but rather to delayed biological consequences associated with personal income. We conclude that the influence of the income level on the AD mortality in 2005 was the highest in the early years of life of the AD victims. Overall, the income had a significant, lifelong, albeit constantly decreasing, influence on the risk of developing AD. We postulate that the susceptibility of a population to late-onset AD (LOAD) is determined to a large extent by the history of income-related modifiable lifestyle risk factors. Among these risk factors, inappropriate diet has a significant contribution.

  10. Correlation of Alzheimer's disease death rates with historical per capita personal income in the USA.

    Directory of Open Access Journals (Sweden)

    Dariusz Stępkowski

    Full Text Available Alzheimer's disease (AD is a progressive degenerating disease of complex etiology. A variety of risk factors contribute to the chance of developing AD. Lifestyle factors, such as physical, mental and social activity, education, and diet all affect the susceptibility to developing AD. These factors are in turn related to the level of personal income. Lower income usually coincides with lower level of education, lesser mental, leisure-social and physical activity, and poorer diet. In the present paper, we have analyzed the correlation of historical (1929-2011 per capita personal income (PCPI for all states of the USA with corresponding age-adjusted AD death rates (AADR for years 2000, 2005 and 2008. We found negative correlations in all cases, the highest one (R ≈ -0.65 for the PCPIs in the year 1970 correlated against the AADRs in 2005. From 1929 to 2005 the R value varies in an oscillatory manner, with the strongest correlations in 1929, 1970, 1990 and the weakest in 1950, 1980, 1998. Further analysis indicated that this oscillatory behavior of R is not artificially related to the economic factors but rather to delayed biological consequences associated with personal income. We conclude that the influence of the income level on the AD mortality in 2005 was the highest in the early years of life of the AD victims. Overall, the income had a significant, lifelong, albeit constantly decreasing, influence on the risk of developing AD. We postulate that the susceptibility of a population to late-onset AD (LOAD is determined to a large extent by the history of income-related modifiable lifestyle risk factors. Among these risk factors, inappropriate diet has a significant contribution.

  11. 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.

  12. [Neonatal mortality and avoidable causes in the micro regions of São Paulo state].

    Science.gov (United States)

    Nascimento, Luiz Fernando Costa; Almeida, Milena Cristina da Silva; Gomes, Camila de Moraes Santos

    2014-07-01

    To identify spatial patterns of neonatal mortality distribution in the micro regions of São Paulo State and verify the role of avoidable causes in the composition of this health indicator. This ecological exploratory study used neonatal mortality information obtained from Information System and Information Technology Department of the Brazilian National Healthcare System (DATASUS) in the period between the years 2007 and 2011. The digital set of micro regions of São Paulo State was obtained from Instituto Brasileiro de Geografia e Estatística (IBGE). Moran Indexes were calculated for the neonatal mortality total rate and rate from avoidable causes; thematic maps were constructed with these rates, as well as the difference between them; and the Box Map was built. The overall neonatal mortality rate was 8.42/1,000 live births and neonatal mortality rate from avoidable causes of 6.19/1,000 live births. Moran coefficients (I) for these rates were significant (p-value<0.05) - for the total rate of neonatal mortality I=0.11 and for mortality from preventable causes I=0.19 -, and neonatal deaths were concentrated in southwest region and the Vale do Paraíba. If preventable causes were abolished, there would be a significant reduction in the average rate of overall neonatal mortality, from 8.42 to 2.23 deaths/1,000 live births, representing a decline of 73%. This study demonstrated that neonatal mortality rate would be close to the rates of developed countries if avoidable causes were abolished.

  13. Interventions to reduce neonatal mortality from neonatal tetanus in low and middle income countries--a systematic review.

    Science.gov (United States)

    Khan, Adeel Ahmed; Zahidie, Aysha; Rabbani, Fauziah

    2013-04-09

    In 1988, WHO estimated around 787,000 newborns deaths due to neonatal tetanus. Despite few success stories majority of the Low and Middle Income Countries (LMICs) are still struggling to reduce neonatal mortality due to neonatal tetanus. We conducted a systematic review to understand the interventions that have had a substantial effect on reducing neonatal mortality rate due to neonatal tetanus in LMICs and come up with feasible recommendations for decreasing neonatal tetanus in the Pakistani setting. We systemically reviewed the published literature (Pubmed and Pubget databases) to identify appropriate interventions for reducing tetanus related neonatal mortality. A total of 26 out of 30 studies were shortlisted for preliminary screening after removing overlapping information. Key words used were "neonatal tetanus, neonatal mortality, tetanus toxoid women". Of these twenty-six studies, 20 were excluded. The pre-defined exclusion criteria was (i) strategies and interventions to reduce mortality among neonates not described (ii) no abstract/author (4 studies) (iii) not freely accessible online (1 study) (iv) conducted in high income countries (2 studies) and (v) not directly related to neonatal tetanus mortality and tetanus toxoid immunization (5). Finally six studies which met the eligibility criteria were entered in the pre-designed data extraction form and five were selected for commentary as they were directly linked with neonatal tetanus reduction. Interventions that were identified to reduce neonatal mortality in LMICs were: a) vaccination of women of child bearing age (married and unmarried both) with tetanus toxoid b) community based interventions i.e. tetanus toxoid immunization for all mothers; clean and skilled care at delivery; newborn resuscitation; exclusive breastfeeding; umbilical cord care and management of infections in newborns c) supplementary immunization (in addition to regular EPI program) d) safer delivery practices. The key intervention to

  14. Interventions to reduce neonatal mortality from neonatal tetanus in low and middle income countries - a systematic review

    Science.gov (United States)

    2013-01-01

    Background In 1988, WHO estimated around 787,000 newborns deaths due to neonatal tetanus. Despite few success stories majority of the Low and Middle Income Countries (LMICs) are still struggling to reduce neonatal mortality due to neonatal tetanus. We conducted a systematic review to understand the interventions that have had a substantial effect on reducing neonatal mortality rate due to neonatal tetanus in LMICs and come up with feasible recommendations for decreasing neonatal tetanus in the Pakistani setting. Methods We systemically reviewed the published literature (Pubmed and Pubget databases) to identify appropriate interventions for reducing tetanus related neonatal mortality. A total of 26 out of 30 studies were shortlisted for preliminary screening after removing overlapping information. Key words used were “neonatal tetanus, neonatal mortality, tetanus toxoid women”. Of these twenty-six studies, 20 were excluded. The pre-defined exclusion criteria was (i) strategies and interventions to reduce mortality among neonates not described (ii) no abstract/author (4 studies) (iii) not freely accessible online (1 study) (iv) conducted in high income countries (2 studies) and (v) not directly related to neonatal tetanus mortality and tetanus toxoid immunization (5). Finally six studies which met the eligibility criteria were entered in the pre-designed data extraction form and five were selected for commentary as they were directly linked with neonatal tetanus reduction. Results Interventions that were identified to reduce neonatal mortality in LMICs were: a) vaccination of women of child bearing age (married and unmarried both) with tetanus toxoid b) community based interventions i.e. tetanus toxoid immunization for all mothers; clean and skilled care at delivery; newborn resuscitation; exclusive breastfeeding; umbilical cord care and management of infections in newborns c) supplementary immunization (in addition to regular EPI program) d) safer delivery

  15. Neonatal near miss in the Birth in Brazil survey.

    Science.gov (United States)

    Silva, Antônio Augusto Moura da; Leite, Alvaro Jorge Madeiro; Lamy, Zeni Carvalho; Moreira, Maria Elisabeth Lopes; Gurgel, Ricardo Queiroz; Cunha, Antonio José Ledo Alves da; Leal, Maria do Carmo

    2014-08-01

    This study used data from the Birth in Brazil survey, a nationwide hospital-based study of 24,197 postpartum women and their newborns, collected between February 2011 and July 2012. A three-stage cluster sampling design (hospitals, days, women) was used consisting of stratification by geographic region, type of municipality (capital or non-capital), and type of hospital financing. Logistic regression was used to identify variables that were potential predictors of neonatal mortality and neonatal near miss indicators. After testing nineteen variables, five were chosen to compose a set of neonatal near miss indicators (birth weight of less than 1,500 g, Apgar score of less than 7 in the 5th minute of life, use of mechanical ventilation, gestational age of less than 32 weeks and congenital malformations). The neonatal near miss rate in the Birth in Brazil survey was 39.2 per thousand live births, three and a half times higher than the neonatal mortality rate (11.1 per thousand). These neonatal near miss indicators were able to identify situations with a high risk of neonatal death.

  16. Modelling the effect of temperature on specific death rate of the micro-flora of raw cotton wool

    Directory of Open Access Journals (Sweden)

    C.C. Opara

    2013-01-01

    Full Text Available Cotton wool for use in medicine must be sterilized and heat treatment is the most common sterilization technique for bulk processing of agricultural materials. Modelling the effect of temperature variations on specific death rate of the micro-flora of raw cotton wool was carried out in this project. The raw cotton wool was collected from a farmer in Kano State, the most important cotton wool producing state of Nigeria. The micro-flora was determined by inoculating and incubating with 0.85% NaCl diluents and the number of bacteria determined by plate count method. As the sterilization temperatures were varied with increased time, the thermal death rates and thermal death time of the micro-flora were determined for each temperature and these was used in the modelling. The model lnK = 83.9 – 34190(1/T shows that the sterilization temperature has a linear relationship with the death rate constant and it is in line with Arrhenius model.

  17. 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.

  18. Effect of marital status on death rates. Part 1: High accuracy exploration of the Farr-Bertillon effect

    Science.gov (United States)

    Richmond, Peter; Roehner, Bertrand M.

    2016-05-01

    The Farr-Bertillon law says that for all age-groups the death rate of married people is lower than the death rate of people who are not married (i.e. single, widowed or divorced). Although this law has been known for over 150 years, it has never been established with well-controlled accuracy (e.g. error bars). This even let some authors argue that it was a statistical artifact. It is true that the data must be selected with great care, especially for age groups of small size (e.g. widowers under 25). The observations reported in this paper were selected in the way experiments are designed in physics, that is to say with the objective of minimizing error bars. Data appropriate for mid-age groups may be unsuitable for young age groups and vice versa. The investigation led to the following results. (1) The FB effect is very similar for men and women, except that (at least in western countries) its amplitude is 20% higher for men. (2) There is a marked difference between single/divorced persons on the one hand, for whom the effect is largest around the age of 40, and widowed persons on the other hand, for whom the effect is largest around the age of 25. (3) When different causes of death are distinguished, the effect is largest for suicide and smallest for cancer. For heart disease and cerebrovascular accidents, the fact of being married divides the death rate by 2.2 compared to non-married persons. (4) For young widowers the death rates are up to 10 times higher than for married persons of same age. This extreme form of the FB effect will be referred to as the "young widower effect". Chinese data are used to explore this effect more closely. A possible connection between the FB effect and Martin Raff's "Stay alive" effect for the cells in an organism is discussed in the last section.

  19. Relation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth.

    Science.gov (United States)

    Georgieva, A; Payne, S J; Moulden, M; Redman, C W G

    2012-07-01

    Electronic fetal heart rates (FHR) are used to monitor fetal health during labour. The paper records are visually assessed by clinicians, but automated alternatives are being developed. Interpretation, visual or computerised, depends on assigning a baseline to identify key features such as accelerations and decelerations. However, when the FHR is unstable the baseline may be unassignable, making conventional analysis unreliable. Such instability may reflect on fetal health. If true, these segments should not be discarded but quantified, for which we have developed a numerical method. In 7,568 labours, the association between unassignable baseline and umbilical arterial blood pH ≤ 7.05 at birth (evidence of poor health) was studied retrospectively. We found a consistent increase of the risk for acidaemia with longer intervals of unassignable baseline. This is detectable at the end of the first stage of labour, but stronger at the end of the second stage: in the last 30 min of labour, the odds ratios (with respect to baseline assignable throughout this period) increased from 1.99 (15 min unassignable) to 4.9 (30 min unassignable). Computerised analysis of the FHR becomes unreliable when the baseline cannot be assigned; however, this pattern is itself a pathological feature associated with acidaemia at birth.

  20. Mortality in Extremely Low-Birth-Weight Neonates in México City (1985–2009

    Directory of Open Access Journals (Sweden)

    José Iglesias-Leboreiro

    2010-01-01

    Full Text Available Objective. To analyze 25 years of mortality of extremely low-birth-weight (ELBW neonates (≤1000 g in a private hospital in Mexico City and to establish the current viability limit for ELBW neonates. Methods. We designed a prospective observational study of all ELBW neonates born between 1985 and 2009. Neonatal mortality, early neonatal mortality, and the 120-day mortality rate were analyzed in 5-year intervals by two categories of birth weight (501–750 g and 751–1000 g. Results. Among the 50,823 total births, 158 were ELBW (3.1 per 103. Neonatal mortality (death ≤28 days decreased for the 501–750 g neonates from 88.9% (1985–1989 to 55.6% (2005–1999 (P=.008 and for 751–1000 g neonates also decreased from 50% to 5.3% (P=.002. The 120-day mortality for neonates over 500 g diminished: 501–750 g neonates, 88.9% to 61.1% (P=.02 and for 751–1000 g neonates, 62.5% to 15.8% (P=.002. The highest viability limit was established in neonates who weighed ≥650 g and were ≥26 weeks in gestational age. Conclusions. The survival of ELBW neonates has improved in Mexico particularly in private hospitals, and it was more evident over the years 2004–2009. These data suggest that it is possible to increase the ELBW neonates survive in developing counties.

  1. The Incidence of Low Birth Weight (LBW and Small- for- Gestational Age (SGA and its Related Factors in Neonates, Sabzevar, Iran

    Directory of Open Access Journals (Sweden)

    Nasrin Hashemian Nejad

    2014-11-01

    Full Text Available Introduction Low birth weight (LBW is a high risk for children's health and a problem of public health in under developing countries. SGA increases neonatal and infant death, and neonatal and adult morbidity. So the present study aimed to assess the incidence of LBW, SGA and their related factors in Sabzevar in 2011 to 2012.   Materials and Methods This prospective descriptive-analytic study was conducted on 481 low birth weight neonates born in Mobini academic hospital of Sabzevar in 2011. Neonates who their BW was   Results 480 (6.33% of participating newborns were LBW (out of 7599. Mean weight of LBW neonates was 2039.1±9.6 g. Among LBW neonates, 62 (12.7% and 24 (5% of neonates were VLBW and ELBW, respectively. 162 (34.1% of neonates were SGA (out of LBW neonates. SGA rate was 2.2% (out of total newborns. Family income (p-value=0.026 and mother's education (p-value=0.004 were significantly lower in SGA neonates rather than LBW neonates. The incidence of mothers' urinary infection in VLBW neonates was significantly higher than non-VLBW neonates (p-value

  2. Mortality Rates and Causes of Death of Convicted Dutch Criminals 25 Years Later

    NARCIS (Netherlands)

    Nieuwbeerta, Paul; Piquero, Alex R.

    2008-01-01

    Extant theory hypothesizes that offenders have greater risk of premature and unnatural death than nonoffenders, but few studies have assessed this hypothesis; those doing so have relied on U.S. samples of male offenders typically followed until midlife. This article examines the relation between cri

  3. Mortality Rates and Causes of Death of Convicted Dutch Criminals 25 Years Later

    NARCIS (Netherlands)

    Nieuwbeerta, Paul; Piquero, Alex R.

    2008-01-01

    Extant theory hypothesizes that offenders have greater risk of premature and unnatural death than nonoffenders, but few studies have assessed this hypothesis; those doing so have relied on U.S. samples of male offenders typically followed until midlife. This article examines the relation between cri

  4. Accelerated growth rate induced by neonatal high-protein milk formula is not supported by increased tissue protein synthesis in low-birth-weight piglets

    OpenAIRE

    Agnès Jamin; Bernard Sève; Jean-Noël Thibault; Nathalie Floc’h

    2012-01-01

    Low-birth-weight neonates are routinely fed a high-protein formula to promote catch-up growth and antibiotics are usually associated to prevent infection. Yet the effects of such practices on tissue protein metabolism are unknown. Baby pigs were fed from age 2 to 7 or 28 d with high protein formula with or without amoxicillin supplementation, in parallel with normal protein formula, to determine tissue protein metabolism modifications. Feeding high protein formula increased growth rate betwee...

  5. Reappraisal of twinning: epidemiology and outcome in the early neonatal period

    Science.gov (United States)

    Gupta, Priyanka; Faridi, Mohammad Moonis Akbar; Goel, Neerja; Zaidi, Zeashan

    2014-01-01

    INTRODUCTION The present study aimed to determine the epidemiology, maternal complications and adverse neonatal outcomes associated with twin births at a tertiary care hospital in India. METHODS A prospective observational study was conducted on all successively born twin pairs (≥ 23 weeks of gestation) and their mothers from January to September 2005. Main outcome measures included maternal medical/obstetric complications, labour characteristics and the morbidities/mortality observed during the early neonatal period. RESULTS The twinning rate was 1 in 54 deliveries. Around 10% of mothers had a predisposition for twinning in the form of familial tendency or consumption of clomiphene. Anaemia (85%) was the most common maternal complication, followed by gestational hypertension (17%). Nearly one-third of births were delivered via Caesarean section. Prematurity (61%) was the most common neonatal complication followed by early-onset neonatal sepsis (21%). The risk of early neonatal death was 27%. Shorter gestation and low birth weight were significantly associated with adverse neonatal outcome (p delivery time interval, gender and intra-pair birth weight discordance did not affect neonatal morbidity or mortality (p ≥ 0.05). CONCLUSION The rates of maternal complications and early neonatal morbidities/mortality were quite high in twin gestations. Except for the prematurity and low birth weight, none of the other factors, including inter-twin delivery time interval of more than 15 mins, were found to affect neonatal outcome. PMID:25017406

  6. State of neonatal health care in eight countries of the SAARC region, South Asia: how can we make a difference?

    Science.gov (United States)

    Das, Jai K; Rizvi, Arjumand; Bhatti, Zaid; Paul, Vinod; Bahl, Rajiv; Shahidullah, Mohammod; Manandhar, Dharma; Stanekzai, Hedayatullah; Amarasena, Sujeewa; Bhutta, Zulfiqar A

    2015-08-01

    The South Asian Association for Regional Cooperation (SAARC) is an organization of eight countries--Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, Sri Lanka and Afghanistan. The major objectives of this review are to examine trends and progress in newborn and neonatal health care in the region. A landscape analysis of the current state of neonatal mortality, stillbirths and trends over the years for each country and the effective interventions to reduce neonatal mortality and stillbirths was undertaken. A modelling exercise using the Lives Saved Tool (LiST) was also undertaken to determine the impact of scaling up a set of essential interventions on neonatal mortality and stillbirths. The findings demonstrate that there is an unacceptably high and uneven burden of neonatal mortality and stillbirths in the region which together account for 39% of global neonatal deaths and 41% of global stillbirths. Progress is uneven across countries in the region, with five of the eight SAARC countries having reduced their neonatal mortality rate by more than 50% since 1990, while India (43%), Afghanistan (29%) and Pakistan (25%) have made slower progress and will not reach their MDG4 targets. The major causes of neonatal mortality are intrapartum-related deaths, preterm birth complications and sepsis which account for nearly 80% of all deaths. The LiST analysis shows that a gradual increase in coverage of proven available interventions until 2020 followed by a uniform scale-up to 90% of all interventions until 2030 could avert 52% of neonatal deaths (0.71 million), 29% of stillbirths (0.31 million) and achieve a 31% reduction in maternal deaths (0.25 million). The analysis demonstrates that the Maldives and Sri Lanka have done remarkably well while other countries need greater attention and specific focus on strategies to improve neonatal health.

  7. Data study of death rate and cancer incidence among Thule workers, 2005; Registerundersoegelse af doedelighed og kraeftforekomst blandt Thulearbejdere, 2005

    Energy Technology Data Exchange (ETDEWEB)

    Juel, K. [Statens Insti. for Folkesundhed, Copenhagen (Denmark); Engholm, G.; Storm, H. [Kraeftens Bekaempelse, Copenhagen (Denmark)

    2005-12-01

    January 21st, 1968, an American B52 bomber with nuclear weapons aboard crashed close to the Thule air-base in Greenland. In 1986 suspicions arose that there might be increased disease incidences and death rate among the employees at the base that were involved in the clearing operations. During 1986 - 1995, several health studies were made of the Thule workers. These studies of death rate, cancer, hospitalization, and fertility did not show any differences between the Thule workers from the clearing operations and those not involved in the clearing. The present study shows no difference in total death rate among the clearing workers compared to other workers. The same results were found for cancer mortality, circulatory diseases, pulmonary diseases, natural causes, and accidents. As the previous studies showed, the present study shows that there were a slightly less number of suicides among the clearing workers. The data analyses show with great certainty that the Thule workers as a group do not have a great excessive mortality or an increased cancer incidence caused by the aircraft crash. Thus, the present results fall in line with the previous investigations. (ln)

  8. An in vivo root hair assay for determining rates of apoptotic-like programmed cell death in plants

    Directory of Open Access Journals (Sweden)

    Hogg Bridget V

    2011-12-01

    Full Text Available Abstract In Arabidopsis thaliana we demonstrate that dying root hairs provide an easy and rapid in vivo model for the morphological identification of apoptotic-like programmed cell death (AL-PCD in plants. The model described here is transferable between species, can be used to investigate rates of AL-PCD in response to various treatments and to identify modulation of AL-PCD rates in mutant/transgenic plant lines facilitating rapid screening of mutant populations in order to identify genes involved in AL-PCD regulation.

  9. Association between resting heart rate and coronary artery disease, stroke, sudden death and noncardiovascular diseases: a meta-analysis

    Science.gov (United States)

    Zhang, Dongfeng; Wang, Weijing; Li, Fang

    2016-01-01

    Background: Resting heart rate is linked to risk of coronary artery disease, stroke, sudden death and noncardiovascular diseases. We conducted a meta-analysis to assess these associations in general populations and in populations of patients with hypertension or diabetes mellitus. Methods: We searched PubMed, Embase and MEDLINE from inception to Mar. 5, 2016. We used a random-effects model to combine study-specific relative risks (RRs). We used restricted cubic splines to assess the dose–response relation. Results: We included 45 nonrandomized prospective cohort studies in the meta-analysis. The multivariable adjusted RR with an increment of 10 beats/min in resting heart rate was 1.12 (95% confidence interval [CI] 1.09–1.14) for coronary artery disease, 1.05 (95% CI 1.01–1.08) for stroke, 1.12 (95% CI 1.02–1.24) for sudden death, 1.16 (95% CI 1.12–1.21) for noncardiovascular diseases, 1.09 (95% CI 1.06–1.12) for all types of cancer and 1.25 (95% CI 1.17–1.34) for noncardiovascular diseases excluding cancer. All of these relations were linear. In an analysis by category of resting heart rate ( 80 beats/min), the RRs were 0.99 (95% CI 0.93–1.04), 1.08 (95% CI 1.01–1.16) and 1.30 (95% CI 1.19–1.43), respectively, for coronary artery disease; 1.08 (95% CI 0.98–1.19), 1.11 (95% CI 0.98–1.25) and 1.08 (95% CI 0.93–1.25), respectively, for stroke; and 1.17 (95% CI 0.94–1.46), 1.31 (95% CI 1.12–1.54) and 1.57 (95% CI 1.39–1.77), respectively, for noncardiovascular diseases. After excluding studies involving patients with hypertension or diabetes, we obtained similar results for coronary artery disease, stroke and noncardiovascular diseases, but found no association with sudden death. Interpretation: Resting heart rate was an independent predictor of coronary artery disease, stroke, sudden death and noncardiovascular diseases over all of the studies combined. When the analysis included only studies concerning general populations, resting

  10. Fatal neonatal parechovirus encephalitis

    NARCIS (Netherlands)

    A.L. van Zwol (Arjen); M.H. Lequin (Maarten); C.D. Tesselaar (Coranne); A.A. Eijck (Annemiek); G.J.A. Driessen (Gertjan); M. de Hoog (Matthijs); P. Govaert (Paul)

    2009-01-01

    textabstractTwo infants developed encephalitis in the late neonatal period due to human parechovirus type 3 (HPeV-3). This finally resulted in intractable seizures leading to death. Both presented with classical signs and symptoms. HPeV-3 was detected in nasopharyngeal and rectal swabs,

  11. Neonatal circumcision.

    Science.gov (United States)

    Lerman, S E; Liao, J C

    2001-12-01

    The merits of neonatal circumcision continue to be debated hotly. Some argue that circumcision is a "uniquely American medical enigma." Most of the world's male population remains uncircumcised; however, most boys born in the United States continue to undergo neonatal circumcision. Review of existing literature supports that most children who are uncircumcised do well from a medical standpoint and, thus, the question of whether US health care practitioners are subjecting neonates to an unnecessary surgical procedure remains. The medical benefits of circumcision are multiple, but most are small. The clearest medical benefit of circumcision is the relative reduction in the risk for a UTI, especially in early infancy. Although this risk [figure: see text] is real, the absolute numbers are small (risk ranges from 1 in 100 to 1 in 1000), and one investigator has estimated that it may take approximately 80 neonatal circumcisions to prevent one UTI. In the case of a patient with known urologic abnormalities that predispose to UTI, neonatal circumcision has a clearer role in terms of medical benefit to the patient. Most of the other medical benefits of circumcision probably can be realized without circumcision as long as access to clean water and proper penile hygiene are achieved. Proper penile hygiene should all but eliminate the risk for foreskin-related medical problems that will require circumcision. Moreover, proper hygiene and access to clean water has been shown to reduce the rate of development of squamous cell carcinoma of the penis in the uncircumcised population. Proper techniques on the care of the foreskin are illustrated in the American Academy of Pediatrics pamphlet titled "How to care for the uncircumcised penis." Regarding the relationship between STDs and circumcision, patient education and the practice of low-risk sexual behavior make a far greater impact than does routine circumcision in hopes of reducing the spread of HIV and other STDs. Nevertheless

  12. Reduced death rates from cyclones in Bangladesh: what more needs to be done?

    Science.gov (United States)

    Haque, Ubydul; Hashizume, Masahiro; Kolivras, Korine N; Overgaard, Hans J; Das, Bivash; Yamamoto, Taro

    2012-02-01

    Tropical storms, such as cyclones, hurricanes and typhoons, present major threats to coastal communities. Around two million people worldwide have died and millions have been injured over the past two centuries as a result of tropical storms. Bangladesh is especially vulnerable to tropical cyclones, with around 718 000 deaths from them in the past 50 years. However, cyclone-related mortality in Bangladesh has declined by more than 100-fold over the past 40 years, from 500 000 deaths in 1970 to 4234 in 2007. The main factors responsible for these reduced fatalities and injuries are improved defensive measures, including early warning systems, cyclone shelters, evacuation plans, coastal embankments, reforestation schemes and increased awareness and communication. Although warning systems have been improved, evacuation before a cyclone remains a challenge, with major problems caused by illiteracy, lack of awareness and poor communication. Despite the potential risks of climate change and tropical storms, little empirical knowledge exists on how to develop effective strategies to reduce or mitigate the effects of cyclones. This paper summarizes the most recent data and outlines the strategy adopted in Bangladesh. It offers guidance on how similar strategies can be adopted by other countries vulnerable to tropical storms. Further research is needed to enable countries to limit the risks that cyclones present to public health.

  13. 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

  14. On the edge of death: Rates of decline and lower thresholds of biochemical condition in food-deprived fish larvae and juveniles

    DEFF Research Database (Denmark)

    Meyer, Stefan; Caldarone, E.M.; Chicharo, M.A.

    2012-01-01

    (degree-days, Dd). The 10th percentile of sRD successfully approximated the lowest, life-stage-specific biochemical condition (the edge of death). Temperature could explain 59% of the variability in time to death whereas DW had no effect. Species and life-stage-specific differences in starvation...... parameters suggest selective adaptation to food deprivation. Previously published, interspecific functions predicting the relationship between growth rate and sRD in feeding fish larvae do not apply to individuals experiencing prolonged food deprivation. Starvation rate, edge of death, and time to death...

  15. A Positive Association Between Hospice Profit Margin And The Rate At Which Patients Are Discharged Before Death.

    Science.gov (United States)

    Dolin, Rachel; Holmes, G Mark; Stearns, Sally C; Kirk, Denise A; Hanson, Laura C; Taylor, Donald H; Silberman, Pam

    2017-07-01

    Hospice care is designed to support patients and families through the final phase of illness and death. Yet for more than a decade, hospices have steadily increased the rate at which they discharge patients before death-a practice known as "live discharge." Although certain live discharges are consistent with high-quality care, regulators have expressed concern that some hospices' desire to maximize profits drives them to inappropriately discharge patients. We used Medicare claims data for 2012-13 and cost reports for 2011-13 to explore relationships between hospice-level financial margins and live discharge rates among freestanding hospices. Adjusted analyses showed positive and significant associations between both operating and total margins and hospice-level rates of live discharge: One-unit increases in operating and total margin were associated with increases of 3 percent and 4 percent in expected hospice-level live discharge rates, respectively. These findings suggest that additional research is needed to explore links between profitability and patient-centeredness in the Medicare hospice program. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008

    Science.gov (United States)

    Chen, Brian K.; Yang, Chun-Yuh

    2014-01-01

    The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result. PMID:24503974

  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. Immigrant suicide rates as a function of ethnophaulisms: hate speech predicts death.

    Science.gov (United States)

    Mullen, Brian; Smyth, Joshua M

    2004-01-01

    The purpose of this study was to determine whether suicide rates among ethnic immigrant groups were predicted by the ethnophaulisms, or the hate speech, used to refer to those ethnic immigrant groups. Data were obtained for 10 European ethnic immigrant groups during the 1950s. These 10 European ethnic immigrant groups accounted for approximately 40% of all immigration into the United States during this time period. Both the suicide rates for these ethnic immigrant groups in the United States and suicide rates for those ethnic immigrant groups in their countries of origin were derived. The complexity and valence of ethnophaulisms used to refer to these ethnic immigrant groups were derived from the historical record of hate speech in the United States. Consistent with previous research, immigrant suicide rates were strongly correlated with origin suicide rates. As expected, the suicide rates for ethnic immigrant groups in the United States were significantly predicted by the negativity of the ethnophaulisms used to refer to those ethnic immigrant groups. This pattern was obtained even after taking into account the suicide rates for those ethnic immigrant groups in their countries of origin, and even after taking into account the size of those ethnic immigrant groups. This study found support for the expectation that suicide rates among ethnic immigrant groups would be predicted by the hate speech directed toward those ethnic immigrant groups.

  19. Motor neuron disease mortality and lifetime petrol lead exposure: Evidence from national age-specific and state-level age-standardized death rates in Australia.

    Science.gov (United States)

    Zahran, Sammy; Laidlaw, Mark A S; Rowe, Dominic B; Ball, Andrew S; Mielke, Howard W

    2017-02-01

    The age standardized death rate from motor neuron disease (MND) for persons 40-84 years of age in the Australian States of New South Wales, Victoria, and Queensland increased dramatically from 1958 to 2013. Nationally, age-specific MND death rates also increased over this time period, but the rate of the rise varied considerably by age-group. The historic use of lead (Pb) additives in Australian petrol is a candidate explanation for these trends in MND mortality (International Classification of Disease (ICD)-10 G12.2). Leveraging temporal and spatial variation in petrol lead exposure risk resulting from the slow rise and rapid phase-out of lead as a constituent in gasoline in Australia, we analyze relationships between (1) national age-specific MND death rates in Australia and age-specific lifetime petrol lead exposure, (2) annual between-age dispersions in age-specific MND death rates and age-specific lifetime petrol lead exposure; and (3) state-level age-standardized MND death rates as a function of age-weighted lifetime petrol lead exposure. Other things held equal, we find that a one percent increase in lifetime petrol lead exposure increases the MND death rate by about one-third of one percent in both national age-specific and state-level age-standardized models of MND mortality. Lending support to the supposition that lead exposure is a driver of MND mortality risk, we find that the annual between-age group standard deviation in age-specific MND death rates is strongly correlated with the between-age standard deviation in age-specific lifetime petrol lead exposure. Legacy petrol lead emissions are associated with age-specific MND death rates as well as state-level age-standardized MND death rates in Australia. Results indicate that we are approaching peak lead exposure-attributable MND mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Noninvasive indocyanine green plasma disappearance rate predicts early complications, graft failure or death after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Lutz Schneider; Martin Spiegel; Sebastian Latanowicz; Markus A Weigand; Jan Schmidt; Jens Werner; Wolfgang Stremmel; Christoph Eisenbach

    2011-01-01

    BACKGROUND: Early  detection  of  graft  malfunction  or postoperative  complications  is  essential  to  save  patients  and organs after orthotopic liver transplantation (OLT). Predictive tests  for  graft  dysfunction  are  needed  to  enable  earlier implementation  of  organ-saving  interventions  following transplantation. This study was undertaken to assess the value of indocyanine green plasma disappearance rates (ICG-PDRs) for predicting postoperative complications, graft dysfunction, and patient survival following OLT. METHODS: Eighty-six patients undergoing OLT were included in this single-centre trial. ICG-PDR was assessed daily for the first 7 days following OLT. Endpoints were graft loss or death within 30 days and postoperative complications, graft loss, or death within 30 days. RESULTS: Postoperative complications of 31 patients included deaths (12 patients) or graft losses. ICG-PDR was significantly different in patients whose endpoints were graft loss or death beginning from day 3 and in those whose endpoints were graft-loss,  death,  or  postoperative  complications  beginning  from day  4  after  OLT.  For  day  7  measurements,  receiver  operating characteristic  curve  analysis  revealed  an  ICG-PDR  cut-off  for predicting  death  or  graft  loss  of  9.6%  per  min  (a  sensitivity of 75.0%, a specificity of 72.6%, positive predictive value 0.35, negative predictive value 0.94). For prediction of graft loss, death, or postoperative complications, the ICG-PDR cut-off was 12.3% per min (a sensitivity of 68.9%,

  1. Effects of Environmental Factors on Death Rate of Pigs in South Korea

    OpenAIRE

    Lee, Seung-Joo; Oh, Taek-Kuen; Kim, Suk; Min, Won-Gi; Gutierrez, Winson-Montanez; Chang, Hong-Hee; Chikushi, Jiro

    2012-01-01

    Reducing the mortality rate among pigs for a swine industry is very important. In this study, environmental factors such as average air temperature, average daily temperature rage and average relative humidity were determined on its effects of on mortality rate of pigs and its optimum ranges to influence pigs health that were correlated with the pigs periodic growth. Data were collected from 10 pig farms in South Korea during the Summer, Fall and Winter seasons. Correlation and regression equ...

  2. Prevalence and factors associated with neonatal sepsis among ...

    African Journals Online (AJOL)

    TOSHIBA

    killer accounting for more than one third of neonatal deaths (Gebremedhin et al., 201). ... therapies would effectively improve management and outcome of neonatal sepsis. Despite ... cleaning and generation of frequency distribution tables.

  3. Impact of delayed diagnosis time in estimating progression rates to hepatitis C virus-related cirrhosis and death.

    Science.gov (United States)

    Fu, Bo; Wang, Wenbin; Shi, Xin

    2015-12-01

    Delay of the diagnosis of hepatitis C virus (HCV), and its treatment to avert cirrhosis, is often present sincethe early stage of HCV progression is latent. Current methods to determine the incubation time to HCV-related cirrhosis and the duration time from cirrhosis to subsequent events (e.g. complications or death) used to be based on the time of liver biopsy diagnosis and ignore this delay which led to an interval censoring for the first event time and a double censoring for the subsequent event time. To investigate the impact of this delay in estimating HCV progression rates and relevant estimating bias, we present a correlated two-stage progression model for delayed diagnosis time and fit the developed model to the previously studied hepatitis C cohort data from Edinburgh. Our analysis shows that taking the delayed diagnosis into account gives a mildly different estimate of progression rate to cirrhosis and significantly lower estimated progression rate to HCV-related death in comparison with conventional modelling. We also find that when the delay increases, the bias in estimating progression increases significantly.

  4. Reliability of the interval death rate analysis for estimating the time course of the motoneurone afterhyperpolarization in humans.

    Science.gov (United States)

    MacDonell, Christopher William; Ivanova, Tanya Dimitrova; Garland, S Jayne

    2007-05-15

    The reliability of the afterhyperpolarization (AHP) time course, as estimated by the interval death rate (IDR) analysis was evaluated both within and between investigators. The IDR analysis uses the firing history of a single motor unit train at low tonic firing rates to calculate an estimate of the AHP time course [Matthews PB. Relationship of firing intervals of human motor units to the trajectory of post-spike after-hyperpolarization and synaptic noise. J Physiol 1996;492:597-628]. Single motor unit trains were collected from the tibialis anterior (TA) to determine intra-rater reliability (within investigator). Data from the first dorsal interosseus (FDI), collected in a previous investigation [Gossen ER, Ivanova TD, Garland SJ. The time course of the motoneurone afterhyperpolarization is related to motor unit twitch speed in human skeletal muscle. J Physiol 2003;552:657-64], were used to examine the inter-rater reliability (between investigators). The lead author was blinded to the original time constants and file identities for the re-analysis. The intra-rater reliability of the AHP time constant in the TA data was high (r(2)=0.88; pFDI data was also strong (r(2)=0.92; pFDI. It is concluded that the interval death rate analysis is a reliable tool for estimating the AHP time course with experienced investigators.

  5. Debris-flow deposits and watershed erosion rates near southern Death Valley, CA, United States

    Science.gov (United States)

    Schmidt, K.M.; Menges, C.M.; ,

    2003-01-01

    Debris flows from the steep, granitic hillslopes of the Kingston Range, CA are commensurate in age with nearby fluvial deposits. Quaternary chronostratigraphic differentiation of debris-flow deposits is based upon time-dependent characteristics such as relative boulder strength, derived from Schmidt Hammer measurements, degree of surface desert varnish, pedogenesis, and vertical separation. Rock strength is highest for Holocene-aged boulders and decreases for Pleistocene-aged boulders weathering to grus. Volumes of age-stratified debris-flow deposits, constrained by deposit thickness above bedrock, GPS surveys, and geologic mapping, are greatest for Pleistocene deposits. Shallow landslide susceptibility, derived from a topographically based GIS model, in conjunction with deposit volumes produces watershed-scale erosion rates of ???2-47 mm ka-1, with time-averaged Holocene rates exceeding Pleistocene rates. ?? 2003 Millpress.

  6. 1:4 matched case-control study on influential factor of early onset neonatal sepsis.

    Science.gov (United States)

    Jiang, Z; Ye, G-Y

    2013-09-01

    Bacteria, funghi, viruses and protozoa can lead to neonatal sepsis. Neonatal sepsis is the leading cause of infectious disease onset and death in many neonates. To explore the major risk factors of early-onset neonatal sepsis and provide a scientific basis for strategies of early-onset neonatal sepsis prevention. A 1:4 matched case-control study was adopted and 147 cases of early-onset neonatal sepsis were enrolled. Conditional logistic regression model was used to analyze the univariate and multivariate data to estimate the odds ratio (OR) and the 95% confidence interval (95% CI). Univariate analysis shows that the impact factors on the occurrence of early-onset neonatal sepsis include the following: Maternal age > 35, mother having fixed occupation, mother of urban residence, abnormal fetal position, fetal times, parity, caesarean section, premature rupture of membranes, amniotic fluid volume abnormalities, pregnancy-induced hypertension, placental abnormalities, fetal distress, newborn gender, low birth weight infants, neonatal Apgar scoring at one and five minutes, neonatal jaundice, wet lung, anemia, IVH, and premature infant. Multivariate logistic regression analysis showed that maternal age > 35 (OR = 4.835, OR 95% CI = 1.170-19.981), cesarean section (OR = 0.103, OR 95% CI = 0.041-0.258), premature rupture of membranes (OR = 0.207, OR 95% CI = 0.078-0.547), premature infants (OR = 0.059, OR 95% CI = 0.010-0.329) and newborn jaundice (OR = 0.092, OR 95% CI = 0.021-0.404) were the factors of early-onset neonatal sepsis. Early-onset neonatal sepsis could be affected by multi-factors, and targeted prevention may reduce the incidence of early-onset neonatal sepsis rates.

  7. 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.

  8. Neonatal resuscitation technique to reduce neonatal asphyxia rate and mortality rate in China:a Meta-analysis%复苏技术降低我国新生儿窒息发生率和死亡率的 Meta分析

    Institute of Scientific and Technical Information of China (English)

    李鸿斌; 顾建明; 冯海娟; 沈莉

    2015-01-01

    目的:评价新生儿复苏技术对我国新生儿窒息发生率和死亡率下降的效果。方法检索万方数据库、知网数据库资料,收集有关新生儿复苏项目现状与效果的相关文献,并根据纳入标准及排除标准筛选文献,采用非随机前后对照试验的二分类数据Meta分析法判断复苏实施效果。结果最终纳入文献3篇。 Meta分析结果显示,项目地区推广应用新生儿复苏技术促进了新生儿窒息发生率和死亡率的下降,新生儿窒息发生率降低46%,RR=0.54,95%CI:0.33~0.91,P=0.02;新生儿窒息死亡率降低45%,RR=0.55,95%CI:0.35~0.86,P=0.009。结论新生儿复苏技术有助于降低新生儿窒息发生率和死亡率,建议向农村、基层医院普及推广。%Objective To evaluate the effect of neonatal resuscitation technique on reducing the neonatal asphyxia rate and mortality in China.Methods Wanfang data and CNKI-CAJD were retrieved to collect the literatures of neonatal resuscitation, and they were screened according to inclusion criteria and exclusion criteria.Meta-analysis of two-category data of non-randomized control study was conducted to evaluate the effect of neonatal resuscitation technique.Results Finally three articles were recruited.Meta-analysis showed that neonatal resuscitation technique applied in program areas reduced the neonatal asphyxia rate and mortality.The neonatal asphyxia rate decreased by 46%(RR=0.54,95%CI:0.33-0.91,P=0.02), and the mortality rate decreased by 45% (RR=0.55,95%CI:0.35-0.86, P=0.009) .Conclusion Neonatal resuscitation technique helps to reduce neonatal asphyxia rate and mortality, so it is suggested to be promoted in countryside and basic-level hospitals.

  9. Effect of marital status on death rates. Part 1: High accuracy exploration of the Farr-Bertillon effect

    CERN Document Server

    Richmond, Peter

    2015-01-01

    The Farr-Bertillon law says that for all age-groups the death rate of married people is lower than the death rate of people who are not married (i.e. single, widowed or divorced). Although this law has been known for over 150 years, it has never been established with great accuracy. This even let some authors argue that it was a statistical artefact. It is true that the data must be selected and analyzed with great care, especially for age groups of small size such as widowers under 25. The observations reported in this paper were selected and designed in the same way as experiments in physics, that is to say with the objective of minimizing the error bars for all age-groups. It will be seen that data appropriate for mid-age groups may be unsuitable for young age groups and vice versa. The investigation led to the following results. (1) The FB effect is basically the same for men and women, except that on average it is about 20\\% stronger for men. (2) There is a marked difference between single or divorced pe...

  10. Human actuarial aging increases faster when background death rates are lower: a consequence of differential heterogeneity?

    Science.gov (United States)

    Hawkes, Kristen; Smith, Ken R; Blevins, James K

    2012-01-01

    Many analyses of human populations have found that age-specific mortality rates increase faster across most of adulthood when overall mortality levels decline. This contradicts the relationship often expected from Williams' classic hypothesis about the effects of natural selection on the evolution of senescence. More likely, much of the within-species difference in actuarial aging is not due to variation in senescence, but to the strength of filters on the heterogeneity of frailty in older survivors. A challenge to this differential frailty hypothesis was recently posed by an analysis of life tables from historical European populations and traditional societies that reported variation in actuarial aging consistent with Williams' hypothesis after all. To investigate the challenge, we reconsidered those cases and aging measures. Here we show that the discrepancy depends on Ricklefs' aging rate measure, ω, which decreases as mortality levels drop because it is an index of mortality level itself, not the rate of increase in mortality with age. We also show unappreciated correspondence among the parameters of Gompertz-Makeham and Weibull survival models. Finally, we compare the relationships among mortality parameters of the traditional societies and the historical series, providing further suggestive evidence that differential heterogeneity has strong effects on actuarial aging.

  11. Centenarian Rates and Life Expectancy Related to the Death Rates of Multiple Sclerosis, Asthma, and Rheumatoid Arthritis and the Incidence of Type 1 Diabetes in Children.

    Science.gov (United States)

    Lens-Pechakova, Lilia S

    2016-02-01

    The autoimmune diseases are among the 10 leading causes of death for women and the number two cause of chronic illness in America as well as a predisposing factor for cardiovascular diseases and cancer. Patients of some autoimmune diseases have shown a shorter life span and are a model of accelerated immunosenescence. Conversely, centenarians are used as a model of successful aging and have shown several immune parameters that are better preserved and lower levels of autoantibodies. The study reported here focused on clarifying the connection between longevity and some autoimmune and allergic diseases in 29 developed Organisation for Economic Co-operation and Development (OECD) countries, because multidisciplinary analyses of the accelerated or delayed aging data could show a distinct relationship pattern, help to identify common factors, and determine new important factors that contribute to longevity and healthy aging. The relationships between the mortality rates data of multiple sclerosis (MS), rheumatoid arthritis (RA), asthma, the incidence of type 1 diabetes (T1D) from one side and centenarian rates (two sets) as well as life expectancy data from the other side were assessed using regression models and Pearson correlation coefficients. The data obtained correspond to an inverse linear correlation with different degrees of linearity. This is the first observation of a clear tendency of diminishing centenarian rates or life expectancy in countries having higher death rates of asthma, MS, and RA and a higher incidence of T1D in children. The conclusion is that most probably there are common mechanistic pathways and factors affecting the above diseases and at the same time but in the opposite direction the processes of longevity. Further study, comparing genetic data, mechanistic pathways, and other factors connected to autoimmune diseases with those of longevity could clarify the processes involved, so as to promote longevity and limit the expansion of those

  12. PROFIL KEMATIAN NEONATAL BERDASARKAN SOSIO DEMOGRAFI DAN KONDISI IBU SAAT HAMIL DI INDONESIA

    Directory of Open Access Journals (Sweden)

    Raharni Raharni

    2012-11-01

    Full Text Available Background: Neonatal mortality is the death of an infant who is born alive within 7 days after birth (early neonatal mortality/perinatal, and the death of a baby born alive more than 7 days until approximately 29 days (advanced neonatal mortality. Neonatal deaths (infants aged 28 days is two thirds of infant mortality, whereas early neonatal mortality/perinatal (infant age of 7 days is two thirds of neonatal deaths. The purpose of this study was to determine neonatal mortality profiles based on socio demografic and the mother condition during pregnancy, and the data based on Riskesdas 2010. Methods: This study used cross sectional design, using data Riskesdas 2010. Result: From the analysis obtained the following results, 144 out of 163 neonatal deaths (88,6% were the early neonatal deaths (7 days of birth, the remain at 11.45% were advanced neonatal mortality. Most of neonatal deaths occur in fertil maternal age at delivery was mature enough that age group 18-34 years, but mostly with low and medium level of education that is 53% and 43% respectively. Mostly neonatal deaths occur when 2 continous birth delivery happens less than 12 months, total number is 100 (61 3%. Percentage of neonatal mortality is equal between working mothers and non working mothers. From the baby's weight with weight < 2500 grams and > 2500 grams, the percentage is nearly equal at 27-29%. Conclusion: The body weight most neonatal deaths were unknown was no significant difference between early neonatal and late neonatal. There demographic information according to both maternal, infant characteristics, or economic status. It is expected the results of this reseach can be used as reference related neonatal mortality profile and as an input in policy to improve the mother health during maternity and birth delivery and also to reduce the risk of neonatal death.   Keywords: early neonatal mortality/perinatal, neonatal mortality, pregnancy

  13. 极低出生体重儿早期死亡的围生期危险因素分析%Analysis of perinatal risk factors for early neonatal death among very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    李月凤; 周平; 吴香兰; 陈睿; 卢光进

    2012-01-01

    [Objective] To investigate the relationship between perinatal risk factors and early neonatal death among very low birth weight (VLBW) infants. [Methods] A retrospective cohort of 143 VLBW infants admitted to NICU was studied. The dependent variable was the outcome, either survival or death at 7 days of life. The independent variables were assigned into three levels: distal, intermediate and proximal according to hierarchical model. All variables were subjected to univariate analysis and multivariate logistic regression. [Results] Early neonatal mortality was 13. 29% (19/143) in VLBW infants. After the adjustment of variables through multivariate Logistic regression it showed that infants born to mother with cord prolapse had higher risk exposure for early death than those of mother without cord prolapse in the distal level (AOR:8. 69;95%C/:1. 128~67. 002). At the intermediate level,infants with gestational age (GAX28 weeks and 5-min Apgar scores<7 had higher odds of early death than those of GA≥28 weeks and 5-min Apgar scores≥7 (AOR: 11. 47, 13. 55;95%CJ:2. 066~63. 712,3. 156 - 58. 221 respectively). At the proximal level, infants with intracranial hemorrhage (ICH) had higher risk of early death than those without ICH (AORS4. 56,95%C7:1. 088 - 19. 170). [Conclusions] The early neonatal mortality among VLBW infants is still high and continues to be a significant public health problem. Asphyxia at birth is the highest risk factor of early neonatal death. Reducing birth asphyxia through enhancing obstetric quality and strengthening cooperation between obstetric and neonatology department is still the key to decrease early neonatal death of VLBW infants.%[目的]探讨极低出生体重(very low birth weight,VLBW)儿早期死亡的围生期高危因素. [方法]选取在本院新生儿科住院的143例VLBW儿为研究对象.生后7d的结果:生存或死亡作为应变量,根据分层分析模型将围产期高危因素(自变量)分为远端、中间和近端3

  14. Global neonatal and perinatal mortality: a review and case study for the Loreto Province of Peru

    Directory of Open Access Journals (Sweden)

    Warren JB

    2012-10-01

    Full Text Available Jamie B Warren,1 William E Lambert,2 Rongwei Fu,2 JoDee M Anderson,1 Alison B Edelman31Department of Pediatrics, 2Department of Public Health and Preventive Medicine, 3Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USABackground: Millennium Development Goal 4 calls for the reduction of the under-five mortality rate by two-thirds between 1990 and 2015. To reach this goal, neonatal mortality must be decreased. The lack of information on global neonatal and perinatal mortality impedes appropriate implementation of interventions, as vital registration systems are not available for the majority of the world's neonatal deaths. Verbal autopsy (VA is a tool that has been used to determine cause of death. Recent studies have attempted to standardize and validate the use of this tool in resource-limited areas. The World Health Organization (WHO International Standard VA Questionnaire was used to conduct a needs assessment in nine rural Peruvian villages. The goal was to determine the neonatal mortality rate (NMR, perinatal mortality rate (PMR, and causes of, and risk factors for, death in these villages.Methods: Eligible women were interviewed using the WHO International Standard VA Questionnaire or a set of questions based on the WHO VA Questionnaire. NMR and PMR were calculated using a generalized estimating equation model. Three neonatologists independently reviewed VA records to provide cause of death determination. Reviewer agreement was assessed using percent agreement. Fisher's exact test was used to determine risk factors associated with death.Results: The NMR was 31.4 per 1000 live births and the PMR was 49.7 per 1000 pregnancies. The main contributor to neonatal death was infection (43%. Percent agreement among reviewers was 90.5% and 38.9% for cause of neonatal death and stillbirth, respectively. Risk factors for death were pregnancy with twins (P = 0.001, preterm delivery (P = 0.003, and cesarean

  15. Taking advantage: high-affinity B cells in the germinal center have lower death rates, but similar rates of division, compared to low-affinity cells.

    Science.gov (United States)

    Anderson, Shannon M; Khalil, Ashraf; Uduman, Mohamed; Hershberg, Uri; Louzoun, Yoram; Haberman, Ann M; Kleinstein, Steven H; Shlomchik, Mark J

    2009-12-01

    B lymphocytes producing high-affinity Abs are critical for protection from extracellular pathogens, such as bacteria and parasites. The process by which high-affinity B cells are selected during the immune response has never been elucidated. Although it has been shown that high-affinity cells directly outcompete low-affinity cells in the germinal center (GC), whether there are also intrinsic differences between these cells has not been addressed. It could be that higher affinity cells proliferate more rapidly or are more likely to enter cell cycle, thereby outgrowing lower affinity cells. Alternatively, higher affinity cells could be relatively more resistant to cell death in the GC. By comparing high- and low-affinity B cells for the same Ag, we show here that low-affinity cells have an intrinsically higher death rate than do cells of higher affinity, even in the absence of competition. This suggests that selection in the GC reaction is due at least in part to the control of survival of higher affinity B cells and not by a proliferative advantage conferred upon these cells compared with lower affinity B cells. Control over survival rather than proliferation of low- and high-affinity B cells in the GC allows greater diversity not only in the primary response but also in the memory response.

  16. Diabetes Mellitus is Associated with Increased Death Rates Among HIV-Infected Patients in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Moreira, Rodrigo C; Pacheco, Antonio G; Paula, Adelzon; Cardoso, Sandra W; Moreira, Ronaldo I; Ribeiro, Sayonara R; Nunes, Estevão P; Guimarães, Maria R; Mello, Fernanda C; Veloso, Valdilea G; Grinsztejn, Beatriz

    2016-12-01

    Diabetes mellitus (DM) is a major cause of morbidity worldwide and a known factor leading to increased risk of death, especially in conjunction with other risk factors. In this study, we evaluated the prevalence of DM among HIV-infected patients and its association with overall mortality. All HIV-infected patients 18 years or older who were followed in the Instituto Nacional de Infectologia Evandro Chagas (INI) cohort from January 1991 to December 2011 were included. Time-updated covariables included DM status, calendar year, combination antiretroviral therapy (cART), and CD4 cell counts. Fixed demographic covariables included gender and age at entry. Poisson models were used to calculate mortality rate ratios (RR) with robust variances. Among the 4,871 patients included, 1,192 (24.4%) died (mortality rate = 4.72/100 person-years [PY]; 95% confidence interval [CI] = 4.46-5.00). Death rates were significantly higher among those presenting with DM compared with those who did not (6.16/100 vs. 4.61/100 PY, respectively. p = 0.001). In the final model, DM was significantly associated with mortality (RR = 1.74; 95% CI = 1.57-1.94; p < 0.001). When the analysis was restricted to those on cART or the period post-1996, the association between DM and mortality was even stronger (RR = 2.17; 95% CI = 1.91-2.46; p < 0.001 and RR = 1.95; 95% CI = 1.75-2.18; p < 0.001, respectively). Among the major groups of cause of deaths (CODs), the proportion of AIDS-related conditions in patients with DM was lower (74.27% vs. 58.93%, respectively; p < 0.001); whereas in non-AIDS-related conditions, nonimmunodeficiency-related causes (22.44% vs. 34.82%, respectively; p = 0.004) were more common in patients with DM. In conclusion, DM was associated with increased mortality rates even after controlling for HIV-related variables associated to this outcome. Differences in the underlying CODs were identified, reinforcing the necessity to

  17. Breast cancer survival rate according to data of cancer registry and death registry systems in Bushehr province, 2001-2013

    Directory of Open Access Journals (Sweden)

    Zahra Rampisheh

    2015-09-01

    Full Text Available Background: Breast cancer is the most common female cancer worldwide. Survival rate of breast cancer, especially as an indicator of the successful implementation of screening, diagnosis and treatment programs, has been at the center of attention of public health experts Material and Methods: In a survival study, the records of breast cancer cases in cancer registry system of Bushehr Province were extracted during 2001, March to 2013, September. These records were linked and matched with records of death registry system. After determining patients, status regarding being alive or dead, survival analysis was done. Life table, Kaplan-Mayer analysis, log rank and Breslow tests were used for computing and comparing survival rates. Results: In 300 recorded breast cancer cases, mean and standard deviation of age was 51.26±13.87. Survival rates were 95, 88, 78, 73 and 68 percent since the first year through the fifth year, respectively. Mean survival was 87.20 months (95% CI= 81.28- 93.12. There was no significant difference in mean survival regarding age and different geographical areas. Conclusion: Although survival rates of registered breast cancer patients in Bushehr Province are similar to other provinces, they are far from those of developed countries. This situation demands more extensive efforts regarding public education and improving the process of diagnosis, treatment and care of patients especially during first two years after diagnosis.

  18. Heart rate and blood pressure in sudden unexpected death in epilepsy (SUDEP).

    Science.gov (United States)

    Nei, Maromi; Mintzer, Scott; Skidmore, Christopher; Sperling, Michael R; Ho, Reginald T

    2016-05-01

    Epilepsy is associated with interictal and ictal autonomic dysfunction. Seizures can immediately cause increases in blood pressure (BP) and heart rate (HR). However, it is unknown whether uncontrolled seizures, particularly when frequent, might chronically elevate the BP or HR. Additionally, it is unknown whether the interictal BP and HR is altered in individuals who are at risk for SUDEP, compared with other individuals with epilepsy. SUDEP often occurs in patients with highly refractory epilepsy. Such individuals might be at risk for a state of chronically heightened sympathetic tone, which might affect the HR and BP interictally. This study compared the resting awake interictal HR and BP in individuals who subsequently died due to SUDEP and compared these to HR and BP in two control epilepsy groups (refractory and controlled). While the overall HR and BP are similar between groups, there is a trend toward a higher diastolic BP and more stable HR in individuals who subsequently died due to SUDEP, compared with epilepsy controls. These data suggest that there may be specific types of interictal autonomic dysfunction in individuals at risk for SUDEP. Such abnormalities might serve as markers for those at elevated risk for SUDEP.

  19. Widening educational disparities in premature death rates in twenty six states in the United States, 1993-2007.

    Directory of Open Access Journals (Sweden)

    Jiemin Ma

    Full Text Available BACKGROUND: Eliminating socioeconomic disparities in health is an overarching goal of the U.S. Healthy People decennial initiatives. We present recent trends in mortality by education among working-aged populations. METHODS AND FINDINGS: Age-standardized death rates and their average annual percent change for all-cause and five major causes (cancer, heart disease, stroke, diabetes, and accidents were calculated from 1993 through 2007 for individuals aged 25-64 years by educational attainment as a marker of socioeconomic status, using national vital registration data for 26 states with consistent educational information on the death certificates. Rate ratios and rate differences were used to assess disparities (≤12 versus ≥16 years of education for 1993 through 2007. From 1993 through 2007, relative educational disparities in all-cause mortality continued to increase among working-aged men and women in the U.S., due to larger decreases of mortality rates among the most educated coupled with smaller decreases or even worsening trends in the less educated. For example, the rate ratios of all-cause mortality increased from 2.5 (95% confidence interval (CI, 2.4-2.6 in 1993 to 3.6 (95% CI, 3.5-3.7 in 2007 in men and from 1.9 (95% CI, 1.8-2.0 to 3.0 (95% CI, 2.9-3.1 in women. Generally, the rate differences (per 100,000 persons of all-cause mortality increased from 415.5 (95% CI, 399.1-431.9 in 1993 to 472.7 (95% CI, 460.2-485.2 in 2007 in men and from 165.4 (95% CI, 154.5-176.2 to 256.2 (95% CI, 248.3-264.2 in women. Disparity patterns varied largely across the five specific causes considered in this study, with the largest increases of relative disparities for accidents, especially in women. CONCLUSIONS: Relative educational differentials in mortality continued to widen among men and women despite emphasis on reducing disparities in the U.S. Healthy People decennial initiatives.

  20. Widening educational disparities in premature death rates in twenty six states in the United States, 1993-2007.

    Science.gov (United States)

    Ma, Jiemin; Xu, Jiaquan; Anderson, Robert N; Jemal, Ahmedin

    2012-01-01

    Eliminating socioeconomic disparities in health is an overarching goal of the U.S. Healthy People decennial initiatives. We present recent trends in mortality by education among working-aged populations. Age-standardized death rates and their average annual percent change for all-cause and five major causes (cancer, heart disease, stroke, diabetes, and accidents) were calculated from 1993 through 2007 for individuals aged 25-64 years by educational attainment as a marker of socioeconomic status, using national vital registration data for 26 states with consistent educational information on the death certificates. Rate ratios and rate differences were used to assess disparities (≤12 versus ≥16 years of education) for 1993 through 2007. From 1993 through 2007, relative educational disparities in all-cause mortality continued to increase among working-aged men and women in the U.S., due to larger decreases of mortality rates among the most educated coupled with smaller decreases or even worsening trends in the less educated. For example, the rate ratios of all-cause mortality increased from 2.5 (95% confidence interval (CI), 2.4-2.6) in 1993 to 3.6 (95% CI, 3.5-3.7) in 2007 in men and from 1.9 (95% CI, 1.8-2.0) to 3.0 (95% CI, 2.9-3.1) in women. Generally, the rate differences (per 100,000 persons) of all-cause mortality increased from 415.5 (95% CI, 399.1-431.9) in 1993 to 472.7 (95% CI, 460.2-485.2) in 2007 in men and from 165.4 (95% CI, 154.5-176.2) to 256.2 (95% CI, 248.3-264.2) in women. Disparity patterns varied largely across the five specific causes considered in this study, with the largest increases of relative disparities for accidents, especially in women. Relative educational differentials in mortality continued to widen among men and women despite emphasis on reducing disparities in the U.S. Healthy People decennial initiatives.

  1. Factors associated with inter-institutional variations in sepsis rates of very-low-birth-weight infants in 34 Malaysian neonatal intensive care units.

    Science.gov (United States)

    Boo, Nem-Yun; Cheah, Irene Guat-Sim

    2016-03-01

    This study aimed to determine whether patient loads, infant status on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis rates in very-low-birth-weight (VLBW) infants in the Malaysian National Neonatal Registry (MNNR). This was a retrospective study of 3,880 VLBW (≤ 1,500 g) infants admitted to 34 neonatal intensive care units (NICUs) in the MNNR. Sepsis was diagnosed in symptomatic infants with positive blood culture. Sepsis developed in 623 (16.1%) infants; 61 (9.8%) had early-onset sepsis (EOS) and 562 (90.2%) had late-onset sepsis (LOS). The median EOS rate of all NICUs was 1.0% (interquartile range [IQR] 0%, 2.0%). Compared with NICUs reporting no EOS (n = 14), NICUs reporting EOS (n = 20) had significantly higher patient loads (total live births, admissions, VLBW infants, outborns); more mothers with a history of abortions, and antenatal steroids and intrapartum antibiotic use; more infants requiring resuscitation procedures at birth; higher rates of surfactant therapy, pneumonia and insertion of central venous catheters. The median LOS rate of all NICUs was 14.5% (IQR 7.8%, 19.2%). Compared with NICUs with LOS rates below the first quartile (n = 8), those above the third quartile (n = 8) used less intrapartum antibiotics, and had significantly bigger and more mature infants, more outborns, as well as a higher number of sick infants requiring ventilator support and total parenteral nutrition. Patient loads, resuscitation at birth, status of infants on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis. Copyright: © Singapore Medical Association.

  2. Regulation of muscle growth in neonates

    Science.gov (United States)

    This review reports recent findings on the multiple factors that regulate skeletal muscle growth in neonates. Skeletal muscle is the fastest growing protein mass in neonates. The high rate of neonatal muscle growth is due to accelerated rates of protein synthesis accompanied by the rapid accumulatio...

  3. Pattern and Management Outcomes of Neonatal Acute Surgical ...

    African Journals Online (AJOL)

    Hp 630 Dual Core

    Key words: Neonates, Acute surgical conditions, Management, Outcomes. Introduction ... undergoing surgery should live and therefore effective and close interdisciplinary collaboration ..... anaesthesia and surgical stress leading to death 13.

  4. Neonatal mortality in intensive care units of Central Brazil Mortalidade neonatal em unidades de cuidados intensivos no Brasil Central

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    Claci F Weirich

    2005-10-01

    Full Text Available OBJECTIVE: To identify potential prognostic factors for neonatal mortality among newborns referred to intensive care units. METHODS: A live-birth cohort study was carried out in Goiânia, Central Brazil, from November 1999 to October 2000. Linked birth and infant death certificates were used to ascertain the cohort of live born infants. An additional active surveillance system of neonatal-based mortality was implemented. Exposure variables were collected from birth and death certificates. The outcome was survivors (n=713 and deaths (n=162 in all intensive care units in the study period. Cox's proportional hazards model was applied and a Receiver Operating Characteristic curve was used to compare the performance of statistically significant variables in the multivariable model. Adjusted mortality rates by birth weight and 5-min Apgar score were calculated for each intensive care unit. RESULTS: Low birth weight and 5-min Apgar score remained independently associated to death. Birth weight equal to 2,500g had 0.71 accuracy (95% CI: 0.65-0.77 for predicting neonatal death (sensitivity =72.2%. A wide variation in the mortality rates was found among intensive care units (9.5-48.1% and two of them remained with significant high mortality rates even after adjusting for birth weight and 5-min Apgar score. CONCLUSIONS: This study corroborates birth weight as a sensitive screening variable in surveillance programs for neonatal death and also to target intensive care units with high mortality rates for implementing preventive actions and interventions during the delivery period.OBJETIVO: Identificar fatores prognósticos de mortalidade neonatal em unidades de cuidados intensivos. MÉTODOS: Realizou-se estudo de coorte de nascidos vivos do município de Goiânia, no período de novembro de 1999 a outubro de 2000. Procedeu-se à vinculação das bases de dados das declarações de nascidos vivos e de óbitos, das quais as variáveis de exposição foram extra

  5. Correction of Neonatal Hypovolemia

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    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. 

  6. Neonatal anemia.

    Science.gov (United States)

    Aher, Sanjay; Malwatkar, Kedar; Kadam, Sandeep

    2008-08-01

    Neonatal anemia and the need for red blood cell (RBC) transfusions are very common in neonatal intensive care units. Neonatal anemia can be due to blood loss, decreased RBC production, or increased destruction of erythrocytes. Physiologic anemia of the newborn and anemia of prematurity are the two most common causes of anemia in neonates. Phlebotomy losses result in much of the anemia seen in extremely low birthweight infants (ELBW). Accepting a lower threshold level for transfusion in ELBW infants can prevent these infants being exposed to multiple donors.

  7. Maternal haemoglobin and short-term neonatal outcome in preterm neonates.

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    Elodie Savajols

    Full Text Available OBJECTIVE: To determine whether there is a significant association between maternal haemoglobin measured before delivery and short-term neonatal outcome in very preterm neonates. STUDY DESIGN: 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. RESULTS: 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. CONCLUSION: 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.

  8. Anorectal malformations in neonates

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    Bilal Mirza

    2011-01-01

    Full Text Available Background : Anorectal malformations (ARM are associated with congenital anomalies and other risk factors, yielding a poor prognosis, especially in neonatal life. Objectives: This study was performed to identify the congenital anomalies as a factor of poor prognosis (mortality in such patients. Settings: Department of Pediatric surgery, The Children′s Hospital and The Institute of Child Health, Lahore. Design: Prospective observational study, with statistical support. Materials and Methods: The information on the demography, clinical features, investigations, management performed, and outcome was entered in the designed proforma and analysed with the help of statistical software EpiInfo version 3.5.1. Statistical test: Chi-square test was used to determine statistical significance of the results. Results : Of 100 neonates with ARM, 77 were male and 23, female (3.4:1. The mean age at presentation was 3.4 days (range, 12 hrs to 28 days. In 60 patients (60%, the presentation was imperforate anus without a clinically identified fistula. In 28 patients (28%, associated anomalies were present. The common associated anomalies were urogenital (10%, cardiovascular (8%, and gastrointestinal (6%. Down′s syndrome was present in 8 (8% patients. A total of 15 (15% deaths occurred in this study. In patients having associated congenital anomalies, 11 deaths occurred, whereas, 4 deaths were in patients without associated anomalies (P < 0.5. Conclusion : The mortality is higher in neonates with ARM having associated congenital anomalies.

  9. Relationship between leukotriene-modifying agent prescriptions dispensed and rate of suicide deaths by county in the US

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    Schumock GT

    2011-09-01

    Full Text Available Glen T Schumock1, Robert D Gibbons2, Todd A Lee1,3,4,6, Min J Joo4, Robert J Valuck5, Leslie T Stayner61Center for Pharmacoeconomic Research, and Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA; 2Center for Health Statistics, and Departments of Medicine and Health Studies, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA; 3Center for Management of Complex Chronic Care, Hines VA Hospital, Hines, IL, USA; 4Section of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA; 5Department of Clinical Pharmacy, School of Pharmacy, University of Colorado, Aurora, CO, USA; 6Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USABackground: The US Food and Drug Administration has issued warnings about a potential link between leukotriene receptor-modifying agents (LTMA and suicide. These warnings are based on case reports and there is controversy about the association. While spontaneous reporting of suicide-related events attributed to LTMA has risen dramatically, these data may be biased by the warnings. The objective of this study was to explore the relationship between LTMA and suicide deaths using event data preceding the Food and Drug Administration warnings.Methods: We conducted a mixed-effects Poisson regression analysis of the association between LTMA prescriptions dispensed and suicide deaths at the county level. Counts of suicide deaths in each US county, stratified by race, age group, gender, and year were obtained from the National Center for Health Statistics for the period January 1, 1999 to December 31, 2006. Counts of LTMA prescriptions dispensed in each US county were obtained from IMS Health Incorporated. The model estimated the overall suicide rate conditional on LTMA use, adjusted for age, gender, race, year

  10. Ethical issues in neonatal intensive care

    OpenAIRE

    Marcello M. Orzalesi; Marina Cuttini

    2011-01-01

    Recent progress in neonatal care have significantly improved the prognosis and chances of survival of critically ill or extremely preterm neonates and have modified the limits of viability. However, in some circumstances, when the child's death can only be briefly postponed at the price of severe suffering, or when survival is associated with severe disabilities and an intolerable life for the child and his/her parents, the application of the full armamentarium of modern neonatal intensive ca...

  11. Neonatal intestinal obstruction in Benin, Nigeria

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    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.

  12. Rapid diagnosis and treatment of TIA results in low rates of stroke, myocardial infarction and vascular death.

    Science.gov (United States)

    Cocho, D; Monell, J; Planells, G; Ricciardi, A C; Pons, J; Boltes, A; Espinosa, J; Ayats, M; Garcia, N; Otermin, P

    2016-01-01

    The 90-day risk of cerebral infarction in patients with transient ischaemic attack (TIA) is estimated at between 8% and 20%. There is little consensus as to which diagnostic strategy is most effective. This study evaluates the benefits of early transthoracic echocardiography (TTE) with carotid and transcranial Doppler ultrasound in patients with TIA. Prospective study of patients with TIA in an emergency department setting. Demographic data, vascular risk factors, and ABCD(2) score were analysed. TIA aetiology was classified according to TOAST criteria. All patients underwent early vascular studies (<72hours), including TTE, carotid ultrasound, and transcranial Doppler. Primary endpoints were recurrence of stroke or TIA, myocardial infarction (MI), or vascular death during the first year. We evaluated 92 patients enrolled over 24 months. Mean age was 68.3±13 years and 61% were male. The mean ABCD(2) score was 3 points (≥5 in 30%). The distribution of TIA subtypes was as follows: 12% large-artery atherosclerosis; 30% cardioembolism; 10% small-vessel occlusion; 40% undetermined cause; and 8% rare causes. Findings from the early TTE led to a change in treatment strategy in 6 patients (6.5%) who displayed normal physical examination and ECG findings. At one year of follow-up, 3 patients had experienced stroke (3.2%) and 1 patient experienced MI (1%); no vascular deaths were identified. In our TIA patients, early vascular study and detecting patients with silent cardiomyopathy may have contributed to the low rate of vascular disease recurrence. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  13. A Neonatal Resuscitation Curriculum in Malawi, Africa: Did It Change In-Hospital Mortality?

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    Michael K. Hole

    2012-01-01

    Full Text Available Objective. The WHO estimates that 99% of the 3.8 million neonatal deaths occur in developing countries. Neonatal resuscitation training was implemented in Namitete, Malawi. The study's objective was to evaluate the training's impact on hospital staff and neonatal mortality rates. Study Design. Pre-/postcurricular surveys of trainee attitude, knowledge, and skills were analyzed. An observational, longitudinal study of secondary data assessed neonatal mortality. Result. All trainees' (n=18 outcomes improved, (P=0.02. Neonatal mortality did not change. There were 3449 births preintervention, 3515 postintervention. Neonatal mortality was 20.9 deaths per 1000 live births preintervention and 21.9/1000 postintervention, (P=0.86. Conclusion. Short-term pre-/postintervention evaluations frequently reveal positive results, as ours did. Short-term pre- and postintervention evaluations should be interpreted cautiously. Whenever possible, clinical outcomes such as in-hospital mortality should be additionally assessed. More rigorous evaluation strategies should be applied to training programs requiring longitudinal relationships with international community partners.

  14. Optimizing Detection Rate and Characterization of Subtle Paroxysmal Neonatal Abnormal Facial Movements with Multi-Camera Video-Electroencephalogram Recordings.

    Science.gov (United States)

    Pisani, Francesco; Pavlidis, Elena; Cattani, Luca; Ferrari, Gianluigi; Raheli, Riccardo; Spagnoli, Carlotta

    2016-06-01

    Objectives We retrospectively analyze the diagnostic accuracy for paroxysmal abnormal facial movements, comparing one camera versus multi-camera approach. Background Polygraphic video-electroencephalogram (vEEG) recording is the current gold standard for brain monitoring in high-risk newborns, especially when neonatal seizures are suspected. One camera synchronized with the EEG is commonly used. Methods Since mid-June 2012, we have started using multiple cameras, one of which point toward newborns' faces. We evaluated vEEGs recorded in newborns in the study period between mid-June 2012 and the end of September 2014 and compared, for each recording, the diagnostic accuracies obtained with one-camera and multi-camera approaches. Results We recorded 147 vEEGs from 87 newborns and found 73 episodes of paroxysmal facial abnormal movements in 18 vEEGs of 11 newborns with the multi-camera approach. By using the single-camera approach, only 28.8% of these events were identified (21/73). Ten positive vEEGs with multicamera with 52 paroxysmal facial abnormal movements (52/73, 71.2%) would have been considered as negative with the single-camera approach. Conclusions The use of one additional facial camera can significantly increase the diagnostic accuracy of vEEGs in the detection of paroxysmal abnormal facial movements in the newborns.

  15. Neonatal renal vein thrombosis.

    Science.gov (United States)

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K

    2011-12-01

    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT.

  16. Tirosinemia neonatal Neonatal tyrosinemia

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    Rafael J. Manotas Cabarcas

    1995-04-01

    Full Text Available Mediante la técnica de Udenfriend y Cooper, se midieron los niveles de tirosina en la sangre del cordón de 26 prematuros y 31 niños de término, con el fin de comparar las concentraciones según la edad gestacional y detectar la presencia de la tirosinemia neonatal. Se encontró un caso de esta entidad en un niño de 31 semanas de edad gestacional, lo cual correspondió al 3.8% de los prematuros y al 1.8% del grupo total. La concentración de tirosina en el paciente fue de 53 JJ.M. El promedio de las concentraciones en los prematuros menores de 32 semanas fue de 16.8 :t 6.3 JJ.M; el de los niños entre 33 y 36 semanas fue de 19.3 :t 7.6 JJ.M y el de los niños de término, de 17.2 :t 9.4 JJ.M. Las pruebas estadísticas no mostraron tendencias ni diferencias significativas entre estas concentraciones. El promedio ponderado para el grupo total fue 17.7 :t 7.3 JJ.M. Se recomienda establecer programas de tamizaje para detectar este problema porque puede presentar repercusiones neurológicas posteriores.

    By means of the Udenfriend-Cooper technique, levels of tyrosine were measured in the cord blood of 26 preterm and 31 term Infants; the objective was to compare tyrosine concentrations according to gestational age and to detect the presence of neonatal tyrosinemia. A case of this disease was found In an Infant with 31 weeks of gestational age; this case represented 3.8% of preterm Infants and 1.8% of the total group. Average tyrosine concentration according to age was as follows: 16.8: ± 6.3  µM in Infants under 32 weeks of gestational age; 19.3: ±: 7.6 µM In those between 33 and 36 weeks and 17.2 : ±: 9.4 µM In the term Infants

  17. 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.

  18. Neonatal Mortality Risk Factors in a Rural Part of Iran: A Nested Case-Control Study

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    R Chaman

    2009-03-01

    Full Text Available "nBackground: Due to complex causal framework of neonatal mortality, improvement of this health indicator is quite gradual and it's decreasing trend is not as great as other health indicators such as infant and under 5 mortality rates.This study was conducted to evaluate neonatal mortality risk factors based on nested case-control design."nMethods:  The study population was 6900 neonates who were born in rural areas of Kohgiluyeh and Boyerahmad province (South of Iran. They were under follow up till the end of neonatal period and the outcome of interest was neonatal death. By using risk set sampling method, 97 cases and 97 controls were selected in study cohort."nResults: Prematurity (OR= 5.57, LBW (OR= 7.68, C-section (OR= 7.27, birth rank more than 3 (OR=6.95 and birth spac­ing less than 24 months (OR= 4.65 showed significant statistical association (P< 0.05 with neonatal mortality. The Popula­tion Attributable Fraction (PAF was 0.45 for LBW, 0.40 for prematurity, 0.28 for C-section, 0.30 for birth rank more than 3, and 0.16 for birth spacing less than 24 months."nConclusion: Prematurity, low birth weight, C-section, birth spacing less than 24 months and birth rank more than 3 are impor­tant risk factors for neonatal mortality.

  19. Does aetiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy influence the outcome of treatment?

    Science.gov (United States)

    Mcintyre, Sarah; Badawi, Nadia; Blair, Eve; Nelson, Karin B

    2015-04-01

    Neonatal encephalopathy, a clinical syndrome affecting term-born and late preterm newborn infants, increases the risk of perinatal death and long-term neurological morbidity, especially cerebral palsy. With the advent of therapeutic hypothermia, a treatment designed for hypoxic or ischaemic injury, associated mortality and morbidity rates have decreased. Unfortunately, only about one in eight neonates (95% confidence interval) who meet eligibility criteria for therapeutic cooling apparently benefit from the treatment. Studies of infants in representative populations indicate that neonatal encephalopathy is a potential result of a variety of antecedents and that asphyxial complications at birth account for only a small percentage of neonatal encephalopathy. In contrast, clinical case series suggest that a large proportion of neonatal encephalopathy is hypoxic or ischaemic, and trials of therapeutic hypothermia are specifically designed to include only infants exposed to hypoxia or ischaemia. This review addresses the differences, definitional and methodological, between infants studied and investigations undertaken, in population studies compared with cooling trials. It raises the question if there may be subgroups of infants with a clinical diagnosis of hypoxic-ischaemic encephalopathy (HIE) in whom the pathobiology of neonatal neurological depression is not fundamentally hypoxic or ischaemic and, therefore, for whom cooling may not be beneficial. In addition, it suggests approaches to future trials of cooling plus adjuvant therapy that may contribute to further improvement of care for these vulnerable neonates.

  20. Neonatal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Sorantin, Erich [Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 9, A8036 Graz (Austria)]. E-mail: erich.sorantin@meduni-graz.at; Brader, Peter [Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 9, A8036 Graz (Austria); Thimary, Felix [Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 9, A8036 Graz (Austria)

    2006-11-15

    A variety of traumatic lesions can occur during the neonatal period. Some of those lesions are clearly birth injuries due to delivery and others are caused by necessary procedures during intensive care in critically ill neonates. As usual patient history must be known and knowledge about the typical complications is necessary in order to select the appropriate imaging modality and thus enabling correct interpretation of those investigations by the radiologist. The purpose of this article is to present typical neonatal injuries, describe the underlying pathomechanisms and aetiology as well as the imaging findings.

  1. Metabolic rates of ATP transfer through creatine kinase (CK Flux) predict clinical heart failure events and death.

    Science.gov (United States)

    Bottomley, Paul A; Panjrath, Gurusher S; Lai, Shenghan; Hirsch, Glenn A; Wu, Katherine; Najjar, Samer S; Steinberg, Angela; Gerstenblith, Gary; Weiss, Robert G

    2013-12-11

    Morbidity and mortality from heart failure (HF) are high, and current risk stratification approaches for predicting HF progression are imperfect. Adenosine triphosphate (ATP) is required for normal cardiac contraction, and abnormalities in creatine kinase (CK) energy metabolism, the primary myocardial energy reserve reaction, have been observed in experimental and clinical HF. However, the prognostic value of abnormalities in ATP production rates through CK in human HF has not been investigated. Fifty-eight HF patients with nonischemic cardiomyopathy underwent ³¹P magnetic resonance spectroscopy (MRS) to quantify cardiac high-energy phosphates and the rate of ATP synthesis through CK (CK flux) and were prospectively followed for a median of 4.7 years. Multiple-event analysis (MEA) was performed for HF-related events including all-cause and cardiac death, HF hospitalization, cardiac transplantation, and ventricular-assist device placement. Among baseline demographic, clinical, and metabolic parameters, MEA identified four independent predictors of HF events: New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF), African-American race, and CK flux. Reduced myocardial CK flux was a significant predictor of HF outcomes, even after correction for NYHA class, LVEF, and race. For each increase in CK flux of 1 μmol g⁻¹ s⁻¹, risk of HF-related composite outcomes decreased by 32 to 39%. These findings suggest that reduced CK flux may be a potential HF treatment target. Newer imaging strategies, including noninvasive ³¹P MRS that detect altered ATP kinetics, could thus complement risk stratification in HF and add value in conditions involving other tissues with high energy demands, including skeletal muscle and brain.

  2. Elevated heart rate triggers action potential alternans and sudden death. translational study of a homozygous KCNH2 mutation.

    Directory of Open Access Journals (Sweden)

    Ulrich Schweigmann

    Full Text Available BACKGROUND: Long QT syndrome (LQTS leads to arrhythmic events and increased risk for sudden cardiac death (SCD. Homozygous KCNH2 mutations underlying LQTS-2 have previously been termed "human HERG knockout" and typically express severe phenotypes. We studied genotype-phenotype correlations of an LQTS type 2 mutation identified in the homozygous index patient from a consanguineous Turkish family after his brother died suddenly during febrile illness. METHODS AND RESULTS: Clinical work-up, DNA sequencing, mutagenesis, cell culture, patch-clamp, in silico mathematical modelling, protein biochemistry, confocal microscopy were performed. Genetic analysis revealed a homozygous C-terminal KCNH2 mutation (p.R835Q in the index patient (QTc ∼506 ms with notched T waves. Parents were I° cousins - both heterozygous for the mutation and clinically unremarkable (QTc ∼447 ms, father and ∼396 ms, mother. Heterologous expression of KCNH2-R835Q showed mildly reduced current amplitudes. Biophysical properties of ionic currents were also only nominally changed with slight acceleration of deactivation and more negative V50 in R835Q-currents. Protein biochemistry and confocal microscopy revealed similar expression patterns and trafficking of WT and R835Q, even at elevated temperature. In silico analysis demonstrated mildly prolonged ventricular action potential duration (APD compared to WT at a cycle length of 1000 ms. At a cycle length of 350 ms M-cell APD remained stable in WT, but displayed APD alternans in R835Q. CONCLUSION: Kv11.1 channels affected by the C-terminal R835Q mutation display mildly modified biophysical properties, but leads to M-cell APD alternans with elevated heart rate and could precipitate SCD under specific clinical circumstances associated with high heart rates.

  3. Dependency and indemnity compensation (DIC) benefits for survivors of former prisoners of war rated totally disabled at time of death. Final rule.

    Science.gov (United States)

    2012-07-10

    The Department of Veterans Affairs (VA) is amending its adjudication regulation regarding benefits for survivors of former prisoners of war who were rated totally disabled at the time of death. This amendment is necessary to conform the regulation to the authorizing statutory provision. The effect of this amendment is to liberalize the eligibility criteria for dependency and indemnity compensation (DIC) based on the death of a former prisoner of war whose service-connected disabilities had been continuously rated totally disabling for at least 1 year when he or she died.

  4. 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

  5. Neonatal Jaundice

    DEFF Research Database (Denmark)

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

    2008-01-01

    .7]). No associations were found between infantile autism and low Apgar scores, acidosis or hypoglycaemia. Our findings suggest that hyperbilirubinaemia and neurological abnormalities in the neonatal period are important factors to consider when studying causes of infantile autism....

  6. Statistical analysis of the maternal death rate at the Ebonyi State University Teaching Hospital, Abakaliki, for the year ending 31 December 2007

    Directory of Open Access Journals (Sweden)

    Uchechukwu M. Okeh

    2009-04-01

    Full Text Available Background: The maternal mortality rate in developing countries, such as Nigeria, remains relatively high, with the causes being multidimensional. The unbooked primigravidae with severe pre-eclampsia/eclampsia constitute a high risk group.Method: The data from the case notes of all the maternal deaths that occurred at the Ebonyi State University Teaching Hospital, Abakaliki, between 1 January and 31 December 2007 form the basis of this study. The case notes relating to all such deaths were stored in the office of the Head of the Department of Obstetrics and Gynaecology when the deaths occurred. Information was extracted from the case files at the end of 2007. Data relating to the total number of deliveries were obtained from the registers kept in the labour and isolation wards.Results: Of the 45 maternal deaths recorded, 40 (88.9% were found to have occurred among the unbooked and 5 (11% among the booked mothers, constituting a maternal mortality ratio (MMR of 23 121.4 and 339.7 per 100 000 deliveries respectively. The combined mortality ratio was 2 735.6 per 100 000 deliveries. Fifteen (37.5% unbooked primigravidae were found to have died of severe pre-eclampsia/eclampsia. A total of 1 645 mothers were noted to have delivered babies, of whom 1 472(89.5% were booked, and 173 (10.5% unbooked, with the hospital.Conclusion: Severe pre-eclampsia/eclampsia, haemorrhaging and sepsis were the major causes of death. A high maternal mortality rate was found to be common among the unbooked primigravidae, who are known usually to present late with pre-eclampsia/eclampsia. More research into the causes and management of pre-eclampsia/eclampsia is needed to reduce the high maternal death rate associated with it. The lack of antenatal care is also a high risk factor for maternal death.

  7. Updated Death and Injury Rates of U.S. Military Personnel During the Conflicts in Iraq and Afghanistan

    Science.gov (United States)

    2014-12-01

    Killed-in-action ( KIA ): those who die immediately on the battlefield; • Died-of-wounds (DOW): those who survive injury on the battlefield, but...initial hospital admission.5 KIA and DOW are often combined as hostile deaths, and I will do so henceforth. DoD also reports non-hostile deaths...seasonal basis. In my earlier paper I estimated the size of the surge in Iraq at 37,000 troops. I estimated the hostile death (combining KIAs and DOWs

  8. Stillbirth rates in singleton pregnancies in a stable population at Karl ...

    African Journals Online (AJOL)

    Stillbirth rates for singleton pregnancies where the fetus weighed ≥1 000 g were collected from 1962 to 2011. From 1972 to ... Stillbirth rates only applied to fetuses ≥1 000 g, as stillbirths of fetuses weighing <1 ... stillbirths, neonatal deaths and deliveries, from which the stillbirth rates ... Stillbirths from multiple pregnancies.

  9. Neonatal Mortality Risk Assessment in a Neonatal Intensive Care Unit (NICU

    Directory of Open Access Journals (Sweden)

    Babak Eshrati

    2007-09-01

    Full Text Available Objective: This study aims to assess the utility of a scoring system as predictor of neonatal mortality rate among the neonates admitted within one year to the neonatal intensive care unit (NICU of the Childrens Medical Center in Tehran, Iran.Material & Methods: Data were gathered from 213 newborns admitted to the NICU from September 2003 to August 2004. In addition to demographic data, Apgar scores at 1 minute and 5 minutes, history and duration of previous hospitalization, initial diagnosis and final diagnosis, and scoring system by using the score for the neonatal acute physiology-perinatal extension II (SNAP-PE II were carried out within 12 hours after admission to the NICU. All of the parameters were prospectively applied to the admitted newborns. The exclusion criteria were discharge or death in less than 24 hours after NICU admission.Findings: 198 newborn infants met the inclusion criteria. The mean and standard deviation (SD of the variables including postnatal age, birth weight, SNAP, and finally Apgar scores at 1 minute and 5 minutes of neonates under this study were 7.6 (0.5 days, 2479.8 (29.4 grams, 21.6 (1.1, 7.47 0.08(, and 7.71 (0.06, respectively. Twenty five of the 198 patients died (12.6%. Gestational age (P=0.03, birth weight (P=0.02, Apgar score at 5 minutes (0.001, and SNAP-PE II (P=0.04 were significantly related to the mortality rate. By Analyzing through logistic regression to evaluate the predictive value of these variables in relation to the risk of mortality, it was shown that only SNAP-PE II and Apgar score at 5 minutes could significantly predict the neonatal mortality.Conclusion: According to this study SNAP-PE II and Apgar score at 5 minutes can be used to predict mortality among the NICU patients. SNAP-PE II score had the best performance in predicting mortality in this study. More studies with larger samples are suggested to evaluate all of the above-mentioned parameters among neonates who are admitted to NICUs

  10. Comparing primary prevention with secondary prevention to explain decreasing coronary heart disease death rates in Ireland, 1985-2000.

    LENUS (Irish Health Repository)

    Kabir, Zubair

    2007-01-01

    BACKGROUND: To investigate whether primary prevention might be more favourable than secondary prevention (risk factor reduction in patients with coronary heart disease(CHD)). METHODS: The cell-based IMPACT CHD mortality model was used to integrate data for Ireland describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in CHD patients and in healthy people without recognised CHD. RESULTS: Between 1985 and 2000, approximately 2,530 fewer deaths were attributable to reductions in the three major risk factors in Ireland. Overall smoking prevalence declined by 14% between 1985 and 2000, resulting in about 685 fewer deaths (minimum estimate 330, maximum estimate 1,285) attributable to smoking cessation: about 275 in healthy people and 410 in known CHD patients. Population total cholesterol concentrations fell by 4.6%, resulting in approximately 1,300 (minimum estimate 1,115, maximum estimate 1,660) fewer deaths attributable to dietary changes(1,185 in healthy people and 115 in CHD patients) plus 305 fewer deaths attributable to statin treatment (45 in people without CHD and 260 in CHD patients). Mean population diastolic blood pressure fell by 7.2%, resulting in approximately 170 (minimum estimate 105, maximum estimate 300) fewer deaths attributable to secular falls in blood pressure (140 in healthy people and 30 in CHD patients), plus approximately 70 fewer deaths attributable to antihypertensive treatments in people without CHD. Of all the deaths attributable to risk factor falls, some 1,715 (68%) occurred in people without recognized CHD and 815(32%) in CHD patients. CONCLUSION: Compared with secondary prevention, primary prevention achieved a two-fold larger reduction in CHD deaths. Future national CHD policies should therefore prioritize nationwide interventions to promote healthy diets and reduce smoking.

  11. 出生24h内新生儿肺出血病因与死因分析%Pathogenesis and death cause of neonatal pulmonary hemorrhage within postnatal 24h

    Institute of Scientific and Technical Information of China (English)

    刘绍基; 陈克正

    2010-01-01

    Objective To investigate the pathogenesis and death cause of neonatal pulmonary hem orrhage (NPH) within postnatal 24 h and speculate their relation to fetal pulmonary hemorrhage. Methods To select the 114 cases of NPH within postnatal 24 h confirmed by pathological examination. According to the pathologic and clinic diagnosis materials, the pathogenesis and death cause of NPH within postnatal 24 h and their relation to fetal pulmonary hemorrhage were analyzed. Results Of the 114 cases with NPH,there were 6 cases of petechial pulmonary hemorrhage,60 cases of focal pulmonary hemorrhage and 48 cases of diffuse pulmonary hemorrhage. The discovery time of NPH were 28 cases at 0~6 h ,71 cases at 7~12 h and 15 cases at 13~24 h after birth. The pathogenesis in 114 cases of NPH could be divided into identical 2 major factors: 110 cases of the oxygen deficient factor consisting of amniotic fluid aspiration pneumonia( 62 cases) .hyaline membrane disease(24 cases) .complexity cyanotic congenital heart disease(7 cases),congenital pulmonary a-genesis(7 cases),neonatal asphyxia (7 cases),intracranial hemorrhage(2 cases) and hypoxic ischemic en-cephalopathy(1 cases) .respectively. Four cases were due to infection including sepsis which was caused by intrauterine infection. The death causes in 114 cases of NPH included hypoxia (113 cases) which consisted of pulmonary hemorrhage (74 cases) .amniotic fluid aspiration pneumonia(15 cases) .hyaline membrane dis-ease(12 cases),complexity cyanotic congenital heart disease(7 cases),congenital pulmonary agenesis(2 ca-ses) ,intracranial hemorrhage(2 cases) .neonatal asphyxia (1 cases) .and infectious factor(1 case) of sepsis which was caused by intrauterine infection. In 114 cases,82 cases had fetal distress,74 cases died from NPH directly including 3 cases with fetal distress died within a few minutes after birth. Conclusion Oxygen defi-cient is an important factor in pathogenesis and death cause of NPH within postnatal 24 h. The

  12. CD4 count and viral load specific rates of AIDS, non-AIDS and deaths according to current antiretroviral use

    Directory of Open Access Journals (Sweden)

    A Mocroft

    2012-11-01

    Full Text Available Background CD4 and viral loads are used in clinical trials as surrogate endpoints for assessing efficacy of newly available antiretrovirals. If antiretrovirals act through other pathways or negatively affect the risk of disease this would not be identified prior to licensing. The aims of this study were to investigate the CD4 and viral load specific rates of fatal and non-fatal AIDS and non-AIDS events according to current antiretrovirals. Methods Poisson regression was used to compare overall events (fatal or non-fatal AIDS, non-AIDS or death, AIDS events (fatal and non-fatal or non-AIDS events (fatal or non-fatal for specific nucleoside pairs and third drugs used with>1000 person-years of follow-up (PYFU after January 1st 2001. Results 9801 patients were included. The median baseline date was January 2004 (interquartile range [IQR] January 2001–February 2007, age was 40.4 (IQR 34.6–47.3 years, and time since starting cART was 3.3 (IQR 0.9–5.1 years. At baseline, the median nadir CD4 was 162 (IQR 71–257/mm3, baseline CD4 was 390 (IQR 249–571/mm3, viral load was 1.9 (IQR 1.7–3.3 log10copies/ml and 2961 (30.2% had a prior AIDS diagnosis and 6.4 years prior to baseline. During 42372.5 PYFU, 1203 (437 AIDS and 766 non-AIDS events occurred. The overall event rate was 2.8 per 100 PYFU (95% confidence interval [CI] 2.7–3.0, of AIDS events was 1.0 (95% CI 0.9–1.1 and of non-AIDS events was 1.8 (95% CI 1.7–1.9. Of the AIDS events, 53 (12.1%were fatal as were 239 (31.2% of the non-AIDS events. After adjustment, there was weak evidence of a difference in the overall events rates between nucleoside pairs (global p-value=0.084, and third drugs (global p-value=0.031. Compared to zidovudine/lamivudine, patients taking abacavir/lamivudine (adjusted incidence rate ratio [aIRR] 1.22; 95% CI 0.99–1.49 and abacavir plus one other nucleoside (aIRR 1.51; 95% CI 1.14–2.02 had an increased incidence of overall events. Comparing the third drugs

  13. Fetal and neonatal thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    Chandar Mohan Batra

    2013-01-01

    Full Text Available 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 20 th week of pregnancy and reaches its maximum by 30 th 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.

  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. The challenges of neonatal magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J.; Graves, Martin J.; Lomas, David J. [Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Edwards, Andrea [Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital, Department of Neonatology, Cambridge (United Kingdom); Austin, Topun [Addenbrooke' s Hospital, Department of Neonatology, Cambridge (United Kingdom)

    2012-10-15

    Improved neonatal survival rates and antenatal diagnostic imaging is generating a growing demand for postnatal MRI examinations. Neonatal brain MRI is now becoming standard clinical care in many settings, but with the exception of some research centres, the technique has not been optimised for imaging neonates and small children. Here, we review some of the challenges involved in neonatal MRI, including recent advances in overall MR practicality and nursing practice, to address some of the ways in which the MR experience could be made more neonate-friendly. (orig.)

  16. On the edge of death: Rates of decline and lower thresholds of biochemical condition in food-deprived fish larvae and juveniles

    Science.gov (United States)

    Meyer, S.; Caldarone, E. M.; Chícharo, M. A.; Clemmesen, C.; Faria, A. M.; Faulk, C.; Folkvord, A.; Holt, G. J.; Høie, H.; Kanstinger, P.; Malzahn, A.; Moran, D.; Petereit, C.; Støttrup, J. G.; Peck, M. A.

    2012-05-01

    Gaining reliable estimates of how long fish early life stages can survive without feeding and how starvation rate and time until death are influenced by body size, temperature and species is critical to understanding processes controlling mortality in the sea. The present study is an across-species analysis of starvation-induced changes in biochemical condition in early life stages of nine marine and freshwater fishes. Data were compiled on changes in body size (dry weight, DW) and biochemical condition (standardized RNA-DNA ratio, sRD) throughout the course of starvation of yolk-sac and feeding larvae and juveniles in the laboratory. In all cases, the mean biochemical condition of groups decreased exponentially with starvation time, regardless of initial condition and endogenous yolk reserves. A starvation rate for individuals was estimated from discrete 75th percentiles of sampled populations versus time (degree-days, Dd). The 10th percentile of sRD successfully approximated the lowest, life-stage-specific biochemical condition (the edge of death). Temperature could explain 59% of the variability in time to death whereas DW had no effect. Species and life-stage-specific differences in starvation parameters suggest selective adaptation to food deprivation. Previously published, interspecific functions predicting the relationship between growth rate and sRD in feeding fish larvae do not apply to individuals experiencing prolonged food deprivation. Starvation rate, edge of death, and time to death are viable proxies for the physiological processes under food deprivation of individual fish pre-recruits in the laboratory and provide useful metrics for research on the role of starvation in the sea.

  17. Fetal heart rate patterns in neonatal hypoxic-ischemic encephalopathy: relationship with early cerebral activity and neurodevelopmental outcome.

    LENUS (Irish Health Repository)

    Murray, Deirdre M

    2009-09-01

    Despite widespread use of fetal heart rate monitoring, the timing of injury in hypoxic-ischemic encephalopathy (HIE) remains unclear. Our aim was to examine fetal heart rate patterns during labor in infants with clinical and electroencephalographic (EEG) evidence of HIE and to relate these findings to neurodevelopmental outcome. Timing of onset of pathological cardiotocographs (CTGs) was determined in each case by two blinded reviewers and related to EEG grade at birth and neurological outcome at 24 months. CTGs were available in 35 infants with HIE (17 mild, 12 moderate, 6 severe on EEG). Admission CTGs were normal in 24\\/35 (69%), suspicious in 8\\/35 (23%), and pathological in 3\\/35 (8%). All CTGs developed nonreassuring features prior to delivery. Three patterns of fetal heart rate abnormalities were seen: group 1, abnormal CTGs on admission in 11\\/35 (31%); group 2, normal CTGs on admission with gradual deterioration to pathological in 20\\/35 cases (57%); and group 3, normal CTGs on admission with acute sentinel events in 4\\/35 (11.5%). The median (interquartile range) duration between the development of pathological CTGs and delivery was 145 (81, 221) minutes in group 2 and 22 (12, 28) minutes in group 3. There was no correlation between duration of pathological CTG trace and grade of encephalopathy (R = 0.09, P = 0.63) or neurological outcome (P = 0.75). However, the grade of encephalopathy was significantly worse in group 3 (P = 0.001), with a trend to worse outcomes. The majority of infants with HIE have normal CTG traces on admission but develop pathological CTG patterns within hours of delivery. More severe encephalopathy was associated with normal admission CTG and acute sentinel events shortly before delivery.

  18. Fetal heart rate patterns in neonatal hypoxic-ischemic encephalopathy: relationship with early cerebral activity and neurodevelopmental outcome.

    LENUS (Irish Health Repository)

    Murray, Deirdre M

    2012-01-31

    Despite widespread use of fetal heart rate monitoring, the timing of injury in hypoxic-ischemic encephalopathy (HIE) remains unclear. Our aim was to examine fetal heart rate patterns during labor in infants with clinical and electroencephalographic (EEG) evidence of HIE and to relate these findings to neurodevelopmental outcome. Timing of onset of pathological cardiotocographs (CTGs) was determined in each case by two blinded reviewers and related to EEG grade at birth and neurological outcome at 24 months. CTGs were available in 35 infants with HIE (17 mild, 12 moderate, 6 severe on EEG). Admission CTGs were normal in 24\\/35 (69%), suspicious in 8\\/35 (23%), and pathological in 3\\/35 (8%). All CTGs developed nonreassuring features prior to delivery. Three patterns of fetal heart rate abnormalities were seen: group 1, abnormal CTGs on admission in 11\\/35 (31%); group 2, normal CTGs on admission with gradual deterioration to pathological in 20\\/35 cases (57%); and group 3, normal CTGs on admission with acute sentinel events in 4\\/35 (11.5%). The median (interquartile range) duration between the development of pathological CTGs and delivery was 145 (81, 221) minutes in group 2 and 22 (12, 28) minutes in group 3. There was no correlation between duration of pathological CTG trace and grade of encephalopathy (R = 0.09, P = 0.63) or neurological outcome (P = 0.75). However, the grade of encephalopathy was significantly worse in group 3 (P = 0.001), with a trend to worse outcomes. The majority of infants with HIE have normal CTG traces on admission but develop pathological CTG patterns within hours of delivery. More severe encephalopathy was associated with normal admission CTG and acute sentinel events shortly before delivery.

  19. 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

  20. 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 ...

  1. Liver transplantation for neonatal hemochromatosis: analysis of the UNOS database.

    Science.gov (United States)

    Sheflin-Findling, Shari; Annunziato, Rachel A; Chu, Jaime; Arvelakis, Antonios; Mahon, Danielle; Arnon, Ronen

    2015-03-01

    NH is the most common identifiable cause of ALF in the neonate. LT is the definitive treatment for neonates with NH who have failed medical therapy. Our aim was to determine the outcomes of LT in infants with NH. Patients (less than one yr of age) with NH who were listed for LT and patients who underwent LT between 1994 and 2013 were identified from the UNOS database for analysis. Risk factors for death and graft loss were analyzed by multivariate logistic regression. Thirty-eight infants with NH with a total of 43 transplants were identified. One- and five-yr patient and graft survival were 84.2%, 81.6%, 71.1%, and 68.4%, respectively. The outcomes for NH were not significantly different when compared to the same age-matched recipients with other causes of ALF. There were no statistically significant risk factors identified for graft loss or death. Ninety infants with NH were listed for LT. Reasons for removal included transplanted (49%), death (27%), too sick to transplant (7%), and improved status (13%). LT for infants with NH has a high rate of graft loss and death; however, outcomes are comparable to the same age-matched recipients with other causes of ALF.

  2. Preliminary evidence for the evolution in complexity of heart rate dynamics during autonomic maturation in neonatal swine.

    Science.gov (United States)

    Lipsitz, L A; Pincus, S M; Morin, R J; Tong, S; Eberle, L P; Gootman, P M

    1997-07-14

    Previous studies suggest that the autonomic nervous system plays an important role in the generation of complex heart rate dynamics. Therefore, we hypothesized that the complexity (irregularity) of cardiac interbeat intervals would evolve with the maturation of autonomic innervation to the heart. Twelve healthy newborn piglets were implanted with ECG transmitters and studied at one or more different ages up to 33 days of age, the period during which pigs develop functional sympathetic innervation of the heart from the stellate ganglia. Three animals underwent right stellate ganglionectomy, two a left stellate ganglionectomy, two a right cardiac vagotomy and five a sham procedure. The statistic, approximate entropy (ApEn), was used to quantify the regularity of interbeat interval fluctuations. Sham-operated animals showed an increase in the standard deviation (SD) and irregularity (ApEn) of cardiac interval fluctuations with increasing age. Right stellate ganglionectomized piglets had lower interbeat interval ApEn values, but similar SD's by 26-27 days of age compared to sham-operated animals. Left stellate ganglionectomy, which affects cardiac inotropy rather than chronotropy, had no effect on cardiac interval irregularity, while vagotomy had an indeterminant effect. The increasing irregularity of interbeat interval dynamics during autonomic maturation and the apparent attenuation of heartbeat irregularity when right stellate ganglion innervation is interrupted, provides empirical support for the notion that complex heartbeat dynamics in the mature animal are the result of a network of autonomic neural pathways that enables an organism to adapt to stress.

  3. 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

  4. 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.

  5. Deaths: Leading Causes for 2011.

    Science.gov (United States)

    Heron, Melonie

    2015-07-27

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

  6. Neonatal hematology.

    Science.gov (United States)

    Diaz-Miron, Jose; Miller, Jacob; Vogel, Adam M

    2013-11-01

    Neonatal hematology is a complex and dynamic process in the pediatric population. Surgeons frequently encounter hematologic issues regarding hemostasis, inflammation, and wound healing. This publication provides a surgeon-directed review of hematopoiesis in the newborn, as well as an overview of the current understanding of their hemostatic profile under normal and pathologic conditions. © 2013 Published by Elsevier Inc.

  7. 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...

  8. Practices of rural Egyptian birth attendants during the antenatal, intrapartum and early neonatal periods.

    Science.gov (United States)

    Darmstadt, Gary L; Hussein, Mohamed Hassan; Winch, Peter J; Haws, Rachel A; Gipson, Reginald; Santosham, Mathuram

    2008-03-01

    Neonatal deaths account for almost two-thirds of infant mortality worldwide; most deaths are preventable. Two-thirds of neonatal deaths occur during the first week of life, usually at home. While previous Egyptian studies have identified provider practices contributing to maternal mortality, none has focused on neonatal care. A survey of reported practices of birth attendants was administered. Chi-square tests were used for measuring the statistical significance of inter-regional differences. In total, 217 recently-delivered mothers in rural areas of three governorates were interviewed about antenatal, intrapartum and postnatal care they received. This study identified antenatal advice of birth attendants to mothers about neonatal care and routine intrapartum and postpartum practices. While mothers usually received antenatal care from physicians, traditional birth attendants (dayas) conducted most deliveries. Advice was rare, except for breastfeeding. Routine practices included hand-washing by attendants, sterile cord-cutting, prompt wrapping of newborns, and postnatal home visits. Suboptimal practices included lack of disinfection of delivery instruments, unhygienic cord care, lack of weighing of newborns, and lack of administration of eye prophylaxis or vitamin K. One-third of complicated deliveries occurred at home, commonly attended by relatives, and the umbilical cord was frequently pulled to hasten delivery of the placenta. In facilities, mothers reported frequent use of forceps, and asphyxiated neonates were often hung upside-down during resuscitation. Consequently, high rates of birth injuries were reported. Priority areas for behaviour change and future research to improve neonatal health outcomes were identified, specific to type of provider (physician, nurse, or daya) and regional variations in practices.

  9. Variations in multiple birth rates and impact on perinatal outcomes in Europe

    NARCIS (Netherlands)

    Heino, A.; Gissler, M.; Hindori-Mohangoo, A.D.; Blondel, B.; Klungsøyr, K.; Verdenik, I.; Mierzejewska, E.; Velebil, P.; Sól Ólafsdóttir, H.; Macfarlane, A.; Zeitlin, J.; et al.

    2016-01-01

    Objective. Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perina

  10. Changes in mortality rates and causes of death in a population-based cohort of persons living with and without HIV from 1996 to 2012.

    Science.gov (United States)

    Eyawo, Oghenowede; Franco-Villalobos, Conrado; Hull, Mark W; Nohpal, Adriana; Samji, Hasina; Sereda, Paul; Lima, Viviane D; Shoveller, Jeannie; Moore, David; Montaner, Julio S G; Hogg, Robert S

    2017-02-27

    Non-HIV/AIDS-related diseases are gaining prominence as important causes of morbidity and mortality among people living with HIV. The purpose of this study was to characterize and compare changes over time in mortality rates and causes of death among a population-based cohort of persons living with and without HIV in British Columbia (BC), Canada. We analysed data from the Comparative Outcomes And Service Utilization Trends (COAST) study; a retrospective population-based study created via linkage between the BC Centre for Excellence in HIV/AIDS and Population Data BC, and containing data for HIV-infected individuals and the general population of BC, respectively. Our analysis included all known HIV-infected adults (≥ 20 years) in BC and a random 10% sample of uninfected BC adults followed from 1996 to 2012. Deaths were identified through Population Data BC - which contains information on all registered deaths in BC (BC Vital Statistics Agency dataset) and classified into cause of death categories using International Classification of Diseases (ICD) 9/10 codes. Age-standardized mortality rates (ASMR) and mortality rate ratios were calculated. Trend test were performed. 3401 (25%), and 47,647 (9%) individuals died during the 5,620,150 person-years of follow-up among 13,729 HIV-infected and 510,313 uninfected individuals, respectively. All-cause and cause-specific mortality rates were consistently higher among HIV-infected compared to HIV-negative individuals, except for neurological disorders. All-cause ASMR decreased from 126.75 (95% CI: 84.92-168.57) per 1000 population in 1996 to 21.29 (95% CI: 17.79-24.79) in 2011-2012 (83% decline; p people living with HIV.

  11. Blacks' Death Rate Due to Circulatory Diseases Is Positively Related to Whites' Explicit Racial Bias: A Nationwide Investigation Using Project Implicit

    OpenAIRE

    2016-01-01

    Perceptions of racial bias have been linked to poorer circulatory health among Blacks compared with Whites. However, little is known about whether Whites' actual racial bias contributes to this racial disparity in health. We compiled racial-bias data from 1,391,632 Whites and examined whether racial bias in a given county predicted Black-White disparities in circulatory-disease risk (access to health care, diagnosis of a circulatory disease; Study 1) and circulatory-disease-related death rate...

  12. Neonatal infectious diseases: evaluation of neonatal sepsis.

    Science.gov (United States)

    Camacho-Gonzalez, Andres; Spearman, Paul W; Stoll, Barbara J

    2013-04-01

    Neonatal sepsis remains a feared cause of morbidity and mortality in the neonatal period. Maternal, neonatal, and environmental factors are associated with risk of infection, and a combination of prevention strategies, judicious neonatal evaluation, and early initiation of therapy are required to prevent adverse outcomes. This article reviews recent trends in epidemiology and provides an update on risk factors, diagnostic methods, and management of neonatal sepsis. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Deaths: leading causes for 2009.

    Science.gov (United States)

    Heron, Melonie

    2012-10-26

    This report presents final 2009 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 2009. 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 2009, 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 approximately 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 2009 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.

  14. 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

  15. STUDY OF INCIDENCE, MORTALITY & CAUSES OF NEONATAL TETANUS AMONG ALL NEONATAL INTENSIVE CARE UNIT [NICU] ADMISSIONS IN TERTIARY HEALTH CARE CENTER OF SBHGMC, DHULE

    OpenAIRE

    Neeta; Neelam; Syed; Arjun

    2015-01-01

    AIM: To find out incidence & mortality due to Neonatal Tetanus and to study its causes among all the admissions in Neonatal Intensive Care Unit [NICU] of tertiary health care center of Shri Bhausaheb Hire Government Medical College, [SBHGMC] Dhule. OBJECTIVES: 1] To find out incidence of Neonatal Teta nus in all neonatal admissions. 2] To find out mortality rate among all Neonatal Tetanus cases. 3] To take detailed history to find out causes of Neonatal Tetanu...

  16. Rates of TBI-related Emergency Department Visits, Hospitalizations, and Deaths by Sex — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — Overall rates of TBI climbed slowly from 2001 through 2007, then spiked sharply in 2008 and continued to climb through 2010. The increase in TBI rates in 2008 was...

  17. Cholera in Pregnancy: A Systematic Review and Meta-Analysis of Fetal, Neonatal, and Maternal Mortality.

    Directory of Open Access Journals (Sweden)

    Nguyen-Toan Tran

    Full Text Available Maternal infection with cholera may negatively affect pregnancy outcomes. The objective of this research is to systematically review the literature and determine the risk of fetal, neonatal and maternal death associated with cholera during pregnancy.Medline, Global Health Library, and Cochrane Library databases were searched using the key terms cholera and pregnancy for articles published in any language and at any time before August 2013 to quantitatively summarize estimates of fetal, maternal, and neonatal mortality. 95% confidence intervals (CIs were calculated for each selected study. Random-effect non-linear logistic regression was used to calculate pooled rates and 95% CIs by time period. Studies from the recent period (1991-2013 were compared with studies from 1969-1990. Relative risk (RR estimates and 95% CIs were obtained by comparing mortality of selected recent studies with published national normative data from the closest year.The meta-analysis included seven studies that together involved 737 pregnant women with cholera from six countries. The pooled fetal death rate for 4 studies during 1991-2013 was 7.9% (95% CIs 5.3-10.4, significantly lower than that of 3 studies from 1969-1990 (31.0%, 95% CIs 25.2-36.8. There was no difference in fetal death rate by trimester. The pooled neonatal death rate for 1991-2013 studies was 0.8% (95% CIs 0.0-1.6, and 6.4% (95% CIs 0.0-20.8 for 1969-1990. The pooled maternal death rate for 1991-2013 studies was 0.2% (95% CIs 0.0-0.7, and 5.0% (95% CIs 0.0-16.0 for 1969-1990. Compared with published national mortality estimates, the RR for fetal death of 5.8 (95% CIs 2.9-11.3 was calculated for Haiti (2013, 1.8 (95% CIs 0.3-10.4 for Senegal (2007, and 2.6 (95% CIs 0.5-14.9 for Peru (1991; there were no significant differences in the RR for neonatal or maternal death.Results are limited by the inconsistencies found across included studies but suggest that maternal cholera is associated with adverse

  18. Cholera in Pregnancy: A Systematic Review and Meta-Analysis of Fetal, Neonatal, and Maternal Mortality.

    Science.gov (United States)

    Tran, Nguyen-Toan; Taylor, Richard; Antierens, Annick; Staderini, Nelly

    2015-01-01

    Maternal infection with cholera may negatively affect pregnancy outcomes. The objective of this research is to systematically review the literature and determine the risk of fetal, neonatal and maternal death associated with cholera during pregnancy. Medline, Global Health Library, and Cochrane Library databases were searched using the key terms cholera and pregnancy for articles published in any language and at any time before August 2013 to quantitatively summarize estimates of fetal, maternal, and neonatal mortality. 95% confidence intervals (CIs) were calculated for each selected study. Random-effect non-linear logistic regression was used to calculate pooled rates and 95% CIs by time period. Studies from the recent period (1991-2013) were compared with studies from 1969-1990. Relative risk (RR) estimates and 95% CIs were obtained by comparing mortality of selected recent studies with published national normative data from the closest year. The meta-analysis included seven studies that together involved 737 pregnant women with cholera from six countries. The pooled fetal death rate for 4 studies during 1991-2013 was 7.9% (95% CIs 5.3-10.4), significantly lower than that of 3 studies from 1969-1990 (31.0%, 95% CIs 25.2-36.8). There was no difference in fetal death rate by trimester. The pooled neonatal death rate for 1991-2013 studies was 0.8% (95% CIs 0.0-1.6), and 6.4% (95% CIs 0.0-20.8) for 1969-1990. The pooled maternal death rate for 1991-2013 studies was 0.2% (95% CIs 0.0-0.7), and 5.0% (95% CIs 0.0-16.0) for 1969-1990. Compared with published national mortality estimates, the RR for fetal death of 5.8 (95% CIs 2.9-11.3) was calculated for Haiti (2013), 1.8 (95% CIs 0.3-10.4) for Senegal (2007), and 2.6 (95% CIs 0.5-14.9) for Peru (1991); there were no significant differences in the RR for neonatal or maternal death. Results are limited by the inconsistencies found across included studies but suggest that maternal cholera is associated with adverse

  19. Candida parapsilosis candidaemia in a neonatal unit over 7 years: a case series study

    Science.gov (United States)

    Miranda, Lourdes das Neves; Rodrigues, Eliete C A; Costa, Silvia F; van der Heijden, Inneke Marie; Dantas, Kátia C; Lobo, Renata D; Basso, Mariusa; Varkulja, Gláucia F; Krebs, Vera Lúcia Jornada; Gibelli, Maria Augusta Bento Cicaroni; Criado, Paulo R; Levin, Anna Sara

    2012-01-01

    Objective To evaluate Candida parapsilosis candidaemia in a neonatal unit over 7 years. Design Case series study. Setting A 2000-bed tertiary-care university hospital at São Paulo, Brazil. Participants Neonates hospitalised in a 63-bed neonatal unit. Primary and secondary outcome measures We evaluated the incidence of C parapsilosis fungemia in a neonatal unit from 2002 through 2008 and the main microbiological, clinical and epidemiological aspects of this disease in neonates. During the study period an outbreak occurred, an infection control programme was implemented, and isolates from blood and hand healthcare workers (HCWs) were submitted to molecular typing. Results During 7 years, there were 36 cases of C parapsilosis fungaemia and annual incidence varied from 0 to 19.7 per 1000 admissions. Evaluating 31 neonates with fungemia, the mean age at diagnosis was 19 days. All children except for one were premature; all had received total parenteral nutrition and all but one had used central venous catheter. Three neonates had received antifungal treatment previously to the diagnosis. Thirty-day mortality was 45%. Only lower birthweight was associated with mortality. C parapsilosis species complex was isolated from hand cultures in eight (11%) of the HCWs (one isolate was identified as C orthopsilosis). By molecular typing no HCW isolate was similar to any of the blood isolates. Conclusions The incidence of C parapsilosis fungemia in a neonatal unit varied widely over 7 years. We observed in our series a higher death rate than that reported in European countries and the USA. PMID:22869093

  20. Methods and Techniques to Improve the Success rate of Neonatal Scalp Superficial Vein Puncture%提高新生儿头皮浅静脉穿刺成功率的方法与技巧

    Institute of Scientific and Technical Information of China (English)

    王元翠

    2016-01-01

    Objective To explore the methods and skills to improve the success rate of neonatal scalp superficial vein puncture. Methodsin neonatal scalp superficial vein puncture should do the preparatory, according to neonatal choose appropriate scalp superficial vein, and puts forward the improved method of neonatal scalp superficial vein puncture, exclude puncture.Results and conclusion in the newborn scalp superficial vein puncture by exclusion of puncture, puncture success rate high, after the successful puncture well fixed. And protect the site of puncture and venous, to ensure long-term venous transfusion puncture success rate.%目的:探究提高新生儿头皮浅静脉穿刺成功率的方法与技巧。方法在进行新生儿头皮浅静脉穿刺前应做好各项准备,根据新生儿情况选择合适的头皮浅静脉,同时提出了新生儿头皮浅静脉穿刺的改进方法—排除穿刺法。结果与结论在为新生儿进行头皮浅静脉穿刺时采用排除穿刺法,穿刺成功率高,在穿刺成功后做好固定,并保护好穿刺部位及静脉,能够确保长期输液静脉穿刺的成功率。

  1. CDC WONDER: Mortality - Infant Deaths

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Mortality - Infant Deaths (from Linked Birth / Infant Death Records) online databases on CDC WONDER provide counts and rates for deaths of children under 1 year...

  2. 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 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....

  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. 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. The effect of topical ointment on neonatal sepsis in preterm infants.

    Science.gov (United States)

    Erdemir, Aydin; Kahramaner, Zelal; Yuksel, Yelda; Cosar, Hese; Turkoglu, Ebru; Sutcuoglu, Sumer; Ozer, Esra Arun; Kose, Sukran

    2015-01-01

    To investigate the effects of topical ointment therapy on neonatal sepsis in premature infants. A total of 197 premature infants≤34 weeks gestation were randomized to receive topical ointment (Aquaphor Original Emollient) or routine skin care group. Skin cultures were obtained on 3th, 7th and 14th day and blood cultures were obtained if sepsis was suspected clinically. Data included the maternal and neonatal characteristics, factors affecting the risk of sepsis and neonatal outcomes of both groups were collected. There were no significant differences in terms of gestational age, birth weight, gender, mode of delivery, multiple pregnancy and receiving antenatal corticosteroids between the study and control group. No statistically significant difference was found in the prevalence of sepsis, in the positive skin culture rates at any follow-up and in terms of the neonatal morbidities including patent ductus arteriosus and necrotizing enterocolitis between the groups. Although the rate of death was higher in the topical ointment group, no statistically significant difference was found between the groups. Our data suggests that applying topical ointment during the first 2 postnatal weeks did not affect the risk of neonatal sepsis in preterm infants, although it changed the bacterial flora on the skin compare to the routine care group.

  6. Abordagem do near miss neonatal no 2005 WHO Global Survey Brazil Neonatal near miss approach in the 2005 WHO Global Survey Brazil

    Directory of Open Access Journals (Sweden)

    Cynthia Pileggi

    2010-02-01

    Full Text Available OBJETIVOS: Explorar o uso do conceito de near miss neonatal como uma ferramenta para a avaliação da qualidade do atendimento neonatal, já que 3 milhões de óbitos neonatais precoces ocorrem a cada ano em todo o mundo. A maioria desses óbitos é evitável e ocorre em países em desenvolvimento. MÉTODOS: Esta é uma análise secundária do 2005 WHO Global Survey on Maternal and Perinatal Health, um estudo transversal. Nossa análise incluiu dados de 19 hospitais brasileiros selecionados aleatoriamente. Uma definição pragmática de near miss neonatal foi desenvolvida e testada. Os indicadores de near miss foram calculados. RESULTADOS: Entre os 15.169 nascidos vivos incluídos nesta análise, 424 apresentaram pelo menos uma das seguintes condições: muito baixo peso ao nascer, menos de 30 semanas de gestação ao nascer ou escore de Apgar aos 5 minutos de vida menor que 7. De acordo com a definição operacional, esses sobreviventes de condições com risco de vida foram considerados casos de near miss. A taxa de mortalidade neonatal precoce foi de 8,2/1.000 nascidos vivos, e a taxa de near miss neonatal foi de 21,4 casos/1.000 nascidos vivos. Variações substanciais na mortalidade entre recém-nascidos com condições com risco de vida ao nascer foram observadas, o que sugere a existência de questões relacionadas à qualidade do atendimento intra-hospitalar. CONCLUSÃO: O conceito de near miss e os indicadores forneceram informações que poderiam ser úteis para avaliar a qualidade do atendimento e para estabelecer prioridades para outras avaliações e para a melhoria da atenção à saúde dos recém-nascidos.OBJECTIVES: To explore the use of the neonatal near miss concept as a tool to evaluate the quality of neonatal care, as 3 million early neonatal deaths occur every year around the world and the majority of these deaths are avoidable and take place in developing countries. METHODS: This is a secondary analysis of the 2005 WHO

  7. Influência de elementos climáticos na mortalidade de cidades brasileiras Climatic factors and total death-rates in brazilian cities

    Directory of Open Access Journals (Sweden)

    João de Barros Barreto

    1946-03-01

    Full Text Available In this paper, preliminary to a series of investigations that the A. has the purpose to make about the influence of climatic factors particularly upon the prevalence of the most important acute infectious diseases in Brazil, he raises the question whether such factors do affect in this country the total death rates, as it is reasonable to suppose, according to what has been observed in temperate zones of northern and southern hemispheres. The inclusion of absolute humidity among other climatic factors to be dealt with seems justifiable according to Rogers and Stallybrass. Owing to scarcety of reliable data the A. was obliged to limit to a five-years period (1940-1944 the complete proposed investigation, which includes seven of the most important cities, scattered throughout the brazilian territory, from north to south - Belém, recife, Salvador, Rio, S. Paulo, Curitiba and Porto Alegre. Reference is made to their normal climatic conditions and monthly death-rates variations with their mean values and standard deviations. In a first part dealing with seasonal variations only for purposes of comparison, he points out that in there tropical cities of Brazil, without very clear seasonal differentiation, the curve of general mortality reached its highest point in austral autumn season and the remaining four (including Rio near the tropic in the spring, with the exception of Curitiba, where the peak coincided with the summer season. He shows how such important causes of deaths, as diarrheas, common respiratory diseases and tuberculosis, whose seasonal distribution for each one of the seven cities is referred, may explain such seasonal variations. On a second part, a study is made of the general mortality distribution by four-months periods selected in accordance respectively with the highest or lowest values of rainfall and of mean temperature and humidity during period 1940-1944. Finally he compares the monthly waves of such climatic factors and the

  8. Pathological fear of cot death.

    Science.gov (United States)

    Weightman, H; Dalal, B M; Brockington, I F

    1998-01-01

    Cot death (sudden infant death syndrome) is one of the most common causes of death in the first year of life. Four cases with a pathological fear of cot death are presented. All the patients were depressed and in 2 cases the fear of cot death had an obsessional quality. In all cases there were complications during pregnancy (miscarriage, threatened abortion, recurrent vomiting in last trimester). In 1 case, the patient knew 3 mothers who had suffered cot deaths; in another, the infant was gravely ill in the neonatal period. Pathological fear of cot death can be recognised by the presence of two central features - overvigilance and excessive nocturnal checking of the baby's breathing. Therapeutic interventions are discussed.

  9. A social autopsy of neonatal mortality suggests needed improvements in maternal and neonatal interventions in Balaka and Salima districts of Malawi

    Directory of Open Access Journals (Sweden)

    Alain K. Koffi

    2015-06-01

    Full Text Available Background The Every Newborn Action Plan calls for reducing the neonatal mortality rates to fewer than 10 deaths per 1000 live births in all countries by 2035. The current study aims to increase our understanding of the social and modifiable factors that can be addressed or reinforced to improve and accelerate the decline in neonatal mortality in Malawi. Methods The data come from the 2013 Verbal and Social Autopsy (VASA study that collected data in order to describe the biological causes and the social determinants of deaths of children under 5 years of age in Balaka and Salima districts of Malawi. This paper analyses the social autopsy data of the neonatal deaths and presents results of a review of the coverage of key interventions along the continuum of normal maternal and newborn care and the description of breakdowns in the care provided for neonatal illnesses within the Pathway to Survival framework. Results A total of 320 neonatal deaths were confirmed from the VASA survey. While one antenatal care (ANC visit was high at 94%, the recommended four ANC visits was much lower at 41% and just 17% of the mothers had their urines tested during the pregnancy. 173 (54% mothers of the deceased newborns had at least one labor/delivery complication that began at home. The caregivers of 65% (n = 75 of the 180 newborns that were born at home or born and left a health facility alive perceived them to be severely ill at the onset of their illness, yet only 44% (n = 80 attempted and 36% (n = 65could reach the first health provider after an average of 91 minutes travel time. Distance, lack of transport and cost emerged as the most important constraints to formal care–seeking during delivery and during the newborn fatal illness. Conclusions This study suggests that maternal and neonatal health organizations and the local government of Malawi should increase the demand for key maternal and child health interventions, including the recommended 4

  10. Neonatal pulmonary artery thrombosis

    Directory of Open Access Journals (Sweden)

    Mangesh Jadhav

    2012-01-01

    Full Text Available Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diagnosis; their presentation, evaluation, and management. These cases highlight the importance of this differential diagnosis when evaluating the cyanotic neonate.

  11. Personal Fear of Death and Grief in Bereaved Mothers

    Science.gov (United States)

    Barr, Peter; Cacciatore, Joanne

    2008-01-01

    The study explored the relation of fear of death (Multidimensional Fear of Death Scale) to maternal grief (Perinatal Grief Scale-33) following miscarriage, stillbirth, neonatal death, or infant/child death. The 400 women participants were recruited from the website, e-mail lists, and parent groups of an organization that supports bereaved parents.…

  12. Personal Fear of Death and Grief in Bereaved Mothers

    Science.gov (United States)

    Barr, Peter; Cacciatore, Joanne

    2008-01-01

    The study explored the relation of fear of death (Multidimensional Fear of Death Scale) to maternal grief (Perinatal Grief Scale-33) following miscarriage, stillbirth, neonatal death, or infant/child death. The 400 women participants were recruited from the website, e-mail lists, and parent groups of an organization that supports bereaved parents.…

  13. Improvement in in vitro fertilization rate, decrease in reactive oxygen species and spermatozoa death incidence in rams by dietary fish oil.

    Science.gov (United States)

    Matini Behzad, A; Ebrahimi, B; Alizadeh, A R; Esmaeili, V; Dalman, A; Rashki, L; Shahverdi, A H

    2014-08-01

    Our aim was to evaluate the effects of fish oil feeding on sperm classical parameters, level of reactive oxygen spices (ROS), spermatozoa death incidence and in vitro fertilization (IVF) rate in rams. We randomly assigned nine rams, into two experimental groups (isoenergetic and isonitrogenous rations with constant level of vitamin E supplement): control (CTR; n = 5) and fish oil (FO; n = 4, 35 g/day/ram). Diets were fed for 70 days during the physiological breeding season. After a 21-day dietary adaptation period, semen was collected weekly from each ram by an artificial vagina. Sperm classical parameters were determined by the computer-assisted sperm analyzer system (CASA), and it was prepared for IVF process by swim-up technique. These evaluations were performed during the first and last weeks of sampling. Intracellular ROS level and spermatozoa death incidence were detected by flow cytometry on a weekly basis after adaptation. Data were analysed with SPSS 15. The volume, concentration (3.6 and 2.7 × 10(9) /ml) and sperm progressive motility (60 and 48%) were significantly improved in the FO group compared with the CTR (p < 0.05). A comparison of two-cell stage embryos following IVF in the two groups showed a significantly higher fertilization rate in the FO group (56%) compared with the CTR (49%). Superoxide anion (O2 (-) ) rate was significantly lower (p < 0.05) at the third week of sampling in the FO. Although the H2 O2 rate was numerically lower in the FO group compared with the CTR, this difference was not significant. In addition, apoptosis showed a significant difference in the third week of sampling (15 and 30% for FO and CTR, respectively; p < 0.05). Overall, adding fish oil to the ram diet not only improved sperm quality and IVF results, it also could reduce oxygen-free radicals and the incidence of spermatozoa death.

  14. Effect of exogenous pulmonary surfactants on mortality rate in neonatal respiratory distress syndrome: A network meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Zhang, Liang; Cao, Hong-Yi; Zhao, Shuang; Yuan, Li-Jie; Han, Dan; Jiang, Hong; Wu, Song; Wu, Hong-Min

    2015-10-01

    The utilization of multiple natural and synthetic products in surfactant replacement therapies in treatment of neonatal respiratory distress syndrome (NRDS) prompted us to take a closer looks at these various therapeutic options and their efficacies. The purpose of our study was to evaluate the effects of six exogenous pulmonary surfactants (EPS) (Survanta, Alveofact, Infasurf, Curosurf, Surfaxin and Exosurf) on mortality rate in NRDS by a network meta-analysis. An exhaustive search of electronic databases was performed in PubMed, Ovid, EBSCO, Springerlink, Wiley, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang and VIP databases (last updated search in October 2014) to retrieve randomized controlled trials (RCTs) relevant to our study topic. Published clinical trials were screened based on the following inclusion criteria: (1) study design: RCTs; (2) interventions: treatment with Survanta, Alveofact, Infasurf, Curosurf, Surfaxin or Exosurf for NRDS; (3) study subject: infants with NRDS confirmed by clinical diagnosis; (4) outcome: the mortality rate of infants with NRDS. Statistical analysis was performed using Stata 12.0 software (Stata Corporation, College Station, TX, USA) and Comprehensive Meta-analysis (CMA 2.0) software. From the 1840 studies initially retrieved through database searches, a total of 17 high quality RCTs were selected for this network meta-analysis. The selected studies included a combined total of 57,223 infants with NRDS treated with various EPS (Survanta, 27,017; Alveofact, 159; Infasurf, 20,377; Curosurf, 20,911; Surfaxin, 646; Exosurf, 1640). Network meta-analysis results showed that the mortality rates in NRDS infants treated with Alveofact, Infasurf, Curosurf, Surfaxin, Exosurf were not significantly different compared to Survanta (Alveofact: OR = 1.163, 95% CI = 0.645-2.099, P = 0.616; Infasurf: OR = 0.985, 95% CI = 0.777-1.248, P = 0.897; Curosurf: OR = 0.789, 95% CI = 0.619-1.007, P = 0

  15. Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip

    Science.gov (United States)

    van den Berg, Maartje M.; Madi, Haifa H.; Khader, Ali; Hababeh, Majed; Zeidan, Wafa’a; Wesley, Hannah; Abd El-Kader, Mariam; Maqadma, Mohamed; Seita, Akihiro

    2015-01-01

    Background The United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA) has periodically estimated infant mortality rates among Palestine refugees in Gaza. These surveys have recorded a decline from 127 per 1000 live births in 1960 to 20.2 in 2008. Methods We used the same preceding-birth technique as in previous surveys. All multiparous mothers who came to the 22 UNRWA health centres to register their last-born child for immunization were asked if their preceding child was alive or dead. We based our target sample size on the infant mortality rate in 2008 and included 3128 mothers from August until October 2013. We used multiple logistic regression analyses to identify predictors of infant mortality. Findings Infant mortality in 2013 was 22.4 per 1000 live births compared with 20.2 in 2008 (p = 0.61), and this change reflected a statistically significant increase in neonatal mortality (from 12.0 to 20.3 per 1000 live births, p = 0.01). The main causes of the 65 infant deaths were preterm birth (n = 25, 39%), congenital anomalies (n = 19, 29%), and infections (n = 12, 19%). Risk factors for infant death were preterm birth (OR 9.88, 3.98–24.85), consanguinity (2.41, 1.35–4.30) and high-risk pregnancies (3.09, 1.46–6.53). Conclusion For the first time in five decades, mortality rates have increased among Palestine refugee newborns in Gaza. The possible causes of this trend may include inadequate neonatal care. We will estimate infant and neonatal mortality rates again in 2015 to see if this trend continues and, if so, to assess how it can be reversed. PMID:26241479

  16. Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip.

    Directory of Open Access Journals (Sweden)

    Maartje M van den Berg

    Full Text Available The United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA has periodically estimated infant mortality rates among Palestine refugees in Gaza. These surveys have recorded a decline from 127 per 1000 live births in 1960 to 20.2 in 2008.We used the same preceding-birth technique as in previous surveys. All multiparous mothers who came to the 22 UNRWA health centres to register their last-born child for immunization were asked if their preceding child was alive or dead. We based our target sample size on the infant mortality rate in 2008 and included 3128 mothers from August until October 2013. We used multiple logistic regression analyses to identify predictors of infant mortality.Infant mortality in 2013 was 22.4 per 1000 live births compared with 20.2 in 2008 (p = 0.61, and this change reflected a statistically significant increase in neonatal mortality (from 12.0 to 20.3 per 1000 live births, p = 0.01. The main causes of the 65 infant deaths were preterm birth (n = 25, 39%, congenital anomalies (n = 19, 29%, and infections (n = 12, 19%. Risk factors for infant death were preterm birth (OR 9.88, 3.98-24.85, consanguinity (2.41, 1.35-4.30 and high-risk pregnancies (3.09, 1.46-6.53.For the first time in five decades, mortality rates have increased among Palestine refugee newborns in Gaza. The possible causes of this trend may include inadequate neonatal care. We will estimate infant and neonatal mortality rates again in 2015 to see if this trend continues and, if so, to assess how it can be reversed.

  17. Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip.

    Science.gov (United States)

    van den Berg, Maartje M; Madi, Haifa H; Khader, Ali; Hababeh, Majed; Zeidan, Wafa'a; Wesley, Hannah; Abd El-Kader, Mariam; Maqadma, Mohamed; Seita, Akihiro

    2015-01-01

    The United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA) has periodically estimated infant mortality rates among Palestine refugees in Gaza. These surveys have recorded a decline from 127 per 1000 live births in 1960 to 20.2 in 2008. We used the same preceding-birth technique as in previous surveys. All multiparous mothers who came to the 22 UNRWA health centres to register their last-born child for immunization were asked if their preceding child was alive or dead. We based our target sample size on the infant mortality rate in 2008 and included 3128 mothers from August until October 2013. We used multiple logistic regression analyses to identify predictors of infant mortality. Infant mortality in 2013 was 22.4 per 1000 live births compared with 20.2 in 2008 (p = 0.61), and this change reflected a statistically significant increase in neonatal mortality (from 12.0 to 20.3 per 1000 live births, p = 0.01). The main causes of the 65 infant deaths were preterm birth (n = 25, 39%), congenital anomalies (n = 19, 29%), and infections (n = 12, 19%). Risk factors for infant death were preterm birth (OR 9.88, 3.98-24.85), consanguinity (2.41, 1.35-4.30) and high-risk pregnancies (3.09, 1.46-6.53). For the first time in five decades, mortality rates have increased among Palestine refugee newborns in Gaza. The possible causes of this trend may include inadequate neonatal care. We will estimate infant and neonatal mortality rates again in 2015 to see if this trend continues and, if so, to assess how it can be reversed.

  18. Utilization of postnatal care for newborns and its association with neonatal mortality in India: An analytical appraisal

    Directory of Open Access Journals (Sweden)

    Singh Abhishek

    2012-05-01

    Full Text Available Abstract Background 39% of neonatal deaths in India occur on the first day of life, and 57% during the first three days of births. However, the association between postnatal care (PNC for newborns and neonatal mortality has not hitherto been examined. The paper aims to examine the association of PNC for newborns with neonatal mortality in India. Methods Data from District Level Household Survey, waive three (DLHS-3 conducted in 2007–08 is utilized in the study. We used conditional logit regression models to examine the association of PNC with neonatal mortality. The matching variables included birth order and the age of the mother at the birth of the newborn. Results The findings suggest no association between check-up of newborns within 24 hours of birth and neonatal mortality. However, the place where the newborns were examined was significantly associated with neonatal mortality. Moreover, findings do reveal that children of mothers who were advised on ‘keeping baby warm (kangaroo care after birth’ during their antenatal sessions were significantly less likely to die during the neonatal period compared to those children whose mothers were not advised about the same. Conclusions The findings are relevant because ‘keeping baby warm’ is one of the most cost-effective and easiest interventions to save babies from dying during the neonatal period. Though randomized controlled trials have already demonstrated the effectiveness of ‘keeping baby warm’, for the first time this has been found effective in a large-scale population-based study. The findings are of immense value for a country like India where the neonatal mortality rates are unacceptably high.

  19. The Effect of Increased Coverage of Participatory Women’s Groups on Neonatal Mortality in Bangladesh: A Cluster Randomized Trial

    Science.gov (United States)

    Fottrell, Edward; Azad, Kishwar; Kuddus, Abdul; Younes, Layla; Shaha, Sanjit; Nahar, Tasmin; Aumon, Bedowra Haq; Hossen, Munir; Beard, James; Hossain, Tanvir; Pulkki-Brannstrom, Anni-Maria; Skordis-Worrall, Jolene; Prost, Audrey; Costello, Anthony; Houweling, Tanja A. J.

    2016-01-01

    Importance Community-based interventions can reduce neonatal mortality when health systems are weak. Population coverage of target groups may be an important determinant of their effect on behavior and mortality. A women’s group trial at coverage of 1 group per 1414 population in rural Bangladesh showed no effect on neonatal mortality, despite a similar intervention having a significant effect on neonatal and maternal death in comparable settings. Objective To assess the effect of a participatory women’s group intervention with higher population coverage on neonatal mortality in Bangladesh. Design A cluster randomized controlled trial in 9 intervention and 9 control clusters. Setting Rural Bangladesh. Participants Women permanently residing in 18 unions in 3 districts and accounting for 19 301 births during the final 24 months of the intervention. Interventions Women’s groups at a coverage of 1 per 309 population that proceed through a participatory learning and action cycle in which they prioritize issues that affected maternal and neonatal health and design and implement strategies to address these issues. Main Outcomes and Measures Neonatal mortality rate. Results Analysis included 19 301 births during the final 24 months of the intervention. More than one-third of newly pregnant women joined the groups. The neonatal mortality rate was significantly lower in the intervention arm (21.3 neonatal deaths per 1000 live births vs 30.1 per 1000 in control areas), a reduction in neonatal mortality of 38% (risk ratio, 0.62 [95% CI, 0.43-0.89]) when adjusted for socioeconomic factors. The cost-effectiveness was US $220 to $393 per year of life lost averted. Cause-specific mortality rates suggest reduced deaths due to infections and those associated with prematurity/low birth weight. Improvements were seen in hygienic home delivery practices, newborn thermal care, and breastfeeding practices. Conclusions and Relevance Women’s group community mobilization, delivered

  20. The death of marriage? The effects of new forms of legal recognition on marriage rates in the United States.

    Science.gov (United States)

    Dillender, Marcus

    2014-04-01

    Some conservative groups argue that allowing same-sex couples to marry reduces the value of marriage to opposite-sex couples. This article examines how changes in U.S. legal recognition laws occurring between 1995 and 2010 designed to include same-sex couples have altered marriage rates in the United States. Using a difference-in-differences strategy that compares how marriage rates change after legal recognition in U.S. states that alter legal recognition versus states that do not, I find no evidence that allowing same-sex couples to marry reduces the opposite-sex marriage rate. Although the opposite-sex marriage rate is unaffected by same-sex couples marrying, it decreases when domestic partnerships are available to opposite-sex couples.

  1. Higher neonatal growth rate and body condition score at 7 months are predictive factors of obesity in adult female Beagle dogs.

    Science.gov (United States)

    Leclerc, Lucie; Thorin, Chantal; Flanagan, John; Biourge, Vincent; Serisier, Samuel; Nguyen, Patrick

    2017-04-13

    The risks during early growth on becoming overweight in adulthood are widely studied in humans. However, early-life predictive factors for canine adult overweight and obesity have not yet been studied. To identify factors that may help explain the development of overweight and obesity at adulthood in dogs, a longitudinal study of 2 years was conducted in 24 female Beagle dogs of the same age, sexual status, and raised under identical environmental conditions. By means of a hierarchical classification on principal components with the following quantitative values: fat-free mass (FFM), percentage fat mass and pelvic circumference at 2 years of age, three groups of dogs were established and were nominally named: ideal weight (IW, n = 9), slightly overweight (OW1, n = 6) and overweight (OW2, n = 9). With the aim of identifying predictive factors of development of obesity at adulthood parental characteristics, growth pattern, energy balance and plasma factors were analysed by logistic regression analysis. At 24 months, the group compositions were in line with the body condition scores (BCS 1-9) values of the IW (5 or 6/9), the OW1 (6/9) and the OW2 (7 or 8/9) groups. Logistic regression analysis permitted the identification of neonatal growth rate during the first 2 weeks of life (GR2W) and BCS at 7 months as predictors for the development of obesity at adulthood. Seventy percent of dogs with either GR2W >125% or with BCS > 6/9 at 7 months belonged to the OW2 group. Results from energy intake and expenditure, corrected for FFM, showed that there was a greater positive energy imbalance between 7 and 10 months for the OW2, compared to the IW group. This study expands the understanding of previously reported risk factors for being overweight or obese in dogs, establishing that (i) 15 out of 24 of the studied dogs became overweight and (ii) GR2W and BCS at 7 months of age could be used as predictive factors as overweight adult dogs in the OW2 group

  2. Influence on the Rates of Neonatal Asphyxia and Successful Resuscitation of Midwife Resuscitation Training%助产士窒息复苏培训对新生儿窒息率及复苏成功率的影响

    Institute of Scientific and Technical Information of China (English)

    叶小苏

    2013-01-01

    Objective:To analyze effects on the rates of neonatal asphyxia and successful resuscitation of midwife resuscitation train-ing. Methods:The control group consisted of 12548 infants born from April 2006 to 2008 Aprils, the observation group consisted of 12460 infants born from May 2008 to May 2010, incidence of neonatal asphyxia was compared and analyzed before and after the midwife training. Results:The incidence of neonatal asphyxia was 3.65%in the control group, and that was 1.94%in the observa-tion group, the observation group was significantly better than the control group (P<0.01). Conclusion: Resuscitation training for midwives is obviously effective to decrease the rate of neonatal asphyxia, and rate of neonatal asphyxia will remain stable at a cer-tain level, when midwives are proficient in resuscitation technique and adhered to standards.%  目的:分析助产士窒息复苏培训对新生儿窒息复苏率以及复苏成功率的影响。方法:选取2006年4月~2008年4月出生的12548名新生儿作为对照组,2008年5月~2010年5月出生的12460名新生儿作为观察组,对助产士培训前后新生儿窒息发生率的变化进行对比分析。结果:对照组新生儿窒息的发生率为3.65%,观察组新生儿窒息的发生率为1.94%,观察组显著低于对照组(P<0.01)。结论:对助产士进行窒息复苏培训对降低新生儿窒息率具有非常明显的效果,且当助产士的复苏技术熟练而且操作规范时,新生儿的窒息率会在一定水平上保持稳定。

  3. The small-molecule TNF-α inhibitor, UTL-5g, delays deaths and increases survival rates for mice treated with high doses of cisplatin.

    Science.gov (United States)

    Shaw, Jiajiu; Media, Joseph; Chen, Ben; Valeriote, Fredrick

    2013-09-01

    UTL-5g is a novel small-molecule chemoprotector that lowers hepatotoxicity, nephrotoxicity, and myelotoxicity induced by cisplatin through TNF-α inhibition among other factors. The objective of this study was to investigate whether UTL-5g can reduce the overall acute toxicity of cisplatin and increase cisplatin tolerability in mice. BDF1 female mice were treated individually with UTL-5g (suspended in Ora-Plus) by oral gavage at 60 mg/kg, 30 min before i.p. injection of cisplatin at 10, 15, and 20 mg/kg, respectively, on Day 0. Starting from Day 1, individual mice were again treated daily by the same dose of UTL-5g for 4 consecutive days. Survivals and body weights were monitored. UTL-5g treatment increased the survival rate and delayed the time to death for mice treated with 150 % of the maximum tolerated dose (MTD) of cisplatin (15 mg/kg). Likewise, at 200 % of the MTD of cisplatin (20 mg/kg), treatment of UTL-5g increased the survival rate and delayed the time to death. Treatment of UTL-5g did not have a significant effect on weight loss induced by cisplatin, indicating that body weight may not be a sensitive-enough measure for chemoprotection of UTL-5g against cisplatin. In summary, UTL-5g delayed deaths and increased survival rates of mice treated by high doses of cisplatin, indicating that UTL-5g is capable of reducing the overall acute toxicity of cisplatin and increased cisplatin tolerability in mice; this is in line with the specific chemoprotective effects of UTL-5g previously reported. Further investigation of UTL-5g in combination with cisplatin is warranted.

  4. Global network for women’s and children’s health research: a system for low-resource areas to determine probable causes of stillbirth, neonatal, and maternal death

    OpenAIRE

    McClure, Elizabeth M; Bose, Carl L.; Garces, Ana; Esamai, Fabian; Goudar, Shivaprasad S; Patel, Archana; Chomba, Elwyn; Pasha, Omrana; Tshefu, Antoinette; Kodkany, Bhalchandra S.; Saleem, Sarah; Carlo, Waldemar A.; Derman, Richard J.; Hibberd, Patricia L.; Liechty, Edward A

    2015-01-01

    Background Determining cause of death is needed to develop strategies to reduce maternal death, stillbirth, and newborn death, especially for low-resource settings where 98% of deaths occur. Most existing classification systems are designed for high income settings where extensive testing is available. Verbal autopsy or audits, developed as an alternative, are time-intensive and not generally feasible for population-based evaluation. Furthermore, because most classification is user-dependent,...

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  6. 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...

  7. 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

  8. Rate of deaths due to child abuse and neglect in children 0-3 years of age in Germany.

    Science.gov (United States)

    Banaschak, Sibylle; Janßen, Katharina; Schulte, Babette; Rothschild, Markus A

    2015-09-01

    In recent years, increasing attention has been paid to the issue of (fatal) child abuse and neglect, largely due to the media attention garnered by some headline-grabbing cases. If media statements are to be believed, such cases may be an increasing phenomenon. With these published accounts in mind, publicly available statistics should be analysed with respect to the question of whether reliable statements can be formulated based on these figures. It is hypothesised that certain data, e.g., the Innocenti report published by UNICEF in 2003, may be based on unreliable data sources. For this reason, the generation of such data, and the reliability of the data itself, should also be discussed. Our focus was on publicly available German mortality and police crime statistics (Polizeiliche Kriminalstatistik). These data were classified with respect to child age, data origin, and cause of death (murder, culpable homicide, etc.). In our opinion, the available data could not be considered in formulating reliable scientific statements about fatal child abuse and neglect, given the lack of detail and the flawed nature of the basic data. Increasing the number of autopsies of children 0-3 years of age should be considered as a means to ensure the capture of valid, practical, and reliable data. This could bring about some enlightenment and assist in the development of preemptive strategies to decrease the incidence of (fatal) child abuse and neglect.

  9. Impact of the 1998 football World Cup on suicide rates in France: results from the national death registry.

    Science.gov (United States)

    Encrenaz, Gaëlle; Contrand, Benjamin; Leffondré, Karen; Queinec, Raphaëlle; Aouba, Albertine; Jougla, Eric; Miras, Alain; Lagarde, Emmanuel

    2012-04-01

    Our objective was to determine whether the Fédération Internationale de Football Association (FIFA) World Cup in 1998 had a short-term impact on the number of suicides in France. Exhaustive individual daily data on suicides from 1979 to 2006 were obtained from the French epidemiological center on the medical causes of death (CepiDC-INSERM; France). These data were analyzed using the seasonal ARIMA model. The overall effect of the World Cup was tested together with potential specific impact on days following the French team games. Between 11th June and 11th July, a significant decline of 95 suicides was observed (-10.3%), this effect being the strongest among men and people aged between 30 and 44. A significant decrease was also observed for the days following French team games (-19.9%). Our results are in favor of an effect of nationwide sport events on suicidal behaviors and are consistent with other studies. Many of the theories explaining the relationship between sports and suicide are related to sense of belongingness and social integration, highlighting the importance of social link reinforcement in suicide prevention.

  10. Active management of third stage of labour, post–partum haemorrhage and maternal death rate in the Vanga Health Zone, Province of Bandundu, Democratic Republic of the Congo

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Fina Lubaki

    2010-03-01

    Full Text Available Background: Post-partum haemorrhage (PPH is the single largest cause of maternal death worldwide and a particular burden for developing countries. In Africa, about 33.9 % of maternal deaths are due to PPH. In the Democratic Republic of the Congo (DRC, the prevalence of PPH is unknown. PPH can be prevented with active management of the third stage of labour (AMTSL. Objectives: To describe the practice of AMTSL in Vanga Health Zone and to calculate the incidence of PPH in Vanga Health Zone.Method: An intervention study with post-test-only design was conducted among health maternity wards using a data collection sheet to obtain information. All pregnant women attending Vanga Health maternity wards constituted the study population. Frequencies were determined for variables of interest.Results: From April 2007 to March 2008, 6339 deliveries took place at Vanga Health maternity wards, representing 71% of the institutional delivery rate. The number of deliveries realised with the practice of (AMTSL were 5562; 366 cases of PPH were reported, making an incidence of 5.77%. Three cases of maternal deaths – two of which were related to PPH – were reported during the study period, which means there was a decline of 70% compared with the previous two years.Conclusion: The prevalence of PPH has been estimated to be 5.77%; PPH represents the cause of 67% of all maternal deaths. The extension of AMTSL practice, combined with the assurance of better supplies of oxytocin to enhance drug management, is strongly advised/suggested. As a number of births still take place outside the health maternity wards, the introduction of oral misoprostol could be considered a part of AMTSL for use by patients being treated by traditional midwives.

  11. Early neonatal lamb mortality: postmortem findings.

    Science.gov (United States)

    Holmøy, I H; Waage, S; Granquist, E G; L'Abée-Lund, T M; Ersdal, C; Hektoen, L; Sørby, R

    2017-02-01

    An investigation of stillbirth and early neonatal lamb mortality was conducted in sheep flocks in Norway. Knowledge of actual causes of death are important to aid the interpretation of results obtained during studies assessing the risk factors for lamb mortality, and when tailoring preventive measures at the flock, ewe and individual lamb level. This paper reports on the postmortem findings in 270 liveborn lambs that died during the first 5 days after birth. The lambs were from 17 flocks in six counties. A total of 27% died within 3 h after birth, 41% within 24 h and 80% within 2 days. Most lambs (62%) were from triplet or higher order litters. In 81% of twin and larger litters, only one lamb died. The most frequently identified cause of neonatal death was infectious disease (n=97, 36%); 48% (n=47) of these died from septicaemia, 25% (n=24) from pneumonia, 22% (n=21) from gastrointestinal infections and 5% (n=5) from other infections. Escherichia coli accounted for 65% of the septicaemic cases, and were the most common causal agent obtained from all cases of infection (41%). In total, 14% of neonatal deaths resulted from infection by this bacterium. Traumatic lesions were the primary cause of death in 20% (n=53) of the lambs. A total of 46% of these died within 3 h after birth and 66% within 24 h. Severe congenital malformations were found in 10% (n=27) of the lambs, whereas starvation with no concurrent lesions was the cause of death in 6% (n=17). In 16% (n=43) of the lambs, no specific cause of death was identified, lambs from triplet and higher order litters being overrepresented among these cases. In this study, the main causes of neonatal lamb mortality were infection and traumatic lesions. Most neonatal deaths occurred shortly after birth, suggesting that events related to lambing and the immediate post-lambing period are critical for lamb survival.

  12. Outcomes of neonates with perinatal asphyxia at a tertiary academic ...

    African Journals Online (AJOL)

    40% of deaths of children under 5, it is apparent that Millennium. Developmental Goal 4 ... cardiopulmonary signs of asphyxia and multi-organ dysfunction.[6] .... and implementation of the South African neonatal resuscitation programme,[13] ...

  13. Neonatal mortality and stillbirths in early twentieth century Derbyshire, England.

    Science.gov (United States)

    Reid, A

    2001-11-01

    Neonatal mortality and stillbirths are recognised to be subject to similar influences, but survival after a successful live birth is usually considered in isolation of foetal wastage. Moreover, individual-level data on age-specific influences and causes of death in a historical context are rare. This paper uses an unusual data set to compare the influences on neonatal mortality and stillbirths in early twentieth century Derbyshire, England. Multivariate hazard and logistic analyses are performed to examine the relative roles of various social, environmental, and demographic factors. The influences on and causal structures of neonatal mortality and stillbirths emerge as broadly similar, with previous reproductive history linked to a considerable amount of variation. The clustering of endogenous deaths was much greater than the clustering of exogenous and post-neonatal deaths, probably reflecting the cause-of-death structure and the relatively healthy social and environmental position of early twentieth century Derbyshire.

  14. The Effects of Turner Syndrome, 45,X on Obstetric and Neonatal Outcomes: A Retrospective Cohort Evaluation.

    Science.gov (United States)

    Dotters-Katz, Sarah K; Humphrey, Whitney M; Senz, Kayli L; Lee, Vanessa R; Shaffer, Brian L; Caughey, Aaron B

    2016-10-01

    Objective This study aims to evaluate the perinatal and neonatal outcomes associated with prenatal diagnosis of 45,X, both with and without fetal cardiac anomalies. Study Design A retrospective cohort of singleton pregnancies in California, 2005 to 2008, using vital statistics and International Classification of Diseases, Ninth Revision data, identifying prenatally diagnosed 45,X. Outcomes included preterm delivery, preeclampsia, intrauterine fetal demise (IUFD), cesarean section, small for gestational age (SGA), neonatal death, and infant death. Bivariate and multivariate analyses were used to compare pregnancies and neonates with and without 45,X. Prenatally diagnosed cardiac anomalies were also considered. Results Of the 2,029,000 deliveries, 138 had prenatally diagnosed 45,X. Out of these 138 deliveries, 22 had a prenatally diagnosed cardiac anomaly. Compared with unaffected pregnancies, those with fetal 45,X had higher rates of preterm delivery (19.5 vs. 9.9%, p = 0.001), cesarean section (44.2 vs. 30.2%, p X cohort (p X (p = 0.005). In adjusted analysis, risk of SGA (X while controlling for fetal cardiac anomalies. Conclusion Prenatally diagnosed 45,X was associated with increased risk of cesarean section, and adverse neonatal outcomes, including mortality.

  15. Community health and medical provision: impact on neonates (the CHAMPION trial

    Directory of Open Access Journals (Sweden)

    Frost Chris

    2007-07-01

    Full Text Available Abstract Background The trial aims to evaluate whether neonatal mortality can be reduced through systemic changes to the provision and promotion of healthcare. Neonatal mortality rates in India are high compared to other low income countries, and there is a wide variation of rates across regions. There is evidence that relatively inexpensive interventions may be able to prevent up to 75% of these deaths. One area with a particularly high rate is Mahabubnagar District in Andhra Pradesh, where neonatal mortality is estimated to be in the region of 4–9%. The area suffers from a vicious cycle of both poor supply of and small demand for health care services. The trial will assess whether a package of interventions to facilitate systemic changes to the provision and promotion of healthcare may be able to substantially reduce neonatal mortality in this area and be cost-effective. If successful, the trial is designed so that it should be possible to substantially scale up the project in regions with similarly high neonatal mortality throughout Andhra Pradesh and elsewhere. Methods/Design This trial will be a cluster-randomised controlled trial involving 464 villages in Mahabubnagar District. The package of interventions will first be introduced in half of the villages with the others serving as controls. The trial will run for a period of three years. The intervention in the trial has two key elements: a community health promotion campaign and a system to contract out healthcare to non-public institutions. The health promotion campaign will include a health education campaign, participatory discussion groups, training of village health workers and midwives, and improved coordination of antenatal services. The intervention group will also have subsidised access to pregnancy-related healthcare services at non-public lth centres (NPHCs. The primary outcome of the trial will be neonatal mortality. Secondary outcomes will include age at and cause of

  16. A mortalidade neonatal em 1998, no município de Botucatu - SP La mortalidad neonatal en 1998, en el município de Botucatu-SP The neonatal mortality in 1998 at the municipality of Botucatu-SP

    Directory of Open Access Journals (Sweden)

    Kátia Poles

    2000-07-01

    present study, whose aim was to analyze the neonatal mortality during the year of 1998 at the municipality Botucatu-SP. The coefficient of neonatal mortality was of 8,3/1000 born alive and the coefficient of precocious neonatal mortality was of 7,3/1000 born alive, confirming the importance of decease in the first week of life. Results showed that approximately 3/4 of the deceases can be reduced through precocious diagnosis and treatment as well as adequate care to birth or partially reduced through appropriate pregnancy control measures, evidencing that in order to decrease the rates of neonatal death, investments must be made to improve the quality of the care to pregnant women, parturients and the new born.

  17. Neonatal Outcomes of Late-Preterm Birth Associated or Not with Intrauterine Growth Restriction

    Directory of Open Access Journals (Sweden)

    Cristiane Ortigosa Rocha

    2010-01-01

    Full Text Available Objective. To compare neonatal morbidity and mortality between late-preterm intrauterine growth-restricted (IUGR and appropriate-for-gestational-age (AGA infants of the comparable gestational ages (GAs. Methods. We retrospectively analyzed neonatal morbidity and mortality of 50 singleton pregnancies involving fetuses with IUGR delivered between 34 and 36 6/7 weeks of GA due to maternal and/or fetal indication. The control group consisted of 36 singleton pregnancies with spontaneous preterm delivery at the same GA, in which the infant was AGA. Categorical data were compared between IUGR and AGA pregnancies by 2 analysis and Fisher's exact test. Ordinal measures were compared using the Kruskal-Wallis test. Results. The length of stay of newborns in the nursery, as well as the need for and duration of hospitalization in the neonatal intensive care unit, was longer in the group with IUGR. Transient tachypnea of the newborn or apnea rates did not differ significantly between the IUGR and AGA groups. IUGR infants were found to be at a higher risk of intraventricular hemorrhage. No respiratory distress syndrome, pulmonary hemorrhage or bronchopulmonary dysplasia was observed in either group. The frequency of sepsis, thrombocytopenia and hyperbilirubinemia was similar in the two groups. Hypoglycemia was more frequent in the IUGR group. No neonatal death was observed. Conclusion. Our study showed that late-preterm IUGR infants present a significantly higher risk of neonatal complications when compared to late-preterm AGA infants.

  18. Epidemiologic features of early onset sepsis in neonatal ward of Shabih Khani hospital in Kashan

    Directory of Open Access Journals (Sweden)

    Ziba Mosayebi

    2015-02-01

    Full Text Available Background and objective: Neonatal sepsis is defined as presence of clinical signs accompanied by positive blood culture in newborns less than one month of age. Sepsis is a common cause of hospital admission in neonates, and it is known as one of the main causes of mortality among them, not only in developed countries but in developing ones. Delay in diagnosis and appropriate antibiotic therapy would result in death. The aim of this study is to find the main pathogens of sepsis and evaluate sensitivity changes of organisms to antibiotics in comparison with the past. Method: In this descriptive study, 104 (files of neonates, admitted to the neonatal ward of Shabih Khani Hospital, with positive blood culture over a 24-month period ( 2005-2007 were assessed. Data were extracted for analysis. Results: Over this 24-month study on 104 neonates with sepsis, the most common organisms included flavobacterium 43.3% , pseudomonas 33.3%, coagulase negative staphylococcus 17.3%, coagulase positive staphylococcus 5.9% followed by enterobacter , E.coli, beta-haemolytic streptococcus, klebsiella, diphtheriod and lysteria. Conclusion: In this study Flavobacterium is found to be the most common organism for early sepsis. Although infection with flavobacterium is rare, its rate of mortality is high and it is resistant to majority of common antibiotics. Therefore, early diagnosis and appropriate antibiotic prescription helps reduce its complications.

  19. [STUDY OF THE INFLUENCE OF MINERAL FERTILIZERS ON THE NEONATAL MORBIDITY RATE IN INFANTS WITH CONGENITAL MALFORMATIONS (CM) IN THE BELGOROD REGION].

    Science.gov (United States)

    Verzilina, I N; Chumosov, M I; Evdokimov, V I

    2015-01-01

    Results of the performed study showed that the use of mineral fertilizers for crops increases the risk of morbidity in neonates with congenital malformations (CM). P-elevated levels of relative environmental risk is established for: anomalies of the musculoskeletal system, multiple congenital malformations, the CM as a whole. Maximum environmental risk in the conditions of high load offertilizers on farmland is established for congenital abnormalities of the development of reproductive system in newborn infants (RR = 2,76).

  20. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015

    DEFF Research Database (Denmark)

    2016-01-01

    . Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3-43·6) to 2·6 million (2·6-2·7) neonatal deaths and 47·0% (35·1-57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3...... among children under 5 years, and stillbirths by geography over time. METHODS: Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1-4 years, and under 5) for 195...... to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources...

  1. Brain death.

    Science.gov (United States)

    Wijdicks, Eelco F M

    2013-01-01

    The diagnosis of brain death should be based on a simple premise. If every possible confounder has been excluded and all possible treatments have been tried or considered, irreversible loss of brain function is clinically recognized as the absence of brainstem reflexes, verified apnea, loss of vascular tone, invariant heart rate, and, eventually, cardiac standstill. This condition cannot be reversed - not even partly - by medical or surgical intervention, and thus is final. Many countries in the world have introduced laws that acknowledge that a patient can be declared brain-dead by neurologic standards. The U.S. law differs substantially from all other brain death legislation in the world because the U.S. law does not spell out details of the neurologic examination. Evidence-based practice guidelines serve as a standard. In this chapter, I discuss the history of development of the criteria, the current clinical examination, and some of the ethical and legal issues that have emerged. Generally, the concept of brain death has been accepted by all major religions. But patients' families may have different ideas and are mostly influenced by cultural attitudes, traditional customs, and personal beliefs. Suggestions are offered to support these families.

  2. 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

  3. 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 con

  4. Acute cell death rate of vascular smooth muscle cells during or after short heating up to 20s ranging 50 to 60°C as a basic study of thermal angioplasty

    Science.gov (United States)

    Shinozuka, Machiko; Shimazaki, Natsumi; Ogawa, Emiyu; Machida, Naoki; Arai, Tsunenori

    2014-02-01

    We studied the relations between the time history of smooth muscle cells (SMCs) death rate and heating condition in vitro to clarify cell death mechanism in heating angioplasty, in particular under the condition in which intimal hyperplasia growth had been prevented in vivo swine experiment. A flow heating system on the microscope stage was used for the SMCs death rate measurement during or after the heating. The cells were loaded step-heating by heated flow using a heater equipped in a Photo-thermo dynamic balloon. The heating temperature was set to 37, 50-60°C. The SMCs death rate was calculated by a division of PI stained cell number by Hoechst33342 stained cell number. The SMCs death rate increased 5-10% linearly during 20 s with the heating. The SMCs death rate increased with duration up to 15 min after 5 s heating. Because fragmented nuclei were observed from approximately 5 min after the heating, we defined that acute necrosis and late necrosis were corresponded to within 5 min after the heating and over 5 min after the heating, respectively. This late necrosis is probably corresponding to apoptosis. The ratio of necrotic interaction divided the acute necrosis rate by the late necrosis was calculated based on this consideration as 1.3 under the particular condition in which intimal hyperplasia growth was prevented in vivo previous porcine experiment. We think that necrotic interaction rate is larger than expected rate to obtain intimal hyperplasia suppression.

  5. 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

  6. 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.

  7. Carnitine in neonatal nutrition.

    Science.gov (United States)

    Borum, P R

    1995-11-01

    Experimental evidence from several investigators suggests that carnitine is a conditionally essential nutrient for neonates. If carnitine is a conditionally essential nutrient for the neonate, most neonates on total parenteral nutrition in the United States are not receiving adequate nutritional support. The metabolic functions of carnitine are varied and important in several aspects of neonatal physiology. All neonates receiving breast milk receive dietary carnitine and most neonates receiving enteral infant formulas receive dietary carnitine at a level similar to that of the breast-fed neonate. However, most neonates on total parenteral nutrition receive no dietary carnitine. Investigators have been testing the working hypothesis that carnitine is a conditionally essential nutrient for the neonate for many years. This review discusses (1) data supporting the hypothesis, (2) reasons why it has not been either proved or disproved by now, and (3) the author's view of a prudent approach to dietary carnitine supplementation of neonates.

  8. Neonatal tetanus in Turkey; what has changed in the last decade?

    Directory of Open Access Journals (Sweden)

    Kocamaz Halil

    2008-08-01

    Full Text Available Abstract Background Neonatal tetanus (NT is still considered as one of the major causes of neonatal death in many developing countries. The aim of the present study was to assess the characteristics of sixty-seven infants with the diagnosis of neonatal tetanus followed-up in the Pediatric Infectious Diseases Ward of Dicle University Hospital, Diyarbakir, between 1991 and 2006, and to draw attention to factors that may contribute (or may have contributed to the elimination of the disease in Diyarbakir. Methods The data of sixty-seven infants whose epidemiological and clinical findings were compatible with neonatal tetanus were reviewed. Patients were stratified into two groups according to whether they survived or not to assess the effect of certain factors in the prognosis. Factors having a contribution to the higher rate of tetanus among newborn infants were discussed. Results A total of 55 cases of NT had been hospitalized between 1991 and 1996 whereas only 12 patients admitted in the last decade. All of the infants had been delivered at home by untrained traditional birth attendants (TBA, and none of the mothers had been immunized with tetanus toxoid during her pregnancy. Twenty-eight (41.8% of the infants died during their follow-up. Lower birth weight, younger age at onset of symptoms and at the time admission, the presence of opisthotonus, risus sardonicus and were associated with a higher mortality rate. Conclusion Although the number of neonatal tetanus cases admitted to our clinic in recent years is lower than in the last decade efforts including appropriate health education of the masses, ensurement of access to antenatal sevices and increasing the rate of tetanus immunization among mothers still should be made in our region to achieve the goal of neonatal tetanus elimination.

  9. Neonatal lupus.

    Science.gov (United States)

    Robles, David T; Jaramillo, Lorena; Hornung, Robin L

    2006-12-10

    An otherwise healthy 5-week-old infant with erythematous plaques predominantly on the face and scalp presented to our dermatology clinic. The mother had been diagnosed with lupus erythematosus 2 years earlier but her disease was quiescent. Neonatal lupus is a rare condition associated with transplacental transfer of IgG anti-SSA/Ro and anti-SSB/La antibodies from the mother to the fetus. Active connective tissue disease in the mother does not have to be present and in fact is often absent. Although the cutaneous, hematologic and hepatic manifestations are transient, the potential for permanent heart block makes it necessary for this to be carefully ruled out. As in this case, the dermatologist may be the one to make the diagnosis and should be aware of the clinical presentation, work-up, and management of this important disease.

  10. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013

    DEFF Research Database (Denmark)

    Peterson, Carrie Beth

    2015-01-01

    the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa...... disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus......BACKGROUND: Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries...

  11. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    2015-01-01

    the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa...... disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus......Background Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries...

  12. Neonatal muscular manifestations in mitochondrial disorders.

    Science.gov (United States)

    Tulinius, Már; Oldfors, Anders

    2011-08-01

    During the last decade rapid development has occurred in defining nuclear gene mutations causing mitochondrial disease. Some of these newly defined gene mutations cause neonatal or early infantile onset of disease, often associated with severe progressive encephalomyopathy combined with other multi-organ involvement such as cardiomyopathy or hepatopathy and with early death. Findings suggesting myopathy in neonates are hypotonia, muscle weakness and wasting, and arthrogryposis. We aim to describe the clinical findings of patients with mitochondrial disease presenting with muscular manifestations in the neonatal period or in early infancy and in whom the genetic defect has been characterized. The majority of patients with neonatal onset of mitochondrial disease have mutations in nuclear genes causing dysfunction of the mitochondrial respiratory chain, leading to defective oxidative phosphorylation.

  13. Ethical issues in neonatal intensive care

    Directory of Open Access Journals (Sweden)

    Marcello M. Orzalesi

    2011-01-01

    Full Text Available Recent progress in neonatal care have significantly improved the prognosis and chances of survival of critically ill or extremely preterm neonates and have modified the limits of viability. However, in some circumstances, when the child's death can only be briefly postponed at the price of severe suffering, or when survival is associated with severe disabilities and an intolerable life for the child and his/her parents, the application of the full armamentarium of modern neonatal intensive care may not be appropriate. In such circumstances the limitation of intensive treatments (withholding or withdrawing and shift towards palliative care, can represent a more humane and reasonable alternative. This article examines and discusses the ethical principles underlying such difficult decisions, the most frequent situations in which these decisions may be considered, the role of parents in the decisional process, and the opinions and behaviours of neonatologists of several European neonatal intensive units as reported by the EURONIC study.

  14. Ethical issues in neonatal intensive care.

    Science.gov (United States)

    Orzalesi, Marcello M; Cuttini, Marina

    2011-01-01

    Recent progress in neonatal care have significantly improved the prognosis and chances of survival of critically ill or extremely preterm neonates and have modified the limits of viability. However, in some circumstances, when the child's death can only be briefly postponed at the price of severe suffering, or when survival is associated with severe disabilities and an intolerable life for the child and his/her parents, the application of the full armamentarium of modern neonatal intensive care may not be appropriate. In such circumstances the limitation of intensive treatments (withholding or withdrawing) and shift towards palliative care, can represent a more humane and reasonable alternative. This article examines and discusses the ethical principles underlying such difficult decisions, the most frequent situations in which these decisions may be considered, the role of parents in the decisional process, and the opinions and behaviours of neonatologists of several European neonatal intensive units as reported by the EURONIC study.

  15. New treatment paradigms in neonatal metabolic epilepsies.

    Science.gov (United States)

    Pearl, P L

    2009-04-01

    Neonatal seizures represent a major challenge among the epilepsies vis-à-vis seizure classification, electroclinical correlation, inherent excitability of neocortex, ontogenic characteristics of neurotransmitter receptors, and responsiveness to standard antiepileptic drugs. Each of these factors renders neonatal seizures more difficult to treat, and therapy has been a vexing area for recent advances in this seizure category. Conversely, specific metabolic disorders have very special therapeutic considerations in the clinical setting of neonatal seizures which require a high index of clinical suspicion and rapid intervention for a successful outcome. The prototype is pyridoxine dependency, although pyridoxal 5'-phosphate dependency is a recently recognized but treatable neonatal epilepsy that deserves earmarked distinction. Clinicians must remain vigilant for these possibilities, including atypical cases where apparent seizure-free intervals may occur. Folinic acid-dependent seizures are allelic with pyridoxine dependency. Serine-dependent seizures and glucose transporter deficiency may present with neonatal seizures and have specific therapy. A vital potassium channel regulated by serum ATP/ADP ratios in the pancreas and brain may be mutated with a resultant neuroendocrinopathy characterized by development delay, epilepsy, and neonatal diabetes (DEND). This requires oral hypoglycaemic therapy, and not insulin, for neurological responsiveness. The startle syndrome of hyperekplexia, which mimics neonatal epilepsy, has been associated with laryngospasm and sudden death but is treated with benzodiazepines.

  16. Mortalidade neonatal no Município de Londrina, Paraná, Brasil, nos anos 1994, 1999 e 2002 Neonatal mortality in Londrina, Paraná State, Brazil, in 1994, 1999, and 2002

    Directory of Open Access Journals (Sweden)

    Lígia Silvana Lopes Ferrari

    2006-05-01

    Full Text Available Apesar dos avanços tecnológicos nas últimas décadas, a mortalidade neonatal é responsável por mais de 2/3 dos óbitos infantis, principalmente em regiões onde o coeficiente de mortalidade infantil é baixo. O objetivo deste estudo é analisar os óbitos neonatais do Município de Londrina, Paraná, Brasil, em três períodos, iniciando por 1994 ­ ano de implantação das UTIs pediátrica e neonatal no município. Foram utilizados dados do SINASC e análise individualizada de cada declaração de óbito neonatal dos anos de 1994, 1999 e 2002. Verificou-se redução do número de nascimentos no município, o índice de baixo peso aumentou de 7,7 para 8,8%, e o de prematuridade aumentou de 6,3 para 8,4%. Houve aumento de gestações múltiplas. A taxa de cesariana variou de 48 a 52%. O coeficiente de mortalidade neonatal declinou de 10,1 para 6,4 por mil nascidos vivos. A maioria dos óbitos são evitáveis, principalmente, por adequada atenção na gravidez. Conclui-se que está ocorrendo uma melhora progressiva na assistência ao recém-nascido, e isso é um bom indicador das ações de saúde do município.Despite technological progress in recent decades, neonatal mortality accounts for some two-thirds of infant deaths where the infant mortality rates are low. This study analyzes neonatal deaths in Londrina, Paraná, Brazil, during three periods, beginning with 1994, the year when pediatric and neonatal intensive care beds were created in the city. The data were collected from live birth certificates in the National Information System on Live Births (SINASC and individual analysis of neonatal death certificates. Births declined in the city, but the low birthweight rate increased from 7.7 to 8.8% and the preterm birth rate from 6.3 to 8.4%. Multiple births also increased. Caesarian sections varied from 48 to 52%. The percentage of deaths from congenital malformations increased. The vast majority of neonatal deaths are preventable, mainly

  17. Intravenous drug delivery in neonates: lessons learnt.

    Science.gov (United States)

    Sherwin, Catherine M T; Medlicott, Natalie J; Reith, David M; Broadbent, Roland S

    2014-06-01

    Intravenous drug administration presents a series of challenges that relate to the pathophysiology of the neonate and intravenous infusion systems in neonates. These challenges arise from slow intravenous flow rates, small drug volume, dead space volume and limitations on the flush volume in neonates. While there is a reasonable understanding of newborn pharmacokinetics, an appreciation of the substantial delay and variability in the rate of drug delivery from the intravenous line is often lacking. This can lead to difficulties in accurately determining the pharmacokinetic and pharmacodynamic relationship of drugs in the smallest patients. The physical variables that affect the passage of drugs through neonatal lines need to be further explored in order to improve our understanding of their impact on the delivery of drugs by this route in neonates. Through careful investigation, the underlying causes of delayed drug delivery may be identified and administration protocols can then be modified to ensure predictable, appropriate drug input kinetics.

  18. Time from uterine incision to delivery and hypoxic neonatal outcomes.

    Science.gov (United States)

    Spain, Janine E; Tuuli, Methodius; Stout, Molly J; Roehl, Kimberly A; Odibo, Anthony O; Macones, George A; Cahill, Alison G

    2015-04-01

    The objective of this study was to estimate the association between time from uterine incision to delivery and hypoxic neonatal outcomes in nonanomalous term infants. All women undergoing in-labor term cesarean deliveries (CDs) in the first 2 years of an ongoing prospective cohort study were included. The primary exposure was time in seconds from uterine incision to delivery. The primary outcome was a composite of hypoxia-associated neonatal outcomes, defined as at least one of: seizures, hypoxic ischemic encephalopathy, need for hypothermia treatment, and death within 7 days. Of 812 patients who underwent in-labor CD, the composite hypoxia outcome occurred in 18 (2.2%) neonates. There was no significant difference in the rate of hypoxic morbidity with increasing increments of 60 seconds from uterine incision to delivery (p = 0.35). There was a significantly increased risk of hypoxic morbidity in those delivered in the highest quintile (>240 seconds) compared with those in the lowest quintile (≤ 60 seconds) in cesareans performed for an indication other than nonreassuring fetal status (relative risk, 5.58; 95% confidence interval, 1.30-23.91). Overall, duration from uterine incision to delivery for in-labor cesareans of nonanomalous term infants was not associated with an increase in risk of hypoxia-associated morbidities. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Knowledge, attitudes and practices of neonatal staff concerning neonatal pain management

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    Sizakele L.T. Khoza

    2014-10-01

    Full Text Available Background: Neonatal pain management has received increasing attention over the past four decades. Research into the effects of neonatal pain emphasises the professional, ethical and moral obligations of staff to manage pain for positive patient outcomes. However, evaluation studies continuously report evidence of inadequate neonate pain management and a gap between theory and practice.Objective: This study reviewed current practice in neonatal pain management to describe the knowledge, attitudes and practices of nurses and doctors regarding pain management for neonates in two academic hospitals.Method: A non-experimental, prospective quantitative survey, the modified Infant Pain Questionnaire, was used to collect data from 150 nurses and doctors working in the neonatal wards of two academic hospitals in central Gauteng.Results: The response rate was 35.33% (n = 53, most respondents being professional nurses (88.68%; n = 47 working in neonatal intensive care units (80.77%; n = 42; 24 (45.28% had less than 5 years’ and 29 respondents 6 or more years’ working experience in neonatal care. A review of pain management in the study setting indicated a preference for pharmacological interventions to relieve moderate to severe pain. An association (p < 0.05 was found between pain ratings on 5 procedures and frequency of administration of pharmacological pain management. Two-thirds of respondents (64% reported that there were no pain management guidelines in the neonatal wards in which they worked.Conclusion: The interventions to manage moderate neonatal pain are in line with international guidelines. However, neonatal pain management may not occur systematically based on prior assessment of neonatal pain, choice of most appropriate intervention and evaluation. This study recommends implementation of a guideline to standardise practice and ensure consistent and adequate pain management in neonates

  20. Management of the sick neonate with suspected heart disease.

    Science.gov (United States)

    Brooks, Paul A; Penny, Daniel J

    2008-03-01

    A proportion of symptomatic neonates with congenital heart disease have lesions requiring urgent stabilisation. Despite increasing antenatal diagnoses, the importance of early recognition of symptomatic neonates is highlighted by the fact that up to 10% of all deaths in congenital heart disease continue to occur in children undiagnosed at the time of death. Specific anatomical knowledge of the many complex lesions is not required for good early management. The focus of this article is the specific symptom complexes in critically ill neonates with congenital heart disease, initial management strategies for stabilization and transfer to specialist centres, and issues in the ongoing preoperative care.

  1. Impact of ALSO training on the management of prolonged labor and neonatal care at Kagera Regional Hospital, Tanzania

    DEFF Research Database (Denmark)

    Sorensen, Bjarke Lund; Rasch, Vibeke; Massawe, Siriel

    2010-01-01

    5.6% to 71.5% (RR 12.71; 95% CI, 9.04-17.88). There was a significant decrease from 6 to 0 neonatal deaths before discharge among those born with an Apgar score after 1minute of 4 or more (P=0.03). CONCLUSION: ALSO training had no effect on the management of prolonged labor. Early contact between......OBJECTIVE: To evaluate the management of prolonged labor and neonatal care before and after Advanced Life Support in Obstetrics (ALSO) training. METHODS: Staff involved in childbirth at Kagera Regional Hospital, Tanzania, attended a 2-day ALSO provider course. In this prospective intervention study....... During prolonged labor, action was delayed for more than 3hours in half of the cases. The stillbirth rate, Apgar scores, and frequency of neonatal resuscitation did not change significantly. After the intervention, there was a significant increase in newborns given to their mothers within 10minutes, from...

  2. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants.

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    Amos Grünebaum

    Full Text Available Over the last decade, planned home births in the United States (US have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status.The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States.This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM, nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board.Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53 than home births attended by certified midwives (NNM: 10.0/10,000; RR 1 and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]. The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2.This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal

  3. Infants at Risk: Perinatal and Neonatal Factors.

    Science.gov (United States)

    Lipsitt, Lewis P.

    1979-01-01

    Reviews studies of infant behavior and development. Delineates a behavioral hypothesis relating prenatal and neonatal risk factors in infancy to crib death. The mutual dependence of experience and neurostructural development suggests that infancy is a period of critical learning experiences. (Author/RH)

  4. Acute kidney injury in asphyxiated neonates

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    Roy Amardiyanto

    2013-07-01

    Full Text Available Background Asphyxia neonatorum may result in multiorgan dysfunction including renal involvement. There is no consensus on the determination of acute kidney injury (AKI in neonates making establishment of the diagnosis and its management becomes difficult. The Acute Kidney Injury Network (AKIN recommends AKI criteria based on increased serum creatinine level and reduced urine output. Objectives To identify the prevalence of AKI in asphyxiated neonates using the AKIN criteria, to compare the difference of AKI stages, and the glomerular filtration rates (GFR between moderate and severe asphyxia. Methods This was a cross-sectional analytical study conducted between July 2012 and January 2013. Subjects were all asphyxiated neonates (Apgar score 35 weeks delivered and hospitalized in Cipto Mangunkusumo Hospital and Koja District Hospital, Jakarta, Indonesia. Glomerular filtration rate was calculated using the components of urine creatinine, serum creatinine, and urine output; while AKI stages were determined according to AKIN criteria. Urinary output was measured via urethral catheterization. Results Of 94 subjects, there were 70 neonates with moderate and 24 neonates with severe asphyxia, with the prevalence of AKI was 63%. Twenty one out of 24 neonates with severe asphyxia experienced AKI, while neonates with moderate asphyxia who experienced AKI was 38 out of 70 subjects (54%. Two third of neonates with severe asphyxia who experienced AKI had stage 3 of AKI. More severe AKI stages and lower median GFR were found in neonates with severe compared to moderate asphyxia (P<0.001. Conclusion The prevalence of AKI in neonatal asphyxia is high (63%. The more severe degree of neonatal asphyxia, the more severe AKI stage and the lower median GFR. [Paediatr Indones. 2013;53:232-8.].

  5. Media Stories on NICU Outbreaks Lead to an Increased Prescription Rate of Third-Line Antibiotics in the Community of Neonatal Care.

    Science.gov (United States)

    Härtel, Christoph; Hartz, Annika; Bahr, Lina; Gille, Christian; Gortner, Ludwig; Simon, Arne; Orlikowsky, Thorsten; Müller, Andreas; Körner, Thorsten; Henneke, Philipp; Haase, Roland; Zemlin, Michael; Viemann, Dorothee; Gebauer, Corinna; Thome, Ulrich; Ziegler, Andreas; Rupp, Jan; Herting, Egbert; Göpel, Wolfgang

    2016-08-01

    BACKGROUND Between 2010 and 2012, 3 outbreaks of nosocomial infections in German neonatal intensive care units (NICUs) attracted considerable public interest. Headlines on national television channels and in newspapers had important consequences for the involved institutions and a negative impact on the relationship between families and staff in many German NICUs. OBJECTIVE To determine whether NICU outbreaks reported in the media influenced provider behavior in the community of neonatal care and led to more third-line antibiotic prescribing. DESIGN Observational cohort study. METHODS To investigate secular trends, we evaluated data for very-low-birth-weight infants (VLBWIs, birth weight <1,500 g) enrolled in the German Neonatal Network (GNN) between 2009 and 2014 (N=10,253). For outbreak effects, we specifically analyzed data for VLBWIs discharged 6 months before (n=2,428) and 6 months after outbreaks (n=2,508). RESULTS The exposure of all VLBWIs to third-line antibiotics increased after outbreaks (19.4% before vs 22.5% after; P=.007). This trend particularly affected male infants (4.6% increase; P=.005) and infants with a birth weight between 1,000 and 1,499 g (3.5% increase; P=.001) In a logistic regression analysis, month of discharge as linear variable of time was associated with increased exposure to third-line antibiotics (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.009-1.014; P<.001), and discharge within the 6-month period after outbreak reports independently contributed to this long-term trend (OR, 1.14; 95% CI, 1.017-1.270; P=.024). CONCLUSIONS Media reports directly affect medical practice, eg, overuse of third-line antibiotics. Future communication and management strategies must be based on objective dialogues between the scientific community and investigative journalists. Infect Control Hosp Epidemiol 2016;37:924-930.

  6. Influence of habitat and intrinsic characteristics on survival of neonatal pronghorn

    Science.gov (United States)

    Jacques, Christopher N.; Jenks, Jonathan A.; Grovenburg, Troy W.; Klaver, Robert W.

    2015-01-01

    Increased understanding of the influence of habitat (e.g., composition, patch size) and intrinsic (e.g., age, birth mass) factors on survival of neonatal pronghorn (Antilocapra americana) is a prerequisite to successful management programs, particularly as they relate to population dynamics and the role of population models in adaptive species management. Nevertheless, few studies have presented empirical data quantifying the influence of habitat variables on survival of neonatal pronghorn. During 2002–2005, we captured and radiocollared 116 neonates across two sites in western South Dakota. We documented 31 deaths during our study, of which coyote (Canis latrans) predation (n = 15) was the leading cause of mortality. We used known fate analysis in Program MARK to investigate the influence of intrinsic and habitat variables on neonatal survival. We generated a priori models that we grouped into habitat and intrinsic effects. The highest-ranking model indicated that neonate mortality was best explained by site, percent grassland, and open water habitat; 90-day survival (0.80; 90% CI = 0.71–0.88) declined 23% when grassland and water increased from 80.1 to 92.3% and 0.36 to 0.40%, respectively, across 50% natal home ranges. Further, our results indicated that grassland patch size and shrub density were important predictors of neonate survival; neonate survival declined 17% when shrub density declined from 5.0 to 2.5 patches per 100 ha. Excluding the site covariates, intrinsic factors (i.e., sex, age, birth mass, year, parturition date) were not important predictors of survival of neonatal pronghorns. Further, neonatal survival may depend on available land cover and interspersion of habitats. We have demonstrated that maintaining minimum and maximum thresholds for habitat factors (e.g., percentages of grassland and open water patches, density of shrub patches) throughout natal home ranges will in turn, ensure relatively high (>0.50) neonatal survival rates

  7. On Death

    Institute of Scientific and Technical Information of China (English)

    Zhangyan

    2016-01-01

    Death is not a terrible word, but a provoking one. Different people have different opinions, but no one can convince others of what death really means. This article made a tentative and superficial analysis on death according to the true feeing and experiences of the author. In her opinion, we needn’t consider more about death; the important for the death is how to live meaningfully.

  8. 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

  9. [Advances in neonatal intensive medicine].

    Science.gov (United States)

    Pérez-González, J; Olivares, J L; Ventura, P; Fabre, E

    1983-09-01

    In the last few year a significative reduction on the rates of neonatal morbimortality have appeared. This has been achieved because a better understanding of embrio-fetal physiology, emerged under the patronage of technological development: new diagnostic techniques, monitorization (physiological and therapeutical) in both, pre and postnatal periods. This model of attendance (perinatology) has its' climax in neonatal intensive care. New scientific plans have to be examined continuously in a critical way, according with ethical reasons related with this type of medical assistance.

  10. Probiotics in neonatal intensive care - back to the future.

    Science.gov (United States)

    Deshpande, Girish; Rao, Shripada; Patole, Sanjay

    2015-06-01

    Survival of extremely preterm and critically ill neonates has improved significantly over the last few decades following advances in neonatal intensive care. These include antenatal glucocorticoids, surfactant, continuous positive airway pressure support, advanced gentle modes of ventilation and inhaled nitric oxide. Probiotic supplementation is a recent significant milestone in the history of neonatal intensive care. Very few, if any, interventions match the ability of probiotics to significantly reduce the risk of death and definite necrotising enterocolitis while facilitating enteral feeds in high-risk preterm neonates. Probiotics also have a potential to benefit neonates with surgical conditions with significant gastrointestinal morbidity. Current evidence for the benefits of probiotic supplementation for neonates in an intensive care unit is reviewed. The mechanisms for the benefits of probiotics in this population are discussed, and guidelines for clinicians are provided in the context of the regulatory framework in Australia. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  11. Bacterial Culture of Neonatal Sepsis

    Directory of Open Access Journals (Sweden)

    AH Movahedian

    2006-08-01

    Full Text Available Neonatal bacterial sepsis is one of the major cause of morbidity and mortality in neonates. This retrospective study was performed to determine the incidence of bacterial sepsis with focus on Gram negative organisms in neonates admitted at Beheshti Hospital in Kashan, during a 3-yr period, from September 2002 to September 2005. Blood culture was performed on all neonates with risk factors or signs of suggestive sepsis. Blood samples were cultured using brain heart infusion (BHI broth according to standard method. From the 1680 neonates 36% had positive blood culture for Pseudomans aeruginosa, 20.7% for Coagulase negative Staphylococci, and 17% for Klebsiella spp. Gram-negative organisms accounted for 72.1% of all positive cultures. The overall mortality rate was 19.8% (22 /111 of whom 63.6% (14 /22 were preterm. Pseudomona aeruginosa and Klebsiella spp. showed a high degree of resistance to commonly used antibiotics (ampicillin, gentamicin as well as third generation cephalosporins. Continued local surveillance studies are urged to monitor emerging antimicrobial resistance and to guide interventions to minimize its occurrence.

  12. Embryonic and neonatal mortality from salmonellosis in captive bred raptors.

    Science.gov (United States)

    Battisti, A; Di Guardo, G; Agrimi, U; Bozzano, A I

    1998-01-01

    In a captive breeding center near Rome (Italy), cases of embryonic and neonatal death were recorded during the breeding seasons in the European eagle owl (Bubo bubo), peregrine falcon (Falco peregrinus), buzzard (Buteo buteo), and lanner falcon. (Falco biarmicus). Salmonella havana and S. virchow were isolated. Three pulli, clinically infected with S. havana, were successfully treated with enrofloxacin. From two groups of healthy 3- to 4-wk-old eagle owls, Salmonella sp. group 61 (61:r:-) and S. havana were collected. A strain of S. paratyphi B was detected in a pharyngeal swab and a fecal sample from an adult female goshawk (Accipiter gentilis), affected with pharyngeal trichomoniasis. A S. hadar strain was collected from a healthy 1-yr-old female eagle owl and S. livingstone was isolated from a 1-mo-old female peregrine, dead of an acute respiratory syndrome. Lesions of fibrinous polyserositis and multivisceral congestion were observed. From frozen 1-day-old chicks, on which adult and young raptors were fed, S. havana and S. livingstone isolates with similar biochemical and drug susceptibility patterns to those isolated from raptors were identified. A surveillance program on infectious diseases reduced embryonic and neonatal death rates in the following breeding seasons.

  13. Causes of early childhood deaths in urban Dhaka, Bangladesh.

    Directory of Open Access Journals (Sweden)

    Amal K Halder

    Full Text Available Data on causes of early childhood death from low-income urban areas are limited. The nationally representative Bangladesh Demographic and Health Survey 2007 estimates 65 children died per 1,000 live births. We investigated rates and causes of under-five deaths in an urban community near two large pediatric hospitals in Dhaka, Bangladesh and evaluated the impact of different recall periods. We conducted a survey in 2006 for 6971 households and a follow up survey in 2007 among eligible remaining households or replacement households. The initial survey collected information for all children under five years old who died in the previous year; the follow up survey on child deaths in the preceding five years. We compared mortality rates based on 1-year recall to the 4 years preceding the most recent 1 year. The initial survey identified 58 deaths among children <5 years in the preceding year. The follow up survey identified a mean 53 deaths per year in the preceding five years (SD+/-7.3. Under-five mortality rate was 34 and neonatal mortality was 15 per thousand live births during 2006-2007. The leading cause of under-five death was respiratory infections (22%. The mortality rates among children under 4 years old for the two time periods (most recent 1-year recall and the 4 years preceding the most recent 1 year were similar (36 versus 32. The child mortality in urban Dhaka was substantially lower than the national rate. Mortality rates were not affected by recall periods between 1 and 5 years.

  14. Value of postmortem studies in deceased neonatal and pediatric intensive care unit patients.

    Science.gov (United States)

    Widmann, Raphael; Caduff, Rosmarie; Giudici, Luca; Zhong, Qing; Vogetseder, Alexander; Arlettaz, Romaine; Frey, Bernhard; Moch, Holger; Bode, Peter K

    2017-02-01

    Worldwide, various autopsy studies have shown a decrease in the diagnostic error rate over the last years. The cause of this positive development is mainly due to the improvement of modern medicine. However, intensive care unit patients are thought to have a higher risk for diagnostic errors, which is documented in several studies in the adult population. In contrast, there is only limited information about diagnostic errors in pediatrics, particularly in pediatric and neonatal intensive care units. The aims of this study were to analyze the spectrum of childhood death, determine the prevalence and distribution of autopsy-confirmed diagnostic errors, and describe patient characteristics that might have influenced the discordance between antemortem and postmortem findings. We analyzed 143 autopsy reports from 2004 to 2013 and correlated these with clinical reports. The overall autopsy rate during this interval was 20.3%. The leading causes of death were congenital malformations (28%), diseases closely associated with perinatal disorders (25%), disorders of the cardiovascular system (18%), and infections (15%). Additional findings were obtained in 23% of the autopsies. Major diagnostic errors were found in 6%, the lowest reported value in a developed country as yet. Most cases (75%) showed complete concordance between clinical diagnoses and postmortem findings, in line with improvements in diagnostic and therapeutic processes over the last decades. In conclusion, autopsy of neonates, infants, and children represents an important tool for monitoring the quality of pediatric and neonatal medical care.

  15. Neonatal tetanus mortality survey, north and south Omo administrative regions, Ethiopia.

    Science.gov (United States)

    Alemu, W

    1993-04-01

    Neonatal tetanus (NNT) is the second most frequent cause of infant mortality among the six vaccine preventable infections in developing countries. However, lack of reliable data has largely obscured the importance of the problem in these countries. A community based NNT mortality survey was conducted, using cluster sample method developed by WHO/EPI, in August 1989 in North and South Omo, Ethiopia. The study found 14 neonatal tetanus deaths among 2100 live births which occurred from 15 July 1988 to 15 July 1989, giving NNT mortality rate of 6.7/1000 LB (live births) and an estimated incidence rate of 8.4/1000 LB, accounting for 40% of all neonatal deaths. Male newborns were 2.5 times more commonly affected than females. Cutting of umbilical cord with unsterile instrument, home delivery attended by untrained TBAs, and lack of adequate tetanus TT immunization were found to be associated with increased incidence of NNT. Acceleration and promotion of TT immunization of all women of child bearing age and training of TBAs in proper obstetric care, coupled with continuous supportive supervision, is recommended in order to successfully execute the NNT elimination initiative undertaken by the Ministry of Health.

  16. 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.

  17. Frequency of Hypoxic-Ischemic Encephalopathy Among Hospitalized Neonates in West Iran

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    Fatemeh Eghbalian

    2010-06-01

    Full Text Available Hypoxic-ischemic encephalopathy (HIE is brain damage from a shortage of oxygen or blood flow to the tissues[1,2] and is characterized by clinical and laboratory evidence of acute or subacute brain injury due to asphyxia[1-6]. It is a major contributor to neonatal death and morbidity[4-6]. 15%-20% of HIE cases die during the neonatal period and 30% of those who survive suffer from neurodevelopmental disorders[1,3,6].An estimated 23% of the 4 million neonatal deaths and 8% of all deaths at <5 years of age throughout the world each year are associated with signs of asphyxia at birth[1,4]. Even at referral centers in developed countries, death or moderate to severe disability occurs for 53% to 61% of infants diagnosed as having moderate to severe HIE[1,4,6]. Children with moderate/severe neonatal encephalopathy are at risk for reduced school performance, whereas those with mild encephalopathy have school performance scores similar to those of their peers[1,6]. HIE is one of the most common causes of cerebral palsy and other severe neurologic deficits in children occurring in two to nine of every 1000 live births [1-6]. The incidence of HIE reported in different studies varies widely[2-6], which may be explained by the selection criteria for studies of HIE during the neonatal period[3,4].The aim of the present study was to evaluate the frequency of hypoxic-ischemic encephalo-pathy in hospitalized neonates with seizure in Hamedan (west Iran in a two year period.This is a retrospective cross sectional study on 34 neonates from 2004 to 2006.Inclusion criteria were: all neonates with seizures due to HIE asphyxia having pH below 7, 5th minute Apgar score between 0 and 3, decreased muscle tone and consciousness, cortical atrophy in brain CT scan and multiple organ involvement (eg, kidney, lungs, liver, heart, intestines. Neonates with jitteriness were excluded from the study.The study was based on the recorded files of the patients. CT scan findings, blood

  18. NEONATAL OUTCOME IN ANEMIC MOTHERS: A PROSPECTIVE STUDY

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    Nisha

    2013-10-01

    Full Text Available BACKGROUND: Sepsis is the commonest cause of neonatal mortality .It is responsible for 30 - 50% of neonatal deaths in developing countries. Anemia during pregnancy is highly prev alent in India. Anemia in pregnancy has adverse effects on maternal and fetal health. Obstetrical complications like low birth weight babies, IUGR, increased rate of preterm deliveries & increased perinatal mortality are known. OBJECTIVES: Primary: To find relation between maternal anemia and proven neonatal sepsis. Secondary: To find long term morbidity and mortality of babies born to anemic mother. METHODS: The study was carried out in the Department of Pediatrics and Obstetrics and Gynaecology, Dr. B. R. Ambedkar Medical College and Hospital, Bangalore for a period of two years. A prospective randomized study conducted on 200 pregnant women who were found to be anaemic. All subjects were analyzed in full details and hemoglobin estimation done during 1 st v isit, at 30 th week and 36 th week of gestation. Blood cultures were done in all the babies admitted to NICU for various reasons. RESULTS: The incidence of mild anaemia 29.5%, moderate anemia 53% and 17.5% severe anaemia was noted in mothers. Out of total 20 0, 194 were liveborn and met the inclusion criteria, 20% were preterm, 28% IUGR, 51 babies(25 % required NICU admission due to various reasons out of which 9% developed proven sepsis. CONCLUSION: Anaemia in pregnancy continues to be a major problem in dev eloping countries with maternal and fetal complications and neonatal sepsis was found to be indirectly associated with maternal anaemia.

  19. Invariant death

    Science.gov (United States)

    Frank, Steven A.

    2016-01-01

    In nematodes, environmental or physiological perturbations alter death’s scaling of time. In human cancer, genetic perturbations alter death’s curvature of time. Those changes in scale and curvature follow the constraining contours of death’s invariant geometry. I show that the constraints arise from a fundamental extension to the theories of randomness, invariance and scale. A generalized Gompertz law follows. The constraints imposed by the invariant Gompertz geometry explain the tendency of perturbations to stretch or bend death’s scaling of time. Variability in death rate arises from a combination of constraining universal laws and particular biological processes.

  20. Subtypes of Preterm Birth and the Risk of Postneonatal Death

    Science.gov (United States)

    Kamath-Rayne, Beena D.; DeFranco, Emily A.; Chung, Ethan; Chen, Aimin

    2013-01-01

    Objective To examine the differences in postneonatal death risk among 3 clinical subtypes of preterm birth: preterm premature rupture of membranes (PROM), indicated preterm birth, and spontaneous preterm labor. Study design We analyzed the 2001–2005 US linked birth/infant death (birth cohort) datasets. The preterm birth subtypes were classified using information on the birth certificate: reported PROM, induction of labor, cesarean section, and complications of pregnancy and labor. Cox proportional hazard models were used to estimate covariate-adjusted hazard ratios and 95% CIs for postneonatal death (from days 28 to 365). Estimation was given for preterm birth subtypes in a week-by-week analysis. Causes of death were analyzed by preterm birth subtype and then separately at 24–27, 28–31, and 32–36 weeks of gestation. Results For the total of 1 895 350 singleton preterm births who survived the neonatal period, the postneonatal mortality rate was 1.11% for preterm PROM, 0.78% for indicated preterm birth, and 0.53% for spontaneous preterm labor. Preterm PROM was associated with significantly higher risk of postneonatal death compared with spontaneous preterm labor in infants born at 27 weeks gestation or later. Similarly, indicated preterm birth was associated with a significantly higher risk of postneonatal death than spontaneous preterm labor in infants born at 25 weeks gestation or later. Preterm PROM and indicated preterm birth were associated with greater risk of death in the postneonatal period compared with spontaneous preterm labor, irrespective of the cause of death. Conclusion Subtypes of preterm birth carry different risks of postneonatal mortality. Prevention of preterm-related postneonatal death may require more research into the root causes of preterm birth subtypes. PMID:22878113

  1. Cot Deaths.

    Science.gov (United States)

    Tyrrell, Shelagh

    1985-01-01

    Addresses the tragedy of crib deaths, giving particular attention to causes, prevention, and medical research on Sudden Infant Death Syndrome (SIDS). Gives anecdotal accounts of coping strategies used by parents and families of SIDS infants. (DT)

  2. Fetal/neonatal alloimmune thrombocytopenia.

    Science.gov (United States)

    Sachs, Ulrich J

    2013-01-01

    In fetal/neonatal alloimmune thrombocytopenia (FNAIT), antibodies against paternal antigens present on fetal platelets are produced by the mother. These antibodies will cross the placenta and can cause thrombocytopenia of the unborn. One severe consequence of thrombocytopenia is intracranial bleeding which may lead to death or severe sequelae. FNAIT index cases in one family are usually detected at birth only since antenatal screening programmes have not been installed so far. Subsequent pregnancies of immunized mothers may require special diagnostic and prophylactic interventions, and interdisciplinary counselling and treatment involving obstetricians, pediatricians and immunohematologists may prove useful for optimized care. This short review covers pathogenesis, clinical presentation, diagnostic, and therapeutic options in FNAIT.

  3. Association of heart rate variability with 5-minute Apgar score in neonates with severe asphyxia%重度窒息新生儿5分钟Apgar评分的心率变异性分析

    Institute of Scientific and Technical Information of China (English)

    王瑾; 李丽; 阚亚楠; 梁宏伟; 陈家菲

    2013-01-01

    目的探讨重度窒息新生儿5 min Apgar评分与心率变异性(HRV)的关系。方法入选103例出生后1 min Apgar评分为0~3分的重度窒息新生儿,根据出生后5 min Apgar评分分组,>7分为A组(n=50),≤7分B组(n=53);同时以40例1、5 min Apgar评分均>7分的足月新生儿作为对照组;三组新生儿均于出生后第3天行24 h动态心电图检查,并分析其HRV变化。结果 B组较对照组及A组HRV时域指标PNN50、rMSSD、SDSD降低,SDNN、SDANN升高,差异均有统计学意义(P0.05)。结论新生儿窒息损伤自主神经功能,5 min Apgar评分联合HRV时域参数可作为重度窒息新生儿自主神经功能损伤及预后的无创判断指标。%Objective To explore the relationship between 5-minute Apgar score and heart rate variability (HRV) in severely asphyxiated neonates. Methods A total of 103 severely asphyxiated neonates with 1-minute Apgar score of 0 to 3 points were selected. They were divided into Group A (>7 points, n=50) and Group B (≤7 points, n=53) based on 5-minute Apgar score. Meanwhile, 40 full-term neonates with 1-and 5-minute Apgar score greater than 7 points were selected as control group. 24-hour dynamic electrocardiogram was performed and HRV was analyzed on the third day after birth in three groups. Results PNN50, rMSSD, SDSD were decreased and SDNN, SDANN were increased in group B as compared with group A and control group (P0.05). Conclusions Neonatal asphyxia can cause damage to autonomic nervous system. 5-minute Apgar score and HRV can be joint-ly used as a non-invasive index in autonomic nervous damage and its prognosis in asphyxiated newborns.

  4. A amamentação na primeira hora de vida e mortalidade neonatal Breastfeeding during the first hour of life and neonatal mortality

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    Cristiano Siqueira Boccolini

    2013-04-01

    countries with more than 29 neonatal deaths per 1000 newborns (Spearman's Rho = -0.327, p = 0.048. According to the statistical model, countries with the lowest breastfeeding tertiles had 24% higher neonatal mortality rates (Rate ratio = 1.24, 95% CI = 1.07-1.44, p < 0.05, even when adjusted for potential confounders. CONCLUSIONS: The protective effect of breastfeeding during the first hour of life on neonatal mortality in this ecological study is consistent with findings from previous observational studies, indicating the importance of adopting breastfeeding within the first hour as a routine neonatal care practice.

  5. Incidence rates and deaths of tuberculosis in HIV-negative patients in the United States and Germany as analyzed by new predictive model for infection.

    Science.gov (United States)

    Ren, Yudong; Ding, Fan; Suo, Siqingaowa; Bu, Ri-e; Zarlenga, Dante S; Ren, Xiaofeng

    2012-01-01

    Incidence and mortality due to tuberculosis (TB) have been decreasing worldwide. Given that TB is a cosmopolitan disease, proper surveillance and evaluation are critical for controlling dissemination. Herein, mathematical modeling was performed in order to: 1) demonstrate a correlation between the incidence of TB in HIV-free patients in the US and Germany, and their corresponding mortality rates; 2) show the utility of the newly developed D-R algorithm for analyzing and predicting the incidence of TB in both countries; and 3) inform us on population death rates due to TB in HIV-negative patients. Using data published by the World Health Organization between 1990 and 2009, the relationship between incidence and mortality that could not be ascribed to HIV infection was evaluated. Using linear, quadratic and cubic curves, we found that a cubic function provided the best fit with the data in both the US (Y = 2.3588+2.2459X+61.1639X(2)-60.104X(3)) and Germany (Y = 1.9271+9.4967X+18.3824X(2)-10.350X(3)) where the correlation coefficient (R) between incidence and mortality was 0.995 and 0.993, respectively. Second, we demonstrated that fitted curves using the D-R model were equal to or better than those generated using the GM(1,1) algorithm as exemplified in the relative values for Sum of Squares of Error, Relative Standard Error, Mean Absolute Deviation, Average Relative Error, and Mean Absolute Percentage Error. Finally, future trends using both the D-R and the classic GM(1,1) models predicted a continued decline in infection and mortality rates of TB in HIV-negative patients rates extending to 2015 assuming no changes to diagnosis or treatment regimens are enacted.

  6. 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

  7. Time since death and decay rate constants of Norway spruce and European larch deadwood in subalpine forests determined using dendrochronology and radiocarbon dating

    Science.gov (United States)

    Petrillo, Marta; Cherubini, Paolo; Fravolini, Giulia; Marchetti, Marco; Ascher-Jenull, Judith; Schärer, Michael; Synal, Hans-Arno; Bertoldi, Daniela; Camin, Federica; Larcher, Roberto; Egli, Markus

    2016-03-01

    Due to the large size (e.g. sections of tree trunks) and highly heterogeneous spatial distribution of deadwood, the timescales involved in the coarse woody debris (CWD) decay of Picea abies (L.) Karst. and Larix decidua Mill. in Alpine forests are largely unknown. We investigated the CWD decay dynamics in an Alpine valley in Italy using the chronosequence approach and the five-decay class system that is based on a macromorphological assessment. For the decay classes 1-3, most of the dendrochronological samples were cross-dated to assess the time that had elapsed since tree death, but for decay classes 4 and 5 (poorly preserved tree rings) radiocarbon dating was used. In addition, density, cellulose, and lignin data were measured for the dated CWD. The decay rate constants for spruce and larch were estimated on the basis of the density loss using a single negative exponential model, a regression approach, and the stage-based matrix model. In the decay classes 1-3, the ages of the CWD were similar and varied between 1 and 54 years for spruce and 3 and 40 years for larch, with no significant differences between the classes; classes 1-3 are therefore not indicative of deadwood age. This seems to be due to a time lag between the death of a standing tree and its contact with the soil. We found distinct tree-species-specific differences in decay classes 4 and 5, with larch CWD reaching an average age of 210 years in class 5 and spruce only 77 years. The mean CWD rate constants were estimated to be in the range 0.018 to 0.022 y-1 for spruce and to about 0.012 y-1 for larch. Snapshot sampling (chronosequences) may overestimate the age and mean residence time of CWD. No sampling bias was, however, detectable using the stage-based matrix model. Cellulose and lignin time trends could be derived on the basis of the ages of the CWD. The half-lives for cellulose were 21 years for spruce and 50 years for larch. The half-life of lignin is considerably higher and may be more than

  8. Vaccines for women for preventing neonatal tetanus.

    Science.gov (United States)

    Demicheli, Vittorio; Barale, Antonella; Rivetti, Alessandro

    2015-07-06

    Tetanus is an acute, often fatal, disease caused by an exotoxin produced by Clostridium tetani. It occurs in newborn infants born to mothers who do not have sufficient circulating antibodies to protect the infant passively, by transplacental transfer. Prevention may be possible by the vaccination of pregnant or non-pregnant women, or both, with tetanus toxoid, and the provision of clean delivery services. Tetanus toxoid consists of a formaldehyde-treated toxin that stimulates the production of antitoxin. To assess the effectiveness of tetanus toxoid, administered to women of reproductive age or pregnant women, to prevent cases of, and deaths from, neonatal tetanus. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015), CENTRAL (The Cochrane Library 2015, Issue 1), PubMed (1966 to 28 January 2015), EMBASE (1974 to 28 January 2015) and reference lists of retrieved studies. Randomised or quasi-randomised trials evaluating the effects of tetanus toxoid in pregnant women or women of reproductive age on numbers of neonatal tetanus cases and deaths. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two effectiveness trials (9823 infants) and one safety trial (48 mothers) were included. The main outcomes were measured on infants born to a subset of those randomised women who became pregnant during the course of the studies. For our primary outcomes, there was no high-quality evidence according to GRADE assessments.One study (1182 infants) assessed the effectiveness of tetanus toxoid in comparison with influenza vaccine in preventing neonatal tetanus deaths. A single dose did not provide significant protection against neonatal tetanus deaths, (risk ratio (RR) 0.57, 95% confidence interval (CI) 0.26 to 1.24; 494 infants; GRADE: low-quality evidence). However, a two- or three-dose course did provide protection against neonatal deaths, (RR 0.02, 95% CI 0.00 to 0

  9. Continuing high early death rate in acute promyelocytic leukemia: a population-based report from the Swedish Adult Acute Leukemia Registry.

    Science.gov (United States)

    Lehmann, S; Ravn, A; Carlsson, L; Antunovic, P; Deneberg, S; Möllgård, L; Derolf, A Rangert; Stockelberg, D; Tidefelt, U; Wahlin, A; Wennström, L; Höglund, M; Juliusson, G

    2011-07-01

    Our knowledge about acute promyelocytic leukemia (APL) patients is mainly based on data from clinical trials, whereas population-based information is scarce. We studied APL patients diagnosed between 1997 and 2006 in the population-based Swedish Adult Acute Leukemia Registry. Of a total of 3897 acute leukemia cases, 3205 (82%) had non-APL acute myeloid leukemia (AML) and 105 (2.7%) had APL. The incidence of APL was 0.145 per 100,000 inhabitants per year. The median age at the time of diagnosis was 54 years; 62% were female and 38% male. Among younger APL patients, female sex predominated (89% of patients <40 years). Of the 105 APL patients, 30 (29%) died within 30 days (that is, early death (ED)) (median 4 days) and 28 (26%) within 14 days from diagnosis. In all, 41% of the EDs were due to hemorrhage; 35% of ED patients never received all-trans-retinoic acid treatment. ED rates increased with age but more clearly with poor performance status. ED was also associated with high white blood cells, lactate dehydrogenase, creatinine, C-reactive protein and low platelet count. Of non-ED patients, 97% achieved complete remission of which 16% subsequently relapsed. In total, 62% are still alive at 6.4 years median follow-up. We conclude that ED rates remain very high in an unselected APL population.

  10. Outcome of Very Lov Birth Weight Infants in Neonatal Care Unit of Dicle University Faculty of Medicine

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    Selahattin Katar

    2006-01-01

    Full Text Available Our purpose was to determine mortality and morbidity rates and selected outcome variables for infants weighing less than 1500 g, who were admitted to the neonatal care unit of our hospital from April 2005 to February 2006.The number of VLBW admissions to the our neonatal care unit was 91, fourty one percent female and %49 were male. The mean birth weight was 1191±261 g and gestational age was 29±2.4 weeks. The mortality rate was 37.3 %. Antenatal steroids had been given to only 8% of mothers. The most important maternal risk factors were preeclampsia/eclampsia 30%, premature rupture of membranes 13%, hemorhage 8%. Respiratory distress syndrome was diagnosed 47%, surfactant was given to 40% of these infants. The major causes of death were sepsis, respiratuar distres syndrome, and extreme prematurity.Compared with reports from other developed NICU, VLBW infants at our center had higher mortality rates. We conclude that, the major cause of high mortality rate depends on low-social –cultural –education conditions associated with insufficient prenatal care, neonatal care and inaccurate neonatal transport in our region.

  11. 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.

  12. A comparative study of neonatal outcomes in placenta previa versus cesarean for other indication at term.

    Science.gov (United States)

    Schneiderman, Megan; Balayla, Jacques

    2013-07-01

    Currently, no ACOG guidelines address the issue of the optimal timing of delivery in placenta previa. Though there is an increased risk of neonatal morbidity and mortality when electively delivered preterm, it is unclear whether adverse neonatal outcomes exist when these pregnancies make it beyond term. By comparing neonatal outcomes amongst pregnancies with placenta previa versus those from cesarean for another indication at term, the objective of this study was to determine whether placenta previa is an independent risk factor for adverse neonatal outcomes at term. We conducted a population-based cohort-study using the CDC's Linked Birth-Infant Death data from the United States. The effect of placenta previa on the risk of adverse neonatal outcomes was estimated using unconditional logistic regression analysis, adjusting for relevant confounders. Our cohort consisted of 3,550,842 deliveries meeting inclusion criteria. The incidence of placenta previa at term was 1.3/1000 (n = 4,492), accounting for 40.6% of all previa cases. Relative to cesareans for other indications, pregnancies with placenta previa had an increased risk of IUGR 3.20 [2.50-4.10], SGA 2.70 [2.45-2.97], respiratory distress 3.82 [2.91-5.00], prolonged ventilation 3.41 [2.70-4.32] and neonatal anemia 6.87 [4.43-10.65]. Rates of meconium aspiration syndrome, seizures, birth injury and overall infant mortality do not appear to be affected by this condition. Relative to cesareans for other indications, placenta previa is associated with increased morbidity, but not mortality, at term. This information might be helpful in the development of future guidelines, which are currently needed to guide and standardize clinical practice regarding the optimal timing of delivery in placenta previa.

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

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    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

  14. 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

  15. The Study of Pulmonary Complication of Neonatal Mechanical Ventilation in NICU

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    M.K. Sabzeie

    2016-01-01

    Full Text Available Introduction & Objective: The main indication of mechanical ventilation is in the treatment of neonates with respiratory failure. With the increased use of mechanical ventilation, its complications have increased too. The aim of this study was to evaluate the prevalence of complications and short-term improvement in infants undergoing mechanical ventilation in the neonatal intensive care unit (NICU. Materials & Methods: In this prospective-analytic study, all infants requiring mechanical ventilation and admitted in the neonatal intensive care unit of Fatemiyeh and Be’sat hospitals, have been evaluated for one year (2012. Their data included: neonatal age, sex, gestational age, birth weight, weight at admission, diagnosis, length of hospitalization, disease outcome (improvement-died, need for mechanical ventilation, complications and culture results (blood, endotracheal tube, urine, CSF insert in check list. The data were analysed by SPSS and c2 statistical test. Results: In this study, a total of 114 infants hospitalized in intensive care unit and needed mechanical ventilation was studied of whom 72 were male and 42 were female. The mean of gestational age in the admitted neonates was 32.9 ± 0.85 weeks. The majority of neonates (80.70% were undergoing mechanical ventilation with respiratory distress syndrome (RDS. 67% of neonates were suffering from complications of mechanical ventilation. The prevalent complication was seen in the neonates was narrowing or obstruction of the endotracheal tube (52.63%. 47.37% of infants died and respiratory distress syndrome was the common cause of death in these neonates (46.29%. In our study, there was significant relationship between resuscitation at birth (P=0.002, time required for mechanical ventilation (P=0.0000 and Apgar score (P=0.0000 and complications of mechanical ventilation. Conclusions: The results show that the high prevalence of pulmonary complications is associated with mechanical

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

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    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

  17. Is Institutional Delivery Protective Against Neonatal Mortality Among Poor or Tribal Women? A Cohort Study From Gujarat, India.

    Science.gov (United States)

    Altman, Rebecca; Sidney, Kristi; De Costa, Ayesha; Vora, Kranti; Salazar, Mariano

    2017-05-01

    Objectives In low-income settings, neonatal mortality rates (NMR) are higher among socioeconomically disadvantaged groups. Institutional deliveries have been shown to be protective against neonatal mortality. In Gujarat, India, the access of disadvantaged women to institutional deliveries has increased. However, the impact of increased institutional delivery on NMR has not been studied here. This paper examined if institutional childbirth is associated with lower NMR among disadvantaged women in Gujarat, India. Methods A community-based prospective cohort of pregnant women was followed in three districts in Gujarat, India (July 2013-November 2014). Two thousand nine hundred and nineteen live births to disadvantaged women (tribal or below poverty line) were included in the study. Data was analyzed using multivariable logistic regression. Results The overall NMR was 25 deaths per 1000 live births. Multivariable analysis showed that institutional childbirth was protective against neonatal mortality only among disadvantaged women with obstetric complications during delivery. Among mothers with obstetric complications during delivery, those who gave birth in a private or public facility had significantly lower odds of having a neonatal death than women delivering at home (AOR 0.07 95% CI 0.01-0.45 and AOR 0.03, 95% CI 0.00-0.33 respectively). Conclusions for Practice Our findings highlight the crucial role of institutional delivery to prevent neonatal deaths among those born to disadvantaged women with complications during delivery in this setting. Efforts to improve disadvantaged women's access to good quality obstetric care must continue in order to further reduce the NMR in Gujarat, India.

  18. Neuropathologic study of border disease virus in naturally infected fetal and neonatal small ruminants and its association with apoptosis.

    Science.gov (United States)

    Toplu, N; Oguzoglu, T Ç; Epikmen, E T; Aydogan, A

    2011-05-01

    The present study describes the pathologic changes and cellular apoptosis in the central nervous system (CNS) of fetal and neonatal small ruminants infected with border disease virus (BDV), as demonstrated by immunohistochemistry and in situ hybridization. Abortions of ewes and goats were