WorldWideScience

Sample records for reported heat-related deaths

  1. Preventing Heat-Related Illness or Death of Outdoor Workers

    Science.gov (United States)

    ... partment of Labor 2011] Heat-related Illness The human body tries to reduce the strain from excessive heat ... to heat stroke. The loss of fluids and electrolytes from sweating, ... nausea, fatigue, and core body temperatures of 100°F or above. Alertness and ...

  2. Heat-related deaths among California residents, May-September, 2000-2009.

    Data.gov (United States)

    California Environmental Health Tracking Program — This dataset contains counts, rates, and confidence intervals of heat-related deaths among California residents for the years 2000-2009. These data are stratified by...

  3. Heat-related deaths after an extreme heat event--four states, 2012, and United States, 1999-2009.

    Science.gov (United States)

    2013-06-07

    On June 29, 2012, a rapidly moving line of intense thunderstorms with high winds swept across the midwestern and eastern United States, causing widespread damage and power outages. Afterward, the area experienced extreme heat, with maximum temperatures exceeding 100°F (37.8°C). This report describes 32 heat-related deaths in Maryland, Ohio, Virginia, and West Virginia that occurred during the 2 weeks following the storms and power outages. Median age of the decedents was 65 years, and most of the excessive heat exposures occurred within homes. During 1999-2009, an annual average of 658 heat-related deaths occurred in the United States. Heat-related deaths are preventable, and heat response plans should be in place before an extreme heat event (EHE). Interventions should focus on identifying and limiting heat exposure among vulnerable populations.

  4. Heat-related deaths in hot cities: estimates of human tolerance to high temperature thresholds.

    Science.gov (United States)

    Harlan, Sharon L; Chowell, Gerardo; Yang, Shuo; Petitti, Diana B; Morales Butler, Emmanuel J; Ruddell, Benjamin L; Ruddell, Darren M

    2014-03-20

    In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax) and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages heat. For this condition-specific cause of death, the heat thresholds in all gender and age groups (ATmax = 90-97 °F; 32.2-36.1 °C) were below local median seasonal temperatures in the study period (ATmax = 99.5 °F; 37.5 °C). Heat threshold was defined as ATmax at which the mortality ratio begins an exponential upward trend. Thresholds were identified in younger and older females for cardiac disease/stroke mortality (ATmax = 106 and 108 °F; 41.1 and 42.2 °C) with a one-day lag. Thresholds were also identified for mortality from respiratory diseases in older people (ATmax = 109 °F; 42.8 °C) and for all-cause mortality in females (ATmax = 107 °F; 41.7 °C) and males Heat-related mortality in a region that has already made some adaptations to predictable periods of extremely high temperatures suggests that more extensive and targeted heat-adaptation plans for climate change are needed in cities worldwide.

  5. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or any situation ... pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss of consciousness, vomiting or a high ...

  6. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share ... Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can ...

  7. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... for Disasters Communication With Your Family And Your Doctor About Your Wishes Visiting the ER Who Takes ... 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat- ...

  8. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or ... the elderly are most at risk, but anyone can be affected. Here you will find information about ...

  9. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Emergencies A-Z Share this! Home » Emergency 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at ... about heat cramps and heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the ...

  10. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share this! Home » Emergency 101 Heat-Related ... if the person becomes unconscious. READ IN EMERGENCIES A-Z Seizures Choking (Heimlich Maneuver) Vomiting and Diarrhea ...

  11. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share this! Home » Emergency 101 Heat-Related ... if the person becomes unconscious. READ IN EMERGENCIES A-Z Suicide Puncture Wounds Shock Resources Home Safety ...

  12. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share this! Home » Emergency 101 Heat-Related ... if the person becomes unconscious. READ IN EMERGENCIES A-Z Listen to your Symptoms - When To Seek ...

  13. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share this! Home » Emergency 101 Heat-Related ... if the person becomes unconscious. READ IN EMERGENCIES A-Z Seizures Sore Throat Sunburn and Sun Safety ...

  14. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share this! Home » Emergency 101 Heat-Related ... if the person becomes unconscious. READ IN EMERGENCIES A-Z Sunburn and Sun Safety Sore Throat Choking ( ...

  15. National Violent Death Reporting System (NVDRS)

    Data.gov (United States)

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

  16. 22 CFR 72.5 - Final report of death.

    Science.gov (United States)

    2010-04-01

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

  17. 22 CFR 72.6 - Report of presumptive death.

    Science.gov (United States)

    2010-04-01

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

  18. Death during police interrogation: Case report

    Directory of Open Access Journals (Sweden)

    Atanasijević Tatjana

    2007-01-01

    Full Text Available Introduction: Cases of sudden and unexpected deaths of criminal suspects in presence of police always have special forensic medical approach. Often, such deaths are preceded by a state of extreme psychophysical activity (excitated delirium of suspects, when they may injure themselves. Police attempts to prevent that can inevitably lead to struggle. Immediately after the struggle ends (but also during a struggle, they abruptly become unresponsive, and develop cardiopulmonary arrest and death. Presence of drugs significantly intensifies the harmful effect of such state and leads to death. Case outline. We present a case of death of a young man brought into custody during police interrogation. Autopsy showed injuries and presence of MDMA, with suspicion that death was preceded by the state of excitated delirium. After thorough analysis of the case (complete autopsy, toxicological screening, microscopic survey of all organs, circumstances of death etc., our conclusion is that death was related to drug consumption - ecstasy. Concentration of ecstasy found in kidneys is the minimum concentration possible that could lead to heart malfunction and death. Conclusion. Our opinion is that there are no medical data by which we could determine if, and in what dosage, undesirable effects of ecstasy were enhanced by the circumstances of the case. .

  19. Do Suicide Survivors Report Near-Death Experiences?

    Science.gov (United States)

    Ring, Kenneth; Franklin, Stephen

    1981-01-01

    Interviewed persons (N=36) who had been close to death as a result of a suicide attempt to determine whether such persons report near-death experiences. Half related such experiences; these were more common for men. Found three patterns in suicide-related, near-death experiences. (Author/JAC)

  20. Impact of Climate Change on Heat-Related Mortality in Jiangsu Province, China

    Science.gov (United States)

    Chen, Kai; Horton, Radley M.; Bader, Daniel A.; Lesk, Corey; Jiang, Leiwen; Jones, Bryan; Zhou, Lian; Chen, Xiaodong; Bi, Jun; Kinney, Patrick L.

    2017-01-01

    A warming climate is anticipated to increase the future heat-related total mortality in urban areas. However, little evidence has been reported for cause-specific mortality or nonurban areas. Here we assessed the impact of climate change on heat-related total and cause-specific mortality in both urban and rural counties of Jiangsu Province, China, in the next five decades. To address the potential uncertainty in projecting future heat-related mortality, we applied localized urban- and nonurban-specific exposure response functions, six population projections including a no population change scenario and five Shared Socioeconomic Pathways (SSPs), and 42 temperature projections from 21 global-scale general circulation models and two Representative Concentration Pathways (RCPs). Results showed that projected warmer temperatures in 2016-2040 and 2041-2065 will lead to higher heat-related mortality for total non-accidental, cardiovascular, respiratory, stroke, ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes occurring annually during May to September in Jiangsu Province, China. Nonurban residents in Jiangsu will suffer from more excess heat-related cause-specific mortality in 2016-2065 than urban residents. Variations across climate models and RCPs dominated the uncertainty of heat-related mortality estimation whereas population size change only had limited influence. Our findings suggest that targeted climate change mitigation and adaptation measures should be taken in both urban and nonurban areas of Jiangsu Province. Specific public health interventions should be focused on the leading causes of death (stroke, IHD, and COPD), whose health burden will be amplified by a warming climate.

  1. Impact of Climate Change on Heat-Related Mortality in Jiangsu Province, China

    Science.gov (United States)

    Chen, Kai; Horton, Radley M.; Bader, Daniel A.; Lesk, Corey; Jiang, Leiwen; Jones, Bryan; Zhou, Lian; Chen, Xiaodong; Bi, Jun; Kinney, Patrick L.

    2017-01-01

    A warming climate is anticipated to increase the future heat-related total mortality in urban areas. However, little evidence has been reported for cause-specific mortality or nonurban areas. Here we assessed the impact of climate change on heat-related total and cause-specific mortality in both urban and rural counties of Jiangsu Province, China, in the next five decades. To address the potential uncertainty in projecting future heat-related mortality, we applied localized urban- and nonurban-specific exposure response functions, six population projections including a no population change scenario and five Shared Socioeconomic Pathways (SSPs), and 42 temperature projections from 21 global-scale general circulation models and two Representative Concentration Pathways (RCPs). Results showed that projected warmer temperatures in 2016-2040 and 2041-2065 will lead to higher heat-related mortality for total non-accidental, cardiovascular, respiratory, stroke, ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes occurring annually during May to September in Jiangsu Province, China. Nonurban residents in Jiangsu will suffer from more excess heat-related cause-specific mortality in 2016-2065 than urban residents. Variations across climate models and RCPs dominated the uncertainty of heat-related mortality estimation whereas population size change only had limited influence. Our findings suggest that targeted climate change mitigation and adaptation measures should be taken in both urban and nonurban areas of Jiangsu Province. Specific public health interventions should be focused on the leading causes of death (stroke, IHD, and COPD), whose health burden will be amplified by a warming climate.

  2. Are Persons Reporting "Near-Death Experiences" Really Near Death? A Study of Medical Records.

    Science.gov (United States)

    Stevenson, Ian; And Others

    1990-01-01

    Examination of medical records from 40 patients who reported unusual experiences during an illness or injury revealed that only 18 patients were judged to have had serious, life-threatening conditions, while 33 believed they had been dead or near death. Findings suggest that an important precipitator of so-called near-death experience is belief…

  3. Brain death in neonates: a case report

    Directory of Open Access Journals (Sweden)

    Georgios Mitsiakos

    2014-06-01

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

  4. CHARACTERISTICS AND COMORBID SYMPTOMS OF OLDER ADULTS REPORTING DEATH IDEATION

    Science.gov (United States)

    Van Orden, Kimberly A.; Simning, Adam; Conwell, Yeates; Marlow, Tom; Skoog, Ingmar; Waern, Margda

    2012-01-01

    Objective To determine whether death ideation in late life is associated with markers of elevated risk for suicide, or reflects normal psychological processes in later life. Design/Setting Population based cross sectional study in Gothenburg, Sweden. Participants The sample consists of 345 men and women aged 85 (born 1901-02) and living in Gothenburg, Sweden. Main Outcome Measures The Paykel Scale measured the most severe level of suicidality over an individual’s lifetime. Other key measures were severity of depression and anxiety and frequency of death/suicidal ideation over the previous month. Results Latent class analysis revealed distinct groups of older adults who reported recent death ideation. Recent death ideation did not occur apart from other risk factors for suicide; instead individuals reporting recent death ideation also reported either 1) recent high levels of depression and anxiety, or 2) more distant histories of serious suicidal ideation (indicative of worst point severity of suicidal ideation)—both of which elevate risk for eventual suicide. Conclusions Our results indicate a heterogeneous presentation of older adults who report death ideation, with some presenting with acute distress and suicidal thoughts, and others presenting with low distress but histories of serious suicidal ideation. The presence of death ideation is associated with markers of increased risk for suicide, including “worst point” active suicidal ideation. PMID:23567393

  5. Aquatic Exercise and Heat-Related Injuries.

    Science.gov (United States)

    Sova, Ruth

    1991-01-01

    Heat-related injuries in aquatics classes are possible, though 100 percent preventable. The article discusses heat-related syndromes; how bodies generate and dissipate heat; how elevated heart rates that burn calories differ from those that dissipate heat; and modification of exercise intensity to provide calorie-burning workouts without…

  6. Death caused by heat stroke: Case report

    Directory of Open Access Journals (Sweden)

    Savić Slobodan

    2014-01-01

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

  7. Behaviorism: Are reports of its death exaggerated?

    Science.gov (United States)

    Wyatt, W. Joseph; Hawkins, Robert P.; Davis, Pamela

    1986-01-01

    Despite reports that behaviorism is dead or dying, examination of the data indicates otherwise. The opinions of psychology historians, the number of professional associations devoted to behaviorism, and the increasing number of behavioral publications all support the conclusion that behaviorism is vital and growing. PMID:22478651

  8. Behaviorism: Are reports of its death exaggerated?

    Science.gov (United States)

    Wyatt, W J; Hawkins, R P; Davis, P

    1986-01-01

    Despite reports that behaviorism is dead or dying, examination of the data indicates otherwise. The opinions of psychology historians, the number of professional associations devoted to behaviorism, and the increasing number of behavioral publications all support the conclusion that behaviorism is vital and growing.

  9. Effect of cause-of-death training on agreement between hospital discharge diagnoses and cause of death reported, inpatient hospital deaths, New York City, 2008-2010.

    Science.gov (United States)

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio; Madsen, Ann

    2015-01-15

    Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality.

  10. Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

    Science.gov (United States)

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

    2015-01-01

    Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality. PMID:25590598

  11. Completeness of HIV reporting on death certificates for Floridians reported with HIV infection, 2000-2011

    OpenAIRE

    Trepka, Mary Jo; Diana M. Sheehan; Fennie, Kristopher P.; Niyonsenga, Theophile; Lieb, Spencer; Maddox, Lorene

    2015-01-01

    HIV mortality is used as a key measure to monitor the impact of HIV throughout the world. It is important that HIV be correctly recorded on death certificates so that the burden of HIV mortality can be tracked accurately. The objective of this study was to determine the extent of failure to correctly report HIV on death certificates and examine patterns of incompleteness by demographic factors. Causes of death on death certificates of people infected with HIV reported to the Florida HIV surve...

  12. Cause of death conundrum with methadone use: a case report.

    Science.gov (United States)

    Letsky, Michael C; Zumwalt, Ross E; Seifert, Steven A; Benson, Blaine E

    2011-06-01

    Deaths caused by a methadone intoxication or overdose are becoming more frequent. We report a case involving a patient who had extremely high methadone blood concentrations but whose cause of death may have been unrelated to the drug. A 51-year-old woman was found deceased in bed by her daughter. At the scene were numerous bottles of methadone, with the chronic dosage of 240 mg 3 times a day. There was no history of prior suicide attempts, there were no reports of suicidal ideation having been voiced and there was no suicide note. At autopsy, there were no pills found in the stomach. Microscopic tissue examination revealed lobar pneumonia of the right lower lobe. Postmortem lung cultures grew out Streptococcus pneumoniae. Femoral blood contained methadone, 5.7 mg/L; EDDP, 2.1 mg/L; oxycodone, 0.017 mg/L; doxylamine, 0.022 mg/L; and ethanol, 13.0 mg/dL. The postmortem methadone concentration was consistent with her known dose, plausible pharmacokinetics and conditions of discovery. Various causes of death, such as a methadone-related arrhythmia from QTc prolongation or the contribution of methadone to the development of the pneumonia, cannot be ruled out and may well have caused or contributed to death, but the pneumonia was felt to be a competent cause of death. Ultimately, the most likely cause(s) of death, is a decision left to the individual medical examiner. This case is illustrative of the growing number of similar cases facing forensic pathologists. The cause of death cannot be solely based on drug concentrations and it may not be possible to come to a conclusion as to "the" cause of death and the forensic pathologist must be content with "a" cause of death.

  13. Heat-Related Illness among Oregon Farmworkers

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Bethel

    2014-09-01

    Full Text Available Farmworkers are particularly vulnerable to climate-sensitive health outcomes such as heat-related illness (HRI given their tasks involve heavy exertion in an outdoor setting. The objectives of the study were to: (1 describe symptoms of HRI experienced by farmworkers and (2 explore factors associated with heat knowledge, level of concern regarding HRI, and comfort level taking breaks at work. Bilingual research staff conducted personal interviews of 100 farmworkers during July and August 2013. Data collected included demographics, work history and current work practices, trainings received, HRI symptoms experienced, health status, and health behaviors. Nearly 30% of participants reported experiencing ≥2 HRI symptoms during the previous work. Few participants had high level of heat knowledge (21.0% and 15.6% of participants reported being “very concerned” about the health effects of working in hot conditions. Participants who were paid by the piece were more likely to have a high heat knowledge score and be “very concerned” about HRI but less likely to be “very comfortable” taking a break compared to workers paid by the hour than those who had not received HRI training. Results suggest several areas in which employers and agencies conducting outreach and education to the workers about HRI can change their practices including providing cooling measures and HRI training about risk factors for HRI.

  14. Accurate Completion of Medical Report on Diagnosing Death.

    Science.gov (United States)

    Savić, Slobodan; Alempijević, Djordje; Andjelić, Sladjana

    2015-01-01

    Diagnosing death and issuing a Death Diagnosing Form (DDF) represents an activity that carries a great deal of public responsibility for medical professionals of the Emergency Medical Services (EMS) and is perpetually exposed to the control of the general public. Diagnosing death is necessary so as to confirm true, to exclude apparent death and consequentially to avoid burying a person alive, i.e. apparently dead. These expert-methodological guidelines based on the most up-to-date and medically based evidence have the goal of helping the physicians of the EMS in accurately filling out a medical report on diagnosing death. If the outcome of applied cardiopulmonary resuscitation measures is negative or when the person is found dead, the physician is under obligation to diagnose death and correctly fill out the DDF. It is also recommended to perform electrocardiography (EKG) and record asystole in at least two leads. In the process of diagnostics and treatment, it is a moral obligation of each Belgrade EMS physician to apply all available achievements and knowledge of modern medicine acquired from extensive international studies, which have been indeed the major theoretical basis for the creation of these expert-methodological guidelines. Those acting differently do so in accordance with their conscience and risk professional, and even criminal sanctions.

  15. Sudden Infant Death Syndrome, FY 1983. Special Report to Congress.

    Science.gov (United States)

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    This report describes research programs focusing on the sudden infant death syndrome (SIDS) and indicates some presently available results. Specific attention is given to research on sleep apnea, respiratory control, and hypoxia, as well as to infectious disease processes and immunology. Findings of a large-scale multidisciplinary SIDS project are…

  16. Suicidal death caused by electrocution: Two case reports

    Directory of Open Access Journals (Sweden)

    Nikolić Slobodan

    2004-01-01

    Full Text Available Suicides by electrocution are extremly rare in our country. In these cases, specific or characteristic external lesions caused through contact with conductors at the sites of entry and exit of the current, as well as general autopsy findings, and excluding the other possible causes of death, are important to elucidate them. Dilema if death was sucidal, homicidal or accidental in manner, could be solved through good police investigation, and properly explained circumstantial events. Herein, we reported two cases of suicidal deaths, caused by electrocution. In the first case, it was a male, age of 32, who wraped the electrical cord around his rists, and kiled himself by plugging it in. In second case, it was a female, age of 46, abused by her husband, who commited suicide by putting the switched hear-dryer into the water in bathtube.

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

    Directory of Open Access Journals (Sweden)

    R. Razuin

    2017-06-01

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

  18. Living after sudden death: A case report of Naxos disease

    Directory of Open Access Journals (Sweden)

    Jose Alberto Garcia Noain

    2012-01-01

    Full Text Available Naxos disease is a recessive inherited condition with arrhythmogenic right ventricular dysplasia (ARVD and a peculiar cutaneous phenotype (woolly hair and a palmoplantar keratoderma. Woolly hair appears from birth, palmoplantar keratoderma develops during childhood and cardiomyopathy is clinically manifested by adolescence. Patients present with syncope, sustained ventricular tachycardia or sudden death. We report a case of a 14 year old boy from Spain, who was admitted into our emergency room after being resuscitated from cardiac arrest, secondary to malignant ventricular tachycardia that developed while he was playing basketball.

  19. Radiological confirmation of brain death: digitised cerebral parenchymography. Preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Huet, H. [Department of Neuroradiology and Interventional Radiology, Caen CHU, Av. de la Cote de Nacre, F-14033 Caen (France); Leroy, G. [Surgical Intensive Care Unit, Caen CHU, Av. de la Cote de Nacre, F-14033 Caen (France); Toulas, P. [Department of Neuroradiology and Interventional Radiology, Caen CHU, Av. de la Cote de Nacre, F-14033 Caen (France); Coskun, O. [Department of Neuroradiology and Interventional Radiology, Caen CHU, Av. de la Cote de Nacre, F-14033 Caen (France); Theron, J. [Department of Neuroradiology and Interventional Radiology, Caen CHU, Av. de la Cote de Nacre, F-14033 Caen (France)

    1996-05-01

    Rates of organ procurement from brain dead subjects have fallen substantially in recent years. In France, the legal definition of brain death is based on electroencephalographic criteria in patients with clinical evidence of irreversible coma. However, sedative drugs used in intensive care units usually render the electroencephalogram uninterpretable, and in our medicolegal framework, it is necessary that intracerebral circulatory arrest be demonstrated. We discuss the value of the various available techniques and report our experience with digitised intra-arterial cerebral parenchymography. This simple, fast technique does not alter physiological conditions and provides high-quality images, ensuring prompt diagnosis, which is a prerequisite for optimal organ harvesting. (orig.). With 5 figs.

  20. A Comparison of Suicides and Undetermined Deaths by Poisoning among Women: An Analysis of the National Violent Death Reporting System.

    Science.gov (United States)

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

    2015-01-01

    The study compared the prevalence of common suicide risk factors between poisoning deaths classified as injuries of undetermined intent or suicides among women. Data were derived from the 2003-10 National Violent Death Reporting System. Multiple logistic regression assessed the factors associated with 799 undetermined deaths (relative to 3,233 suicides). Female decedents with lower education, a substance use problem, and a health problem were more likely to be classified as undetermined death. Older women, those with an intimate partner problem, financial problem, depressed mood, mental health problem, attempted suicide, and disclosed intent to die were less likely to be classified as undetermined death. The present study raises the possibility that many (perhaps most) undetermined female poisoning deaths are suicides.

  1. [Are near-death experiences following attempted suicide important for suicide risk assessment? A case report].

    Science.gov (United States)

    Kralovec, Karl; Plöderl, Martin; Aistleiner, Ursula; Fartacek, Clemens; Fartacek, Reinhold

    2009-01-01

    We describe a 59-year old patient who reported a near-death experience following attempted suicide. The near-death experience induced reduction of suicidality. Previous studies suggested a high prevalence of near-death experiences following attempted suicide and that near-death experiences may decrease rather than increase subsequent suicide risk. Implications for suicide risk assessment are discussed.

  2. Pediatric heat-related illness: recommendations for prevention and management

    Science.gov (United States)

    Dunn, Roberta J.; Kim, Tommy Y.

    2017-08-01

    Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air). The choice of method used may depend on availability of equipment, but there is evidence that can guide optimal use of resources. This issue presents evidence-based recommendations and best practices in heat-illness resuscitation, including managing children who are obese, have special needs or take medications, and advocacy for prevention strategies. Copyright © 2017 EB Medicine

  3. Preventing heat-related illness among agricultural workers.

    Science.gov (United States)

    Jackson, Larry L; Rosenberg, Howard R

    2010-07-01

    Hyperthermia from exertion and environmental conditions during agricultural work manifests itself by various symptoms and may lead to death. From 1992 through 2006, 68 workers employed in crop production and related services died from heat-related illness. The crop worker fatality rate averaged 4 heat-related deaths per one million workers per year-20 times higher than the 0.2 rate for US civilian workers overall. Many of the agricultural workers who died were foreign-born. Foreign-born workers tend to have limited English language skills and often are not acclimatized to exertion in hot weather when beginning seasonal jobs. Increased recognition of heat hazards to agricultural workers, in particular, has stimulated concern among employers, workers, and public policy makers. California and Washington have led the nation in adopting workplace safety standards designed to prevent heat-related illnesses. These state regulations include new specific requirements for employer provision of drinking water, shade for rest or other sufficient means to recover from heat, worker and supervisor training, and written heat safety plans. Agricultural employers face practical challenges in fulfilling the purpose and complying with these standards. By their very nature the standards impose generic requirements in a broad range of circumstances and may not be equally protective in all agricultural work settings. It is vital that employers and supervisors have a thorough knowledge of heat illness prevention to devise and implement safety measures that suit local conditions. Ongoing risk-based assessment of current heat conditions by employers is important to this safety effort. Workers need training to avoid heat illness and recognize the symptoms in themselves and coworkers. Innovative management practices are joining time-honored approaches to controlling heat stress and strain. Research targeted to answer questions about heat accumulation and dissipation during agricultural work

  4. Sudden death due to medulloblastoma: a case report.

    Science.gov (United States)

    Ho, Cheng-Hsuan; Chen, Shyi-Jou; Juan, Chun-Jung; Lee, Herng-Shen; Tsai, Shin-Hung; Fan, Hueng-Chuen

    2013-06-01

    Medulloblastoma is one of the notorious CNS malignancies for subtle and atypical clinical presentations, causing rapid neurological deterioration and death, especially in pediatric patients. The delay in diagnosis leads to painful remorse, conflicts, and lawsuits for parents and medical staff. We report a 2 year old girl with initial presentation of febrile pyuria. Soon after admission, a generalized clonic-tonic seizure attacked to her and led to an impression of febrile convulsion. However, an unusual postical slowness of pupils to light stimulation propelled a further investigation. A contrast enhanced brain computer tomography (CT) unexpectedly showed a mass occupied the fourth ventricle resulting in obstructive hydrocephalus and compressed adjacent brain stem and cerebellum. The disease rapidly progressed and she died 18 hours after an emergent decompression with extraventricular drainage (EVD) installation. Cytology of cerebrospinal fluid proved medulloblastoma. This case report highlights the importance of clinical suspicion, such as a trivial but unusual presentation, a lagged pupil response to light stimulation. A brain CT scan should be done to rule out any possibility of an organic lesion. Close monitor is required in order to catch and treat medulloblastoma early. However, once discovered, the cancer has spread.

  5. First report of death due to Hemiscorpius acanthocercus envenomation in Iran: Case report

    Science.gov (United States)

    Shahi, Mehran; Rafinejad, Javad; Az-Khosravi, Leyla; Moosavy, Seyed Hamid

    2015-01-01

    Scorpion stings are significant causes of death in the western and southern regions of Iran. To date, reports have indicated that the H. lepturus species is the main cause of mortality due to scorpion stings. One of the species that belongs to this genus is Hemiscorpius acanthocercus (H. acanthocercus). This scorpion’s venom is cytotoxic, and it causes pathological changes in the blood and can cause severe damage to the kidneys. The pain of Hemiscorpius’ sting is mild and asymptomatic in the early hours. Delays in the treatment of these victims can cause hemolysis, hematuria, kidney failure, and even death. In this paper, we report the first known death due to an H. acanthocercus’ sting in Iran. PMID:26435822

  6. Adverse medical complications: an under-reported contributory cause of death in New York City.

    Science.gov (United States)

    Gill, J R; Ely, S F; Toriello, A; Hirsch, C S

    2014-04-01

    The current death certification system in the USA fails to accurately track deaths due to adverse medical events. The aim of this study was to demonstrate the under-reporting of deaths due to adverse medical events due to limitations in the current death certification/reporting system, and the benefits of using the term 'therapeutic complication' as the manner of death. Retrospective review and comparison of death certificates and vital statistical coding. The manner of death is certified as a therapeutic complication when death is caused by predictable complications of appropriate therapy, and would not have occurred but for the medical intervention. Based on medical examiner records, complications that caused or contributed to deaths over a five-year period were examined retrospectively. These fatalities were compared with deaths coded as medical and surgical complications by the New York City Bureau of Vital Statistics. The Medical Examiner's Office certified 2471 deaths as therapeutic complications and 312 deaths as accidents occurring in healthcare facilities. In contrast, the New York City Bureau of Vital Statistics reported 188 deaths due to complications of medical and surgical care. Use of the term 'therapeutic complication' as the manner of death identified nearly 14 times more deaths than were reported by the New York City Bureau of Vital Statistics. If these therapeutic complications and medical accidents were considered as a 'disease', they would rank as the 10th leading cause of death in New York City, surpassing homicides and suicides in some years. Nationwide policy shifts that use the term 'therapeutic complication' would improve the capture and reporting of these deaths, thus allowing better identification of fatal adverse medical events in order to focus on and assess preventative strategies. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Login Ivan S

    2002-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Robert A. Wise

    2017-03-01

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

  9. 20 CFR 10.414 - What reports of dependents are needed in death cases?

    Science.gov (United States)

    2010-04-01

    ... death cases? 10.414 Section 10.414 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS...' COMPENSATION ACT, AS AMENDED Compensation and Related Benefits Compensation for Death § 10.414 What reports of dependents are needed in death cases? If a beneficiary is receiving compensation benefits on account of an...

  10. A modified exponential model for reported death toll during earthquakes

    Institute of Scientific and Technical Information of China (English)

    Xinyan Wu; Jianhua Gu

    2009-01-01

    Reliable earthquake death toll estimate can provide valuable references for disaster relief headquarters and civil administration departments to make arrangement and deployment plan during post-earthquake relief work, thus increasing the efficiency of the relief work to a certain extent. In this study, we acquired the death toll data of Wenchuan earthquake, fitted the data using modified exponential curve and compared the result with that of the exponential function. Experimental verification with Chi-Chi earthquake and Kobe earthquake data shows that the fitted result by modified exponential curve is more satisfactory. The final death toll resulting from future destructive earthquakes can be estimated by the acquired fitting function.

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

    Directory of Open Access Journals (Sweden)

    Ramazan Akcan

    2010-06-01

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

  12. Heat-Related Mortality in a Warming Climate: Projections for 12 U.S. Cities

    Directory of Open Access Journals (Sweden)

    Elisaveta P. Petkova

    2014-10-01

    Full Text Available Heat is among the deadliest weather-related phenomena in the United States, and the number of heat-related deaths may increase under a changing climate, particularly in urban areas. Regional adaptation planning is unfortunately often limited by the lack of quantitative information on potential future health responses. This study presents an assessment of the future impacts of climate change on heat-related mortality in 12 cities using 16 global climate models, driven by two scenarios of greenhouse gas emissions. Although the magnitude of the projected heat effects was found to differ across time, cities, climate models and greenhouse pollution emissions scenarios, climate change was projected to result in increases in heat-related fatalities over time throughout the 21st century in all of the 12 cities included in this study. The increase was more substantial under the high emission pathway, highlighting the potential benefits to public health of reducing greenhouse gas emissions. Nearly 200,000 heat-related deaths are projected to occur in the 12 cities by the end of the century due to climate warming, over 22,000 of which could be avoided if we follow a low GHG emission pathway. The presented estimates can be of value to local decision makers and stakeholders interested in developing strategies to reduce these impacts and building climate change resilience.

  13. Heat-Related Mortality in a Warming Climate: Projections for 12 U.S. Cities

    Science.gov (United States)

    Petkova, Elisaveta P.; Bader, Daniel A.; Anderson, G. Brooke; Horton, Radley M.; Knowlton, Kim; Kinney, Patrick L.

    2014-01-01

    Heat is among the deadliest weather-related phenomena in the United States, and the number of heat-related deaths may increase under a changing climate, particularly in urban areas. Regional adaptation planning is unfortunately often limited by the lack of quantitative information on potential future health responses. This study presents an assessment of the future impacts of climate change on heat-related mortality in 12 cities using 16 global climate models, driven by two scenarios of greenhouse gas emissions. Although the magnitude of the projected heat effects was found to differ across time, cities, climate models and greenhouse pollution emissions scenarios, climate change was projected to result in increases in heat-related fatalities over time throughout the 21st century in all of the 12 cities included in this study. The increase was more substantial under the high emission pathway, highlighting the potential benefits to public health of reducing greenhouse gas emissions. Nearly 200,000 heat-related deaths are projected to occur in the 12 cities by the end of the century due to climate warming, over 22,000 of which could be avoided if we follow a low GHG emission pathway. The presented estimates can be of value to local decision makers and stakeholders interested in developing strategies to reduce these impacts and building climate change resilience. PMID:25365060

  14. Death due to Occupational Accident a Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Celal Bütün

    2015-07-01

    Full Text Available Today's rapid technological developments increase, also the risks to worker's health and work safety. Occupational accidents occurred with reasons such as necessary safety measures in work environment, incorrect behavior, inability on personal skills, technical failures result in bodily injury, loss of labor, disability or death. In this study; two male death cases aged 27 and 39 occured as a result of work accident in the area at the chrome mines were discussed. On the cases, physical examination, forensic autopsy and post-mortem examinations were performed. Event-related findings are similar; the cases were evaluated, together. It was determined that, respectively, cyanotic appearance on facial area and the front of the neck, the hyperemia on the sclera during external body examinations; in places punctuated hemorrhages under the skin and on the visceral organs' surfaces during the autopsies; hemorrhage in subarachoidal area of the brain, hemorrhage on pleural areas of the lungs, sub-mucosal bleeding and congestion in the stomach during the post-mortem histopathology. Finally, the death cause of cases was due to lack of oxygen. In this study; also taking into account of work accident related injuries and deaths seen hight rates in our country, the determination of personal, socio-economic and enviromental factors and, the importance of taking the necessary measures for prevention of occupational accident were emphasized. Also, it aimed to be discussed forensic medical approach to occupational injuriy cases in the literature. Key Word: Forensic medicine, Work accident, Asphyxia, Death, Autopsy.

  15. Witnessed sleep-related seizure and sudden unexpected death in infancy: a case report

    OpenAIRE

    Kinney, Hannah C.; McDonald, Anna G.; Minter, Megan E.; Gerard T. Berry; Poduri, Annapurna; Goldstein, Richard D.

    2013-01-01

    Witnessed reports of sudden death are rare, but critical to deciphering its mechanism(s). We report such a death in a seemingly healthy 8-month-old boy in whom seizures and respiratory distress in the prone position were witnessed upon discovery during a sleep period. Following cardiopulmonary resuscitation, anoxic encephalopathy resulted in “brain death” and withdrawal of life support after 2 days. The autopsy did not reveal a primary anatomic cause of death. Metabolic evaluation failed to u...

  16. Pitfalls in brain death diagnosis: a case report.

    Science.gov (United States)

    Ruess, Daniel; Rieger, Bernhard; Goldbrunner, Roland; Schlacke, Hans-Peter

    2013-05-01

    Although there are distinct guidelines in nearly all countries, a reliable secure assessment of brain death in cases with open head injury can be challenging. We present a case of a 32-year-old man with severe head injury after intracranial penetration of a grindstone fragment. As the injury led to destruction of nearly the whole greater wing of the right sphenoid bone and parts of the right orbit, the examination of brainstem reflexes and the confirmation of brain death was unfeasible. On day 2, all clinical criteria of brain death (coma, absence of brainstem reflexes, apnea) were fulfilled. In addition, there was an extinction of brainstem auditory (BAEP) and cerebral (N20) components of median nerve somatosensory evoked potentials, while electroencephalogram (EEG) activity was still present. In the following days, a persisting EEG activity was obtained. Thus, an irreversible loss of whole brain functions could not be proved. As the patient had agreed to organ donation in case of brain death several years ago, ancillary methods to test the cessation of cerebral blood flow were mandatory. However, in this patient these methods turned out either to be doubtful or unavailable. For example, values of transcranial Doppler ultrasonography are not reliable in cases with open head injury. Due to a progressive septic state, time was running out to get the radiopharmaceutical agent for a cerebral scintigraphy (delivery time about 7 days, as the radiopharmaceutical agent was not in stock). Referring to the actual German guidelines, we had no legitimating indication for a cerebral angiography. Finally, the patient died of sepsis. We discuss the widening of the German guidelines in assessing brain death with the fast and low-risk method of cerebral computed tomography-angiography (CTA) to confirm diagnosis of brain death.

  17. Sudden death due to Eagle syndrome: a case report.

    Science.gov (United States)

    Kumar, Pradeep; Rayamane, Anand P; Subbaramaiah, Mouna

    2013-09-01

    Eagle syndrome represents symptoms manifested by compression of regional structures by elongation of the styloid process or ossification of the stylohyoid membrane. Various theories have been put forward toward the development of Eagle syndrome. Depending on the underlying pathogenetic mechanism and the anatomical structures compressed or irritated by the elongated styloid process, symptoms vary greatly, ranging from cervicofacial pain to cerebral ischemia. Because the symptoms are variable and nonspecific, patients land up in different clinics for treatment. In the present case, the victim had previous episode of unconsciousness along with frequent headache for which she visited various clinics on numerous occasions. The elongated styloid process was appreciated during the postmortem examination, and the diagnosis of sudden death due to mechanical irritation of the carotid sinus by elongated styloid process was made as the sign of acute cardiovascular failure was present and upon exclusion of other causes of death.

  18. Avoided heat-related mortality through climate adaptation strategies in three US cities.

    Science.gov (United States)

    Stone, Brian; Vargo, Jason; Liu, Peng; Habeeb, Dana; DeLucia, Anthony; Trail, Marcus; Hu, Yongtao; Russell, Armistead

    2014-01-01

    Heat-related mortality in US cities is expected to more than double by the mid-to-late 21st century. Rising heat exposure in cities is projected to result from: 1) climate forcings from changing global atmospheric composition; and 2) local land surface characteristics responsible for the urban heat island effect. The extent to which heat management strategies designed to lessen the urban heat island effect could offset future heat-related mortality remains unexplored in the literature. Using coupled global and regional climate models with a human health effects model, we estimate changes in the number of heat-related deaths in 2050 resulting from modifications to vegetative cover and surface albedo across three climatically and demographically diverse US metropolitan areas: Atlanta, Georgia, Philadelphia, Pennsylvania, and Phoenix, Arizona. Employing separate health impact functions for average warm season and heat wave conditions in 2050, we find combinations of vegetation and albedo enhancement to offset projected increases in heat-related mortality by 40 to 99% across the three metropolitan regions. These results demonstrate the potential for extensive land surface changes in cities to provide adaptive benefits to urban populations at risk for rising heat exposure with climate change.

  19. Avoided heat-related mortality through climate adaptation strategies in three US cities.

    Directory of Open Access Journals (Sweden)

    Brian Stone

    Full Text Available Heat-related mortality in US cities is expected to more than double by the mid-to-late 21st century. Rising heat exposure in cities is projected to result from: 1 climate forcings from changing global atmospheric composition; and 2 local land surface characteristics responsible for the urban heat island effect. The extent to which heat management strategies designed to lessen the urban heat island effect could offset future heat-related mortality remains unexplored in the literature. Using coupled global and regional climate models with a human health effects model, we estimate changes in the number of heat-related deaths in 2050 resulting from modifications to vegetative cover and surface albedo across three climatically and demographically diverse US metropolitan areas: Atlanta, Georgia, Philadelphia, Pennsylvania, and Phoenix, Arizona. Employing separate health impact functions for average warm season and heat wave conditions in 2050, we find combinations of vegetation and albedo enhancement to offset projected increases in heat-related mortality by 40 to 99% across the three metropolitan regions. These results demonstrate the potential for extensive land surface changes in cities to provide adaptive benefits to urban populations at risk for rising heat exposure with climate change.

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

    Science.gov (United States)

    Klevens, Joanne; Leeb, Rebecca T.

    2010-01-01

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

  1. [Sudden cardiac death due to sarcoidosis. Case report].

    Science.gov (United States)

    Sejben, István; Som, Zoltán; Cserni, Gábor

    2017-07-01

    Sarcoidosis is a systemic granulomatous disease of unknown aetiology, which is characterized by bilateral hilar lymphadenopathy and pulmonary disease. Clinically detected cardiac involvement occurs in 5% of sarcoid patients, although cardiac manifestations are discovered in 25% of the cases at autopsy. Sarcoid heart disease frequently causes atrioventricular block. The authors present the case of a 44-year-old man with bradycardia. On admission, second degree Mobitz II, then third degree atrioventricular block was diagnosed. Coronarography showed normal coronary arteries. 2.5 years following artificial Biotronik Entovis DR type pacemaker implantation, sudden cardiac death occurred. Autopsy revealed sarcoidosis with cardiac, pulmonary, splenic, renal and lymph node involvement. In case of young or middle-aged patients with atrioventricular block, it is best to search for other causes if the most common coronary origin can be excluded. Orv Hetil. 2017; 158(27): 1067-1070.

  2. Scuba diver deaths due to air embolism: two case reports.

    Science.gov (United States)

    Türkmen, Nursel; Akan, Okan; Cetin, Selçuk; Eren, Bülent; Gürses, Murat Serdar; Gündoğmuş, Umit Naci

    2013-04-01

    Barotraumas and decompression sickness are the two most well-known complications of diving. First presented case was 32 year-old male with recreational diver, who was found floating prone position on the bottom of sea in a depth of 33 m. He had been carried to the surface in a controlled ascent. Second case was a 39 year-old male experienced dive instructor in a diving school, after following an uneventful duration of dive was found unconscious with a floating supine position in a depth of 30 m and there were no signs of life when they were transported to the hospital. Extensive subcutaneous emphysema of the extremities was detected by palpation of the skin. In the autopsy diffuse gas bubbles like beads were seen in the coronary arteries and in ventricles, basilar artery and all of the cerebral arteries. The cause of death was attributed due to gas embolism and drowning.

  3. Progressive Primary Pulmonary Tuberculosis Presenting as the Sudden Unexpected Death in Infancy: A Case Report

    Science.gov (United States)

    Dempers, Johan; Sens, Mary Ann; Wadee, Shabbir Ahmed; Kinney, Hannah C.; Odendaal, Hein J.; Wright, Colleen A.

    2010-01-01

    The classification of an unexpected infant death as the sudden infant death syndrome (SIDS) depends upon a complete autopsy and death scene investigation to exclude known causes of death. Here we report the death of a four-month-old infant in a tuberculosis endemic area that presented as a sudden unexpected death in infancy (SUDI) with no apparent explanation based on the death scene characteristics. The autopsy, however, revealed progressive primary pulmonary tuberculosis with intrathoracic adenopathy, compression of the tracheobronchial tree and miliary lesions in the liver. This case underscores the clinical difficulties in the diagnosis of infantile tuberculosis, as well as the possibility of sudden death as part of its protean manifestations. The pathology and clinical progression of tuberculosis in infants differs from older children and adults due to the immature immune response in infants. This case dramatically highlights the need for complete autopsies in all sudden and unexpected infant deaths, as well as the public health issues in a sentinel infant tuberculosis diagnosis. PMID:20705406

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

    LENUS (Irish Health Repository)

    Treacy, A

    2013-03-01

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

  5. Sudden twin infant death on the same day: a case report and review of the literature.

    Science.gov (United States)

    Huang, Ping; Yu, Rongjun; Li, Shiying; Qin, Zhiqiang; Liu, Ningguo; Zhang, Jianhua; Zou, Donghua; Chen, Yijiu

    2013-06-01

    Sudden infant death syndrome (SIDS) is a major contributor to infant mortality. The cause of death is unknown: suggested possibilities include cardiovascular disease, anaphylactic shock, and suffocation. The occurrence of simultaneous sudden infant death syndrome is uncommon, such cases being extremely rare in forensic pathologic practice. We report two 10-week-old male twins who appeared well at the time of their evening feeding, yet died while sleeping on their backs. Both infants had petechial hemorrhages on the visceral pleura, epicardial surface of the heart, and thymus gland. Microscopic examination revealed pulmonary edema, intra-alveolar hemorrhage, and minor lymphocytic infiltration, again in both infants. In this report, we discuss the risk factors for SIDS, which should be considered individually or in combination as possible causes of death.

  6. An Immediate Death by Seat Belt Compression; a Forensic Medicine Report

    Directory of Open Access Journals (Sweden)

    Fares Najari

    2014-09-01

    Full Text Available Although death is a gradual process, sometimes sudden death occurs in a fraction of a minute or seconds. Here we report a 49-year-old man without any underlying disease, which has instantly died in an accident scene due to compression of neck critical elements by a three-point seat belt. The examination of the body and the results of the autopsy, toxicology and pathology tests are described from the viewpoint of forensic medicine.

  7. 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…

  8. 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…

  9. Hyperthermia, Thermal Injuries, and Death from a Forced Convection Heat Source: A Case Report and Experimental Model.

    Science.gov (United States)

    Fisher-Hubbard, Amanda O; Sung, LokMan; Hubbard, Sean A; Hlavaty, Leigh

    2017-05-01

    Heat-related deaths of children are most often encountered in the context of enclosed vehicles in summer months. Deviating from this, a 16-month-old boy was found unresponsive in a stroller that was placed adjacent to a space heater during mid-winter. The cause of death was hyperthermia and thermal injuries. Manner of death determination was difficult due to alleged surrounding circumstances. To understand the time-course of this child's injuries, a child death scene investigation was performed; the stroller and space heater were recovered. In a re-enactment of the events, a slaughtered pig approximating the child's size was warmed using a water bath and placed in the stroller beside the space heater. Cutaneous temperature measurements showed rapid initial temperature rise with subsequent steady increases. Tanning of the skin was seen on periodic direct observations. Internal temperature monitoring illustrated steady increases. This experiment was essential in classifying the manner of death as homicide. © 2016 American Academy of Forensic Sciences.

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

    Science.gov (United States)

    Harris, Andrew

    2017-07-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  12. Aging Will Amplify the Heat-related Mortality Risk under a Changing Climate: Projection for the Elderly in Beijing, China

    Science.gov (United States)

    Li, Tiantian; Horton, Radley M.; Bader, Daniel A.; Zhou, Maigeng; Liang, Xudong; Ban, Jie; Sun, Qinghua; Kinney, Patrick L.

    2016-06-01

    An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heat-related mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events.

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

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Dinesh Rao

    2014-03-01

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

  15. Milder form of heat-related symptoms and thermal sensation: a study in a Mediterranean climate

    Science.gov (United States)

    Pantavou, Katerina G.; Lykoudis, Spyridon P.; Nikolopoulos, Georgios K.

    2016-06-01

    Mild heat-related health effects and their potential association with meteorological and personal parameters in relation to subjective and objective thermal sensation were investigated. Micrometeorological measurements and questionnaire surveys were conducted in an urban Mediterranean environment during a warm, cool, and a transitional season. The participants were asked to indicate their thermal sensation based on a seven-point scale and report whether they were experiencing any of the following symptoms: headache, dizziness, breathing difficulties, and exhaustion. Two thermal indices, Actual Sensation Vote (ASV) and Universal Thermal Climate Index (UTCI), were estimated in order to obtain an objective measure of individuals' thermal sensation. Binary logistic regression was applied to identify risk parameters while cluster analysis was used to determine thresholds of air temperature, ASV and UTCI related to health effects. Exhaustion was the most frequent symptom reported by the interviewees. Females and smokers were more likely to report heat-related symptoms than males and nonsmokers. Based on cluster analysis, 35 °C could be a cutoff point for the manifestation of heat-related symptoms during summer. The threshold for ASV was 0.85 corresponding to "warm" thermal sensation and for UTCI was about 30.85 °C corresponding to "moderate heat stress" according to the Mediterranean assessment scale.

  16. Sudden infant death syndrome: a case report in Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Dragan Ćajić

    2010-11-01

    Full Text Available Sudden infant death syndrome (SIDS is an idiopathic condition that affects seemingly healthy infants under one year of age, whose death remains unexplained after the performance of a complete postmortem examination, toxicological analyses, genetic testing, death scene investigation, and a review of the mother’s and infant’s medical history. Detailed epidemiological, pathological, and forensic information has been reported regarding SIDS from the developed countries. However, SIDS information from developing countries is either widely scattered or non-existent. This is the first published case report of SIDS from the country of Bosnia and Herzegovina. A previously healthy 3 months old, white male infant was found dead after being placed to sleep in the prone position. The features of this case report closely parallel the classical features of SIDS cited in the world literature. The infant was healthy, male, between the ages of 2-12 months, discovered in the prone position and had a negative postmortem investigation. It is important for developing countries such as Bosnia and Herzegovina to conduct detailed forensic investigations of deaths from SIDS and provide epidemiological, pathological, and circumstances of that information to the world’s collective knowledge.

  17. Subvalvular aortic stenosis as a cause of sudden death: two case reports.

    Science.gov (United States)

    Turan, Arzu Akcay; Guven, Taner; Karayel, Ferah; Pakis, Isil; Gurpinar, Kagan; Ozaslan, Abdi

    2006-03-01

    Sudden death is defined as a death that occurs suddenly, develops during an unpredictable course, and is due to natural or unnatural causes. Although there is no universally standardized definition on how "sudden" a sudden death is, WHO defines sudden death as a death that occurs within 24 hours after the onset of symptoms. The aim of this study is to present 2 rarely reported autopsy cases and to emphasize the importance of systemic autopsy at sudden death. On macroscopic examination, crescent-shaped, thick, fibrous membranes, located 5 mm and 3 mm away from the aortic valves, were detected. Fibrous membranes extended from the ventricular septum to the left ventricular outflow tract, thus apparently narrowing this region. Left ventricular wall and septum were slightly thickened, and there were scattered grayish-white areas of a small diameter. These became more intense in the septum and myocardium of the left ventricle on the anterior plane of the myocardial sections. In both cases, the aortic valves of were thickened and also markedly narrowed on one of them. In this case, the fibrous membrane adhered to the aortic valve and extended to the anterior leaflet of the mitral valve at one side. Both aortic valves comprised 3 leaflets. Other valves and coronary arteries showed no macroscopic pathologic findings. Microscopic examination of both cases demonstrated that the fibrous membrane comprising abundant collagen fibers was situated on the ventricular septum. Hypertrophy, moderate to severe interstitial fibrosis, and focal areas of scarring were observed in the specimens taken from the septal and ventricular myocardium. No abnormality was found on the conduction system examinations. Toxicologic analysis results in blood were negative. Based on the findings, membranous-type (discrete type) subvalvular aortic stenosis, diagnosed during the autopsy, was considered as the cause of sudden death in both cases.

  18. Sudden Death in Sauna Due to Fatal Burns: A Case Report.

    Science.gov (United States)

    Lindroos, Katarina; Keltanen, Terhi

    2016-03-01

    Sudden death during or after sauna bathing is a rare event. When occurring accidentally, it is often caused or contributed by consumption of ethanol. To accidentally burn to death because of hot air is highly uncommon without some contributing factor that lowers the person's consciousness. Hot air burns have been reported to develop in 20 to 60 minutes. We present a case of sudden death of a healthy man with rare and extensive hot air burns that developed in less than 10 minutes in the sauna. Ethanol was not a contributing factor. Substantial injuries were found at the autopsy, both external and internal, for instance, small hemorrhages in the stomach mucosa, indicating a heavy antemortem stress reaction. The most probable reason for the extensive scalds was concluded to be, apart from the high temperature, the high degree of relative humidity in the sauna.

  19. A Unusual Lightning Death in an Indoor Setting: A Case Report.

    Science.gov (United States)

    Ventura, Francesco; Barranco, Rosario; Bonsignore, Alessandro; De Stefano, Francesco

    2017-03-01

    Death due to lightning strikes is infrequent, above all indoors. Some cases may take on a medical legal interest due to the unusual and uncommon circumstances in which they occur. The authors report an extremely rare case of electrocution occurred inside a house in a rural area. A 53-year-old man was reached by an electrical discharge originating from lightning while he was doing renovation work on a cottage. In this case, the correct interpretation of the autopsy and histological aspects and the attentive analysis of the circumstantial and environmental data led to the correct diagnosis of death and to the reconstruction of the dynamics with which it occurred. It was in fact possible to reconstruct that during a violent thunderstorm, lightning, discharging from the bottom upward formed an electric arc. The victim, who was close to metal objects (sawhorses), was struck on the left foot and the current exited from the right hand passing through the heart causing immediate death.

  20. Medical neglect death due to acute lymphoblastic leukaemia: an autopsy case report.

    Science.gov (United States)

    Usumoto, Yosuke; Sameshima, Naomi; Tsuji, Akiko; Kudo, Keiko; Nishida, Naoki; Ikeda, Noriaki

    2014-12-01

    We report the case of 2-year-old girl who died of precursor B-cell acute lymphoblastic leukaemia (ALL), the most common cancer in children. She had no remarkable medical history. She was transferred to a hospital because of respiratory distress and died 4 hours after arrival. Two weeks before death, she had a fever of 39 degrees C, which subsided after the administration of a naturopathic herbal remedy. She developed jaundice 1 week before death, and her condition worsened on the day of death. Laboratory test results on admission showed a markedly elevated white blood cell count. Accordingly, the cause of death was suspected to be acute leukaemia. Forensic autopsy revealed the cause of death to be precursor B-cell ALL. With advancements in medical technology, the 5-year survival rate of children with ALL is nearly 90%. However, in this case, the deceased's parents preferred complementary and alternative medicine (i.e., naturopathy) to evidence-based medicine and had not taken her to a hospital for a medical check-up or immunisation since she was an infant. Thus, if she had received routine medical care, she would have a more than 60% chance of being alive 5 years after diagnosis. Therefore, we conclude that the parents should be accused of medical neglect regardless of their motives.

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

    LENUS (Irish Health Repository)

    Cantwell, Roch

    2011-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Carter Karen L

    2012-06-01

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

  3. 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

  4. When evidence of heat-related vulnerability depends on the contrast measure

    Science.gov (United States)

    Benmarhnia, Tarik; Kaufman, Jay S.

    2017-02-01

    Many studies assessing which population subgroups are more vulnerable to heat-related mortality and morbidity have been conducted in recent years. However, given the non-linear (U or J shaped) relationship of temperature with mortality and morbidity, they generally consider only a single contrast measure to report evidence of heat-related vulnerability, despite the possibility that vulnerability depends on the selected contrast measure. In this manuscript, we highlight the importance of considering such issue in further studies by providing evidence for and against heat-related vulnerability using two different temperature contrast measures. We conducted time series analyses to characterize the association between mortality and mean daily temperature in Montreal, Canada (1990-2010). We used age (≥65 vs. 0-64 years) as the effect modifier in stratified analyses. We assessed the presence of effect modification using Cochran Q tests. As contrast measures, we used (1) the percentage change in the outcome above 25 °C, obtained through spline functions showing a linear relationship after this threshold and (2) a comparison of two percentiles (26 vs. 20 °C) of the temperature. We found that evidence of effect modification depended on the contrast measure used. We encourage researchers aiming to identify populations more vulnerable to heat to perform sensitivity analyses using different contrast measures.

  5. Death by dengue fever in a Brazilian child: a case report.

    Science.gov (United States)

    Sacramento, Rafael Henrique Machado; de Melo Braga, Deborah Nunes; Sacramento, Franciane Fardin; de Carvalho Araújo, Fernanda Montenegro; Lima, Antônio Afonso Bezerra; de Lima Pompeu, Margarida Maria; Lima, Danielle Malta; de Góes Cavalcanti, Luciano Pamplona

    2014-11-27

    Dengue is an important worldwide public health problem, and continues to spread in Brazil. This article presents the first Brazilian case report of the death of an indigenous child by dengue fever. In August 2013, a child aged 2 years and from the Tremembé ethnic group, who was previously healthy with no complaints, suddenly presented intense crying, precordial pain, and general malaise. A few minutes after these non-specific symptoms, the patient started tonic-clonic convulsions and had cyanosis, a substantial increase in body temperature to the touch, cold sudoresis, sphincter relaxation, and unconsciousness. This situation remained for 15 minutes, progressing to respiratory insufficiency, with consequent absence of peripheral pulses. Death was confirmed approximately 40 minutes after the first symptoms. An autopsy was performed using the usual techniques. Immunohistochemistry was positive for dengue, and microscopic examination indicated micro perivascular edema and cerebral hemorrhage. Considering that the death occurred during the major endemic seasonal period for dengue fever, primary clinical evidence suggestive of viral infection presenting with sudden and quick death, and positive immunohistochemistry results, the case was closed as severe dengue fever. Clinicians must consider dengue as a diagnostic hypothesis among the indigenous population in Brazil.

  6. Different perspectives: a comparison of newspaper articles to medical examiner data in the reporting of violent deaths.

    Science.gov (United States)

    Genovesi, Andrea L; Donaldson, Amy E; Morrison, Brynna L; Olson, Lenora M

    2010-03-01

    This study compared violent death information reported in state-wide newspaper articles to the medical examiner reports collected for a state public health surveillance system-the National Violent Death Reporting System (NVDRS). While suicides accounted for 83% of deaths in the NVDRS database, more than three-quarters (79%) of violent deaths reported in newspaper articles were homicides. The majority of the suicide incidents were reported in 1-2 newspaper articles whereas the majority of homicide incidents were reported in 11-34 articles. For suicide incidents, the NVDRS reported more circumstances related to mental health problems while newspaper articles reported recent crisis more often. Results show that there is a mismatch in both frequency and type of information reported between a public health surveillance system (NVDRS) and newspaper reporting of violent deaths. As a result of these findings, scientists and other public health professionals may want to engage in media advocacy to provide newspaper reporters with timely and important health information related to the prevention and intervention of violent deaths in their community. Copyright 2009 Elsevier Ltd. All rights reserved.

  7. Kidney transplantation from donors after cardiac death: an initial report of 71 cases from China.

    Science.gov (United States)

    Chen, G-D; Shiu-Chung Ko, D; Wang, C-X; Qiu, J; Han, M; He, X-S; Chen, L-Z

    2013-05-01

    Shortage of deceased donors is a severe problem in recent years in China especially in a culture in which brain death criteria is not widely accepted. Donation after cardiac death (DCD) has been reported to expand the donor pool despite higher rates of primary nonfunction (PNF) and delayed graft function (DGF) after transplantation. We collected 71 DCD kidney transplants performed at our hospital between February, 2007 and June, 2012 with aims to demonstrate the feasibility of DCD donation in China. All patients were followed up, and postoperative complications and graft loss were recorded. The PNF rate was 2.8%, and DGF rate was 28.2%. The 1- and 3-year graft survival was 95.7% and 92.4%. In conclusion, graft survival of DCD kidney transplantation in China is excellent despite of higher rates of PNF and DGF after transplantation. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

  8. Near-death experience and out of body phenomenon during torture--a case report.

    Science.gov (United States)

    Cooper, Maxwell J F

    2011-01-01

    A case of a near death experience (NDE) associated with an "Out of body" phenomenon in an African man as a result of torture is presented. Although NDEs occur in approximately ten per cent of survivors of cardiac arrest, case reports emerging from the medical examination of torture victims are lacking. This may be due to cultural/linguistic barriers and fear of disbelief. Low NDE incidence during torture would suggest that torture techniques rarely induce the critical brain ischaemia considered necessary to provoke an NDE. Alternatively psychological or physical characteristics of torture may render NDE harder to recall. Proof of low incidence during torture would counter the theory that NDEs are a psychological response to perceived threat of death. NDEs often induce transformational benefits in patients' lives and for this reason the author urges physicians to consider the possibility of NDE amongst torture victims under their care. A request for information about similar cases is made.

  9. Pediatric heat-related illness: recommendations for prevention and management [digest].

    Science.gov (United States)

    Dunn, Roberta J; Kim, Tommy Y; Chaudhari, Pradip

    2017-08-22

    Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air). The choice of method used may depend on availability of equipment, but there is evidence that can guide optimal use of resources. This issue presents evidence-based recommendations and best practices in heat-illness resuscitation, including managing children who are obese, have special needs or take medications, and advocacy for prevention strategies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  10. Aging Will Amplify the Heat-Related Mortality Risk Under a Changing Climate: Projection for the Elderly in Beijing, China

    Science.gov (United States)

    Li, Tiantian; Horton, Radley M.; Bader, Daniel A.; Zhou, Maigeng; Liang, Xudong; Ban, Jie; Sun, Qinghua; Kinney, Patrick L.

    2016-01-01

    An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heatrelated mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events.

  11. Towards More Comprehensive Projections of Urban Heat-Related Mortality: Estimates for New York City Under Multiple Population, Adaptation, and Climate Scenarios

    Science.gov (United States)

    Petkova, Elisaveta P.; Vink, Jan K.; Horton, Radley M.; Gasparrini, Antonio; Bader, Daniel A.; Francis, Joe D.; Kinney, Patrick L.

    2016-01-01

    High temperatures have substantial impacts on mortality and, with growing concerns about climate change, numerous studies have developed projections of future heat-related deaths around the world. Projections of temperature-related mortality are often limited by insufficient information necessary to formulate hypotheses about population sensitivity to high temperatures and future demographics. This study has derived projections of temperature-related mortality in New York City by taking into account future patterns of adaptation or demographic change, both of which can have profound influences on future health burdens. We adopt a novel approach to modeling heat adaptation by incorporating an analysis of the observed population response to heat in New York City over the course of eight decades. This approach projects heat-related mortality until the end of the 21st century based on observed trends in adaptation over a substantial portion of the 20th century. In addition, we incorporate a range of new scenarios for population change until the end of the 21st century. We then estimate future heat-related deaths in New York City by combining the changing temperature-mortality relationship and population scenarios with downscaled temperature projections from the 33 global climate models (GCMs) and two Representative Concentration Pathways (RCPs).The median number of projected annual heat-related deaths across the 33 GCMs varied greatly by RCP and adaptation and population change scenario, ranging from 167 to 3331 in the 2080s compared to 638 heat-related deaths annually between 2000 and 2006.These findings provide a more complete picture of the range of potential future heat-related mortality risks across the 21st century in New York, and highlight the importance of both demographic change and adaptation responses in modifying future risks.

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

    Directory of Open Access Journals (Sweden)

    Amaral Eliana

    2006-04-01

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

  13. Near-death states reported in a sample of 50 misusers.

    Science.gov (United States)

    Corazza, Ornella; Schifano, Fabrizio

    2010-05-01

    Increase in recreational ketamine use may be a cause for concern. We aimed here at assessing, in a sample of ketamine misusers, concordance between the typical near-death experience (NDE) features and the on-drug psychoactive effects the subjects experienced. In 2003-2005, a sample of previous ketamine misusers recollecting a ketamine-related NDE were recruited through snowballing and screened with the means of the Greyson NDE Scale; 125 participants made an initial contact with the researcher and 50 reported a minimum score of seven at the "Greyson NDE Scale". Interviewees were in the range 21-66 years old; 27 participants (54%) were educated at BA level, 18 (36%) had an MSc, and 5 (10%) a PhD. Eight (16%) interviewees had a definite religious background. An average lifetime ketamine intake of 140 occasions was reported by the interviewees, who typically presented with a polydrug, including cannabis and MDMA/ecstasy, misuse history. In 45 (90%) cases, the NDE occurred during the first few occasions of intake. Most frequent features of reported NDE states included: altered perception of time (90%), strong sense of detaching from own physical body (88%), and a sense of peace/joy (76% of subjects). Although results here described were elicited from a self-selected, nonrandomized, limited size sample of misusers, we suggest that recreational ketamine intake may be associated with occurrence of near-death related states.

  14. Infant death after nose-horned viper (Vipera ammodytes ammodytes) bite in Croatia: A case report.

    Science.gov (United States)

    Lukšić, Boris; Culić, Viktor; Stričević, Luka; Brizić, Ivica; Poljak, Nikola K; Tadić, Zoran

    2010-12-01

    A case of a 45-day-old male infant, bitten on the neck by nose-horned viper (Vipera ammodytes ammodytes), is reported. This episode occurred while the baby was on a picnic with his parents in a hill near a town in southern Croatia. In spite of immediate arrival at hospital, where antivenom was administrated and all the necessary treatment measures were carried out, the infant died 6 h following the bite. The cause of death was severe and progressive hyperkalaemia, massive intravascular haemolysis, severe coagulopathy and myocardial dysfunction. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Paraquat-induced convulsion and death: a report of five cases.

    Science.gov (United States)

    Huang, Changbao; Zhang, Xigang; Jiang, Yun; Li, Guang; Wang, Haochun; Tang, Xueping; Wang, Qunli

    2013-09-01

    Paraquat (PQ) is a potent toxicant for humans, and poisoning with PQ is associated with high mortality. Patients with severe PQ-induced poisoning may die of multiple organ failure involving the circulatory and respiratory systems. Death resulting from epilepsy-like convulsions, which are infrequently noted reported with PQ poisoning, is observed clinically with this condition. This study presents the clinical data of five patients with severe PQ-induced poisoning who died of epilepsy-like convulsions, and related publications were reviewed in order to investigate the pathogenesis, clinical manifestations, and prognosis of these convulsions. Our results may help prevent this event and improve the success of treatment.

  16. Final report : Albuquerque Ecological Services, interpretation of cause of death of 3 golden eagles and 1 bald eagle

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report was prepared by Environmental Contaminant Specialists on the cause of death of the 3 golden eagles and 1 bald eagle found near Folsom, New Mexico. This...

  17. Cytokine Elevation in Sudden Death With Respiratory Syncytial Virus: A Case Report of 2 Children.

    Science.gov (United States)

    Kakimoto, Yu; Seto, Yoshihisa; Ochiai, Eriko; Satoh, Fumiko; Osawa, Motoki

    2016-12-01

    Respiratory syncytial virus (RSV) is the most common viral cause of bronchiolitis and pneumonia in young children worldwide. Premature birth, bronchopulmonary dysplasia, congenital heart disease, and Down syndrome are risk factors for high mortality and prolonged morbidity after RSV infection. Conversely, many previously healthy, full-term children are also admitted to the hospital because of RSV, and some of them experience severe sequelae or die due to the virus. Various complications of RSV infection have been reported, such as encephalopathy, encephalitis, and cardiomyopathy. However, the pathogenesis of serious cases in children without an underlying disease has not been elucidated. In this report, we present 2 RSV-related deaths of children who were born at full-term and developed normally up to the age of 19 months. Their cardiopulmonary arrests occurred within half a day after the onset of symptoms, such as cough and high fever. Many postmortem examinations were performed to investigate their unexpected deaths. Histopathological examinations revealed extensive bronchiolitis and mild pneumonia accompanying airway obstruction. Immunostaining revealed the presence of the virus mainly in bronchial epithelia, but not in alveoli. Complete brain edema was prominent, and encephalopathy was developing. Blood tests revealed that the IL-6 level was elevated more than >200-fold above normal, despite a normal C-reactive protein level. Because IL-6 may reflect the severity of bronchial epithelial damage and contribute to brain edema, an extreme elevation of IL-6 may predict the risk for sudden death in children with RSV infection. Copyright © 2016 by the American Academy of Pediatrics.

  18. Drug-related deaths with evidence of intracorporeal drug concealment at autopsy: five case reports.

    Science.gov (United States)

    Wilcher, Glenn

    2011-12-01

    Intracorporeal concealment of illicit drugs is a rare observation at coronial autopsy examinations. The article reports 5 cases of accidental drug overdoses at the Westmead Coronial Morgue, Sydney New South Wales, over a 6-year period with evidence of intracorporeal drug concealment known as body packing or body stuffing. Three different forms of anatomic concealment of drugs are illustrated, Case 2 involving therapeutic medication in the form of glass ampoules for parenteral injection not previously reported. Three deaths were the result of acute toxicity due to polydrug abuse rather than as a consequence of the body packing behavior and rupture of the drug packaging, with the intracorporeal drug concealments an adjunct finding at the autopsy examinations. The cause of death in Case 3 was the direct result of acute cocaine intoxication due to rupture of drug packages in the rectum and mucosal absorption. The article details forensic sociological aspects of drug concealment and subcultural group human behavior that can assist in providing information for the initiation of investigations.

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

    Directory of Open Access Journals (Sweden)

    Maeda Shoichi

    2010-02-01

    Full Text Available Abstract Background In Japan, medical error leading to patient death is often handled through the criminal rather than civil justice system. However, the number of cases handled through the criminal system and how this has changed in recent years has not previously been described. Our aim was to determine the trend in reports of patient death to the police and the trend in the resulting prosecution of healthcare providers for medical error leading to patient death from 1998 to 2008. Methods We collected data regarding the number of police reports of patient death made by physicians, next-of-kin, and other sources between 1998 and 2008. We also collected data regarding the number of resulting criminal prosecutions of healthcare providers between 1998 and 2008. Reporting and prosecution trends were analyzed using annual linear regression models. Results Reports: The number physician reports of patient deaths to the police increased significantly during the study period (slope 18.68, R2 = 0.78, P 2 = 0.83, P Conclusions The reporting of patient deaths to the police by physicians increased significantly from 1998 to 2008 while those made by next-of-kin and others did not. The resulting criminal prosecutions of healthcare providers increased significantly during the same time period. The reasons for these increases are unclear and should be the focus of future research.

  20. Maternal Death Due to Placenta Percreta with Bladder Involvement: A Case Report

    Directory of Open Access Journals (Sweden)

    Sedigheh Ayati M.D.

    2011-06-01

    Full Text Available Background: Placenta accreta is a life-threatening complication after previous cesarean delivery. The aim of this case report is to present a case of placenta percreta with bladder involvement and subsequent maternal death.Case presentation: The patient was a 37-year old who had an unwanted pregnancy due to tubectomy failure two years afterwards. She was hospitalized at 26th and 30th week of gestation because of gross hematuria. Sonography reported placenta previa. Cesarean section was performed at 34th gestational week. Due to severe hemorrhage, hysterectomy with resection of some part of the bladder was done. Died at the operating room after four hours of severe uncontrollable hemorrhage. Conclusion: The increasing prevalence of different forms of placenta accreta is the result of the ever-increasing rate of cesarean deliveries. One of the strategies to prevent this catastrophic obstetric complication is decreasing the number of cesarean deliveries without appropriate indications.

  1. Mapping playa evaporite minerals with AVIRIS data: A first report from death valley, California

    Science.gov (United States)

    Crowley, J.K.

    1993-01-01

    Efflorescent salt crusts in Death Valley, California, were mapped by using Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data and a recently developed least-squares spectral band-fitting algorithm. Eight different saline minerals were remotely identified, including three borates, hydroboracite, pinnoite, and rivadavite, that have not been previously reported from the Death Valley efflorescent crusts. The three borates are locally important phases in the crusts, and at least one of the minerals, rivadavite, appears to be forming directly from brine. Borates and other evaporite minerals provide a basis for making remote chemical measurements of desert hydrologic systems. For example, in the Eagle Borax Spring area, the AVIRIS mineral maps pointed to elevated magnesium and boron levels in the ground waters, and to the action of chemical divides causing subsurface fractionation of calcium. Many other chemical aspects of playa brines should have an expression in the associated evaporite assemblages. Certain anhydrous evaporites, including anhydrite, glauberite, and thenardite, lack absorption bands in the visible and near-infrared wavelength range, and crusts composed of these minerals could not be characterized by using AVIRIS. In these situations, thermal-infrared remote sensing data may complement visible and near-infrared data for mapping evaporites. Another problem occurred in wet areas of Death Valley, where water absorption caused low signal levels in the 2.0-2.5 ??m wavelength region that obscured any spectral features of evaporite minerals. Despite these difficulties, the results of this study demonstrate the potential for using AVIRIS and other imaging spectrometer data to study playa chemistry. Such data can be useful for understanding chemical linkages between evaporites and ground waters, and will facilitate studies of how desert ground-water regimes change through time in response to climatic and other variables. ?? 1993.

  2. Creation and characterization of a cell-death reporter cell line for hepatitis C virus infection

    Science.gov (United States)

    Chen, Zhilei; Simeon, Rudo; Chockalingam, Karuppiah; Rice, Charles M.

    2010-01-01

    The present study describes the creation and characterization of a hepatoma cell line, n4mBid, that supports all stages of the hepatitis C virus (HCV) life cycle and strongly reports HCV infection by a cell-death phenotype. The n4mBid cell line is derived from the highly HCV-permissive Huh-7.5 hepatoma cell line and contains a modified Bid protein (mBid) that is cleaved and activated by the HCV serine protease NS3-4A. N4mBid exhibited a 10–20 fold difference in cell viability between the HCV-infected and mock-infected states, while the parental Huh-7.5 cells showed <2 fold difference under the same conditions. The pronounced difference in n4mBid cell viability between the HCV- and mock-infected states in a 96-well plate format points to its usefulness in cell survival-based high-throughput screens for anti-HCV molecules. The degree of cell death was found to be proportional to the intracellular load of HCV. HCV-low n4mBid cells, expressing an anti-HCV short hairpin RNA, showed a significant growth advantage over naïve cells and could be rapidly enriched after HCV infection, suggesting the possibility of using n4mBid cells for the cell survival-based selection of genetic anti-HCV factors. PMID:20188762

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

    Science.gov (United States)

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

    2017-06-01

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

  4. Fulminant Peripartum myocarditis associated with sudden cardiac death: a case report.

    Science.gov (United States)

    Ciccone, Marco Matteo; Dentamaro, Ilaria; Carbonara, Santa; Ricci, Gabriella; Vestito, Domenico; Marzullo, Andrea; Tunzi, Francesco; Solarino, Biagio

    2016-01-01

    Myocarditis is an inflammatory disease of myocardium, associated with nonischemic necrosis and degeneration of myocytes. Although the clinical course is rapid, myocarditis can lead to dilated cardiomyopathy with chambers dilatation and ventricular dysfunction. The pathophysiology of myocarditis in humans is not completely understood. There are several etiological agents implicated, mainly viral agents. The clinical presentation is extremely various, with nonspecific systemic symptoms until sudden death. The great variability of symptoms makes the diagnosis, therefore, extremely difficult. We report the case of a 40-year-old woman who developed, after childbirth, hyperthermia associated with neck and left arm pain; initially treated with acetaminophen, without any benefit, the young woman, after few days, died suddenly. The autopsy documented the presence of edematous lungs and enlarged and congested liver. The microbiological tests performed 4 days after death were negative. The heart was normal in shape and volume; a section of the left ventricle wall showed subendocardial discromic areas histologically characterized by multifocal perivascular and interstitial inflammatory infiltrates. These infiltrates consisted mainly of neutrophils with eosinophil component associated with myocyte necrosis and hemorrhagic interstitial infiltration.

  5. Vulnerability Reduction Needed to Maintain Current Burdens of Heat-Related Mortality in a Changing Climate-Magnitude and Determinants.

    Science.gov (United States)

    Åström, Christofer; Åström, Daniel Oudin; Andersson, Camilla; Ebi, Kristie L; Forsberg, Bertil

    2017-07-07

    The health burden from heatwaves is expected to increase with rising global mean temperatures and more extreme heat events over the coming decades. Health-related effects from extreme heat are more common in elderly populations. The population of Europe is rapidly aging, which will increase the health effects of future temperatures. In this study, we estimate the magnitude of adaptation needed to lower vulnerability to heat in order to prevent an increase in heat-related deaths in the 2050s; this is the Adaptive Risk Reduction (ARR) needed. Temperature projections under Representative Concentration Pathway (RCP) 4.5 and RCP 8.5 from 18 climate models were coupled with gridded population data and exposure-response relationships from a European multi-city study on heat-related mortality. In the 2050s, the ARR for the general population is 53.5%, based on temperature projections under RCP 4.5. For the population above 65 years in Southern Europe, the ARR is projected to be 45.9% in a future with an unchanged climate and 74.7% with climate change under RCP 4.5. The ARRs were higher under RCP 8.5. Whichever emission scenario is followed or population projection assumed, Europe will need to adapt to a great degree to maintain heat-related mortality at present levels, which are themselves unacceptably high, posing an even greater challenge.

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

    Directory of Open Access Journals (Sweden)

    Penny Hawkins

    2016-08-01

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

  7. Spatial and temporal investigations of reported movements, births and deaths of cattle and pigs in Sweden

    Directory of Open Access Journals (Sweden)

    Lindström Tom

    2009-10-01

    Full Text Available Abstract Background Livestock movements can affect the spread and control of contagious diseases and new data recording systems enable analysis of these movements. The results can be used for contingency planning, modelling of disease spread and design of disease control programs. Methods Data on the Swedish cattle and pig populations during the period July 2005 until June 2006 were obtained from databases held by the Swedish Board of Agriculture. Movements of cattle and pigs were investigated from geographical and temporal perspectives, births and deaths of cattle were investigated from a temporal perspective and the geographical distribution of holdings was also investigated. Results Most movements of cattle and pigs were to holdings within 100 km, but movements up to 1200 km occurred. Consequently, the majority of movements occurred within the same county or to adjacent counties. Approximately 54% of the cattle holdings and 45% of the pig holdings did not purchase any live animals. Seasonal variations in births and deaths of cattle were identified, with peaks in spring. Cattle movements peaked in spring and autumn. The maximum number of holdings within a 3 km radius of one holding was 45 for cattle and 23 for pigs, with large variations among counties. Missing data and reporting bias (digit preference were detected in the data. Conclusion The databases are valuable tools in contact tracing. However since movements can be reported up to a week after the event and some data are missing they cannot replace other methods in the acute phase of an outbreak. We identified long distance transports of cattle and pigs, and these findings support an implementation of a total standstill in the country in the case of an outbreak of foot-and-mouth disease. The databases contain valuable information and improvements in data quality would make them even more useful.

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

    Directory of Open Access Journals (Sweden)

    Marinković Nadica

    2017-01-01

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

  9. Methylenedioxypyrovalerone ("bath salts"), related death: case report and review of the literature.

    Science.gov (United States)

    Kesha, Kilak; Boggs, Cassie L; Ripple, Mary G; Allan, Carol H; Levine, Barry; Jufer-Phipps, Rebecca; Doyon, Suzanne; Chi, PaoLin; Fowler, David R

    2013-11-01

    Cathinone derivatives (bath salts) have emerged as the latest drugs of abuse. 3,4-methylenedioxypyrovalerone (MDPV) is the primary active ingredient in bath salts used in this country. This article presents the second reported cause of death by MDPV intoxication alone. In April 2011, a delusional man was emergently brought to a hospital, where he self-reported bath salt usage. He became agitated, developed ventricular tachycardia, hyperthermia, and died. Comprehensive alcohol and drug testing was performed. Using the alkaline drug screen, heart blood contained 0.7 mg/L MDPV and peripheral blood contained 1.0 mg/L MDPV. His bizarre behavior with life-threatening hyperthermia was consistent with an MDPV-induced excited delirium state. MDPV is not yet found by routine immunoassay toxicology screens. Testing for MDPV should be considered in cases with a history of polysubstance abuse with stimulant type drugs, report of acute onset of psychogenic symptoms, excited delirium syndrome, or presentation in a hyperthermic state. © 2013 American Academy of Forensic Sciences.

  10. [Triplet pregnancy complicated by intrauterine death of two fetuses--case report].

    Science.gov (United States)

    Teliga-Czajkowska, Justyna; Dadalska, Ewa; Sopliński, Aleksander

    2003-10-01

    Multiple pregnancy still constitutes a difficult therapeutic problem in perinatology. The incidence of this phenomenon describes Hellin's formula: the number of twin pregnancy is 1/n, triplet--1/n 2 etc. Among complications observed in multiple pregnancy intrauterine death of one or more foetuses is not rare. Due to progressive disturbances in haemostasis the risk for a mother and remaining live foetus increases with gestation. The aim of this paper was to present a case report of triplet pregnancy complicated by an intrauterine death of two foetuses. 33 years old patient was diagnosed by ultrasound in the 19th week of her second gestation (1 child) a triplet pregnancy. Three live foetuses were seen then with biometry of about 14/15 gestational week There was one joint placenta on the back uterine wall and two children were sharing an amniotic sac. On the consecutive ultrasound examination the three foetuses were alive, but only one had a biometry for 21st week, two--were slowing down having measurements adequate for 19/20th week. After four weeks on usg the death of two siblings was confirmed (age 19/20 gestational week). One remaining live foetus was according to usg 24 weeks old. The patient was transferred to the II Dept. Even though no disturbances in coagulation were observed, low molecule heparin prophylaxis was introduced. During hospital stay a gestational diabetes was diagnosed well corrected by diet only. Coagulation parameters as well as infection indexes were regularly monitored. The foetal well-being was established by non-stress test, biophysical profile and Doppler vascular flows. After 39 days of hospitalisation an elevation of fibrin degradation products (FDP) was noted so the dosage of low molecule heparin was immediately increased to the therapeutic values. In spite of that FDP still were growing. It was decided to introduce a steroids treatment to accelerate the maturity of foetal lungs. In the 31st week according to usg, after PROM, the

  11. Rapid Death Due to Alcohol Withdrawal Syndrome: Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Rahul Mohanrao Band

    2015-03-01

    Full Text Available Background: Alcohol withdrawal syndrome (AWS is one of the most serious complications associated with chronic alcoholism. Sudden deaths are not uncommon in AWS. In severe stages of AWS, delirium tremens (DT occurs, which is characterized with agitation, global confusion, disorientation, visual and auditory hallucinations in addition to autonomic hyperactivity. Case report: A 30-year old man, chronic and heavy alcohol drinker for 10 years, abstained from alcohol for 3 days. Consequently, he started having palpitations, sweating and tremors. A day later, he was found having hallucinations and delirium. The patient was immediately transferred to the hospital. On admission, he was stuporous and had difficulty in breathing. He developed generalized seizures later on. He was successfully intubated, but there was bleeding through it. The patient’s condition deteriorated very rapidly and he died within two hours. After death, his body was transferred to forensic department. In autopsy, gastrointestinal tract was found to be intact. Massive pulmonary hemorrhage was present on cut section. Liver was found to be with yellowish discoloration and early cirrhotic changes. In heart, left ventricular hypertrophy with narrowed lumen was present and coronary arteries were patent. Discussion: Alcoholism is associated with liver dysfunction and especially in final phases with cirrhosis. Hence and due to resultant coagulopathy, patients are vulnerable to internal bleedings. Hypertrophic cardiomyopathy also occurs in chronic alcoholics. Therefore, we can speculate that our patient developed pulmonary hemorrhage as a result of combined effect of coagulopathy secondary to cirrhosis, alveolar damage (seizure and artificial ventilation and congestive heart failure. Conclusion: For a patient with delirium, convulsions, respiratory distress and coagulopathy, diagnosis of DT should be kept in mind.

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

    Science.gov (United States)

    Hawkins, Penny; Prescott, Mark J.; Carbone, Larry; Dennison, Ngaire; Johnson, Craig; Makowska, I. Joanna; Marquardt, Nicole; Readman, Gareth; Weary, Daniel M.; Golledge, Huw D. R.

    2016-01-01

    Simple Summary Millions of laboratory animals are killed each year worldwide. However, there is a lack of consensus regarding what methods of killing are humane for many species and stages of development. This report summarises research findings and discussions from an international meeting of experts and stakeholders, with recommendations to inform good practice for humane killing of mice, rats and zebrafish. It provides additional guidance and perspectives for researchers designing projects that involve euthanasing animals, researchers studying aspects of humane killing, euthanasia device manufacturers, regulators, and institutional ethics or animal care and use committees that wish to review local practice. Abstract Millions of laboratory animals are killed each year worldwide. There is an ethical, and in many countries also a legal, imperative to ensure those deaths cause minimal suffering. However, there is a lack of consensus regarding what methods of killing are humane for many species and stages of development. In 2013, an international group of researchers and stakeholders met at Newcastle University, United Kingdom to discuss the latest research and which methods could currently be considered most humane for the most commonly used laboratory species (mice, rats and zebrafish). They also discussed factors to consider when making decisions about appropriate techniques for particular species and projects, and priorities for further research. This report summarises the research findings and discussions, with recommendations to help inform good practice for humane killing. PMID:27563926

  13. An investigative report on circumstances leading to death among Indian cotton farmers.

    Science.gov (United States)

    Patil, Rajan R

    2002-01-01

    Andhra Pradesh, a southern state of India has been in the news for cotton farmers' deaths/suicides since 1998. The occurrence of 12 deaths among the farmers in the years 2001-2002 clustering around September-October expedited the investigation. The objective of our investigation was to identify the circumstances leading to death of cotton farmers in Warangal district of Andhra Pradesh. Some of the broadly held hypotheses were also analyzed for their validity. The socioeconomic-political factors emerge as very strong determinants of deaths, given the occupational work environment.

  14. The National School Safety Center's Report on School Associated Violent Deaths

    Science.gov (United States)

    National School Safety Center (NJ1), 2010

    2010-01-01

    A school-associated violent death is any homicide, suicide, or weapons-related violent death in the United States in which the fatal injury occurred: (1) on the property of a functioning public, private or parochial elementary or secondary school, Kindergarten through grade 12, (including alternative schools); (2) on the way to or from regular…

  15. Sudden death due to arrhythmogenic right ventricular cardiomyopathy: Two case reports

    Institute of Scientific and Technical Information of China (English)

    CHEN Xinshan; ZHANG Yigu; RAO Guangxun; HUANG Guangzhao

    2007-01-01

    Arrhythmogenic right ventricular cardiomyopathy(ARVC)is a kind of primary myocardial disease characterized by the regional or global replacement of right ventricular myocardium by fatty and fibrolipomatous tissues.The ARVC,usually presenting with difrerent clinical manifestations and pathological changes,were mainly seen in young men and is one of the main causes of sudden death in the young.Here two autopsied cases of Chinese men aged 30 and 23 years old who appeared healthy but died suddenly while at work arc reported respectively.One of the victims had extensive and severe pathological changes in his heart involving the left ventricular wall as well as the ventricular septum and the right atrium.Not only was there a global fatty and fibrolipomatous tissue replacement of the right ventricular myocardia,but also mild sarcoplasmic coagulation in the myocardium and focal lymphocytic infiltration in the myocardial interstitium of the right ventricular wall.In addition,slight atherosclerosis of the coronary artery and intimal thickening of the sino-atrial node were observed.It is believed that there are no marked differences in the pathological changes of ARVC between Chinese patients and patients from western countries.The etiology and pathogenesis of ARVC could not be explained by a single cause or factor and they are probably related to various congenital and acquired causes or factors.

  16. Are Suicide Note Writers Representative of All Suicides? Analysis of the National Violent Death Reporting System.

    Science.gov (United States)

    Stack, Steven; Rockett, Ian R H

    2016-12-16

    While suicide notes can offer insights into the causes of suicide and clues for prevention, there is disagreement regarding the degree to which note leavers are representative of the general population of suicides. Previous relevant research on the United States is marked by a series of limitations: small local samples, an over focus on demographic constructs, and lack of multivariable analysis. This study uses a large national sample, a wide range of predictor variables, and multivariable statistical techniques to estimate more reliable similarities and differences between note leavers and other suicides. All data are taken from the National Violent Death Reporting System, which covers 17 states. A total of 9,048 note writers were compared to 21,522 other suicides in terms of 39 variables. In both bivariable (32/39 variables) and multivariable analyses (30/39 variables), note leavers differed from other suicides in most demographic variables, stressful life events, psychiatric issues, and methods of suicide. The national evidence suggests that caution be exercised in generalizing patterns found among writers of suicide notes to suicides in general. This is the first analysis of suicide notes using US data on the issue. © 2016 The American Association of Suicidology.

  17. Towards More Comprehensive Projections of Urban Heat-Related Mortality: Estimates for New York City under Multiple Population, Adaptation, and Climate Scenarios

    OpenAIRE

    Petkova, EP; Vink, JK; Horton, RM; Gasparrini, A; Bader, DA; Francis, JD; Kinney, PL

    2016-01-01

    Background: High temperatures have substantial impacts on mortality and, with growing concerns about climate change, numerous studies have developed projections of future heat-related deaths around the world. Projections of temperature-related mortality are often limited by insufficient information to formulate hypotheses about population sensitivity to high temperatures and future demographics. Objectives: The present study derived projections of temperature-related mortality in New York Cit...

  18. Analysis of the reports of high-level commissions that have comprehensively reviewed US public policy on brain death.

    Science.gov (United States)

    Kofke, W Andrew

    2014-12-01

    The notion of brain death from its inception has not been uniformly understood with many grisly conceptions of it as it pertains to reliability and to organ donation. Accordingly, the aforementioned recitation of statutes and commission reports has served a useful societal role in addressing controversies and misconceptions while promulgating unifying foundational concepts and guidance in practical translation to clinical practice. There is clearly a consensus that statutory uniformity across jurisdictions is important and that there are two ways to define death. The first is the traditional cardiopulmonary criteria of cessation of cardiac function and breathing. The second is through established procedures to reliably determine the presence of total brain death with the presence of a comatose state which is irreversible. Another common thread through the ethically focused reports has been recognition that organ donation and death are temporally and geographically associated but there is emphasis that the processes of determination of death(by somatic or cerebral criteria) must be logically, ethically, and procedurally separate from the procedures for performing organ harvesting and transplantation.

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

    Directory of Open Access Journals (Sweden)

    Mohammad Ranjbar

    2013-09-01

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

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

    LENUS (Irish Health Repository)

    Collins, C J

    2011-02-01

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

  1. Physiological mechanisms of acute intestinal radiation death. Technical report, 1 June 1983-1 June 1986

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, K.L.; Geraci, J.P.

    1986-06-01

    The overall objective was to clarify the role of fluid and electrolyte loss, bile-duct ligation, radiation-damaged intestinal mucosa, bacterial toxemia and their interrelationships on radiation-induced gastrointestinal death. Using specific pathogen-free CD-1 male rats, this study found that endogenous enteric bacteria did not play a significant role in pure intestinal radiation death. Bile acids, per se, were shown to play little role in intestinal radiation death, but the inability of the denuded mucosa to absorb fluid and electrolytes, thereby producing hypovolemic shock, was the major mechanism.

  2. Monitoring child mortality through community health worker reporting of births and deaths in Malawi: validation against a household mortality survey.

    Science.gov (United States)

    Amouzou, Agbessi; Banda, Benjamin; Kachaka, Willie; Joos, Olga; Kanyuka, Mercy; Hill, Kenneth; Bryce, Jennifer

    2014-01-01

    The rate of decline in child mortality is too slow in most African countries to achieve the Millennium Development Goal of reducing under-five mortality by two-thirds between 1990 and 2015. Effective strategies to monitor child mortality are needed where accurate vital registration data are lacking to help governments assess and report on progress in child survival. We present results from a test of a mortality monitoring approach based on recording of births and deaths by specially trained community health workers (CHWs) in Malawi. Government-employed community health workers in Malawi are responsible for maintaining a Village Health Register, in which they record births and deaths that occur in their catchment area. We expanded on this system to provide additional training, supervision and incentives. We tested the equivalence between child mortality rates obtained from data on births and deaths collected by 160 randomly-selected and trained CHWs over twenty months in two districts to those computed through a standard household mortality survey. CHW reports produced an under-five mortality rate that was 84% (95%CI: [0.71,1.00]) of the household survey mortality rate and statistically equivalent to it. However, CHW data consistently underestimated under-five mortality, with levels of under-estimation increasing over time. Under-five deaths were more likely to be missed than births. Neonatal and infant deaths were more likely to be missed than older deaths. This first test of the accuracy and completeness of vital events data reported by CHWs in Malawi as a strategy for monitoring child mortality shows promising results but underestimated child mortality and was not stable over the four periods assessed. Given the Malawi government's commitment to strengthen its vital registration system, we are working with the Ministry of Health to implement a revised version of the approach that provides increased support to CHWs.

  3. Do prevailing societal models influence reports of near-death experiences?: a comparison of accounts reported before and after 1975.

    Science.gov (United States)

    Athappilly, Geena K; Greyson, Bruce; Stevenson, Ian

    2006-03-01

    Transcendental near-death experiences show some cross-cultural variation that suggests they may be influenced by societal beliefs. The prevailing Western model of near-death experiences was defined by Moody's description of the phenomenon in 1975. To explore the influence of this cultural model, we compared near-death experience accounts collected before and after 1975. We compared the frequency of 15 phenomenological features Moody defined as characteristic of near-death experiences in 24 accounts collected before 1975 and in 24 more recent accounts matched on relevant demographic and situational variables. Near-death experience accounts collected after 1975 differed from those collected earlier only in increased frequency of tunnel phenomena, which other research has suggested may not be integral to the experience, and not in any of the remaining 14 features defined by Moody as characteristic of near-death experiences. These data challenge the hypothesis that near-death experience accounts are substantially influenced by prevailing cultural models.

  4. Deaths due to Plasmodium knowlesi malaria in Sabah, Malaysia: association with reporting as Plasmodium malariae and delayed parenteral artesunate

    Directory of Open Access Journals (Sweden)

    Rajahram Giri S

    2012-08-01

    Full Text Available Abstract Background The simian parasite Plasmodium knowlesi is recognized as a common cause of severe and fatal human malaria in Sabah, Malaysia, but is morphologically indistinguishable from and still commonly reported as Plasmodium malariae, despite the paucity of this species in Sabah. Since December 2008 Sabah Department of Health has recommended intravenous artesunate and referral to a general hospital for all severe malaria cases of any species. This paper reviews all malaria deaths in Sabah subsequent to the introduction of these measures. Reporting of malaria deaths in Malaysia is mandatory. Methods Details of reported malaria deaths during 2010-2011 were reviewed to determine the proportion of each Plasmodium species. Demographics, clinical presentations and management of severe malaria caused by each species were compared. Results Fourteen malaria deaths were reported, comprising seven Plasmodium falciparum, six P. knowlesi and one Plasmodium vivax (all PCR-confirmed. Of the six P. knowlesi deaths, five were attributable to knowlesi malaria and one was attributable to P. knowlesi-associated enterobacter sepsis. Patients with directly attributable P. knowlesi deaths (N = 5 were older than those with P. falciparum (median age 51 [IQR 50-65] vs 22 [IQR 9-55] years, p = 0.06. Complications in fatal P. knowlesi included respiratory distress (N = 5, 100%, hypotension (N = 4, 80%, and renal failure (N = 4, 80%. All patients with P. knowlesi were reported as P. malariae by microscopy. Only two of five patients with severe knowlesi malaria on presentation received immediate parenteral anti-malarial treatment. The patient with P. vivax-associated severe illness did not receive parenteral treatment. In contrast six of seven patients with severe falciparum malaria received immediate parenteral treatment. Conclusion Plasmodium knowlesi was responsible, either directly or through gram-negative bacteraemia, for almost half of

  5. Patient-safety-related hospital deaths in England: thematic analysis of incidents reported to a national database, 2010-2012.

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    Liam J Donaldson

    2014-06-01

    Full Text Available BACKGROUND: Hospital mortality is increasingly being regarded as a key indicator of patient safety, yet methodologies for assessing mortality are frequently contested and seldom point directly to areas of risk and solutions. The aim of our study was to classify reports of deaths due to unsafe care into broad areas of systemic failure capable of being addressed by stronger policies, procedures, and practices. The deaths were reported to a patient safety incident reporting system after mandatory reporting of such incidents was introduced. METHODS AND FINDINGS: The UK National Health Service database was searched for incidents resulting in a reported death of an adult over the period of the study. The study population comprised 2,010 incidents involving patients aged 16 y and over in acute hospital settings. Each incident report was reviewed by two of the authors, and, by scrutinising the structured information together with the free text, a main reason for the harm was identified and recorded as one of 18 incident types. These incident types were then aggregated into six areas of apparent systemic failure: mismanagement of deterioration (35%, failure of prevention (26%, deficient checking and oversight (11%, dysfunctional patient flow (10%, equipment-related errors (6%, and other (12%. The most common incident types were failure to act on or recognise deterioration (23%, inpatient falls (10%, healthcare-associated infections (10%, unexpected per-operative death (6%, and poor or inadequate handover (5%. Analysis of these 2,010 fatal incidents reveals patterns of issues that point to actionable areas for improvement. CONCLUSIONS: Our approach demonstrates the potential utility of patient safety incident reports in identifying areas of service failure and highlights opportunities for corrective action to save lives.

  6. Heat-Related Mortality Projections for Cardiovascular and Respiratory Disease Under the Changing Climate in Beijing, China

    Science.gov (United States)

    Li, Tiantian; Ban, Jie; Horton, Radley M.; Bader, Daniel A.; Huang, Ganlin; Sun, Qinghua; Kinney, Patrick L.

    2015-01-01

    Because heat-related health effects tend to become more serious at higher temperatures, there is an urgent need to determine the mortality projection of specific heat-sensitive diseases to provide more detailed information regarding the variation of the sensitivity of such diseases. In this study, the specific mortality of cardiovascular and respiratory disease in Beijing was initially projected under five different global-scale General Circulation Models (GCMs) and two Representative Concentration Pathways scenarios (RCPs) in the 2020s, 2050s, and 2080s compared to the 1980s. Multi-model ensembles indicated cardiovascular mortality could increase by an average percentage of 18.4 percent, 47.8 percent, and 69.0 percent in the 2020s, 2050s, and 2080s under RCP 4.5, respectively, and by 16.6 percent, 73.8 percent and 134 percent in different decades respectively, under RCP 8.5 compared to the baseline range. The same increasing pattern was also observed in respiratory mortality. The heat-related deaths under the RCP 8.5 scenario were found to reach a higher number and to increase more rapidly during the 21st century compared to the RCP4.5 scenario, especially in the 2050s and the 2080s. The projection results show potential trends in cause-specific mortality in the context of climate change, and provide support for public health interventions tailored to specific climate-related future health risks.

  7. Cause-Specific Mortality and Death Certificate Reporting in Adults with Moderate to Profound Intellectual Disability

    Science.gov (United States)

    Tyrer, F.; McGrother, C.

    2009-01-01

    Background: The study of premature deaths in people with intellectual disability (ID) has become the focus of recent policy initiatives in England. This is the first UK population-based study to explore cause-specific mortality in adults with ID compared with the general population. Methods: Cause-specific standardised mortality ratios (SMRs) and…

  8. Comparison of Continuing Bonds Reported by Parents and Siblings after a Child's Death from Cancer

    Science.gov (United States)

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

    2011-01-01

    Few studies have distinguished similarities and differences between continuing bonds as they appear in various bereaved populations, particularly parent versus sibling cohorts following a child's death. This mixed-method study compared how parents and siblings experienced continuing bonds in 40 families who lost a child to cancer. Thirty-six…

  9. Sudden death in a child with Carpenter Syndrome. Case report and literature review.

    Science.gov (United States)

    Ramos, Jeanette M; Davis, Gregory J; Hunsaker, John C; Balko, M Gregory

    2009-12-01

    Carpenter syndrome (Acrocephalopolysyndactyly type II) is a rare disorder characterized by acrocephaly, mental retardation, congenital heart disease, syndactyly, preaxial polydactyly, obesity, cryptorchidism, hypogenitalism, bony abnormalities, and umbilical hernia. We present a case of unexpected death of a 7-year-old boy with Carpenter Syndrome complicated by twin and premature birth as well as repaired congenital heart disease.

  10. Physician reports of terminal sedation without hydration or nutrition for patients nearing death in the Netherlands

    NARCIS (Netherlands)

    A. van der Heide (Agnes); A.M. Vrakking (Astrid); B.D. Onwuteaka-Philipsen (Bregje); P.J. van der Maas (Paul); G. van der Wal (Gerrit); J.A.C. Rietjens (Judith)

    2004-01-01

    textabstractBACKGROUND: Terminal sedation in patients nearing death is an important issue related to end-of-life care. OBJECTIVE: To describe the practice of terminal sedation in the Netherlands. DESIGN: Face-to-face interviews. SETTING: The Netherlands. PARTICIPANTS: Nationwide st

  11. 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.

  12. Case report of death from falling: Did heart tumor cause syncope?

    Science.gov (United States)

    Yamamoto, Takuma; Takasu, Kosho; Emoto, Yuko; Shikata, Nobuaki; Matoba, Ryoji

    2012-07-01

    A healthy man in his 30s was working on the balustrade of stairs on the second floor. He suddenly fell downstairs without saying anything. On emergency hospitalization, chest echogram showed left hemothorax. Cardiac echogram showed a floating mass from the mitral valve in the left ventricle and severe mitral regurgitation. Surgery for hemothorax and pulmonary contusion was immediately undertaken. However, bleeding from pulmonary contusion could not be controlled and he underwent cardiopulmonary arrest. Autopsy showed a white, elastic, pendulous mass in the left atrium and a white mass in the lower lobe of the left lung. Tumor histology showed a reticular pattern, Schiller-Duval bodies, eosinophilic hyaline globules, and positive staining for α-fetoprotein. We diagnosed primary lung yolk sac tumor with metastatic intracardiac yolk sac tumor, a rare and highly malignant germ cell tumor. It usually arises in the ovaries and testes, and intracardiac yolk sac tumor is rare. Intracavitary tumors induce obstruction of inflow into and outflow from the ventricular cavity. The most common clinical presentation is dyspnea and syncope. In the present case, metastatic cardiac yolk sac tumor might have disturbed cardiac outflow and affected hemodynamics, probably causing syncope. Unfortunately, he was in a high place at that time and fell to receive pulmonary contusion that led to death. Autopsy may sometimes reveal latent diseases which might be related to the cause of death. We should perform autopsy thoroughly to diagnose not only the cause of death but also the factors leading to death.

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

    Directory of Open Access Journals (Sweden)

    Bácskai Erika

    2005-07-01

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

  14. Potential escalation of heat-related working costs with climate and socioeconomic changes in China

    National Research Council Canada - National Science Library

    Yan Zhao; Benjamin Sultan; Robert Vautard; Pascale Braconnot; Huijun J. Wang; Agnes Ducharne

    2016-01-01

    .... In mainland China, high-temperature subsidies (HTSs) are allocated to employees for each working day in extremely hot environments, but the potential heat-related increase in labor cost has not been evaluated so far...

  15. Projecting future heat-related mortality under climate change scenarios: a systematic review.

    Science.gov (United States)

    Huang, Cunrui; Barnett, Adrian Gerard; Wang, Xiaoming; Vaneckova, Pavla; FitzGerald, Gerard; Tong, Shilu

    2011-12-01

    Heat-related mortality is a matter of great public health concern, especially in the light of climate change. Although many studies have found associations between high temperatures and mortality, more research is needed to project the future impacts of climate change on heat-related mortality. We conducted a systematic review of research and methods for projecting future heat-related mortality under climate change scenarios. A literature search was conducted in August 2010, using the electronic databases PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search was limited to peer-reviewed journal articles published in English from January 1980 through July 2010. Fourteen studies fulfilled the inclusion criteria. Most projections showed that climate change would result in a substantial increase in heat-related mortality. Projecting heat-related mortality requires understanding historical temperature-mortality relationships and considering the future changes in climate, population, and acclimatization. Further research is needed to provide a stronger theoretical framework for projections, including a better understanding of socioeconomic development, adaptation strategies, land-use patterns, air pollution, and mortality displacement. Scenario-based projection research will meaningfully contribute to assessing and managing the potential impacts of climate change on heat-related mortality.

  16. Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study

    Science.gov (United States)

    Perera, Gayan; Stewart, Robert; Higginson, Irene J.; Sleeman, Katherine E.

    2016-01-01

    Background: mortality statistics are a frequently used source of information on deaths in dementia but are limited by concerns over accuracy. Objective: to investigate the frequency with which clinically diagnosed dementia is recorded on death certificates, including predictive factors. Methods: a retrospective cohort study assembled using a large mental healthcare database in South London, linked to Office for National Statistics mortality data. People with a clinical diagnosis of dementia, aged 65 or older, who died between 2006 and 2013 were included. The main outcome was death certificate recording of dementia. Results: in total, 7,115 people were identified. Dementia was recorded on 3,815 (53.6%) death certificates. Frequency of dementia recording increased from 39.9% (2006) to 63.0% (2013) (odds ratio (OR) per year increment 1.11, 95% CI 1.07–1.15). Recording of dementia was more likely if people were older (OR per year increment 1.02, 95% CI 1.01–1.03), and for those who died in care homes (OR 1.89, 95% CI 1.50–2.40) or hospitals (OR 1.14, 95% CI 1.03–1.46) compared with home, and less likely for people with less severe cognitive impairment (OR 0.95, 95% CI 0.94–0.96), and if the diagnosis was Lewy body (OR 0.30, 95% CI 0.15–0.62) or vascular dementia (OR 0.79, 95% CI 0.68–0.93) compared with Alzheimer's disease. Conclusions: changes in certification practices may have contributed to the rise in recorded prevalence of dementia from mortality data. However, mortality data still considerably underestimate the population burden of dementia. Potential biases affecting recording of dementia need to be taken into account when interpreting mortality data. PMID:27146301

  17. [Two sudden deaths of children with mesenterium commune -- a case report].

    Science.gov (United States)

    Grusová, Kateřina; Votava, Milan; Zeman, Martin

    2015-01-01

    Congenital anomalies of the digestive system represent a complicated topic concerning many medical specializations. The goal of this article is to describe two cases of children with mesenterium commune. First was an infant (5.5 months old female) who died shortly after being admitted to hospital with acute bronchitis, vomiting and diarrhoea. The autopsy revealed the cause of death--volvulus of the entire small intestine and the first portion of the large intestine with haemorrhagic infarsation of the intestinal wall in an infant with congenital anomaly of intestinal fixation--mesenterium commune. Second case was a 2.5 years old female after two heart surgeries, with pulmonary hypertension, who died suddenly at home. The cause of death was volvulus of a portion of the small intestine with haemorrhagic infarsation of the intestinal wall and also mesenterium commune. Congenital malpositions of the intestine originate due to malrotation and malfixation of the intestine during prenatal and early postnatal period. This wide range of the individuals developmental disorders always result in a condition where the topographical findings in the abdominal cavity are not as commonly found. Abnormally positioned intestines cannot develop a normal mesentery and are prone to volvulus, which represents the most serious complication with acute abdominal symptoms and when diagnosed late, it can lead to sudden death. Whilst performing autopsies such cases are rarely seen. However in forensic medicine and also in clinical practice it is important to consider intestinal malposition as a cause of acute abdomen.

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

    Directory of Open Access Journals (Sweden)

    Maria Hernandez Trejo

    2014-04-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Economic Burden of Hospitalizations for Heat-Related Illnesses in the United States, 2001–2010

    Directory of Open Access Journals (Sweden)

    Michael T. Schmeltz

    2016-09-01

    Full Text Available Understanding how heat waves affect morbidity and mortality, as well as the associated economic costs, is essential for characterizing the human health impacts of extreme heat under a changing climate. Only a handful of studies have examined healthcare costs associated with exposures to high temperatures. This research explores costs associated with hospitalizations for heat-related illness (HRI in the United States using the 2001 to 2010 Nationwide Inpatient Sample (NIS. Descriptive statistics of patient data for HRI hospitalizations were examined and costs of hospitalizations were reported using the all-payer inpatient cost-to-charge ratio. Costs were examined using a log-gamma model with patient and hospital characteristics included as fixed effects. Adjusted mean costs were then compared across racial groups. The mean costs of HRI hospitalizations were higher among racial/ethnic minorities compared to Whites, who accounted for almost 65% of all HRI hospitalizations. Observed differences in costs based on income, insurance, and gender were also significant. These results suggest that these populations are suffering disproportionately from health inequity, thus, they could shoulder greater disease and financial burdens due to climate change. These findings may have important implications in understanding the economic impact public health planning and interventions will have on preventing hospitalizations related to extreme heat.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Enrico eFacco

    2012-11-01

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

  3. Idiopathic systemic granulomatous pathology causing sudden death due to myocarditis: A rare case report

    Directory of Open Access Journals (Sweden)

    Harpal Singh

    2015-01-01

    Full Text Available Idiopathic granulomatous myocarditis is extremely rare, particularly since the introduction of drugs effective against tuberculosis (TB, viruses, fungi and the effective treatment of sarcoidosis. Here is a case of a 65-year-old female prisoner having history of sudden collapse and ultimately death. Autopsy findings of various viscera on histopathological examination show granulomatous pathology, that is, in spleen, liver and in the left ventricular wall of heart. Ziehl-Neelsen staining of the sections show the absence of acid fast bacilli, negative for fungal staining as most of the granulomas are noncaseating type with presence of giant cells having no asteroid body and Schuamann body, real-time polymerase chain reaction for TB is negative. Idiopathic giant cell myocarditis is a disease of relatively young adults, that is, between 3 rd and 4 th decade of life. So, this case is strongly considered to be a case of sudden death due to myocarditis as a result of idiopathic systemic granulomatous pathology, a rare case in in literature.

  4. Detection of diabetic metabolism disorders post-mortem--forensic case reports on cause of death hyperglycaemia.

    Science.gov (United States)

    Hess, C; Wöllner, K; Musshoff, F; Madea, B

    2013-01-01

    Diabetic coma is the most severe form of hyperglycaemic metabolic disorders. The post-mortem diagnosis of this disorder of glucose metabolism can be difficult and vague due to a lack of characteristic morphological findings. Six death cases caused by diabetic coma are described with special focus on biochemical (and histological) findings. The possible glycaemia markers glucose, lactate, HbA1c, fructosamine, anhydroglucitol, and ketone bodies were measured and the usefulness of these parameters is evaluated and discussed. Estimations of glucose concentrations in vitreous humour or cerebrospinal fluid and of ketone bodies in blood or other matrices are obligatory while measurements of HbA1c, fructosamine, or anhydroglucitol can only provide additional information on the long-term adjustment of diabetes in the deceased. Lactate concentrations (addition of glucose and lactate levels to form the sum formula of Traub) do not give more information than the glucose concentration itself and can be therefore omitted.

  5. [Death after the intake of amphetamine/ecstasy: two case reports].

    Science.gov (United States)

    Wöllner, Kirsten; Stockhausen, Sarah; Mußhoff, Frank; Madea, Burkhard

    2015-01-01

    Synthetic amphetamines such as 3,4-methylenedioxy-N-methylamphetamine (MDMA, Ecstasy) have become recreational drugs in German discotheques because of their euphoric and mood-brightening effects. However, their consumption involves considerable risks, which may even be lethal under certain circumstances. A 19-year-old man was taken to a university hospital for suspected intoxication with a narcotic drug, where he died the next day. As cause of death "fulminant liver failure" was diagnosed. In blood from the femoral vein, MDMA was found in a concentration of 4.27 mg/l. Histological examination showed acute necrosis of the liver and parenchymatous bleeding. The second case is that of a 39-year-old man who collapsed at his workplace and died in hospital shortly afterwards. In his rucksack, a small bag with 1.6 g of amphetamine was found. Analysis of blood from the femoral vein showed an amphetamine concentration of 1.08 mg/l.

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

    Directory of Open Access Journals (Sweden)

    Fragkouli Kleio

    2012-09-01

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

  7. Can Community Health Workers Report Accurately on Births and Deaths? Results of Field Assessments in Ethiopia, Malawi and Mali.

    Directory of Open Access Journals (Sweden)

    Romesh Silva

    Full Text Available Most low-income countries lack complete and accurate vital registration systems. As a result, measures of under-five mortality rates rely mostly on household surveys. In collaboration with partners in Ethiopia, Ghana, Malawi, and Mali, we assessed the completeness and accuracy of reporting of births and deaths by community-based health workers, and the accuracy of annualized under-five mortality rate estimates derived from these data. Here we report on results from Ethiopia, Malawi and Mali.In all three countries, community health workers (CHWs were trained, equipped and supported to report pregnancies, births and deaths within defined geographic areas over a period of at least fifteen months. In-country institutions collected these data every month. At each study site, we administered a full birth history (FBH or full pregnancy history (FPH, to women of reproductive age via a census of households in Mali and via household surveys in Ethiopia and Malawi. Using these FBHs/FPHs as a validation data source, we assessed the completeness of the counts of births and deaths and the accuracy of under-five, infant, and neonatal mortality rates from the community-based method against the retrospective FBH/FPH for rolling twelve-month periods. For each method we calculated total cost, average annual cost per 1,000 population, and average cost per vital event reported.On average, CHWs submitted monthly vital event reports for over 95 percent of catchment areas in Ethiopia and Malawi, and for 100 percent of catchment areas in Mali. The completeness of vital events reporting by CHWs varied: we estimated that 30%-90% of annualized expected births (i.e. the number of births estimated using a FPH were documented by CHWs and 22%-91% of annualized expected under-five deaths were documented by CHWs. Resulting annualized under-five mortality rates based on the CHW vital events reporting were, on average, under-estimated by 28% in Ethiopia, 32% in Malawi, and 9% in

  8. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness.

    Science.gov (United States)

    Lipman, Grant S; Eifling, Kurt P; Ellis, Mark A; Gaudio, Flavio G; Otten, Edward M; Grissom, Colin K

    2013-12-01

    The Wilderness Medical Society (WMS) convened an expert panel to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat-related illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures as well as best-practice recommendations for both field- and hospital-based therapeutic management of heat-related illness. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each modality. © 2013 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  9. Report on veterinary matters, births and deaths at the Amsterdam Zoo 1959-1966

    NARCIS (Netherlands)

    Jacobi, E.F.; Smits, G.M.

    1968-01-01

    Extensive reports on losses in zoo animals are very rare. As fas as we know only London, Paris, Philadelphia and Washington give yearly reports. Of these London and Paris give very complete information. One of the reasons that so few zoos publish their results may be that it is always more pleasant

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

    Science.gov (United States)

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

    2017-09-01

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

  11. Analysis of the reported symptoms that preceded the death of King Rajasinghe of Sithawake (1592 AD).

    Science.gov (United States)

    Veerasingam, Philip G

    2002-06-01

    A copy of an ola leaf manuscript, the original of which was written around the late 1590s, was published recently. It describes the sequence of events leading to the death of the warrior King Rajasinghe of the Sithawake Kingdom (1521-1593). A study of the contents of this letter is presented. The dressing applied to a wound on the foot of the King is described in that letter. It is likely that this dressing would have been an ideal medium to produce the highly potent tetanus exotoxin. The toxin would have diffused into the open wound and produced the sequence of symptoms and signs mentioned in the letter. An analysis of the symptoms and signs noted during the King's last illness as described in the letter is presented. Laryngospasm, and tonic and clonic spasms are easily identified. In addition, a group of symptoms attributed in the 1960s to sympathetic over-activity in tetanus are also recognisable. The conclusion is drawn that the King died of tetanus. The intriguing possibility of the wilful use of a lethal dressing on an open wound as a biological contact poison is left open for discussion.

  12. Death following bilateral complete Achilles tendon rupture in a patient on fluoroquinolone therapy: a case report

    Directory of Open Access Journals (Sweden)

    Gottschalk Andrew W

    2009-01-01

    Full Text Available Abstract Introduction Risk of tendon rupture, especially of the Achilles tendon, is one of the many potential side-effects of fluoroquinolone therapy. Achilles tendon rupture may be painful, debilitating or, as seen in our patient, devastating. While fluoroquinolone-induced tendon rupture typically accompanies other comorbidities (for example renal impairment or concurrent steroid therapy, our case represents a medical 'first' in that there were no such comorbidities and no steroid therapy. Furthermore, our case is remarkable in that tendon rupture was bilateral, complete, and resulted in a devastating outcome. Case presentation A healthy 91-year-old Caucasian man was placed on fluoroquinolone (levofloxacin therapy for a presumed bacterial pneumonitis. Subsequently, he developed bilateral heel pain, edema, and ecchymoses leading to a diagnosis of bilateral complete Achilles tendon rupture. This drug's side-effect was directly responsible for his subsequent physical and psychologic decline and unfortunate death. Conclusion Fluoroquinolones are a powerful and potent tool in the fight against bacterial infection. As a class, they are employed by primary care physicians as well as by subspecialty physicians in all areas of medical practice. However, as this case illustrates, the use of these drugs is not without risk. Attention must be paid to potential side-effects when prescribing any medication, and close follow-up with patients is a medical necessity to evaluate for these adverse reactions, especially with fluoroquinolones.

  13. Death by Suicide Within 1 Week of Hospital Discharge: A Retrospective Study of Root Cause Analysis Reports.

    Science.gov (United States)

    Riblet, Natalie; Shiner, Brian; Watts, Bradley V; Mills, Peter; Rusch, Brett; Hemphill, Robin R

    2017-06-01

    There is a high risk for death by suicide after discharge from an inpatient mental health unit. To better understand system and organizational factors associated with postdischarge suicide, we reviewed root cause analysis reports of suicide within 7 days of discharge from across all Veterans Health Administration inpatient mental health units between 2002 and 2015. There were 141 reports of suicide within 7 days of discharge, and a large proportion (43.3%, n = 61) followed an unplanned discharge. Root causes fell into three major themes including challenges for clinicians and patients after the established process of care, awareness and communication of suicide risk, and flaws in the established process of care. Flaws in the design and execution of processes of care as well as deficits in communication may contribute to postdischarge suicide. Inpatient teams should be aware of the potentially heightened risk for suicide among patients with unplanned discharges.

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

    Data.gov (United States)

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

  15. Determination of susceptibility to heat-related disorders and prevention methods among agriculture workers

    Directory of Open Access Journals (Sweden)

    2012-01-01

    Conclusion: According to the results, agriculture workers based on their age distribution, education, body mass index, health knowledge, drug use and incidence of chronic diseases, are very vulnerable to heat-related disorders. Therefore, training on recognizing the early signs and doing control measures as essential element in heat stress prevention should be seriously considered.

  16. Maternal death after oocyte donation at high maternal age: case report

    Directory of Open Access Journals (Sweden)

    Steegers Eric AP

    2008-12-01

    Full Text Available Abstract Background The percentage of women giving birth after the age of 35 increased in many western countries. The number of women remaining childless also increased, mostly due to aging oocytes. The method of oocyte donation offers the possibility for infertile older women to become pregnant. Gestation after oocyte-donation-IVF, however, is not without risks for the mother, especially at advanced age. Case presentation An infertile woman went abroad for oocyte-donation-IVF, since this treatment is not offered in The Netherlands after the age of 45. The first oocyte donation treatment resulted in multiple gestation, but was ended by induced abortion: the woman could not cope with the idea of being pregnant with twins. During the second pregnancy after oocyte donation, at the age of 50, she was mentally more stable. The pregnancy, again a multiple gestation, was uneventful until delivery. Immediately after delivery the woman had hypertension with nausea and vomiting. A few hours later she had an eclamptic fit. HELLP-syndrome was diagnosed. She died due to cerebral haemorrhage. Conclusion In The Netherlands, the age limit for women receiving donor oocytes is 45 years and commercial oocyte donation is forbidden by law. In other countries there is no age limit, the reason why some women are going abroad to receive the treatment of their choice. Advanced age, IVF and twin pregnancy are all risk factors for pre-eclampsia, the leading cause of maternal death in The Netherlands. Patient autonomy is an important ethical principle, but doctors are also bound to the principle of 'not doing harm', and do have the right to refuse medical treatment such as IVF-treatment. The discussion whether women above 50 should have children is still not closed. If the decision is made to offer this treatment to a woman at advanced age, the doctor should counsel her intensively about the risks before treatment is started.

  17. Decisions about life and death: assessing the Law Reform Commission and the Presidential Commission Reports.

    Science.gov (United States)

    Winkler, E

    1985-01-01

    This paper compares the critically comments upon certain aspects of the Canadian Law Reform Commission Report, Euthanasia, Aiding Suicide and Cessation of Treatment, and the United States Presidential Commission Report, Deciding to Forego Life-Sustaining Treatment. It focuses on their positions on euthanasia and on the general principles, values, and procedures that ought to govern practices of foregoing life-sustaining treatment. The paper first comments on the recent debate over the moral relevance of the killing/letting die distinction, since this issue appears crucial in assessing the rationality of the current, absolute prohibitions of direct killing in medical contexts, embodied both in law and in codes of ethics. This issue bear upon a question in the closing section--whether the withdrawal of foods and fluids is ever morally permissible.

  18. Heroin Body Packer’s Death in Shiraz, Iran; a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Nahid Najafi

    2017-03-01

    Conclusion: In conclusion, in body packer’s postmortem pathological signs are combined with evidence of the presence of drug pellets in the body as well as toxicological analysis in the ante-mortem history, and clinical reports. Toxicological analysis of the presence of the drug in body fluids, such as plasma, and in tissue extracts may not be of value when the level of the drug decreases after a period of metabolism.

  19. [The death of Helene Althusser: a case of altruistic homicide reported by the melancholic person].

    Science.gov (United States)

    Deniker, P; Olié, J P

    1994-01-01

    Authors suggest to read carefully the text written by Louis Althusser concerning the murder of his wife, Hélène. In place of hypothetical psychopathological elaborations they propose to take into account the narration of his personal story, and his illness leading to a delusional and confusional depression. The precision in the written report by Althusser on his painful manic depression demonstrates that there is no place for hypothesis too different from an ordinary reality.

  20. 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.

  1. A Death Involving a Fired and Deflected Bullet: A Case Report from Lyon University Institute of Forensic Science, France.

    Science.gov (United States)

    Maujean, Géraldine; Guinet, Tiphaine; Malicier, Daniel

    2016-01-01

    In case of gunshot deaths, atypical wounds can make the distinction between entrance and exit wounds harder. They may be due either to anatomical reasons or to diverse cogent ballistic arguments. The reported case pertains to a fatal hunting accident involving an expanded conical point bullet against the neck with both atypical entrance and exit wounds. Ballistic analyses including test firings allowed a better understanding of the external and internal findings. Upon premature impact with an intermediary target, the bullet experienced expansion in the formation of sharp brass petals responsible for a star-shaped entry wound. The trajectory of the deformed high energy projectile through the victim's body was then deviated by the cervical column, causing it to be tangential to the skin when exiting the body. The description of such atypical cases may benefit other experts and may assist in their investigation into similar cases.

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

    Science.gov (United States)

    Finsterer, Josef; Stöllberger, Claudia

    2014-06-01

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

  3. Death Due to an Unusual Angio-Seal-Related Complication: Case Report and Literature Review.

    Science.gov (United States)

    D'Ovidio, Cristian; Sablone, Sara; Carnevale, Aldo

    2016-09-01

    Angio-SealTM is a vascular closure device (VCD) that can be applied to the femoral artery following cardiac catheterization to achieve hemostasis. Although it has been demonstrated to be superior to conventional manual pressure and to reduce time to hemostasis and patient ambulation, the use of this VCD is not without its complications. In this report, we describe the case of a 55-year-old man who died due to an extremely rare event that occurred several hours after the deployment of an Angio-SealTM VCD: acute complete transverse laceration of the femoral artery that occurred because of the particular fragility of the vessel due to an unrecognized and asymptomatic arteriosclerotic disease. Few data are available in the literature about the incidence of such events, and much more remains to be done to determine how to prevent and manage its occurrence.

  4. A case report of a pregnancy-related death caused by primary antiphospholipid antibody syndrome

    Directory of Open Access Journals (Sweden)

    Sun Y

    2014-11-01

    Full Text Available Yingjian Sun,1 Manhua Cui,1 Wanan Zhu,2 Weiling Xu,2 Na Li2 1Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, Jilin, People's Republic of China; 2Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China Abstract: Primary antiphospholipid antibody syndrome (APS is a rare clinical event in the People's Republic of China. As APS is easily neglected or misdiagnosed, a delayed treatment can result. The patient reported here was a 32-year-old female who died by systemic venous thrombosis on day 11 after a cesarean section delivery. Luckily, the baby survived. A blood test demonstrated that the patient's platelets were decreased at 19 weeks of gestation. Anti-cardolipin antibody and antiß2GP1 (anti-ß2-glycoprotein-I antibody were positive at 36 weeks and 2 days of gestation. This patient was diagnosed with APS. Unfortunately, as physicians, we could not provide proper treatment as the patient's relatives were concerned that the proposed treatment would have negative effects on the infant's health. This clinical case strongly suggests that physicians need to appreciate that APS is a very serious condition, especially for pregnant women, and that proper treatment should be provided as early as possible to avoid a bad outcome, despite the fact that a cure for this disease is not currently available. Keywords: APS, thrombosis, Hughes syndrome

  5. A case report of a pregnancy-related death caused by primary antiphospholipid antibody syndrome.

    Science.gov (United States)

    Sun, Yingjian; Cui, Manhua; Zhu, Wanan; Xu, Weiling; Li, Na

    2014-01-01

    Primary antiphospholipid antibody syndrome (APS) is a rare clinical event in the People's Republic of China. As APS is easily neglected or misdiagnosed, a delayed treatment can result. The patient reported here was a 32-year-old female who died by systemic venous thrombosis on day 11 after a cesarean section delivery. Luckily, the baby survived. A blood test demonstrated that the patient's platelets were decreased at 19 weeks of gestation. Anti-cardolipin antibody and antiβ2GP1 (anti-β2-glycoprotein-I antibody) were positive at 36 weeks and 2 days of gestation. This patient was diagnosed with APS. Unfortunately, as physicians, we could not provide proper treatment as the patient's relatives were concerned that the proposed treatment would have negative effects on the infant's health. This clinical case strongly suggests that physicians need to appreciate that APS is a very serious condition, especially for pregnant women, and that proper treatment should be provided as early as possible to avoid a bad outcome, despite the fact that a cure for this disease is not currently available.

  6. Potential escalation of heat-related working costs with climate and socioeconomic changes in China

    OpenAIRE

    Yan ZHAO; Sultan, Benjamin; Vautard, Robert; Braconnot, Pascale; Wang, Huijun J.; Ducharne, Agnes

    2016-01-01

    Global climate change will increase the frequency of hot temperatures, impairing health and productivity for millions of working people and raising labor costs. In mainland China, high-temperature subsidies (HTSs) are allocated to employees for each working day in extremely hot environments, but the potential heat-related increase in labor cost has not been evaluated so far. Here, we estimate the potential HTS cost in current and future climates under different scenarios of socioeconomic deve...

  7. Unrecognised HIV related deaths.

    OpenAIRE

    McCormick, A.

    1991-01-01

    OBJECTIVES--To establish whether follow up of deaths from selected HIV related causes could increase the number of cases of HIV infection reported to the Public Health Laboratory Service Communicable Disease Surveillance Centre (CDSC), and to estimate the proportion of deaths among HIV positive men that occurred in men who were not known to be HIV positive at the time of death by the person who signed the death certificate. DESIGN--Follow up of draft death entries received by the Office of Po...

  8. Knowledge and awareness of heat-related morbidity among adult recreational endurance athletes

    Science.gov (United States)

    Shendell, Derek G.; Alexander, Melannie S.; Lorentzson, Lauren; McCarty, Frances A.

    2010-07-01

    Adults have been increasingly motivated to compete in recreational endurance sports events. Amateurs may lack a complete understanding of recommended strategies for handling heat and humidity, making heat-related illnesses increasingly possible. This is compounded by global climate change and increasing average surface and air temperatures, especially in urban areas of industrialized nations in Europe and North America that have hosted most events to date. We conducted an on-line, secure survey at the 2nd Annual ING Georgia Marathon and Half-Marathon in Atlanta, Georgia, in 2008. We included previously validated questions on participant socio-demographics, training locations, and knowledge and awareness of heat-related illnesses. Participants were aware of heat illnesses, and of heat stroke as a serious form of heat stress. However, the majority, across age and gender, did not understand the potential severity of heat stroke. Furthermore, 1-in-5 participants did not understand the concept of heat stress as a form of heat-related illness, and how heat stress may result from buildup of muscle-generated heat in the body. Adult recreational endurance athletes are another susceptible, vulnerable population sub-group for applied research and public health educational interventions, especially in urban areas of industrialized nations in Europe and North America.

  9. Community Trial on Heat Related-Illness Prevention Behaviors and Knowledge for the Elderly

    Directory of Open Access Journals (Sweden)

    Noriko Takahashi

    2015-03-01

    Full Text Available This study aims to explore whether broadcasting heat health warnings (HHWs, to every household and whether the additional home delivery of bottled water labeled with messages will be effective in improving the behaviors and knowledge of elderly people to prevent heat-related illness. A community trial on heat-related-illness-prevention behaviors and knowledge for people aged between 65 and 84 years was conducted in Nagasaki, Japan. Five hundred eight subjects were selected randomly from three groups: heat health warning (HHW, HHW and water delivery (HHW+W, and control groups. Baseline and follow-up questionnaires were conducted in June and September 2012, respectively. Of the 1524 selected subjects, the 1072 that completed both questionnaires were analyzed. The HHW+W group showed improvements in nighttime AC use (p = 0.047, water intake (p = 0.003, cooling body (p = 0.002 and reduced activities in heat (p = 0.047 compared with the control, while the HHW group improved hat or parasol use (p = 0.008. An additional effect of household water delivery was observed in water intake (p = 0.067 and cooling body (p = 0.095 behaviors. HHW and household bottled water delivery improved heat-related-illness-prevention behaviors. The results indicate that home water delivery in addition to a HHW may be needed to raise awareness of the elderly.

  10. 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.

  11. Death Threat and Death Concerns in the College Student.

    Science.gov (United States)

    Tobacyk, Jerome; Eckstein, Daniel

    1980-01-01

    Thanatology students reported significantly lesser death threat and significantly greater death concerns. Trait anxiety was found to be a significant predictor of change in death threat in the Thanatology Group, with lesser anxiety associated with greater decline in death threat. (Author)

  12. Infant death scene investigation.

    Science.gov (United States)

    Tabor, Pamela D; Ragan, Krista

    2015-01-01

    The sudden unexpected death of an infant is a tragedy to the family, a concern to the community, and an indicator of national health. To accurately determine the cause and manner of the infant's death, a thorough and accurate death scene investigation by properly trained personnel is key. Funding and resources are directed based on autopsy reports, which are only as accurate as the scene investigation. The investigation should include a standardized format, body diagrams, and a photographed or videotaped scene recreation utilizing doll reenactment. Forensic nurses, with their basic nursing knowledge and additional forensic skills and abilities, are optimally suited to conduct infant death scene investigations as well as train others to properly conduct death scene investigations. Currently, 49 states have child death review teams, which is an idea avenue for a forensic nurse to become involved in death scene investigations.

  13. 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.

  14. Patient and procedural factors associated with an increased risk of harm or death in the first 4,000 incidents reported to webAIRS.

    Science.gov (United States)

    Gibbs, N M; Culwick, M D; Merry, A F

    2017-03-01

    This report describes an analysis of patient and procedural factors associated with a higher proportion of harm or death versus no harm in the first 4,000 incidents reported to webAIRS. The report is supplementary to a previous cross-sectional report on the first 4,000 incidents reported to webAIRS. The aim of this analysis was to identify potential patient or procedural factors that are more common in incidents resulting in harm or death than in incidents with more benign outcomes. There was a >50% higher proportion of harm (versus no harm) for incidents in which the patient's body mass index (BMI) was incidents in post-anaesthesia care units and non-theatre procedural areas, and for incidents under the main category of cardiovascular or neurological. The proportion of incidents associated with death was also higher (risk ratio >1.5) for BMI incidents in non-theatre procedural areas, and incidents under the main category of cardiovascular or neurological. In addition, the proportion of incidents associated with death was higher for incidents in which the patient's age was >80 years, the American Society of Anesthesiologists physical status was 4 or 5, incidents involving non-elective procedures, and incidents occurring after hours (1800 to 0800 hours). When faced with incidents with these potential risk factors, anaesthetists should consider earlier interventions and request assistance at an earlier stage. Educational strategies on incident prevention and management should place even further emphasis on scenarios involving these factors.

  15. La Belle Mort en Milieu Rural: a report of an ethnographic study of the good death for Quebec rural francophones.

    Science.gov (United States)

    Veillette, Anne-Marie; Fillion, Lise; Wilson, Donna M; Thomas, Roger; Dumont, Serge

    2010-01-01

    An ethnographic study was undertaken in two rural areas of Quebec to conceptualize the good death. The findings reveal that a good quality of life for the dying person and his or her family and friends is essential for a good death. The resulting conceptual model emphasized four dimensions: physical, spiritual, social, and emotiona/psychological. These dimensions were determined to be similar to those discovered through a previous urban study, indicating that there may be considerable overlap between good deaths in rural and urban areas. Some findings of this Quebec French-language rural study were similar to those of an Alberta English-language rural study, indicating that rural people may have some common needs and interests with regard to the good death. As such, there could be some common elements of the good death that transcend culture or ethnicity. Chief among these is the desire of rural people to die at home or in their home communities.

  16. 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)

  17. Single-center study on transplantation of livers donated after cardiac death: A report of 6 cases

    Science.gov (United States)

    SUN, XU-YONG; DONG, JIAN-HUI; QIN, KE; LAN, LIU-GEN; LI, HAI-BIN; HUANG, YING; CAO, SONG; LI, ZHUANG-JIANG; DAI, LONG-JUN

    2016-01-01

    Effective use of all available donated organs is critical, in order to meet the increasing demand for transplants. The present study explored liver transplantation with livers that were donated following cardiac death (DCD). According to the guidelines established by The Red Cross Society of China, 42 DCD organs were procured. Selected donors were treated with extracorporeal membrane oxygenation (ECMO) prior to the organ retrieval. The present single-center study included 6 liver transplantations of DCD organs (5 liver transplants and 1 liver-kidney combined transplant). All 6 recipients had a successful recovery without significant complications. The serum alanine transaminase, total bilirubin and international normalized ratio returned to the normal levels within a short period of time following transplantation, and the liver function remained normal during the follow-up period, which lasted up to 24 months. The present report demonstrated the feasibility of orthotopic liver transplantation using DCD livers. The pre-conditioning DCD donors and optimization of the recipient's condition using ECMO, played a crucial role in ensuring the success of transplantation. PMID:26998025

  18. Automatic ICD-10 multi-class classification of cause of death from plaintext autopsy reports through expert-driven feature selection

    Science.gov (United States)

    Mujtaba, Ghulam; Shuib, Liyana; Raj, Ram Gopal; Rajandram, Retnagowri; Shaikh, Khairunisa; Al-Garadi, Mohammed Ali

    2017-01-01

    Objectives Widespread implementation of electronic databases has improved the accessibility of plaintext clinical information for supplementary use. Numerous machine learning techniques, such as supervised machine learning approaches or ontology-based approaches, have been employed to obtain useful information from plaintext clinical data. This study proposes an automatic multi-class classification system to predict accident-related causes of death from plaintext autopsy reports through expert-driven feature selection with supervised automatic text classification decision models. Methods Accident-related autopsy reports were obtained from one of the largest hospital in Kuala Lumpur. These reports belong to nine different accident-related causes of death. Master feature vector was prepared by extracting features from the collected autopsy reports by using unigram with lexical categorization. This master feature vector was used to detect cause of death [according to internal classification of disease version 10 (ICD-10) classification system] through five automated feature selection schemes, proposed expert-driven approach, five subset sizes of features, and five machine learning classifiers. Model performance was evaluated using precisionM, recallM, F-measureM, accuracy, and area under ROC curve. Four baselines were used to compare the results with the proposed system. Results Random forest and J48 decision models parameterized using expert-driven feature selection yielded the highest evaluation measure approaching (85% to 90%) for most metrics by using a feature subset size of 30. The proposed system also showed approximately 14% to 16% improvement in the overall accuracy compared with the existing techniques and four baselines. Conclusion The proposed system is feasible and practical to use for automatic classification of ICD-10-related cause of death from autopsy reports. The proposed system assists pathologists to accurately and rapidly determine underlying

  19. Automatic ICD-10 multi-class classification of cause of death from plaintext autopsy reports through expert-driven feature selection.

    Science.gov (United States)

    Mujtaba, Ghulam; Shuib, Liyana; Raj, Ram Gopal; Rajandram, Retnagowri; Shaikh, Khairunisa; Al-Garadi, Mohammed Ali

    2017-01-01

    Widespread implementation of electronic databases has improved the accessibility of plaintext clinical information for supplementary use. Numerous machine learning techniques, such as supervised machine learning approaches or ontology-based approaches, have been employed to obtain useful information from plaintext clinical data. This study proposes an automatic multi-class classification system to predict accident-related causes of death from plaintext autopsy reports through expert-driven feature selection with supervised automatic text classification decision models. Accident-related autopsy reports were obtained from one of the largest hospital in Kuala Lumpur. These reports belong to nine different accident-related causes of death. Master feature vector was prepared by extracting features from the collected autopsy reports by using unigram with lexical categorization. This master feature vector was used to detect cause of death [according to internal classification of disease version 10 (ICD-10) classification system] through five automated feature selection schemes, proposed expert-driven approach, five subset sizes of features, and five machine learning classifiers. Model performance was evaluated using precisionM, recallM, F-measureM, accuracy, and area under ROC curve. Four baselines were used to compare the results with the proposed system. Random forest and J48 decision models parameterized using expert-driven feature selection yielded the highest evaluation measure approaching (85% to 90%) for most metrics by using a feature subset size of 30. The proposed system also showed approximately 14% to 16% improvement in the overall accuracy compared with the existing techniques and four baselines. The proposed system is feasible and practical to use for automatic classification of ICD-10-related cause of death from autopsy reports. The proposed system assists pathologists to accurately and rapidly determine underlying cause of death based on autopsy findings

  20. Intra-urban vulnerability to heat-related mortality in New York City, 1997–2006

    Science.gov (United States)

    Rosenthal, Joyce Klein; Kinney, Patrick L.; Metzger, Kristina B.

    2015-01-01

    The health impacts of exposure to summertime heat are a significant problem in New York City (NYC) and for many cities and are expected to increase with a warming climate. Most studies on heat-related mortality have examined risk factors at the municipal or regional scale and may have missed the intra-urban variation of vulnerability that might inform prevention strategies. We evaluated whether place-based characteristics (socioeconomic/demographic and health factors, as well as the built and biophysical environment) may be associated with greater risk of heat-related mortality for seniors during heat events in NYC. As a measure of relative vulnerability to heat, we used the natural cause mortality rate ratio among those aged 65 and over (MRR65+), comparing extremely hot days (maximum heat index 100 °F+) to all warm season days, across 1997–2006 for NYC's 59 Community Districts and 42 United Hospital Fund neighborhoods. Significant positive associations were found between the MRR65+ and neighborhood-level characteristics: poverty, poor housing conditions, lower rates of access to air-conditioning, impervious land cover, surface temperatures aggregated to the area-level, and seniors’ hypertension. Percent Black/African American and household poverty were strong negative predictors of seniors’ air conditioning access in multivariate regression analysis. PMID:25199872

  1. Heat-Related Hospitalizations in Older Adults: An Amplified Effect of the First Seasonal Heatwave

    Science.gov (United States)

    Liss, Alexander; Wu, Ruiruo; Chui, Kenneth Kwan Ho; Naumova, Elena N.

    2017-01-01

    Older adults are highly vulnerable to the detriment of extreme weather. The rapid non-linear increase in heat-related morbidity is difficult to quantify, hindering the attribution of direct effects of exposure on severe health outcomes. We examine the effects of ambient temperatures on heat-related hospitalizations (HH) among the elderly in presence of strong seasonality and by assessing the effects caused by the first and subsequent seasonal heatwaves. We empirically derived the thresholds for a heatwave episode in Boston MSA based on 16 years of daily observations. We compared the health risks of heatwaves using the proposed and four alternative definitions. 701 cases of HH in older residents of Boston area were examined using harmonic regression models, designed to capture the non-linear effects of ambient temperatures and heatwave episodes when the night-time temperature is above 65.5 °F for 3 consecutive nights. The overall relative risk of HH associated with a heatwave episode was 6.9 [95%CI:4.8-9.8]. The relative risk of HH associated with the first heatwave increases up to 13.3 [95%CI:7.4-24.0]. The risk declined to 3.7 [95%CI:2.4-5.8] for the subsequent heatwave. Four other commonly used heatwave definitions confirmed these findings. Public health actions have to target the first heatwave to maximize the impact of preventive measures.

  2. Intra-urban vulnerability to heat-related mortality in New York City, 1997-2006.

    Science.gov (United States)

    Klein Rosenthal, Joyce; Kinney, Patrick L; Metzger, Kristina B

    2014-11-01

    The health impacts of exposure to summertime heat are a significant problem in New York City (NYC) and for many cities and are expected to increase with a warming climate. Most studies on heat-related mortality have examined risk factors at the municipal or regional scale and may have missed the intra-urban variation of vulnerability that might inform prevention strategies. We evaluated whether place-based characteristics (socioeconomic/demographic and health factors, as well as the built and biophysical environment) may be associated with greater risk of heat-related mortality for seniors during heat events in NYC. As a measure of relative vulnerability to heat, we used the natural cause mortality rate ratio among those aged 65 and over (MRR65+), comparing extremely hot days (maximum heat index 100°F+) to all warm season days, across 1997-2006 for NYC's 59 Community Districts and 42 United Hospital Fund neighborhoods. Significant positive associations were found between the MRR65+ and neighborhood-level characteristics: poverty, poor housing conditions, lower rates of access to air-conditioning, impervious land cover, surface temperatures aggregated to the area-level, and seniors' hypertension. Percent Black/African American and household poverty were strong negative predictors of seniors' air conditioning access in multivariate regression analysis.

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

    Science.gov (United States)

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

    2010-02-01

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

  4. Pesticide residues in honeybees, honey and bee pollen by LC-MS/MS screening: reported death incidents in honeybees.

    Science.gov (United States)

    Kasiotis, Konstantinos M; Anagnostopoulos, Chris; Anastasiadou, Pelagia; Machera, Kyriaki

    2014-07-01

    The aim of this study was to investigate reported cases of honeybee death incidents with regard to the potential interrelation to the exposure to pesticides. Thus honeybee, bee pollen and honey samples from different areas of Greece were analyzed for the presence of pesticide residues. In this context an LC-ESI-MS/MS multiresidue method of total 115 analytes of different chemical classes such as neonicotinoids, organophosphates, triazoles, carbamates, dicarboximides and dinitroanilines in honeybee bodies, honey and bee pollen was developed and validated. The method presents good linearity over the ranges assayed with correlation coefficient values r(2)≥0.99, recoveries ranging for all matrices from 59 to 117% and precision (RSD%) values ranging from 4 to 27%. LOD and LOQ values ranged - for honeybees, honey and bee pollen - from 0.03 to 23.3 ng/g matrix weight and 0.1 up to 78 ng/g matrix weight, respectively. Therefore this method is sufficient to act as a monitoring tool for the determination of pesticide residues in cases of suspected honeybee poisoning incidents. From the analysis of the samples the presence of 14 active substances was observed in all matrices with concentrations ranging for honeybees from 0.3 to 81.5 ng/g, for bee pollen from 6.1 to 1273 ng/g and for honey one sample was positive to carbendazim at 1.6 ng/g. The latter confirmed the presence of such type of compounds in honeybee body and apicultural products. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Heat-related inpatient hospitalizations and emergency room visits among California residents, May-September, 2000-2010.

    Data.gov (United States)

    California Environmental Health Tracking Program — This dataset contains case counts, rates, and confidence intervals of heat-related inpatient hospitalizations and ED visits among California residents for the years...

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

    Science.gov (United States)

    Christy, Alison; Nyhan, William; Wilson, Jenny

    2017-01-01

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

  7. Mapping Heat-related Risks for Community-based Adaptation Planning under Uncertainty

    Science.gov (United States)

    Bai, Yingjiu; Kaneko, Ikuyo; Kobayashi, Hikaru; Kurihara, Kazuo; Sasaki, Hidetaka; Murata, Akihiko; Takayabu, Izuru

    2016-04-01

    Climate change is leading to more frequent and intense heat waves. Recently, epidemiologic findings on heat-related health impacts have reinforced our understanding of the mortality impacts of extreme heat. This research has several aims: 1) to promote climate prediction services with spatial and temporal information on heat-related risks, using GIS (Geographical Information System), and digital mapping techniques; 2) to propose a visualization approach to articulating the evolution of local heat-health responses over time and the evaluation of new interventions for the implementation of valid community-based adaptation strategies and reliable actionable planning; and 3) to provide an appropriate and simple method of adjusting bias and quantifying the uncertainty in future outcomes, so that regional climate projections may be transcribed into useful forms for a wide variety of different users. Following the 2003 European heat wave, climatologists, medical specialists, and social scientists expedited efforts to revise and integrate risk governance frameworks for communities to take appropriate and effective actions themselves. Recently, the Coupled Model Intercomparison Project (CMIP) methodology has made projections possible for anyone wanting to openly access state-of-the-art climate model outputs and climate data to provide the backbone for decisions. Furthermore, the latest high-solution regional climate model (RCM) has been a huge increase in the volumes of data available. In this study, we used high-quality hourly projections (5-km resolution) from the Non-Hydrostatic Regional Climate Model (NHRCM-5km), following the SRES-A1B scenario developed by the Meteorological Research Institute (MRI) and observational data from the Automated Meteorological Data Acquisition System, Japan Meteorological Agency (JMA). The NHRCM-5km is a dynamic downscaling of results from the MRI-AGCM3.2S (20-km resolution), an atmospheric general circulation model (AGCM) driven by the

  8. Severe acute hemorrhagic pancreatitis secondary to cholelithiasis as a rare cause of sudden unexpected death in medico-legal case: A case report.

    Science.gov (United States)

    Srettabunjong, Supawon; Limgitisupasin, Wiratchaya

    2016-08-01

    Acute pancreatitis (AP) is an uncommon disease with a wide clinical course varying from mild and self-limiting to severe with eventual death. However, death caused by AP is rare. Most cases of AP reported in the English-language literature are based on clinical data; few are medico-legal studies. The author recently experienced a case of sudden unexpected death in a young man caused by extensive severe hemorrhagic AP secondary to cholelithiasis, not chronic alcoholism, which is a much more prominent etiology of AP in medico-legal perspectives. The deceased had complained of dizziness, nausea, and fatigue without significant abdominal pain for about 1 week and received some home medications for symptomatic treatment including an antibiotic drug from a clinic just 2 days prior to his death. He had complained of lower extremity weakness, intense thirst, and subsequently collapsed and was brought to a nearby hospital where he was pronounced dead shortly after his admission following unsuccessful advanced cardiopulmonary resuscitation attempts. This case is herein reported with an extensive review of the pertinent literature to highlight the findings of the case and raise awareness within the medico-legal profession and also the medical profession.

  9. Suicide among veterans in 16 states, 2005 to 2008: comparisons between utilizers and nonutilizers of Veterans Health Administration (VHA) services based on data from the National Death Index, the National Violent Death Reporting System, and VHA administrative records.

    Science.gov (United States)

    Katz, Ira R; McCarthy, John F; Ignacio, Rosalinda V; Kemp, Janet

    2012-03-01

    We sought to compare suicide rates among veterans utilizing Veterans Health Administration (VHA) services versus those who did not. Suicide rates from 2005 to 2008 were estimated for veterans in the 16 states that fully participated in the National Violent Death Reporting System (NVDRS), using data from the National Death Index, NVDRS, and VHA records. Between 2005 and 2008, veteran suicide rates differed by age and VHA utilization status. Among men aged 30 years and older, suicide rates were consistently higher among VHA utilizers. However, among men younger than 30 years, rates declined significantly among VHA utilizers while increasing among nonutilizers. Over these years, an increasing proportion of male veterans younger than 30 years received VHA services, and these individuals had a rising prevalence of diagnosed mental health conditions. The higher rates of suicide for utilizers of VHA among veteran men aged 30 and older were consistent with previous reports about which veterans utilize VHA services. The increasing rates of mental health conditions in utilizers younger than 30 years suggested that the decreasing relative rates in this group were related to the care provided, rather than to selective enrollment of those at lower risk for suicide.

  10. Natural death.

    Science.gov (United States)

    Oehmichen, M; Meissner, C

    2000-01-01

    The increasing age of every human being is the beginning of the end of life, an obviously natural process, but any attempt to define the term 'natural death' soon encounters difficulties in defining what is meant by 'natural'. In the industrialized countries of the West, for example 'natural death' is thought of as the opposite of non-natural types of death such as accidental death, suicide, and homicide. The aim of our present survey is to discuss the meaning of the term 'natural death' under a clinical, a forensic and a scientific point of view with regard to recent developments especially in molecular biology. If there are 'external' physical influences, a medical-technical manipulation, a therapeutic or molecular biological intervention cannot be definitely ruled out as the cause of death, then use of the term 'natural death' in general is open to question. It will only remain meaningful if it can be applied with a specific meaning in definite practical situations. Current research and medical technology, however, do not allow use of the term 'natural death' in its conventional sense: it can thus be stricken from the medical vocabulary. Copyright 2000 S. Karger AG, Basel

  11. Recovery from a possible cytomegalovirus meningoencephalitis-induced apparent brain stem death in an immunocompetent man: a case report.

    Science.gov (United States)

    Rahardjo, Theresia Monica; Maskoen, Tinni Trihartini; Redjeki, Ike Sri

    2016-08-26

    Recovery from cytomegalovirus meningoencephalitis with brain stem death in an immunocompetent patient is almost impossible. We present a remarkable recovery from a possible cytomegalovirus infection in an immunocompetent man who had severe neurological syndromes, suggesting brain stem death complicated by pneumonia and pleural effusion. A 19-year-old Asian man presented at our hospital's emergency department with reduced consciousness and seizures following high fever, headache, confusion, and vomitus within a week before arrival. He was intubated and sent to our intensive care unit. He had nuchal rigidity and tetraparesis with accentuated tendon reflexes. Electroencephalography findings suggested an acute structural lesion at his right temporal area or an epileptic state. A cerebral spinal fluid examination suggested viral infection. A computed tomography scan was normal at the early stage of disease. Immunoglobulin M, immunoglobulin G anti-herpes simplex virus, and immunoglobulin M anti-cytomegalovirus were negative. However, immunoglobulin G anti-cytomegalovirus was positive, which supported a diagnosis of cytomegalovirus meningoencephalitis. His clinical condition deteriorated, spontaneous respiration disappeared, cranial reflexes became negative, and brain stem death was suspected. Therapy included antivirals, corticosteroids, antibiotics, anticonvulsant, antipyretics, antifungal agents, and a vasopressor to maintain hemodynamic stability. After 1 month, he showed a vague response to painful stimuli at his supraorbital nerve and respiration started to appear the following week. After pneumonia and pleural effusion were resolved, he was weaned from the ventilator and moved from the intensive care unit on day 90. This case highlights several important issues that should be considered. First, the diagnosis of brain stem death must be confirmed with caution even if there are negative results of brain stem death test for a long period. Second, cytomegalovirus

  12. 38 CFR 3.211 - Death.

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

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

    2010-06-08

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

  14. Absence of Doppler signal in transcranial color-coded ultrasonography may be confirmatory for brain death: A case report

    Directory of Open Access Journals (Sweden)

    Mehmet Akif Topçuoğlu

    2015-08-01

    Full Text Available Transcranial Doppler ultrasonography (TCD is a valuable tool for demonstrating cerebral circulatory arrest (CCA in the setting of brain death. Complete reversal of diastolic flow (to-and-fro flow and systolic spikes in bilateral terminal internal carotid arteries and vertebrobasilar circulation are considered as specific sonogram configurations supporting the diagnosis of CCA. Because of the possibility of sonic bone window impermeability, absence of any waveform in TCD is not confirmatory for CCA unless there is documentation of disappearance of a previously well detected signal by the same recording settings. Transcranial color-coded sonography (TCCS with B-mode imaging can reliably detect adequacy of bone windows with clarity contralateral skull and ipsilateral planum temporale visualization. Therefore, absence of detectable intracranial Doppler signal along with available ultrasound window in TCCS can confirm clinical diagnosis of brain death. We herein discuss this entity from the frame of a representative case.

  15. 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 ...

  16. Potential escalation of heat-related working costs with climate and socioeconomic changes in China.

    Science.gov (United States)

    Zhao, Yan; Sultan, Benjamin; Vautard, Robert; Braconnot, Pascale; Wang, Huijun J; Ducharne, Agnes

    2016-04-26

    Global climate change will increase the frequency of hot temperatures, impairing health and productivity for millions of working people and raising labor costs. In mainland China, high-temperature subsidies (HTSs) are allocated to employees for each working day in extremely hot environments, but the potential heat-related increase in labor cost has not been evaluated so far. Here, we estimate the potential HTS cost in current and future climates under different scenarios of socioeconomic development and radiative forcing (Representative Concentration Pathway), taking uncertainties from the climate model structure and bias correction into account. On average, the total HTS in China is estimated at 38.6 billion yuan/y (US $6.22 billion/y) over the 1979-2005 period, which is equivalent to 0.2% of the gross domestic product (GDP). Assuming that the HTS standards (per employee per hot day) remain unchanged throughout the 21st century, the total HTS may reach 250 billion yuan/y in the 2030s and 1,000 billion yuan/y in 2100. We further show that, without specific adaptation, the increased HTS cost is mainly determined by population growth until the 2030s and climate change after the mid-21st century because of increasingly frequent hot weather. Accounting for the likely possibility that HTS standards follow the wages, the share of GDP devoted to HTS could become as high as 3% at the end of 21st century.

  17. Non-heat related impacts of climate change on working populations

    Directory of Open Access Journals (Sweden)

    Charmian M. Bennett

    2010-12-01

    Full Text Available Environmental and social changes associated with climate change are likely to have impacts on the well-being, health, and productivity of many working populations across the globe. The ramifications of climate change for working populations are not restricted to increases in heat exposure. Other significant risks to worker health (including physical hazards from extreme weather events, infectious diseases, under-nutrition, and mental stresses may be amplified by future climate change, and these may have substantial impacts at all scales of economic activity. Some of these risks are difficult to quantify, but pose a substantial threat to the viability and sustainability of some working populations. These impacts may occur in both developed and developing countries, although the latter category is likely to bear the heaviest burden.This paper explores some of the likely, non-heat-related health issues that climate change will have on working populations around the globe, now and in the future. These include exposures to various infectious diseases (vector-borne, zoonotic, and person-to-person, extreme weather events, stress and mental health issues, and malnutrition.

  18. Assessment of heat-related health impacts in Brisbane, Australia: comparison of different heatwave definitions.

    Directory of Open Access Journals (Sweden)

    Shilu Tong

    Full Text Available BACKGROUND: There is no global definition of a heatwave because local acclimatisation and adaptation influence the impact of extreme heat. Even at a local level there can be multiple heatwave definitions, based on varying temperature levels or time periods. We investigated the relationship between heatwaves and health outcomes using ten different heatwave definitions in Brisbane, Australia. METHODOLOGY/PRINCIPAL FINDINGS: We used daily data on climate, air pollution, and emergency hospital admissions in Brisbane between January 1996 and December 2005; and mortality between January 1996 and November 2004. Case-crossover analyses were used to assess the relationship between each of the ten heatwave definitions and health outcomes. During heatwaves there was a statistically significant increase in emergency hospital admissions for all ten definitions, with odds ratios ranging from 1.03 to 1.18. A statistically significant increase in the odds ratios of mortality was also found for eight definitions. The size of the heat-related impact varied between definitions. CONCLUSIONS/SIGNIFICANCE: Even a small change in the heatwave definition had an appreciable effect on the estimated health impact. It is important to identify an appropriate definition of heatwave locally and to understand its health effects in order to develop appropriate public health intervention strategies to prevent and mitigate the impact of heatwaves.

  19. Susceptibility to Heat-Related Fluid and Electrolyte Imbalance Emergency Department Visits in Atlanta, Georgia, USA

    Directory of Open Access Journals (Sweden)

    Leila Heidari

    2016-10-01

    Full Text Available Identification of populations susceptible to heat effects is critical for targeted prevention and more accurate risk assessment. Fluid and electrolyte imbalance (FEI may provide an objective indicator of heat morbidity. Data on daily ambient temperature and FEI emergency department (ED visits were collected in Atlanta, Georgia, USA during 1993–2012. Associations of warm-season same-day temperatures and FEI ED visits were estimated using Poisson generalized linear models. Analyses explored associations between FEI ED visits and various temperature metrics (maximum, minimum, average, and diurnal change in ambient temperature, apparent temperature, and heat index modeled using linear, quadratic, and cubic terms to allow for non-linear associations. Effect modification by potential determinants of heat susceptibility (sex; race; comorbid congestive heart failure, kidney disease, and diabetes; and neighborhood poverty and education levels was assessed via stratification. Higher warm-season ambient temperature was significantly associated with FEI ED visits, regardless of temperature metric used. Stratified analyses suggested heat-related risks for all populations, but particularly for males. This work highlights the utility of FEI as an indicator of heat morbidity, the health threat posed by warm-season temperatures, and the importance of considering susceptible populations in heat-health research.

  20. Heat-Related Mortality in India: Excess All-Cause Mortality Associated with the 2010 Ahmedabad Heat Wave

    Science.gov (United States)

    Azhar, Gulrez Shah; Mavalankar, Dileep; Nori-Sarma, Amruta; Rajiva, Ajit; Dutta, Priya; Jaiswal, Anjali; Sheffield, Perry; Knowlton, Kim; Hess, Jeremy J.; Azhar, Gulrez Shah; Deol, Bhaskar; Bhaskar, Priya Shekhar; Hess, Jeremy; Jaiswal, Anjali; Khosla, Radhika; Knowlton, Kim; Mavalankar, Mavalankar; Rajiva, Ajit; Sarma, Amruta; Sheffield, Perry

    2014-01-01

    Introduction In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8°C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality. Methods We conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1–31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations. Results The May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths). In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest “summer” months of April (r = 0.69, pheat (May 19–25, 2010), mortality rate ratios were 1.76 [95% CI 1.67–1.83, pheat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot temperatures prevail through much of April-June. PMID:24633076

  1. Dialysis Disequilibrium Syndrome: Brain death following hemodialysis for metabolic acidosis and acute renal failure – A case report

    Directory of Open Access Journals (Sweden)

    Bagshaw Sean M

    2004-08-01

    Full Text Available Abstract Background Dialysis disequilibrium syndrome (DDS is the clinical phenomenon of acute neurologic symptoms attributed to cerebral edema that occurs during or following intermittent hemodialysis (HD. We describe a case of DDS-induced cerebral edema that resulted in irreversible brain injury and death following acute HD and review the relevant literature of the association of DDS and HD. Case Presentation A 22-year-old male with obstructive uropathy presented to hospital with severe sepsis syndrome secondary to pneumonia. Laboratory investigations included a pH of 6.95, PaCO2 10 mmHg, HCO3 2 mmol/L, serum sodium 132 mmol/L, serum osmolality 330 mosmol/kg, and urea 130 mg/dL (46.7 mmol/L. Diagnostic imaging demonstrated multifocal pneumonia, bilateral hydronephrosis and bladder wall thickening. During HD the patient became progressively obtunded. Repeat laboratory investigations showed pH 7.36, HCO3 19 mmol/L, potassium 1.8 mmol/L, and urea 38.4 mg/dL (13.7 mmol/L (urea-reduction-ratio 71%. Following HD, spontaneous movements were absent with no pupillary or brainstem reflexes. Head CT-scan showed diffuse cerebral edema with effacement of basal cisterns and generalized loss of gray-white differentiation. Brain death was declared. Conclusions Death is a rare consequence of DDS in adults following HD. Several features may have predisposed this patient to DDS including: central nervous system adaptations from chronic kidney disease with efficient serum urea removal and correction of serum hyperosmolality; severe cerebral intracellular acidosis; relative hypercapnea; and post-HD hemodynamic instability with compounded cerebral ischemia.

  2. A retrospective study of clinical profile and outcomes of critically ill patients with heat-related illness

    Directory of Open Access Journals (Sweden)

    M S Kalaiselvan

    2015-01-01

    Full Text Available Background and Aims: Heat-related illness (HRI due to high ambient temperatures is a common feature during the Indian summer. HRI often results in Intensive Care Unit (ICU admissions and are associated with significant morbidity and mortality. However, published report on the effects of HRI among the Indian population is lacking. This study was undertaken to identify the profile of patients admitted to ICU with clinical features of HRI and study their clinical outcomes. Methods: This was a retrospective case series of patients admitted with features of HRI during the summer of 2012 in our multidisciplinary ICU. Data on demographics, co-morbid illness, admission severity of illness (Acute Physiology and Chronic Health Evaluation II [APACHE II], organ failure scores (Sequential Organ Failure Assessment [SOFA] and neuroimaging studies were collected. Outcome data studied included mortality, ICU length of stay (LOS, ventilator days and hospital LOS. Statistical analysis was performed using Student′s t-test, Chi-square test and multivariate analysis. Results: Twenty-six patients met the diagnostic criteria for HRI. Fifteen were males. The mean age was 53.12 ΁ 18.6 years. Mean APACHE II score was 19.6 ΁ 7.7 and mean SOFA score was 7.5 ΁ 2.6. The common presenting symptoms were fever with neurological impairment (100% and gastrointestinal symptoms (30%. Major organ systems involvement include neurological (100%, renal (57%, hepatic (34% and coagulation abnormalities (26%. Most common metabolic abnormality noted was hyponatraemia (73%. Magnetic resonance imaging findings suggestive of heat stroke were seen in 5 of 26 patients. Mortality rate was 34%. 8 of 17 survivors had residual neurological impairment. Conclusion: HRI carries a high mortality and significant neurological morbidity.

  3. SURGICAL TREATMENT OF TETRALOGY OF FALLOT IN CHILDREN:A REPORT OF NO SURGICAL DEATH IN 115 CONSECUTIVE CASES

    Institute of Scientific and Technical Information of China (English)

    刘锦纷; 朱宏斌; 朱德明; 陈玲; 苏肇伉; 丁文祥

    2001-01-01

    Objective A surgical team has performed total correction of Tetralogy of Fallot ( TF) consecutively in 115 patients without surgical death. This paper presents an investigation of how to improve the surgical outcome. Methods This group included 115 children, the ages of these children at operation were from 9 months to 13 years(4.6 ± 2.7 years), 47.8% of whom were younger than 3 years old. Associated anomalies included atresia of main pulmonary artery or unilateral pulmonary artery in 4 cases, atrial septal defect ( ASD ) and patent ductus arteriosus ( PDA ) in 11 cases. All patients have undergone total correction. Ventricular septal defects were closed with Dacron patches. Autologous-pericardial patches were used to enlarge the right ventricular outflow tract and pulmonary arteries. 102 cases (89%) needed transannular patches. Results There was no surgical death and the patients have been followed up for 2 months to 4 years. One child died of cardiac arrhythmia 3 months after operation. The remaining patients recovered well. Conclusion The key points in improving the surgical outcome in TF patients lie in the improvement of surgical technique, total elimination of obstruction of right ventricular outflow tract and distal pulmonary arteries. Attention should be paid to the cardiopulmonary bypass and the postoperative care should also be emphasized.

  4. Death preparedness: a concept analysis.

    Science.gov (United States)

    McLeod-Sordjan, Renee

    2014-05-01

    To report analysis of the concept death preparedness in the context of end-of-life shared decisions and communication. Forty percent of older people require decision-making and communication in the final days of life. Elaborate defence mechanisms have yielded a public consciousness that no longer passively views death acceptance, but instead has a defensive orientation of preparedness. The term 'death preparedness' depicts this death attitude. Concept analysis. Data were collected over 3 months in 2013. A series of searches of scholarly peer-reviewed literature published in English were conducted of multiple databases. Specific keywords included such phrases as: death acceptance, death avoidance, death rejection, death preparedness, resolution of life, breaking bad news and readiness to die. Walker and Avant's method was chosen as a deductive method to distinguish between the defining attributes of death preparedness and its relevant attributes. Death preparedness involves a transition of facilitated communication with a healthcare provider that leads to awareness and/or acceptance of end of life, as evidenced by an implementation of a plan. An appraisal of attitudes towards death and one's mortality precedes the concept, followed by an improved quality of death and dignity at end of life. The concept of death preparedness in the process of dying should be the focus of research to explore areas to improve advanced directive planning and acceptance of palliation for chronic health conditions. © 2013 John Wiley & Sons Ltd.

  5. Surviving death

    DEFF Research Database (Denmark)

    Gerstroem, Anna

    2013-01-01

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

  6. Adaptation to Climate Change: A Comparative Analysis of Modeling Methods for Heat-Related Mortality.

    Science.gov (United States)

    Gosling, Simon N; Hondula, David M; Bunker, Aditi; Ibarreta, Dolores; Liu, Junguo; Zhang, Xinxin; Sauerborn, Rainer

    2017-08-16

    Multiple methods are employed for modeling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known about the relative sensitivity of impacts to "adaptation uncertainty" (i.e., the inclusion/exclusion of adaptation modeling) relative to using multiple climate models and emissions scenarios. This study had three aims: a) Compare the range in projected impacts that arises from using different adaptation modeling methods; b) compare the range in impacts that arises from adaptation uncertainty with ranges from using multiple climate models and emissions scenarios; c) recommend modeling method(s) to use in future impact assessments. We estimated impacts for 2070-2099 for 14 European cities, applying six different methods for modeling adaptation; we also estimated impacts with five climate models run under two emissions scenarios to explore the relative effects of climate modeling and emissions uncertainty. The range of the difference (percent) in impacts between including and excluding adaptation, irrespective of climate modeling and emissions uncertainty, can be as low as 28% with one method and up to 103% with another (mean across 14 cities). In 13 of 14 cities, the ranges in projected impacts due to adaptation uncertainty are larger than those associated with climate modeling and emissions uncertainty. Researchers should carefully consider how to model adaptation because it is a source of uncertainty that can be greater than the uncertainty in emissions and climate modeling. We recommend absolute threshold shifts and reductions in slope. https://doi.org/10.1289/EHP634.

  7. Modeling effects of urban heat island mitigation strategies on heat-related morbidity: a case study for Phoenix, Arizona, USA.

    Science.gov (United States)

    Silva, Humberto R; Phelan, Patrick E; Golden, Jay S

    2010-01-01

    A zero-dimensional energy balance model was previously developed to serve as a user-friendly mitigation tool for practitioners seeking to study the urban heat island (UHI) effect. Accordingly, this established model is applied here to show the relative effects of four common mitigation strategies: increasing the overall (1) emissivity, (2) percentage of vegetated area, (3) thermal conductivity, and (4) albedo of the urban environment in a series of percentage increases by 5, 10, 15, and 20% from baseline values. In addition to modeling mitigation strategies, we present how the model can be utilized to evaluate human health vulnerability from excessive heat-related events, based on heat-related emergency service data from 2002 to 2006. The 24-h average heat index is shown to have the greatest correlation to heat-related emergency calls in the Phoenix (Arizona, USA) metropolitan region. The four modeled UHI mitigation strategies, taken in combination, would lead to a 48% reduction in annual heat-related emergency service calls, where increasing the albedo is the single most effective UHI mitigation strategy.

  8. Survival and death of epiblast cells during embryonic stem cell derivation revealed by long-term live-cell imaging with an Oct4 reporter system.

    Science.gov (United States)

    Yamagata, Kazuo; Ueda, Jun; Mizutani, Eiji; Saitou, Mitinori; Wakayama, Teruhiko

    2010-10-01

    Despite the broad literature on embryonic stem cells (ESCs), their derivation process remains enigmatic. This may be because of the lack of experimental systems that can monitor this prolonged cellular process. Here we applied a live-cell imaging technique to monitor the process of ESC derivation over 10 days from morula to outgrowth phase using an Oct4/eGFP reporter system. Our imaging reflects the 'natural' state of ESC derivation, as the ESCs established after the imaging were both competent in chimeric mice formation and germ-line transmission. Using this technique, ESC derivation in conventional conditions was imaged. After the blastocoel was formed, the intensity of Oct4 signals attenuated in the trophoblast cells but was maintained in the inner cell mass (ICM). Thereafter, the Oct4-positive cells scattered and their number decreased along with apoptosis of the other Oct4-nagative cells likely corresponds to trophoblast and hypoblast cells, and then only the surviving Oct4-positive cells proliferated and formed the colony. All embryos without exception passed through this cell death phase. Importantly, the addition of caspase inhibitor Z-VAD-FMK to the medium dramatically suppressed the loss of Oct4-positive cells and also other embryo-derived cells, suggesting that the cell deaths was induced by a caspase-dependent apoptotic pathway. Next we imaged the ESC derivation in 3i medium, which consists of chemical compounds that can suppress differentiation. The most significant difference between the conventional and 3i methods was that there was no obvious cell death in 3i, so that the colony formation was rapid and all of the Oct4-positive cells contributed to the formation of the outgrown colony. These data indicate that the prevention of cell death in epiblast cells is one of the important events for the successful establishment of ESCs. Thus, our imaging technique can advance the understanding of the time-dependent cellular changes during ESC derivation.

  9. Death cap

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  10. Death Drive

    OpenAIRE

    Stühler, Rebekka Hellstrøm

    2012-01-01

    The aim of this project is to investigate why the Freudian term Death Drive is not acknowledged in modern psychological therapy. On basis of psychoanalytical theory and through a literary analysis, the project will present a discussion of the significance and presence of the term within these practises.

  11. "Spectacular Death"

    DEFF Research Database (Denmark)

    Jacobsen, Michael Hviid

    2016-01-01

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

  12. 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

  13. 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

  14. Sudden unexpected death caused by stroke

    DEFF Research Database (Denmark)

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

    2017-01-01

    Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered...... sudden death by stroke. Methods We conducted a retrospective, nationwide study including all deaths within Danish borders between 2000-2009 and 2007-2009 in persons aged 1-35 years and 36-49 years, respectively. Two physicians identified all sudden death cases through review of all death certificates....... All available autopsy reports and records from hospitals and general practitioners were retrieved and a neurologist identified all sudden death by stroke cases. Results Of the 14,567 deaths in the 10-year period, there were 1,698 sudden death cases, of which 52 (3%) were sudden death by stroke...

  15. 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.

  16. Surviving death

    DEFF Research Database (Denmark)

    Gerstroem, Anna

    2013-01-01

    such phases. The aim of this paper is to explore how an organization’s identity is re-constructed after organizational death. Based on interviews with members of a bankrupted bank who narrate their bankruptcy experiences, the paper explores how legacy organizational identity is constructed after...... organizational death. The paper shows how members draw on their legacy organizational identity to justify their past interpretations and responses to the intensifying bankruptcy threats. Members refer to their firm belief in the bank’s solid and robust identity claim when they explain how they disregarded...... increasing threats and fought to defend and preserve the organization. When the bank was declared bankrupt and the solid and robust identity claim was disconfirmed, members found comfort and guidance in an identity claim of local care and support. After the bankruptcy, part of the bank was acquired...

  17. Brain Death,Concept and Criteria

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

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

  18. 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.

  19. 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

  20. Heat-related mortality in India: excess all-cause mortality associated with the 2010 Ahmedabad heat wave.

    Directory of Open Access Journals (Sweden)

    Gulrez Shah Azhar

    Full Text Available INTRODUCTION: In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8 °C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality. METHODS: We conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1-31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations. RESULTS: The May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths. In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest "summer" months of April (r = 0.69, p<0.001, May (r = 0.77, p<0.001, and June (r = 0.39, p<0.05. During a period of more intense heat (May 19-25, 2010, mortality rate ratios were 1.76 [95% CI 1.67-1.83, p<0.001] and 2.12 [95% CI 2.03-2.21] applying reference periods (May 12-18, 2010 from various years. CONCLUSION: The May 2010 heat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot temperatures

  1. Temperature-Related Death and Illness. Chapter 2

    Science.gov (United States)

    Sarofim, Marcus C.; Saha, Shubhayu; Hawkins, Michelle D.; Mills, David M.; Hess, Jeremy; Horton, Radley; Kinney, Patrick; Schwartz, Joel; St. Juliana, Alexis

    2016-01-01

    Based on present-day sensitivity to heat, an increase of thousands to tens of thousands of premature heat-related deaths in the summer and a decrease of premature cold-related deaths in the winter are projected each year as a result of climate change by the end of the century. Future adaptation will very likely reduce these impacts (see Changing Tolerance to Extreme Heat Finding). The reduction in cold-related deaths is projected to be smaller than the increase in heat-related deaths in most regions. Days that are hotter than usual in the summer or colder than usual in the winter are both associated with increased illness and death. Mortality effects are observed even for small differences from seasonal average temperatures. Because small temperature differences occur much more frequently than large temperature differences, not accounting for the effect of these small differences would lead to underestimating the future impact of climate change. An increase in population tolerance to extreme heat has been observed over time. Changes in this tolerance have been associated with increased use of air conditioning, improved social responses, and or physiological acclimatization, among other factors. Expected future increases in this tolerance will reduce the projected increase in deaths from heat. Older adults and children have a higher risk of dying or becoming ill due to extreme heat. People working outdoors, the socially isolated and economically disadvantaged, those with chronic illnesses, as well as some communities of color, are also especially vulnerable to death or illness.

  2. [Death of Napoleon Bonaparte].

    Science.gov (United States)

    Camici, M

    2003-06-01

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

  3. 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.

  4. Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

    Science.gov (United States)

    Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

    2015-01-01

    Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65). A long time-series (2001-2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat-related

  5. Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

    Directory of Open Access Journals (Sweden)

    Marco Morabito

    Full Text Available Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks.Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65.A long time-series (2001-2013 of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m daytime and night-time land surface temperatures (LST. LST was estimated pixel-wise by applying two statistical model approaches: 1 the Linear Regression Model (LRM; 2 the Generalized Additive Model (GAM. Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m from the 2001 census (Eurostat source, and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI.The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities.This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat-related

  6. Sudden unexpected death in infancy in Denmark

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  7. Report of Increasing Overdose Deaths that include Acetyl Fentanyl in Multiple Counties of the Southwestern Region of the Commonwealth of Pennsylvania in 2015-2016.

    Science.gov (United States)

    Dwyer, Jessica B; Janssen, Jennifer; Luckasevic, Todd M; Williams, Karl E

    2017-06-12

    Acetyl fentanyl is a Schedule I controlled synthetic opioid that is becoming an increasingly detected "designer drug." Routine drug screening procedures in local forensic toxicology laboratories identified a total of 41 overdose deaths associated with acetyl fentanyl within multiple counties of the southwestern region of the state of Pennsylvania. The range, median, mean, and standard deviation of blood acetyl fentanyl concentrations for these 41 cases were 0.13-2100 ng/mL, 11 ng/mL, 169.3 ng/mL, and 405.3 ng/mL, respectively. Thirty-six individuals (88%) had a confirmed history of substance abuse, and all but one case (96%) were ruled multiple drug toxicities. This report characterizes this localized trend of overdose deaths associated with acetyl fentanyl and provides further evidence supporting an alarmingly concentrated opiate and opioid epidemic of both traditional and novel drugs within this region of the United States. © 2017 American Academy of Forensic Sciences.

  8. [Deaths in hotels].

    Science.gov (United States)

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

    2010-01-01

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

  9. Eosinophilic bronchitis-like lesion as the cause of death in a Macaca mulatta: a first case report

    Science.gov (United States)

    Christal, J.L.; Hubbard, G.B.; Dick, E.J.; Brasky, K.M.; Jagirdar, J.

    2009-01-01

    Background Eosinophilic bronchitis is a recently described, relatively benign condition in humans that is characterized by a corticosteroid-responsive chronic cough and sputum eosinophilia without the abnormalities of airway function seen in asthma. The exact cause of this condition is currently unknown, however has been associated with various occupational exposures in humans. It has also been reported to progress to irreversible airway obstruction. This disease has been reported in dogs and horses, but not in non-human primates. Methods Gross examination of an otherwise healthy 13-year-old, colony-born Macaca mulatta, which died of severe non-responsive respiratory distress revealed that the lungs were markedly inflated and moist. Results Hematoxylin and eosin-stained sections from the lungs contained widespread accumulation of eosinophils, sloughed epithelial cells, and mucus centered around bronchioles and adjacent airways. There was no evidence of mast cell infiltration of peribronchiolar smooth muscle, goblet cell hyperplasia, or basement membrane thickening. Conclusions This ruled out recurrent episodes as would be expected in asthma, favoring the diagnosis of an eosinophilic bronchitis-like lesion. We report a first case of eosinophilic bronchitis-like features in a M. mulatta. PMID:18333916

  10. Births and deaths including fetal deaths

    Data.gov (United States)

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

  11. The prevalence of heat-related cardiorespiratory symptoms: the vulnerable groups identified from the National FINRISK 2007 Study

    Science.gov (United States)

    Näyhä, Simo; Rintamäki, Hannu; Donaldson, Gavin; Hassi, Juhani; Jousilahti, Pekka; Laatikainen, Tiina; Jaakkola, Jouni J. K.; Ikäheimo, Tiina M.

    2016-09-01

    The prevalence of heat-related cardiorespiratory symptoms among vulnerable groups is not well known. We therefore estimated the prevalence of heat-related cardiorespiratory symptoms among the Finnish population and their associations with social and individual vulnerability factors. The data came from the National FINRISK 2007 Study, in which 4007 men and women aged 25-74 answered questions on heat-related cardiorespiratory symptoms in the Oulu Cold and Heat Questionnaire 2007. Logistic regression was used to calculate odds ratios (ORs), their 95 % confidence intervals (CIs), and model-predicted prevalence figures. The prevalence of heat-related cardiorespiratory symptoms was 12 %. It increased with age, from 3 % at the age of 25 years to 28 % at the age of 75 years. The symptoms were associated with pre-existing lung (OR 3.93; CI 3.01-5.13) and cardiovascular diseases (OR 2.27; 1.78-2.89); being a pensioner (OR 2.91; 1.65-5.28), unemployed (OR 2.82; 1.47-5.48), or working in agriculture (OR 2.27; 1.14-4.46) compared with working in industry; having only basic vs academic education (OR 1.98; 1.31-3.05); being female (OR 1.94; 1.51-2.50); being heavy vs light alcohol consumer (OR 1.89; 1.02-3.32); undertaking hard vs light physical work (OR 1.48;1.06-2.07); and being inactive vs active in leisure time (OR 1.97; 1.39-2.81). The adjusted prevalence of symptoms showed a wide range of variation, from 3 to 61 % depending on sex, age, professional field, education, and pre-existing lung and cardiovascular diseases. In conclusion, heat-related cardiorespiratory symptoms are commonly perceived among people with pre-existing lung or cardiovascular disease, agricultural workers, unemployed, pensioners, and people having only basic education. This information is needed for any planning and targeting measures to reduce the burden of summer heat.

  12. The prevalence of heat-related cardiorespiratory symptoms: the vulnerable groups identified from the National FINRISK 2007 Study

    Science.gov (United States)

    Näyhä, Simo; Rintamäki, Hannu; Donaldson, Gavin; Hassi, Juhani; Jousilahti, Pekka; Laatikainen, Tiina; Jaakkola, Jouni J. K.; Ikäheimo, Tiina M.

    2017-04-01

    The prevalence of heat-related cardiorespiratory symptoms among vulnerable groups is not well known. We therefore estimated the prevalence of heat-related cardiorespiratory symptoms among the Finnish population and their associations with social and individual vulnerability factors. The data came from the National FINRISK 2007 Study, in which 4007 men and women aged 25-74 answered questions on heat-related cardiorespiratory symptoms in the Oulu Cold and Heat Questionnaire 2007. Logistic regression was used to calculate odds ratios (ORs), their 95 % confidence intervals (CIs), and model-predicted prevalence figures. The prevalence of heat-related cardiorespiratory symptoms was 12 %. It increased with age, from 3 % at the age of 25 years to 28 % at the age of 75 years. The symptoms were associated with pre-existing lung (OR 3.93; CI 3.01-5.13) and cardiovascular diseases (OR 2.27; 1.78-2.89); being a pensioner (OR 2.91; 1.65-5.28), unemployed (OR 2.82; 1.47-5.48), or working in agriculture (OR 2.27; 1.14-4.46) compared with working in industry; having only basic vs academic education (OR 1.98; 1.31-3.05); being female (OR 1.94; 1.51-2.50); being heavy vs light alcohol consumer (OR 1.89; 1.02-3.32); undertaking hard vs light physical work (OR 1.48;1.06-2.07); and being inactive vs active in leisure time (OR 1.97; 1.39-2.81). The adjusted prevalence of symptoms showed a wide range of variation, from 3 to 61 % depending on sex, age, professional field, education, and pre-existing lung and cardiovascular diseases. In conclusion, heat-related cardiorespiratory symptoms are commonly perceived among people with pre-existing lung or cardiovascular disease, agricultural workers, unemployed, pensioners, and people having only basic education. This information is needed for any planning and targeting measures to reduce the burden of summer heat.

  13. Impact of heat waves on nonaccidental deaths in Jinan, China, and associated risk factors

    Science.gov (United States)

    Zhang, Jun; Liu, Shouqin; Han, Jing; Zhou, Lin; Liu, Yueling; Yang, Liu; Zhang, Ji; Zhang, Ying

    2016-09-01

    An ecological study and a case-crossover analysis were conducted to evaluate the impact of heat waves on nonaccidental deaths, and to identify contributing factors of population vulnerability to heat-related deaths in Jinan, China. Daily death data and meteorological data were collected for summer months (June to August) of 2012-2013. Excess mortality was calculated and multivariate linear regression models were used to assess the increased risk of heat waves on deaths. Univariate and multivariate logistic regression models were performed to estimate the odd ratios (ORs) of risk factors and their 95 % confidence intervals (CIs). Overall, heat waves were related to 24.88 % excess deaths of total nonaccidental deaths and 31.33 % excess deaths of circulatory diseases, with an OR of 16.07 (95 % CI 8.80-23.33) for total nonaccidental deaths and 12.46 (95 % CI 7.39-17.53) for deaths of circulatory diseases. The case-crossover analysis indicated that older people were more likely to die during heat waves (OR = 1.233, 95 % CI 1.076-1.413) and more deaths occurred outside a hospital during heat waves (OR = 1.142, 95 % CI 1.006-1.296). In conclusion, heat waves have caused excess deaths and significantly increased the risk of circulatory deaths. The risk factors identified in our study have implications for public health interventions to reduce heat-related mortality during extreme heat events.

  14. Precipitating circumstances of suicide among youth aged 10-17 years by sex: data from the National Violent Death Reporting System, 16 states, 2005-2008.

    Science.gov (United States)

    Karch, Debra L; Logan, J; McDaniel, Dawn D; Floyd, C Faye; Vagi, Kevin J

    2013-07-01

    We examined the circumstances that precipitated suicide among 1,046 youth aged 10-17 years in 16 U.S. states from 2005 to 2008. The majority of deaths were among male subjects (75.2%), non-Hispanic whites (69.3%), those aged 16-17 years (58.1%), those who died by hanging/strangulation/suffocation (50.2%) and those who died in a house or an apartment (82.5%). Relationship problems, recent crises, mental health problems, and intimate partner and school problems were the most common precipitating factors and many differed by sex. School problems were reported for 25% of decedents, of which 30.3% were a drop in grades and 12.4% were bullying related. Prevention strategies directed toward relationship-building, problem-solving, and increasing access to treatment may be beneficial for this population.

  15. Arthrogryposis multiplex with deafness, inguinal hernias, and early death: a family report of a probably autosomal recessive trait.

    Science.gov (United States)

    Tiemann, Christian; Bührer, Christoph; Burwinkel, Barbara; Wirtenberger, Michael; Hoehn, Thomas; Hübner, Christoph; van Landeghem, Frank K H; Stoltenburg, Gisela; Obladen, Michael

    2005-08-30

    We report on three male newborn infants of a highly inbred Lebanese family presenting with a characteristic phenotype: arthrogryposis multiplex, deafness, large inguinal hernia, hiccup-like diaphragmatic contractions, and inability to suck, requiring nasogastric gavage feeding. All three boys died from respiratory failure during the first 3 months of life. Intra vitam or post mortem examinations revealed myopathic changes and elevated glycogen content of muscle tissue. This new syndrome is probably transmitted in an autosomal recessive mode, although X-linked inheritance cannot be excluded.

  16. Attacks by jaguars (Panthera onca) on humans in central Brazil: report of three cases, with observation of a death.

    Science.gov (United States)

    Neto, Manoel Francisco Campos; Garrone Neto, Domingos; Haddad, Vidal

    2011-06-01

    Conflicts between humans and big cats have been known for centuries throughout the world, but have intensified in recent decades. Recently, attacks by Panthera onca on humans in Brazil have been brought to the forefront through exposure in the press and because of the severity of the attacks. We report 3 cases of patients attacked by jaguars in provoked and predatory situations. Two patients survived the attacks and one died. Attack mechanisms and lesions in victims are discussed. The attacks demonstrate a real risk of accidents from jaguars in certain regions, such as the Pantanal and the Amazon. Copyright © 2011 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  17. 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.

  18. Spatial Patterns of Heat-Related Cardiovascular Mortality in the Czech Republic.

    Science.gov (United States)

    Urban, Aleš; Burkart, Katrin; Kyselý, Jan; Schuster, Christian; Plavcová, Eva; Hanzlíková, Hana; Štěpánek, Petr; Lakes, Tobia

    2016-03-04

    The study examines spatial patterns of effects of high temperature extremes on cardiovascular mortality in the Czech Republic at a district level during 1994-2009. Daily baseline mortality for each district was determined using a single location-stratified generalized additive model. Mean relative deviations of mortality from the baseline were calculated on days exceeding the 90th percentile of mean daily temperature in summer, and they were correlated with selected demographic, socioeconomic, and physical-environmental variables for the districts. Groups of districts with similar characteristics were identified according to socioeconomic status and urbanization level in order to provide a more general picture than possible on the district level. We evaluated lagged patterns of excess mortality after hot spell occurrences in: (i) urban areas vs. predominantly rural areas; and (ii) regions with different overall socioeconomic level. Our findings suggest that climatic conditions, altitude, and urbanization generally affect the spatial distribution of districts with the highest excess cardiovascular mortality, while socioeconomic status did not show a significant effect in the analysis across the Czech Republic as a whole. Only within deprived populations, socioeconomic status played a relevant role as well. After taking into account lagged effects of temperature on excess mortality, we found that the effect of hot spells was significant in highly urbanized regions, while most excess deaths in rural districts may be attributed to harvesting effects.

  19. Death by bleomycin pulmonary toxicity in ovarian dysgerminoma with pathologic complete response to chemotherapy. A case report.

    Science.gov (United States)

    Calzas Rodríguez, Julia; Carmen Juarez Morales, María Del; Casero, Miguel Angel Racionero

    2016-01-01

    With cisplatin-based chemotherapy, most patients with ovarian dysgerminoma will survive long-term. Bleomycin is an important part of ovarian germ cell tumors (OGCT) treatment, and its dose-limiting toxicity is the development of pulmonary toxicity and it is increased in patients older than 40 years. We report the case of an elderly patient with an unresectable ovarian dysgerminoma who received neoadjuvant chemotherapy and who developed fatal bleomycin pulmonary toxicity (BPT) after surgery. A monitoring of pulmonary function is not routinely recommended for detecting BPT, although together with carefully assessment for symptoms or signs suggestive of pulmonary toxicity is the best way to reduce the risk of BPT. The frequency of pulmonary events in older patients makes us to think about the possibility of either reduce the dose of bleomycin or removing it from the BEP in ovarian GCT.

  20. Sudden fetal death associated with both duodenal atresia and umbilical cord ulcer: a case report and review.

    Science.gov (United States)

    Anami, Ai; Morokuma, Seiichi; Tsukimori, Kiyomi; Kondo, Haruhiko; Nozaki, Masahiro; Sueishi, Katsuo; Nakano, Hitoo

    2006-04-01

    We encountered one case of duodenal atresia complicated by massive intrauterine hemorrhage due to the perforation of an umbilical cord ulceration (UCU). UCU is an extremely rare complication in the perinatal period. Although the prenatal diagnosis of upper intestinal atresia has been established, little is known about the association between UCU and upper intestinal atresia. In this article, we report our case, review past articles, and discuss the underlying pathophysiological mechanisms of the cause of an UCU. Given the characteristic sites of upper intestinal atresia, we speculate that regurgitation of gastric or intestinal juice into the amniotic fluid could be responsible for the development of UCU. We also believe that close observation is required for patients who have upper intestinal atresia.

  1. Relationship of Death Education to the Anxiety, Fear, and Meaning Associated with Death.

    Science.gov (United States)

    Knight, Kim H.; Elfenbein, Morton H.

    1993-01-01

    Compared death anxiety and fear of death levels expressed by 29 college students who had completed death and dying course with comparison group of 74 students. Found that those enrolled in thanatology class reported significantly higher death anxiety at end of semester. Results suggest different effect that thanatology course can have on…

  2. Cost of preventing workplace heat-related illness through worker breaks and the benefit of climate-change mitigation

    Science.gov (United States)

    Takakura, Jun'ya; Fujimori, Shinichiro; Takahashi, Kiyoshi; Hijioka, Yasuaki; Hasegawa, Tomoko; Honda, Yasushi; Masui, Toshihiko

    2017-06-01

    The exposure of workers to hot environments is expected to increase as a result of climate change. In order to prevent heat-related illness, it is recommended that workers take breaks during working hours. However, this would lead to reductions in worktime and labor productivity. In this study, we estimate the economic cost of heat-related illness prevention through worker breaks associated with climate change under a wide range of climatic and socioeconomic conditions. We calculate the worktime reduction based on the recommendation of work/rest ratio and the estimated future wet bulb glove temperature, which is an index of heat stresses. Corresponding GDP losses (cost of heat-related illness prevention through worker breaks) are estimated using a computable general equilibrium model throughout this century. Under the highest emission scenario, GDP losses in 2100 will range from 2.6 to 4.0% compared to the current climate conditions. On the other hand, GDP losses will be less than 0.5% if the 2.0 °C goal is achieved. The benefit of climate-change mitigation for avoiding worktime loss is comparable to the cost of mitigation (cost of the greenhouse gas emission reduction) under the 2.0 °C goal. The relationship between the cost of heat-related illness prevention through worker breaks and global average temperature rise is approximately linear, and the difference in economic loss between the 1.5 °C goal and the 2.0 °C goal is expected to be approximately 0.3% of global GDP in 2100. Although climate mitigation and socioeconomic development can limit the vulnerable regions and sectors, particularly in developing countries, outdoor work is still expected to be affected. The effectiveness of some adaptation measures such as additional installation of air conditioning devices or shifting the time of day for working are also suggested. In order to reduce the economic impacts, adaptation measures should also be implemented as well as pursing ambitious climate change

  3. Urban-Hazard Risk Analysis: Mapping of Heat-Related Risks in the Elderly in Major Italian Cities

    Science.gov (United States)

    Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

    2015-01-01

    Background Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Objectives Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥65). Methods A long time-series (2001–2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using “Crichton’s Risk Triangle” hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). Results The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. Conclusions This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public

  4. 22 CFR 72.4 - Notifications of death.

    Science.gov (United States)

    2010-04-01

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

  5. History of brain death as death: 1968 to the present.

    Science.gov (United States)

    De Georgia, Michael A

    2014-08-01

    The concept of brain death was formulated in 1968 in the landmark report A Definition of Irreversible Coma. While brain death has been widely accepted as a determination of death throughout the world, many of the controversies that surround it have not been settled. Some may be rooted in a misconstruction about the history of brain death. The concept evolved as a result of the convergence of several parallel developments in the second half of the 20th century including advances in resuscitation and critical care, research into the underlying physiology of consciousness, and growing concerns about technology, medical futility, and the ethics of end of life care. Organ transplantation also developed in parallel, and though it clearly benefited from a new definition of death, it was not a principal driving force in its creation. Since 1968, the concept of brain death has been extensively analyzed, debated, and reworked. Still there remains much misunderstanding and confusion, especially in the general public. In this comprehensive review, I will trace the evolution of the definition of brain death as death from 1968 to the present, providing background, history and context.

  6. Sudden death in eating disorders.

    Science.gov (United States)

    Jáuregui-Garrido, Beatriz; Jáuregui-Lobera, Ignacio

    2012-01-01

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

  7. Scintigraphic evaluation of brain death

    Energy Technology Data Exchange (ETDEWEB)

    Park, C. H.; Bai, M. S.; Cho, K. K.; Kim, S. J.; Yoon, S. N.; Cho, C. W. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

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

  8. Cell death in Pseudomonas aeruginosa biofilm development

    DEFF Research Database (Denmark)

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

    2003-01-01

    . However, key developmental processes regulating these events are poorly understood. A normal component of multicellular development is cell death. Here we report that a repeatable pattern of cell death and lysis occurs in biofilms of P. aeruginosa during the normal course of development. Cell death....... We propose that prophage-mediated cell death is an important mechanism of differentiation inside microcolonies that facilitates dispersal of a subpopulation of surviving cells....

  9. Fournier gangrene and unexpected death.

    Science.gov (United States)

    Bury, Danielle; Byard, Roger W

    2012-11-01

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

  10. Psychiatry and the death penalty.

    OpenAIRE

    Kastrup, M.

    1988-01-01

    Mentally ill people are not to be judged by the same rules as the mentally fit. Prisoners evaluated medically unfit for execution must undergo psychiatric treatment until their mental health is restored. Psychiatrists are placed in an ethical dilemma when asked to judge the mental health of prisoners on death row. A high prevalence of psychiatric and neurological disorders are reported on death row. Health professionals have an important role in implementing codes of ethics prohibiting any in...

  11. Dowry death: implications of law.

    Science.gov (United States)

    Latha, K S; Narendra, R

    1998-04-01

    The giving of dowry on marriage is a widespread custom in India, but the attitude of society towards this practice is neither uniform nor consistent. 'Dowry death' is the result of a unique form of violence suffered by Indian women. The existing legal provisions relating to dowry and dowry deaths are summarized, and the role of the Indian Penal Code is discussed. Case reports are presented.

  12. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness: 2014 update.

    Science.gov (United States)

    Lipman, Grant S; Eifling, Kurt P; Ellis, Mark A; Gaudio, Flavio G; Otten, Edward M; Grissom, Colin K

    2014-12-01

    The Wilderness Medical Society (WMS) convened an expert panel to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures as well as best practice recommendations for both field and hospital-based therapeutic management of heat illness. These recommendations are graded on the basis of the quality of supporting evidence, and balance between the benefits and risks or burdens for each modality. This is an updated version of the original WMS Practice Guidelines for the Prevention and Treatment of Heat-Related Illness published in Wilderness & Environmental Medicine 2013;24(4):351-361. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  13. Death: 'nothing' gives insight.

    Science.gov (United States)

    Ettema, Eric J

    2013-08-01

    According to a widely accepted belief, we cannot know our own death--death means 'nothing' to us. At first sight, the meaning of 'nothing' just implies the negation or absence of 'something'. Death then simply refers to the negation or absence of life. As a consequence, however, death has no meaning of itself. This leads to an ontological paradox in which death is both acknowledged and denied: death is … nothing. In this article, I investigate whether insight into the ontological paradox of the nothingness of death can contribute to a good end-of-life. By analysing Aquinas', Heidegger's and Derrida's understanding of death as nothingness, I explore how giving meaning to death on different ontological levels connects to, and at the same time provides resistance against, the harsh reality of death. By doing so, I intend to demonstrate that insight into the nothingness of death can count as a framework for a meaningful dealing with death.

  14. Real-time appraisal of the spatially distributed heat related health risk and energy demand of cities

    Science.gov (United States)

    Keramitsoglou, Iphigenia; Kiranoudis, Chris T.; Sismanidis, Panagiotis

    2016-08-01

    The Urban Heat Island (UHI) is an adverse environmental effect of urbanization that increases the energy demand of cities, impacts the human health, and intensifies and prolongs heatwave events. To facilitate the study of UHIs the Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing of the National Observatory of Athens (IAASARS/NOA) has developed an operational real-time system that exploits remote sensing image data from Meteosat Second Generation - Spinning Enhanced Visible and Infrared Imager (MSG-SEVIRI) and generates high spatiotemporal land surface temperature (LST) and 2 m air temperature (TA) time series. These datasets form the basis for the generation of higher value products and services related to energy demand and heat-related health issues. These products are the heatwave hazard (HZ); the HUMIDEX (i.e. an index that describes the temperature felt by an individual exposed to heat and humidity); and the cooling degrees (CD; i.e. a measure that reflects the energy needed to cool a building). The spatiotemporal characteristics of HZ, HUMIDEX and CD are unique (1 km/5 min) and enable the appraisal of the spatially distributed heat related health risk and energy demand of cities. In this paper, the real time generation of the high spatiotemporal HZ, HUMIDEX and CD products is discussed. In addition, a case study corresponding to Athens' September 2015 heatwave is presented so as to demonstrate their capabilities. The overall aim of the system is to provide high quality data to several different end users, such as health responders, and energy suppliers. The urban thermal monitoring web service is available at http://snf-652558.vm.okeanos.grnet.gr/treasure/portal/info.html.

  15. Death Valley 1/sup 0/ x 2/sup 0/ NTMS area, California and Nevada. Data report: National Uranium Resource Evaluation program, hydrogeochemical and stream sediment reconnaissance

    Energy Technology Data Exchange (ETDEWEB)

    Cook, J.R.

    1980-04-01

    Results of ground water and stream sediment reconnaissance in the National Topographic Map Series (NTMS) Death Valley 1/sup 0/ x 2/sup 0/ quadrangle are presented. Stream sediment samples were collected from small streams at 649 sites or at a nominal density of one site per 20 square kilometers. Ground water samples were collected at 62 sites or at a nominal density of one site per 220 square kilometers. Neutron activation analysis results are given for uranium and 16 other elements in sediments, and for uranium and 8 other elements in ground water and surface water. Mass spectrometry results are given for helium in ground water. Field measurements and observations are reported for each site. Analytical data and field measurements are presented in tables and maps. Statistical summaries of data and a brief description of results are given. A generalized geologic map and a summary of the geology of the area are included. Key data from ground water sites include (1) water chemistry measurements (pH, conductivity, and alkalinity), (2) scintillometer readings, and (3) elemental analyses (U, Br, Cl, F, He, Mn, Na, and V). Supplementary data include site descriptors, tabulated analytical data for Al, Dy, and Mg, and histograms and cumulative frequency plots for all elements. Key data from stream sediment sites include (1) water quality measurements (2) important elemental analyses, (U, Th, Hf, Ce, Fe, Mn, Sc, Na, Ti, and V), and (3) scintillometer readings. Supplementary data from stream sediment sites include sample site descriptors (stream characteristics, vegetation, etc.), additional elemental analyses (Dy, Eu, La, Lu, Sm, and Yb), and histograms and cumulative frequency plots for all elements.

  16. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... cool place and give small amounts of cool water, juice or a commercial sports liquid. (Do not ... non-caffeinated fluids. Apply cool, wet cloths or water mist while fanning the person. Seek immediate medical ...

  17. Heat-Related Illnesses

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    Full Text Available ... and stomach area. To treat, have the person rest in a cool place and give small amounts ... 104 degrees. People with these symptoms should immediately rest in a cool, shaded place and (if conscious) ...

  18. Heat-Related Illnesses

    Science.gov (United States)

    ... stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the legs and stomach area. To treat, have the person rest in a cool place and give small amounts of cool water, juice or a commercial sports liquid. (Do not give liquids if the person ...

  19. Heat-Related Illnesses

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    Full Text Available ... for signs of heat stroke or exhaustion. Heat Stroke and Exhaustion Symptoms of early heat exhaustion symptoms ... heavy sweating; nausea; and giddiness. Symptoms of heat stroke (late stage of heat illness) include flushed, hot, ...

  20. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the legs and stomach area. To treat, have the person rest in a cool place and give small amounts of cool water, juice or a commercial sports liquid. (Do not ...

  1. Heat-Related Illnesses

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    Full Text Available ... illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; vomiting; and increased body temperature of ... for symptoms that include cool, moist, pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss ...

  2. Heat-Related Illnesses

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    Full Text Available ... cool place and give small amounts of cool water, juice or a commercial sports liquid. (Do not ... non-caffeinated fluids. Apply cool, wet cloths or water mist while fanning the person. Seek immediate medical ...

  3. Heat-Related Illnesses

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    Full Text Available ... Young children and the elderly are most at risk, but anyone can be affected. Here you will ... moist, pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss of consciousness, vomiting or a high body temperature. For late stage heat stroke symptoms, ...

  4. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Emergencies Be ready to be a hero. Learn CPR Use “ICE” in Your Cell Phone Prepare for ... ankles, groin and neck and in armpits. Administer CPR if the person becomes unconscious. READ IN EMERGENCIES ...

  5. Heat-Related Illnesses

    Science.gov (United States)

    1988-04-01

    to cold stress. Despite this ability, man has been plagued by heat illness throughout recorded history. The Old Testament describes a young man’s...encounter heat illness because of the requirement to train unacclimatized men by means of forced heavy physical cxercise. The United States Army...dyspnea, dysphagia , and urinary incontinence. 2 6 Although the muscular rigidity and hyperthermia are reminiscent of malignant hyperthermia, the putative

  6. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss of consciousness, vomiting or a high ... unconscious. READ IN EMERGENCIES A-Z Your Blood Pressure Score is as Important as Your Credit Score! ...

  7. Heat Related Illnesses

    Institute of Scientific and Technical Information of China (English)

    Robert Carter III; Samuel N. Cheuvront; Michael N. Sawka

    2007-01-01

    @@ KEY POINTS · Heat illnesses range in severity from mild (heat rash, heat syncope, cramps) to serious (heat exhaustion, heat injury, heat stroke). · Although heat illness can occur in anyone, an increased risk is associated with a variety of environmental factors, personal characteristics,health conditions, and medications.

  8. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... exhaustion symptoms include cool, moist, pale or flushed skin; headache; dizziness; weakness; feeling exhausted; heavy sweating; nausea; ... stage of heat illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; ...

  9. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... sun or any situation that involves extreme heat. Young children and the elderly are most at risk, but anyone can be affected. Here you will find information about heat cramps and heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the legs and stomach area. ...

  10. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... exhaustion symptoms include cool, moist, pale or flushed skin; headache; dizziness; weakness; feeling exhausted; heavy sweating; nausea; ... stage of heat illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; ...

  11. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... for signs of heat stroke or exhaustion. Heat Stroke and Exhaustion Symptoms of early heat exhaustion symptoms ... heavy sweating; nausea; and giddiness. Symptoms of heat stroke (late stage of heat illness) include flushed, hot, ...

  12. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Until Help Arrives What To Do In A Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds ... Lives Be Prepared Safe Citizen Day Organize Important Medical Information ER Checklists Preparing for Emergencies Be ready ...

  13. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... A Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds Save Lives Be Prepared Safe Citizen Day ... So Long? Admission to the Hospital Heroes on Medicine's Front Line Observation Emergency Care Fact Sheet Health & ...

  14. A case of female autoerotic death.

    Science.gov (United States)

    Danto, B L

    1980-06-01

    This paper reviews some of the types of autoerotic death which have been reported and some of the psychodynamic principles which are associated with them. As cases involving females have never been reported, this presentation offers some opportunity to see how psychiatric insight assisted police investigation of an autoerotic death. Crime scene sketching and photographic evidence complement the case material so that the reader can feel he is at the crime scene. A comparison between male and female autoerotic deaths is made.

  15. 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

    Full Text Available A doença de Still do adulto é uma desordem inflamatória sistêmica rara, caracterizada por febre alta, erupção evanescente, poliartrite e leucocitose. A gravidez não é referida como fator de risco para a doença. Os autores relatam um caso iniciado na 30ª semana de gestação, com febre alta, poliartrite, erupção cutânea, mialgia, cefaléia, nódulos subcutâneos em membros inferiores e linfadenopatia cervical. Evoluiu com oligoidrâmnio acentuado e alteração do fluxo fetoplacentário e cerebral fetal, sendo realizada cesárea na 33ª semana de gestação. O recém-nascido teve Apgar de 7/8, peso de 1.500 g, sendo internado em unidade de terapia intensiva com desconforto respiratório, icterícia, exantema, enterocolite necrotizante, entre outras complicações, indo a óbito após 41 dias de internação. A paciente evoluiu com quadros clínico e laboratorial sugestivos de doença de Still do adulto, sendo investigadas outras patologias febris como diagnóstico diferencial. Houve evolução satisfatória com o uso de indometacina, prednisona e metotrexato, estando atualmente em remissão, fazendo uso apenas de metotrexato. A paciente apresentou diagnóstico definitivo para doença de Still do adulto segundo os critérios propostos para a doença e o óbito fetal ocorreu em decorrência da prematuridade e risco infeccioso, fatos que talvez pudessem ter sido minimizados com o diagnóstico materno precoce.The adult-onset Still disease is a rare systemic inflammatory disease characterized by high fever, evanescent eruption, polyarthritis and leukocytosis. Pregnancy is not a risk factor for this disease. The authors report a case which started on the pregnancy's thirtieth week, with high fever, polyarthritis, cutaneous eruption, myalgia, headache, subcutaneous nodules in lower limbs and cervical lymphadenopathy. It evolved to accentuated oligohydramnios and alteration of the fetus-placenta and fetal cerebral flow. A Caesarean section

  16. Brain Death Determination.

    Science.gov (United States)

    Spinello, Irene M

    2015-09-01

    In the United States, each year 1% to 2% of deaths are brain deaths. Considerable variation in the practice of determining brain death still remains, despite the publication of practice parameters in 1995 and an evidence-based guideline update in 2010. This review is intended to give bedside clinicians an overview of definition, the causes and pitfalls of misdiagnosing brain death, and a focus on the specifics of the brain death determination process.

  17. Asthma, sports, and death.

    Science.gov (United States)

    DiDario, A Geoffrey; Becker, Jack M

    2005-01-01

    The impact of asthma on the general population has been described in detail in medical literature. However, asthma also has a significant impact on the pediatric and adult athlete. This is rarely reported in either the lay press or the medical literature. In 2003, Becker and coworkers conducted a retrospective analysis of the incidence of asthma as a direct cause of death in competitive athletes across the United States between 1993 and 2000. They sought to raise awareness that severe asthma exacerbations and even death can occur during sports from asthma in athletes, while still supporting the concept of maximal participation in sporting activities. To their knowledge, this remains the only published study looking specifically at this issue. Fortunately, fatal asthma events are infrequent in either the adult or the pediatric populations. Those rare cases involving athletes are commonly highlighted in the lay press when they do occur, e.g., when the victim is a college football player such as Rashidi Wheeler. Wheeler died of a fatal asthma exacerbation on August 3, 2002, during a conditioning drill as a member of the Northwestern University football team. Although he was known to have chronic asthma with no obvious barriers to health care, he nevertheless succumbed to his condition. Here, we report a similar, although less well-known, case of an adolescent who died as a direct result of an asthma exacerbation during a high school physical education class. We also offer a brief review of the literature regarding morbidity and mortality in athletes.

  18. Death Education and Death-Related Attitudes.

    Science.gov (United States)

    Hoelter, Jon W.; Epley, Rita J.

    1979-01-01

    Assessed the impact of a death and dying course. Results showed no significant pre-test/post-test differences for the experimental or the control group, but indicated initial differences between the two groups, suggesting that students enrolling in a death and dying course have more favorable attitudes toward both suicide and abortion. (Author)

  19. Death Education and Death-Related Attitudes.

    Science.gov (United States)

    Hoelter, Jon W.; Epley, Rita J.

    1979-01-01

    Assessed the impact of a death and dying course. Results showed no significant pre-test/post-test differences for the experimental or the control group, but indicated initial differences between the two groups, suggesting that students enrolling in a death and dying course have more favorable attitudes toward both suicide and abortion. (Author)

  20. Current asthma deaths among adults in Japan

    Directory of Open Access Journals (Sweden)

    Tsugio Nakazawa

    2004-01-01

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

  1. Whither brain death?

    Science.gov (United States)

    Bernat, James L

    2014-01-01

    The publicity surrounding the recent McMath and Muñoz cases has rekindled public interest in brain death: the familiar term for human death determination by showing the irreversible cessation of clinical brain functions. The concept of brain death was developed decades ago to permit withdrawal of therapy in hopeless cases and to permit organ donation. It has become widely established medical practice, and laws permit it in all U.S. jurisdictions. Brain death has a biophilosophical justification as a standard for determining human death but remains poorly understood by the public and by health professionals. The current controversies over brain death are largely restricted to the academy, but some practitioners express ambivalence over whether brain death is equivalent to human death. Brain death remains an accepted and sound concept, but more work is necessary to establish its biophilosophical justification and to educate health professionals and the public.

  2. Sudden death in eating disorders

    Directory of Open Access Journals (Sweden)

    Jáuregui-Garrido B

    2012-02-01

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

  3. The Experience of Near Death

    Science.gov (United States)

    Sabom, M. B.; Kreutziger, S.

    1977-01-01

    Reported phenomena occurring in people encountering near-death situations have recently stimulated considerable public interest. In an informal survey, few professionals who care for critically ill patients were aware of these occurrences. Approximately 50 patients with documented near-fatal encounters were interviewed to confirm the existence and…

  4. National Death Index

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Death Index (NDI) is a centralized database of death record information on file in state vital statistics offices. Working with these state offices, the...

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

    Science.gov (United States)

    Tanaka, Toshihide; Kato, Naoki; Hasegawa, Yuzuru; Murayama, Yuichi

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Toshihide Tanaka

    2014-01-01

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

  7. Detection of Cell Death in Drosophila Tissues

    Science.gov (United States)

    Vasudevan, Deepika; Ryoo, Hyung Don

    2016-01-01

    Drosophila has served as a particularly attractive model to study cell death due to the vast array of tools for genetic manipulation under defined spatial and temporal conditions in vivo as well as in cultured cells. These genetic methods have been well supplemented by enzymatic assays and a panel of antibodies recognizing cell death markers. This chapter discusses reporters, mutants and assays used by various laboratories to study cell death in the context of development and in response to external insults. PMID:27108437

  8. Death and Grief

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Death and Grief KidsHealth > For Teens > Death and Grief Print A A A What's in ... the reaction we have in response to a death or loss. Grief can affect our body, mind, ...

  9. Dreams of Death.

    Science.gov (United States)

    Barrett, Deirdre

    1989-01-01

    Examined frequency and characteristics of overt dreams of dying among healthy young adults. Dreams of dying were found to be rare but distinctive content category, representing overwhelmingly pleasant dreams. Over one-half of death dreams involved lengthy afterlife sequence, remainder focused on process of death. Death dreams of these healthy…

  10. Using Literal Text From the Death Certificate to Enhance Mortality Statistics: Characterizing Drug Involvement in Deaths.

    Science.gov (United States)

    Trinidad, James P; Warner, Margaret; Bastian, Brigham A; Minino, Arialdi M; Hedegaard, Holly

    2016-12-01

    Objectives-This report describes the development and use of a method for analyzing the literal text from death certificates to enhance national mortality statistics on drug-involved deaths. Drug-involved deaths include drug overdose deaths as well as other deaths where, according to death certificate literal text, drugs were associated with or contributed to the death. Methods-The method uses final National Vital Statistics System-Mortality files linked to electronic files containing literal text information from death certificates. Software programs were designed to search the literal text from three fields of the death certificate (the cause of death from Part I, significant conditions contributing to the death from Part II, and a description of how the injury occurred from Box 43) to identify drug mentions as well as contextual information. The list of drug search terms was developed from existing drug classification systems as well as from manual review of the literal text. Literal text surrounding the identified drug search terms was analyzed to ascertain the context. Drugs mentioned in the death certificate literal text were assumed to be involved in the death unless contextual information suggested otherwise (e.g., "METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS INFECTION"). The literal text analysis method was assessed by comparing the results from application of the method with results based on ICD-10 codes, and by conducting a manual review of a sample of records.

  11. Large multifocal cardiac myxoma causing the sudden unexpected death of a 2-month-old infant--a rapidly growing, acquired lesion versus a congenital process?: a case report.

    Science.gov (United States)

    Kure, Kiyoe; Lingamfelter, Daniel; Taboada, Eugenio

    2011-06-01

    We report the occurrence of a clinically undiagnosed biatrial myxoma with left ventricular involvement in a 2-month-old male infant, resulting in sudden death. During a routine well-baby examination, a grade (34) holosystolic murmur was detected at the left sternal border with radiation to the axilla and back. On the following day, the patient collapsed and died suddenly. An autopsy revealed a large multifocal neoplasm diffusely involving the aortic valve while displaying mitral, tricuspid, and left ventricular extensions. The ensuing histopathologic and immunohistochemical studies were diagnostic for myxoma. We discuss the occurrence of cardiac myxoma within the pediatric population and review the literature as to theorize whether this lesion was a congenital process versus a rapidly growing tumor that developed after the child was born. Lastly, we address the potential for sudden death in patients with such tumors.

  12. Eyelid closure at death

    Directory of Open Access Journals (Sweden)

    A D Macleod

    2009-01-01

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

  13. Teachers' Attitudes Toward Death-Related Issues

    Science.gov (United States)

    Perkes, A. Cordell

    1978-01-01

    Reports a study to assess teachers attitudes toward death-related issues. A questionnaire was given to 61 teachers in a graduate education course. It was found that the teachers tended to favor liberal abortion laws (67 percent), euthanasia (83 percent), and the majority (65 percent) believed in life after death. (SLH)

  14. Teachers' Attitudes Toward Death-Related Issues

    Science.gov (United States)

    Perkes, A. Cordell

    1978-01-01

    Reports a study to assess teachers attitudes toward death-related issues. A questionnaire was given to 61 teachers in a graduate education course. It was found that the teachers tended to favor liberal abortion laws (67 percent), euthanasia (83 percent), and the majority (65 percent) believed in life after death. (SLH)

  15. Guillain Barre syndrome mimicking cerebral death

    Directory of Open Access Journals (Sweden)

    Rajdev S

    2003-01-01

    Full Text Available Guillain Barre Syndrome, an acute diffuse demyelinating disorder, predominantly present with the motor manifestations with few variants. The present report describes an unusual presentation of GBS, which initially suggested brain death. A 14 years old male presented with sudden onset of rapidly progressive weakness of all four limbs which progressively evolved into clinical condition simulating brain death.

  16. Forensic Analysis of Parachute Deaths.

    Science.gov (United States)

    Burke, Michael Philip; Chitty, Johannes

    2017-03-01

    Deaths associated with parachuting are very uncommon. However, these deaths do tend to be "high profile" in the traditional and social media. When forensic pathologists examine the deceased after a fatal parachuting incident, the anatomical cause of death is usually not in question. For most forensic pathologists, it is usually the case that we will have very limited knowledge of parachuting equipment or the mechanics of a typical successful parachute jump. As such, the investigation of the death should involve a multidisciplinary approach with an appropriate expert providing the formal forensic examination of the parachuting equipment. We have endeavored to describe, in simple terms, the usual components of a typical parachute rig, a précis of the sequence of events in a routine skydive and BASE jump, and the various types of malfunctions that may occur. Last, we present a case report of a BASE jump fatality to illustrate how an expert examination of the BASE jumper's gear aided the medicolegal investigation of the death with some important aspects in the forensic examination of the jumper's equipment.

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

    Science.gov (United States)

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

    2010-01-01

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

  18. Maternal deaths in the Nordic countries

    DEFF Research Database (Denmark)

    Vangen, Siri; Bødker, Birgit; Ellingsen, Liv

    2017-01-01

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

  19. [The diagnosis of death].

    Science.gov (United States)

    Echeverría, Carlos; Goic, Alejandro; Lavados, Manuel; Quintana, Carlos; Rojas, Alberto; Serani, Alejandro; Vacarezza, Ricardo

    2004-01-01

    This paper undertakes an analysis of the scientific criteria used in the diagnosis of death and underscores the importance of intellectual rigor in the definition of medical concepts, particularly regarding such a critical issue as the diagnosis of death. Under the cardiorespiratory criterion, death is defined as "the irreversible cessation of the functioning of an organism as a whole", and the tests used to confirm this criterion (negative life-signs) are sensitive and specific. In this case, cadaverous phenomena appear immediately following the diagnosis of death. On the other hand, doubts have arisen concerning the theoretical and the inner consistency of the criterion of brain death, since it does not satisfy the definition of "the irreversible cessation of the functioning of an organism as a whole", nor the requirement of "total and irreversible cessation of all functions of the entire brain, including the brain stem". There is evidence to the effect that the tests used to confirm this criterion are not specific enough. It is clear that brain death marks the beginning of a process that eventually ends in death, though death does not occur at that moment. From an ethical point of view, the conflict arises between the need to provide an unequivocal diagnosis of death and the possibility of saving a life through organ transplantation. The sensitive issue of brain death calls for a more thorough and in-depth discussion among physicians and the community at large.

  20. Programmed cell death: Superman meets Dr Death.

    Science.gov (United States)

    Meier, Pascal; Silke, John

    2003-12-01

    This year's Cold Spring Harbor meeting on programmed cell death (September 17-21, 2003), organised by Craig Thompson and Junying Yuan, was proof that the 'golden age' of research in this field is far from over. There was a flurry of fascinating insights into the regulation of diverse apoptotic pathways and unexpected non-apoptotic roles for some of the key apoptotic regulators and effectors. In addition to their role in cell death, components of the apoptotic molecular machinery are now known to also function in a variety of essential cellular processes, such as regulating glucose homeostasis, lipid metabolism, cell proliferation and differentiation.

  1. Existential Concerns About Death

    DEFF Research Database (Denmark)

    Moestrup, Lene; Hansen, Helle Ploug

    2014-01-01

    psychology or Kübler-Ross’ theory about death stages. The complex concerns might be explained using Martin Heidegger’s phenomenological thinking. We aimed to illuminate dying patients´ existential concerns about the impending death through a descriptive analysis of semi-structured interviews with 17 cancer...... patients in Danish hospices. The main findings demonstrated how the patients faced the forthcoming death without being anxious of death but sorrowful about leaving life. Furthermore, patients expressed that they avoided thinking about death. However, some had reconstructed specific and positive ideas about...... afterlife and made accurate decisions for practical aspects of their death. The patients wished to focus on positive aspects in their daily life at hospice. It hereby seems important to have ongoing reflections and to include different theoretical perspectives when providing existential support to dying...

  2. Existential Concerns About Death

    DEFF Research Database (Denmark)

    Moestrup, Lene; Hansen, Helle Ploug

    2015-01-01

    psychology or Kübler-Ross’ theory about death stages. The complex concerns might be explained using Martin Heidegger’s phenomenological thinking. We aimed to illuminate dying patients´ existential concerns about the impending death through a descriptive analysis of semi-structured interviews with 17 cancer...... patients in Danish hospices. The main findings demonstrated how the patients faced the forthcoming death without being anxious of death but sorrowful about leaving life. Furthermore, patients expressed that they avoided thinking about death. However, some had reconstructed specific and positive ideas about...... afterlife and made accurate decisions for practical aspects of their death. The patients wished to focus on positive aspects in their daily life at hospice. It hereby seems important to have ongoing reflections and to include different theoretical perspectives when providing existential support to dying...

  3. The Effects of Death Education.

    Science.gov (United States)

    Freitag, Carl B.; Hassler, Shawn David

    Although fear of death is recorded in the writings of the oldest major religions, the study of death and the fear of death have only occurred for the last few decades. Death education courses have grown in number since the early 1970's. College students participated in an investigation of the effects of death education on death anxiety by…

  4. Nuclear apoJ: A low dose radiation inducible regulator of cell death. Final report for period September 15, 1998 - September 14, 2001

    Energy Technology Data Exchange (ETDEWEB)

    Aronow, Bruce J.

    2002-04-19

    This project was based on preliminary data that was published by Dr. Boothman (Yang et al. 2000) which indicated a strong induction of apoJ gene expression, increased secretion of the protein, and accumulation of an apparently somewhat different form of the apoJ protein in the nucleus of MCF-7 breast carcinoma cells undergoing response to DNA damage. A clone expressing apoJ protein was isolated that was capable of interacting with Ku80, a component of the double strand break repair complex that is essential for the successful repair of rearranging immunoglobulin and T-cell receptor genes as evidenced by failure to produce mature B and T cells in the absence of Ku70. ApoJ clones isolated and characterized by Dr. Boothman bound strongly to a Ku-70 ''bait'' protein. Over-expression of these same clones in a cell line was capable of killing the cell. ApoJ is very strongly induced in many instances of programmed cell death and has been proposed repeatedly to play some sort of effector role in the process. Our principle hypothesis for this study was that the strong induction of the apoJ gene and the particular expression of a nuclear form of the protein was potentially a causal factor in the decision point made by the cell as it attempts to repair double-strand breakage based DNA damage. The hypothesis was that if sufficiently high damage occurred, it would be deleterious to maintain the cell's viability through continued DNA repair. One method to inhibit DNA repair might be by inhibiting proteins such as Ku-70 that are necessary for double-strand break repair. If apoJ does play a critical role in tipping the decision balance over to cell death, we reasoned that deficiency of apoJ would cause increased accumulation of cells with DNA damage and that this might decrease cell death in response to DNA damage and increase tumor occurrence rates. To test this hypothesis and its potential implications, we exposed wildtype and apoJ deficient animals that

  5. Sudden Infant Death Syndrome

    Science.gov (United States)

    ... found in their cribs. SIDS is the leading cause of death in children between one month and one year old. Most SIDS deaths occur when babies are between one month and four months old. Premature babies, boys, African Americans, and American Indian/Alaska ...

  6. Death Writ Large

    Science.gov (United States)

    Kastenbaum, Robert

    2004-01-01

    Mainstream thanatology has devoted its efforts to improving the understanding, care, and social integration of people who are confronted with life-threatening illness or bereavement. This article suggests that it might now be time to expand the scope and mission to include large-scale death and death that occurs through complex and multi-domain…

  7. Programmed cell death

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    The purpose of this conference to provide a multidisciplinary forum for exchange of state-of-the-art information on the role programmed cell death plays in normal development and homeostasis of many organisms. This volume contains abstracts of papers in the following areas: invertebrate development; immunology/neurology; bcl-2 family; biochemistry; programmed cell death in viruses; oncogenesis; vertebrate development; and diseases.

  8. Death, Children, and Books.

    Science.gov (United States)

    Carr, Robin L.

    The books listed in this annotated bibliography are intended to help children understand the reality of death and deal with the mystery and emotions that accompany it. Each entry indicates the genre and reading level of the book and provides a brief description of the attitude toward death that it conveys. The selections include fables, fantasy,…

  9. Date with Death

    Institute of Scientific and Technical Information of China (English)

    郑慧敏

    2016-01-01

    Have you ever heard about a popular movie called date with an angel? It must be sweet and lovely. But have you ever imagine about dating with death? What is your feeling when you have a chance to talk with death? Excited or afraid? I believe that many people definitely do not think about this question and neither do I.

  10. Death Acceptance through Ritual

    Science.gov (United States)

    Reeves, Nancy C.

    2011-01-01

    This article summarizes the author's original research, which sought to discover the elements necessary for using death-related ritual as a psychotherapeutic technique for grieving people who experience their grief as "stuck," "unending," "maladaptive," and so on. A "death-related ritual" is defined as a ceremony, directly involving at least 1…

  11. Conflicting Thoughts about Death

    Science.gov (United States)

    Harris, Paul L.

    2011-01-01

    Most research on children's conception of death has probed their understanding of its biological aspects: its inevitability, irreversibility and terminal impact. Yet many adults subscribe to a religious conception implying that death marks the beginning of a new life. Two recent empirical studies confirm that in the course of development, children…

  12. Facing Up to Death

    Science.gov (United States)

    Ross, Elizabeth Kubler

    1972-01-01

    Doctor urges that Americans accept death as a part of life and suggests ways of helping dying patients and their families face reality calmly, with peace. Dying children and their siblings, as well as children's feelings about relatives' deaths, are also discussed. (PD)

  13. Facing Up to Death

    Science.gov (United States)

    Ross, Elizabeth Kubler

    1972-01-01

    Doctor urges that Americans accept death as a part of life and suggests ways of helping dying patients and their families face reality calmly, with peace. Dying children and their siblings, as well as children's feelings about relatives' deaths, are also discussed. (PD)

  14. Death proteases come alive

    NARCIS (Netherlands)

    Woltering, E.J.

    2004-01-01

    Cell death in plants exhibits morphological features comparable to caspase-mediated apoptosis in animals, suggesting that plant cell death is executed by (caspase-like) proteases. However, to date, no caspase homologues have been identified in plants and therefore the existence and nature of these p

  15. Sudden deaths following the unexpected demise of a popular politician in India.

    Science.gov (United States)

    Babu, Varsha; Paul, Navin

    2010-11-19

    The recent death of a popular politician in India was followed by a spate of sudden deaths. In this letter, we analyze the deaths as reported in newspapers, and try to arrive at a reason for this strange phenomenon.

  16. Sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Neeraj Parakh

    2015-01-01

    Full Text Available Sudden cardiac death is one of the most common cause of mortality worldwide. Despite significant advances in the medical science, there is little improvement in the sudden cardiac death related mortality. Coronary artery disease is the most common etiology behind sudden cardiac death, in the above 40 years population. Even in the apparently healthy population, there is a small percentage of patients dying from sudden cardiac death. Given the large denominator, this small percentage contributes to the largest burden of sudden cardiac death. Identification of this at risk group among the apparently healthy individual is a great challenge for the medical fraternity. This article looks into the causes and methods of preventing SCD and at some of the Indian data. Details of Brugada syndrome, Long QT syndrome, Genetics of SCD are discussed. Recent guidelines on many of these causes are summarised.

  17. Death in media

    Directory of Open Access Journals (Sweden)

    Pavićević Aleksandra

    2010-01-01

    Full Text Available This paper discusses the role of media in a construction of public image speech and presentation of death. The main research questions could be posed as follows: does the media discourse confirm a thesis about modern society as the one which intensely avoids encounter with Death, or does it defy it? Frequent images or hints of death in visual media in films informative and entertainment programs-suggest certain changes related to this issue in the past few decades. This analysis focuses on printed media hence the paper assesses numerous issues of the daily journal Politika from 1963, 1972, 1973, 1979, 1985, 1991, 1995, 1999, 2007 and 2008, as well as some other daily journals after 2000. The analysis confirms a strong connection between the current political systems and ideology and speech about death. In addition, it reveals a political usage of this event but also speaks up about cultural and historical models, underlying all other constructions. During the 1960's and 1970's, the presentations, including the speech about death relied on the traditional understandings about inevitability of death and dying, and alternatively on atheistic beliefs related to the progress and wellbeing of the society. In this particular discourse, death was present to a limited degree, serving primarily to glorify socialist order. The end of the 1970's witnessed an increase in the glorification of the death, correlated with the decrease of the dominant political ideology. On the other hand, the 1990's brought about more presence of the national and religious symbolism and glorification of the dead as heroes. After 2000, mercantilism is evident throughout the media. All of the media broadcast drastic images of death and dead, thus providing an answer to the posed question at the beginning of this paper about the relationship of the modern society towards death but nevertheless, this still leaves out many implicit consequences and possible meanings.

  18. 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.

  19. Instantaneous death due to transorbital reverse penetration of a screw in an accidental fall: unusual autopsy case report and review of the literature.

    Science.gov (United States)

    Gioia, Sara; Bacci, Mauro; Lancia, Massimo; Carlini, Luigi; Suadoni, Fabio

    2014-03-01

    We present a peculiar autopsy case of a transorbital penetrating head injury, in a male worker, after an accidental fall onto a screw not completely stuck into a wooden board. A 13-cm screw entered the cranium 9.5 cm deep, penetrating with the flat end, a condition defined in literature as "reverse penetration." The death was instantaneous and caused by a neurogenic shock due to injuries to the brain stem and the right cerebellar hemisphere. These injuries, enabled by the length of the screw, are generally described in literature as due to nontransorbital penetrations, frequently associated with posterior entry and a large intracranial injury. The ocular globe has been, furthermore, perfectly preserved thanks to its mobility in the orbit. Even the dynamic of the incident is peculiar because of the stationary nature of the penetrating object, which the victim actively fell on by accident. To the best of our knowledge, the matter is therefore a very peculiar mortal case of transorbital intracranial penetration, whose verified injuries and dynamics are absolutely atypical. The case is now under discussion, and a review of pertinent literature is performed.

  20. Lung transplantation from donor of cardiac death in China (report of 3 cases)%心脏死亡供者供肺移植三例报告

    Institute of Scientific and Technical Information of China (English)

    叶书高; 刘东; 陈静瑜; 毛文君; 刘峰; 陆荣国; 陈若

    2011-01-01

    目的 总结心脏死亡供者供肺获取以及应用于临床肺移植的经验.方法 共进行3例心脏死亡供者供肺获取及肺移植.3例供者平素健康,因发生严重颅脑外伤或脑肿瘤,经严格医学检查后均被明确判定为脑死亡,并被确定为潜在心脏死亡供者.供者的近亲亲属均知情同意心脏死亡器官捐献,临床评估供肺良好,供者在停止呼吸机,心脏停跳5 min后,确定为心脏死亡,并在全身麻醉下切取供肺.3例受者术前淋巴细胞毒交叉配合试验均为阴性,供、受者ABO血型相同,身高相近,体重相差均在20%以内,胸腔大小匹配.结果 利用3例心脏死亡供者供肺成功进行了2例双肺移植和1例单肺移植,3例供肺的热缺血时间分别为23、27和32 min.3例受者手术顺利,在ICU的监护时间分别为31、18和26 d,术后肺功能得到极大改善,例1和例2分别于术后30和19d发生急性排斥反应,经皮质激素冲击治疗后好转,3例受者均未发生感染等并发症,随访期间生活质量良好.结论 在现有条件下,严格按《中国心脏死亡器官捐献工作指南》开展心脏死亡器官捐献应用于临床肺移植的工作,正确维护好潜在心脏死亡供者,在全面评估供肺质量的前提下,心脏死亡供肺可作为肺移植的主要供肺之一.%Objective To summarize the clinical experience of harvesting and using the lungs of cardiac death donor.Methods The lungs from donation after cardiac death (DCD) were harvested and used for lung transplantation.The donors suffered from severe craniocerebral trauma or brain neoplasms and were identified after cardiac death post declaration of brain death.Written consent about DCD was obtained from the consanguinities.The donor lungs were harvested after clinical evaluation of donors with considerable function and after the determination of DCD.The preoperative lymphocytotoxic cross match test was negative,ABO blood type was compatible,and the

  1. Sudden cardiac death after repair of anomalous origin of left coronary artery from right sinus of Valsalva with an interarterial course : Case report and review of the literature.

    Science.gov (United States)

    Nguyen, A L; Haas, F; Evens, J; Breur, J M P J

    2012-11-01

    Anomalous aortic origin of the coronary artery from the opposite sinus with interarterial course (AAOCA) is a rare condition with a high risk of sudden cardiac death (SCD) during or after strenuous exertion. SCD after repair of this anomaly is extremely rare. Here we present a 15-year-old athlete who collapsed on the basketball court in whom an anomalous origin of the left coronary artery from the right sinus of Valsalva with interarterial course (ALCA) was diagnosed. In spite of extensive pre-sport participation testing, SCD occurred shortly after surgical correction. We reviewed the literature to establish an evidence-based recommendation to aid physicians in conducting the optimal pre-sport participation management for the prevention of SCD in patients with a surgically corrected AAOCA/ALCA, especially for those who participate in strenuous exercise. Review of the literature (60 articles with 325 patients) reveals that post-surgical, pre-sport participation testing varies greatly but that mortality after surgical repair is extremely low (1.5 %). In conclusion, SCD can still rarely occur after repair of AAOCA despite extensive pre-sport participation testing. This should raise awareness among physicians treating these patients and raises the question whether or not return-to-play guidelines need to be revised.

  2. Life and Death Decision Analysis.

    Science.gov (United States)

    1979-12-01

    LIFE SMOKING: CANCER, EMPHYSEMA, SHORTENED LIFE BATHING: FALLING, ELECTROCUTION CONTRACEPTION: DEATH , ILLNESS PREGNANCY: DEATH , ILLNESS ABORTION ...economic effect is the one with the highest probability of causing my death . -13- EXPECTED NET SYSTEM DESIGN BENEFIT TO ME DEATH DEATH (r A(excluding death ...0-AO81 424 STANFORD UNIV CALIF DEPT OF ENGtNEERING-ECONOM!C SYSTEMS F/6 12/1 LIFE ANDI DEATH DECISION ANALYSIS.CU) DEC 79 R A HOWARD N0OOIN-79-C-0036

  3. [Death experience. Antidote against fear to death].

    Science.gov (United States)

    Fericgla, Josep M

    2003-12-01

    Fortunately, anthropology has brought to our modern society a higher interest for mankind's cultural dimension and the values which each people employ in order to make sense out of the changes which occur during our lives. It is this cultural dimension which permits men to develop our innate capacities and to become humans. However, in order to achieve this, we need experiences which are codified and interpreted by a values system which each individual has made his/her own. Some of these experiences take place inside cultural mores constructed expressly so that they are useful for one's lifestyle; these are known as rites. A rite, therefore, is an experience which leaves an impression, which implies social and biographical changes, which provides meaning to human beings' universal interests. Nonetheless, since rites usually are organized by diverse religions, it is convenient, as we enter the 21st Century, to speak about Experiences which Activate Structures as means to approach, to come to grasp with, some of the great causes of anxiety in humans: death and insanity. These Experiences which Activate Structures allow us to subjectively experiment, to conquer our fears and to be more conscious of our here and our now. Workshops on the Living Integration of One's Own Death are included in this context as an appropriate forum through which to approach death with knowledge and serenity, inducing changes in our own lifestyle as well and helping us to overcome situations of existential blockage.

  4. Brain death is not death: a critique of the concept, criterion, and tests of brain death.

    Science.gov (United States)

    Joffe, Ari R

    2009-01-01

    This paper suggests that there are insurmountable problems for brain death as a criterion of death. The following are argued: (1) brain death does not meet an accepted concept of death, and is not the loss of integration of the organism as a whole; (2) brain death does not meet the criterion of brain death itself; brain death is not the irreversible loss of all critical functions of the entire brain; and (3) brain death may, however rarely, be reversible. I conclude that brain death, while a devastating neurological state with a dismal prognosis, is not death.

  5. Symptoms Before Sudden Arrhythmic Death Syndrome

    DEFF Research Database (Denmark)

    Glinge, Charlotte; Jabbari, Reza; Risgaard, Bjarke

    2015-01-01

    INTRODUCTION: No studies in an unselected and nationwide setting have characterized the symptoms and medical history of patients with sudden arrhythmic death syndrome (SADS). The aim of this study was to identify and describe the symptoms and medical history of patients before the presentation....... The National Patient Registry was utilized to obtain information on all in- and outpatient activity in Danish hospitals. All medical records from hospitals and general practitioners, including death certificates and autopsy reports were reviewed. Before death, 48 (35%) SADS patients had cardiac symptoms; among...... these, 30 (22%) had contacted the healthcare system. Antecedent symptoms (symptoms >24 hours before death) were present in 34 (25%) patients. Prodromal symptoms (symptoms ≤24 hours before death) were present in 23 (17%) patients. Cardiac symptoms included chest pain (n = 16, 12%), dyspnea (n = 18, 13...

  6. Deaths due to physical restraint.

    Science.gov (United States)

    Berzlanovich, Andrea M; Schöpfer, Jutta; Keil, Wolfgang

    2012-01-01

    Physical restraint is used primarily for patients at risk of falling, those with motor unrest and agitated behavior, and those who manifest an intention of doing harm to themselves or are at risk of suicide. The use of freedom-restraining measures (FRM), and, in particular, the use of physical restraints against the patient's will, can be a serious intrusion of basic human rights and, as such, an act of violence against the patient. The improper use of physical restraints can cause injuries of varying severity, which can sometimes be fatal. We analyzed all cases of death under physical restraint that were recorded in the autopsy reports of the Institute of Forensic Medicine in Munich from 1997 to 2010. Among the 27 353 autopsies conducted over the period of the study, there were 26 cases of death while the individual was physically restrained. Three of these cases involved patients who died of natural causes while restrained, and one was a suicide. The remaining 22 deaths were caused solely by physical restraint; all of them occurred in patients under nursing care who were not continuously observed. The immediate cause of death was strangulation (11 cases), chest compression (8 cases), or dangling in the head-down position (3 cases). In 19 of these 22 patients, the restraints were incorrectly fastened, including two cases in which improvised non-standard restraints were used. One nursing-home patient died because of an abdominal restraint even though it had been correctly applied: She was mobile enough to slip through the restraint till it compressed her neck, and then unable to extricate herself from it, so that she died of strangulation. To prevent such deaths, we recommend from a forensic medical standpoint that all possible alternatives to FRM should be used instead. If direct-contact restraints are truly necessary, they must be applied as recommended and the restrained person must be closely observed.

  7. 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.

  8. Histological Findings in Unclassified Sudden Infant Death, Including Sudden Infant Death Syndrome

    NARCIS (Netherlands)

    Liebrechts-Akkerman, Germaine; Bovee, Judith V. M. G.; Wijnaendts, Liliane C. D.; Maes, Ann; Nikkels, Peter G. J.; de Krijger, Ronald R.

    2013-01-01

    Our objective was to study histological variations and abnormalities in unclassified sudden infant death (USID), including sudden infant death syndrome (SIDS), in The Netherlands. Two hundred Dutch USID cases between 1984 and 2005 were identified. The histology slides and autopsy reports of 187 case

  9. Histological findings in unclassified sudden infant death, including sudden infant death syndrome

    NARCIS (Netherlands)

    G. Liebrechts-Akkerman (Germaine); J.V.M.G. Bovée (Judith V. M. G.); L.C.D. Wijnaendts (Liliane); A. Maes (Ann); P.G.J. Nikkels (Peter); R.R. de Krijger (Ronald)

    2013-01-01

    textabstractOur objective was to study histological variations and abnormalities in unclassified sudden infant death (USID), including sudden infant death syndrome (SIDS), in The Netherlands. Two hundred Dutch USID cases between 1984 and 2005 were identified. The histology slides and autopsy reports

  10. Incidence of Near-Death Experiences Following Attempted Suicide.

    Science.gov (United States)

    Greyson, Bruce

    1986-01-01

    Near-death experiences, profound subjective experiences occurring during a close brush with death and containing transcendental or mystical elements, have been reported to reduce suicidal ideation, despite their "romanticization" of death. Further studies are indicated in regard to the effect of those experiences on subsequent suicidal behavior.…

  11. Glucose sensor excludes hypoglycaemia as cause of death

    DEFF Research Database (Denmark)

    Schmidt, Signe; Nørgaard, Kirsten

    2012-01-01

    The cause of death can be difficult to verify post-mortem in unexpected deaths in patients with Type 1 diabetes. This report describes an unexpected death in a 44-year-old man with Type 1 diabetes treated with sensor-augmented pump therapy. Continuous glucose monitoring data proved useful...

  12. Improving the accuracy of death certification

    Science.gov (United States)

    Myers, K A; Farquhar, D R

    1998-01-01

    BACKGROUND: Population-based mortality statistics are derived from the information recorded on death certificates. This information is used for many important purposes, such as the development of public health programs and the allocation of health care resources. Although most physicians are confronted with the task of completing death certificates, many do not receive adequate training in this skill. Resulting inaccuracies in information undermine the quality of the data derived from death certificates. METHODS: An educational intervention was designed and implemented to improve internal medicine residents' accuracy in death certificate completion. A total of 229 death certificates (146 completed before and 83 completed after the intervention) were audited for major and minor errors, and the rates of errors before and after the intervention were compared. RESULTS: Major errors were identified on 32.9% of the death certificates completed before the intervention, a rate comparable to previously reported rates for internal medicine services in teaching hospitals. Following the intervention the major error rate decreased to 15.7% (p = 0.01). The reduction in the major error rate was accounted for by significant reductions in the rate of listing of mechanism of death without a legitimate underlying cause of death (15.8% v. 4.8%) (p = 0.01) and the rate of improper sequencing of death certificate information (15.8% v. 6.0%) (p = 0.03). INTERPRETATION: Errors are common in the completion of death certificates in the inpatient teaching hospital setting. The accuracy of death certification can be improved with the implementation of a simple educational intervention. PMID:9614825

  13. Propuesta de un certificado de defunción para mejorar el registro y reporte de la muerte en el periodo perinatal Proposal for a death certificate to improve recording and reporting of perinatal mortality

    Directory of Open Access Journals (Sweden)

    Javier Contreras-Lemus

    2001-06-01

    Full Text Available Objetivo. Analizar la forma en que se registran los nacimientos y la muerte en el periodo perinatal, en el Instituto Mexicano del Seguro Social (IMSS, y documentar si el registro de la muerte, en este periodo, es adecuado. Material y métodos. Entre enero y marzo de 2000, se aplicó una encuesta en las 37 delegaciones del IMSS, para conocer, del año 1999, el total de nacimientos vivos y muertos, las defunciones ocurridas antes del séptimo día, considerando su edad gestacional y peso al nacimiento. Con estos datos se analizó la mortalidad hebdomadal e infantil y se calcularon las tasas correspondientes, incluyendo o desagregando a los niños con o = 28 semanas de gestación. Antes de la primera semana de vida extrauterina fallecieron 4 556 niños, de los cuales 1 385 (30.4% pesaron http://www.insp.mx/salud/index.htmlObjective. To analyze perinatal births and deaths recording at the Mexican Institute of Social Security (MISS, and to evaluate the correct classification of perinatal deaths. Material and methods. From January to March 2000, data were collected from the 37 MISS districts on the total number of births and deaths occurring during 1999, deaths occurring before the seventh day of life, and gestational age and weight at birth. Early neonatal and infant mortality rates were analyzed including or separating newborns with or = 28 gestation weeks. There were 4 556 newborns who died before the seventh day of extrauterine life; 1 385 of them (30.4% weighed less than 1 000 g and had a gestational age http://www.insp.mx/salud/index.html

  14. Complications and Deaths - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications and deaths - provider data. This data set includes provider data for the hip/knee complication measure, the Agency for Healthcare Research and Quality...

  15. Complications and Deaths - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications and deaths - national data. This data set includes national-level data for the hip/knee complication measure, the Agency for Healthcare Research and...

  16. Death with dignity

    National Research Council Canada - National Science Library

    Aungst, Heide

    2008-01-01

      Aungst evaluates the first decade of Oregon's Death with Dignity Act, a law enacted in 1997 that permits physicians to assist terminally ill patients in ending their lives by prescribing lethal doses of medication...

  17. Amending Death Rules

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China’s Criminal Law is being revised to cut down on death sentences and tighten up punishment for surging crimes The eighth amendment to the Criminal Law, demanding moreprudent use of capital punishment

  18. Hitler's Death Camps.

    Science.gov (United States)

    Wieser, Paul

    1995-01-01

    Presents a high school lesson on Hitler's death camps and the widespread policy of brutality and oppression against European Jews. Includes student objectives, instructional procedures, and a chart listing the value of used clothing taken from the Jews. (CFR)

  19. Eighth Amendment & Death Penalty.

    Science.gov (United States)

    Shortall, Joseph M.; Merrill, Denise W.

    1987-01-01

    Presents a lesson on capital punishment for juveniles based on three hypothetical cases. The goal of the lesson is to have students understand the complexities of decisions regarding the death penalty for juveniles. (JDH)

  20. Autoerotic deaths: four cases.

    Science.gov (United States)

    Cooke, C T; Cadden, G A; Margolius, K A

    1994-07-01

    We describe the circumstances and post mortem medical findings of 4 unusual fatalities where death occurred during autoerotic practice. Three cases occurred in young to middle-aged men--hanging, electrocution and inhalation of a zucchini. The manner of death in each was accidental. The fourth case was an elderly man who died of ischemic heart disease, apparently whilst masturbating with a vacuum cleaner and a hair dryer.

  1. Dog-Mediated Human Rabies Death, Haiti, 2016

    OpenAIRE

    Ryan M Wallace; Etheart, Melissa D.; Doty, Jeff; Monroe, Ben; Crowdis, Kelly; Augustin, Pierre Dilius; Blanton, Jesse; Fenelon, Natael

    2016-01-01

    Haiti has experienced numerous barriers to rabies control over the past decades and is one of the remaining Western Hemisphere countries to report dog-mediated human rabies deaths. We describe the circumstances surrounding a reported human rabies death in 2016 as well as barriers to treatment and surveillance reporting.

  2. Characterisation of Classical Sudden Infant Death Syndrome SIDS and Gray Zone SIDS in Japan Using Japanese Pathology and Autopsy Report 1982-1986 From the Japanese Society of Pathology

    Directory of Open Access Journals (Sweden)

    Toshiko Sawaguchia

    1996-07-01

    Full Text Available There is no standardised criterion on the handling of Classical Sudden Infant Death Syndrome (SIDS and Gray Zone SIDS. Particularly international discussion is needed on the handling of Gray Zone cases. Autopsy findings for Classical SIDS and Gray Zone SIDS in Japan has been analysed in preparing the basic data for this discussion in this report. The material analysed was found in the Japanese Pathology and Autopsy Report from the Japanese Society of Pathology (January 1982 to December 1986. A x2 test was required to find the difference between Classical SIDS and Gray Zone SIDS in each autopsy finding. In addition, factor analysis (the principal factor method with Varimax rotation was carried out to identify the structure of the autopsy findings not only for Gray Zone SIDS but also for Classical SIDS. Using the x2 test a lymph tissue enlargement was found to have a high statistical value in Classical SIDS. Congestion, thymus enlargement, pulmonary oedema, adrenal gland atrophy, lymph tissue enlargement and neonate were recorded with .high factor loadings in Classical SIDS by factor analysis. Pneumonia, premature baby, and cardiomegaly was recorded with high statistical value in Gray Zone SIDS by the x2 test. Asphyxia, congestion, atelectasis, pulmonary emphysema, adrenal gland atrophy, premature baby, thymus hypoplasia, cardial malformation and ectopic hemopoesis were recorded as having high factor loadings in Gray Zone SIDS using factor analysis. Thymus enlargement and adrenal gland atrophy were recorded in the third factor of Gray Zone SIDS having rather high negative factor loading using factor analysis. It is remarkable that asphyxia was extracted in the first factor of Gray Zone SIDS with the highest loading factor using factor analysis. This fact might suggest indirectly that a percentage of Gray Zone SIDS would be underdiagnosed because of a substitutional diagnosis of asphyxia as being an external cause of death in Japan, even in general

  3. Supravalvular aortic stenosis with sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Pradeep Vaideeswar

    2015-01-01

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

  4. Supporting families after sudden infant death.

    Science.gov (United States)

    McClain, M E; Shaefer, S J

    1996-04-01

    Parents consistently report that supportive contacts with their health care providers make a difference in their overall adjustment to their baby's death. Parents require continuing validation that the baby's death is no one's fault, that it was not caused by anything they did or did not do. In supporting bereaved families, our goal is to assist parents to incorporate the baby's death into their lives in a way that allows them to continue to function and to recognize life as worth living and happiness as possible.

  5. Sudden infant death syndrome: diagnostic practices and investigative policies, 2004.

    Science.gov (United States)

    Camperlengo, Lena T; Shapiro-Mendoza, Carrie K; Kim, Shin Y

    2012-09-01

    Using a 2004 population-based survey of all US medical examiner and coroner offices, we examined the characteristics of offices accepting an infant death case and calculated the percentage of offices that had death scene investigation or autopsy policies for the investigation of sudden unexpected infant death (SUID). We also calculated the percentage of offices that used and did not use sudden infant death syndrome (SIDS) as a cause of death, and we compared differences in characteristics among those offices.Of medical examiner and coroner offices, 52% did not report an infant death in 2004. Of the 7957 infant deaths reported, 43% occurred in jurisdictions that experienced 1 or 2 infant deaths. Of the offices that used SIDS as a classification, 34% did not have policies for conducting death scene investigations and autopsies for SUID. At least 5% of offices that reported an infant death did not use SIDS as a cause of death classification. These findings have important implications for understanding recent trends in SIDS and SUID. Supporting the implementation of national standards for investigating and certifying infant deaths could provide guidelines for consistent practices in medical examiner and coroner offices.

  6. Modification of Heat-Related Mortality in an Elderly Urban Population by Vegetation (Urban Green) and Proximity to Water (Urban Blue): Evidence from Lisbon, Portugal.

    Science.gov (United States)

    Burkart, Katrin; Meier, Fred; Schneider, Alexandra; Breitner, Susanne; Canário, Paulo; Alcoforado, Maria João; Scherer, Dieter; Endlicher, Wilfried

    2016-07-01

    Urban populations are highly vulnerable to the adverse effects of heat, with heat-related mortality showing intra-urban variations that are likely due to differences in urban characteristics and socioeconomic status. We investigated the influence of urban green and urban blue, that is, urban vegetation and water bodies, on heat-related excess mortality in the elderly > 65 years old in Lisbon, Portugal, between 1998 and 2008. We used remotely sensed data and geographic information to determine the amount of urban vegetation and the distance to bodies of water (the Atlantic Ocean and the Tagus Estuary). Poisson generalized additive models were fitted, allowing for the interaction between equivalent temperature [universal thermal climate index (UTCI)] and quartiles of urban greenness [classified using the Normalized Difference Vegetation Index (NDVI)] and proximity to water (≤ 4 km vs. > 4 km), while adjusting for potential confounders. The association between mortality and a 1°C increase in UTCI above the 99th percentile (24.8°C) was stronger for areas in the lowest NDVI quartile (14.7% higher; 95% CI: 1.9, 17.5%) than for areas in the highest quartile (3.0%; 95% CI: 2.0, 4.0%). In areas > 4 km from water, a 1°C increase in UTCI above the 99th percentile was associated with a 7.1% increase in mortality (95% CI: 6.2, 8.1%), whereas in areas ≤ 4 km from water, the estimated increase in mortality was only 2.1% (95% CI: 1.2, 3.0%). Urban green and blue appeared to have a mitigating effect on heat-related mortality in the elderly population in Lisbon. Increasing the amount of vegetation may be a good strategy to counteract the adverse effects of heat in urban areas. Our findings also suggest potential benefits of urban blue that may be present several kilometers from a body of water. Burkart K, Meier F, Schneider A, Breitner S, Canário P, Alcoforado MJ, Scherer D, Endlicher W. 2016. Modification of heat-related mortality in an elderly urban population by

  7. A comprehensive overview of medical error in hospitals using incident-reporting systems, patient complaints and chart review of inpatient deaths.

    Directory of Open Access Journals (Sweden)

    Jeantine M de Feijter

    Full Text Available BACKGROUND: Incident reporting systems (IRS are used to identify medical errors in order to learn from mistakes and improve patient safety in hospitals. However, IRS contain only a small fraction of occurring incidents. A more comprehensive overview of medical error in hospitals may be obtained by combining information from multiple sources. The WHO has developed the International Classification for Patient Safety (ICPS in order to enable comparison of incident reports from different sources and institutions. METHODS: The aim of this paper was to provide a more comprehensive overview of medical error in hospitals using a combination of different information sources. Incident reports collected from IRS, patient complaints and retrospective chart review in an academic acute care hospital were classified using the ICPS. The main outcome measures were distribution of incidents over the thirteen categories of the ICPS classifier "Incident type", described as odds ratios (OR and proportional similarity indices (PSI. RESULTS: A total of 1012 incidents resulted in 1282 classified items. Large differences between data from IRS and patient complaints (PSI = 0.32 and from IRS and retrospective chart review (PSI = 0.31 were mainly attributable to behaviour (OR = 6.08, clinical administration (OR = 5.14, clinical process (OR = 6.73 and resources (OR = 2.06. CONCLUSIONS: IRS do not capture all incidents in hospitals and should be combined with complementary information about diagnostic error and delayed treatment from patient complaints and retrospective chart review. Since incidents that are not recorded in IRS do not lead to remedial and preventive action in response to IRS reports, healthcare centres that have access to different incident detection methods should harness information from all sources to improve patient safety.

  8. EP2 Receptor Signaling Regulates Microglia Death

    OpenAIRE

    Fu, Yujiao; Yang, Myung-Soon; Jiang, Jianxiong; Ganesh, Thota; Joe, Eunhye; Dingledine, Raymond

    2015-01-01

    The timely resolution of inflammation prevents continued tissue damage after an initial insult. In the brain, the death of activated microglia by apoptosis has been proposed as one mechanism to resolve brain inflammation. How microglial death is regulated after activation is still unclear. We reported that exposure to lipopolysaccharide (LPS) and interleukin (IL)-13 together initially activates and then kills rat microglia in culture by a mechanism dependent on cyclooxygenase-2 (COX-2). We sh...

  9. 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...

  10. Hurricane Katrina deaths, Louisiana, 2005.

    Science.gov (United States)

    Brunkard, Joan; Namulanda, Gonza; Ratard, Raoult

    2008-12-01

    Hurricane Katrina struck the US Gulf Coast on August 29, 2005, causing unprecedented damage to numerous communities in Louisiana and Mississippi. Our objectives were to verify, document, and characterize Katrina-related mortality in Louisiana and help identify strategies to reduce mortality in future disasters. We assessed Hurricane Katrina mortality data sources received in 2007, including Louisiana and out-of-state death certificates for deaths occurring from August 27 to October 31, 2005, and the Disaster Mortuary Operational Response Team's confirmed victims' database. We calculated age-, race-, and sex-specific mortality rates for Orleans, St Bernard, and Jefferson Parishes, where 95% of Katrina victims resided and conducted stratified analyses by parish of residence to compare differences between observed proportions of victim demographic characteristics and expected values based on 2000 US Census data, using Pearson chi square and Fisher exact tests. We identified 971 Katrina-related deaths in Louisiana and 15 deaths among Katrina evacuees in other states. Drowning (40%), injury and trauma (25%), and heart conditions (11%) were the major causes of death among Louisiana victims. Forty-nine percent of victims were people 75 years old and older. Fifty-three percent of victims were men; 51% were black; and 42% were white. In Orleans Parish, the mortality rate among blacks was 1.7 to 4 times higher than that among whites for all people 18 years old and older. People 75 years old and older were significantly more likely to be storm victims (P Hurricane Katrina was the deadliest hurricane to strike the US Gulf Coast since 1928. Drowning was the major cause of death and people 75 years old and older were the most affected population cohort. Future disaster preparedness efforts must focus on evacuating and caring for vulnerable populations, including those in hospitals, long-term care facilities, and personal residences. Improving mortality reporting timeliness will

  11. Uncovering the 2010 Haiti earthquake death toll

    Science.gov (United States)

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

    2013-05-01

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

  12. Childhood deaths from external causes in Estonia, 2001–2005

    Directory of Open Access Journals (Sweden)

    Soonets Ruth

    2007-07-01

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

  13. Pediatric brain death determination.

    Science.gov (United States)

    Mathur, Mudit; Ashwal, Stephen

    2015-04-01

    Clinical guidelines for the determination of brain death in children were first published in 1987. These guidelines were revised in 2011 under the auspices of the Society of Critical Care Medicine, the American Academy of Pediatrics, and the Child Neurology Society, and provide the minimum standards that must be satisfied before brain death can be declared in infants and children. After achieving physiologic stability and exclusion of confounders, two examinations including apnea testing separated by an observation period (24 hours for term newborns up to 30 days of age, and 12 hours for infants and children from 31 days up to 18 years) are required to establish brain death. Apnea testing should demonstrate a final arterial PaCO2 20 mm Hg above the baseline and ≥ 60 mm Hg with no respiratory effort during the testing period. Ancillary studies (electroencephalogram and radionuclide cerebral blood flow) are not required to establish brain death and are not a substitute for the neurologic examination. The committee concluded that ancillary studies may be used (1) when components of the examination or apnea testing cannot be completed, (2) if uncertainty about components of the neurologic examination exists, (3) if a medication effect may be present, or (4) to reduce the interexamination observation period. When ancillary studies are used, a second clinical examination and apnea test should still be performed and components that can be completed must remain consistent with brain death.

  14. 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.

  15. Direct maternal deaths in Norway 1976-1995

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  16. Perspectives on Death: An Experiential Course on Death Education.

    Science.gov (United States)

    Stefan, Edwin S.

    1978-01-01

    Describes and evaluates a college psychology course on death education (thanatology). Course objectives were to help students become aware of the feelings involved in facing death, encourage discussion on the subject of death, motivate students to change their attitudes about death, and encourage practical planning for funeral arrangements.…

  17. Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Yipsy María Gutiérrez Báez

    2015-09-01

    Full Text Available Since the second half of the twentieth century, dying suddenly due to heart-related problems has become the main health issue in all countries where infectious diseases are not prevalent. Sudden death from cardiac causes is an important global health problem. Major databases were searched for the leading causes of sudden cardiac death. It has been demonstrated that there is a group of hereditary diseases with structural alterations or without apparent organic cause that explains many cases of sudden death in young people, whether related or not to physical exertion. Certain population groups are at higher risk for this disease. They are relatively easy to identify and can be the target of primary prevention measures.

  18. Amphetamine derivative related deaths.

    Science.gov (United States)

    Lora-Tamayo, C; Tena, T; Rodríguez, A

    1997-02-28

    Amphetamine its methylendioxy (methylendioxyamphetamine methylenedioxymethylamphetamine, methylenedioxyethylamphetamine) and methoxy derivatives (p-methoxyamphetamine and p-methoxymethylamphetamine) are widely abused in Spanish society. We present here the results of a systematic study of all cases of deaths brought to the attention of the Madrid department of the Instituto Nacional de Toxicologia from 1993 to 1995 in which some of these drugs have been found in the cadaveric blood. The cases were divided into three categories: amphetamine and derivatives, amphetamines and alcohol, amphetamines and other drugs. Data on age, sex, clinical symptoms, morphological findings, circumstances of death, when known, and concentration of amphetamine derivatives, alcohol and other drugs in blood are given for each group. The information provided here may prove to be useful for the forensic interpretation of deaths which are directly or indirectly related to abuse of amphetamine derivatives.

  19. Orchestrating an Exceptional Death

    DEFF Research Database (Denmark)

    Jensen, Anja Marie Bornø

    , reinterpret and translate death and organ donation into something culturally acceptable and sense making. With chapters focusing analytically on the performance of trust, the transformative practices of hope, the aesthetization of ambiguous bodies, the sociality of exchangeable organs and the organ donation......This Ph.D. thesis explores the experiences of Danish donor families and the context of organ donation in Denmark. Based on comprehensive ethnographic studies at Danish hospitals and interviews with health care professionals and donor families, readers are invited on a journey into the complex...... processes of facing brain death and deciding about organ donation. This study suggests that organ donation should be understood as a ‘strange figure’ challenging traditions and attitudes regarding the boundaries between life and death and the practices surrounding dead human bodies. Simultaneously, organ...

  20. Orchestrating an Exceptional Death

    DEFF Research Database (Denmark)

    Jensen, Anja Marie Bornø

    This Ph.D. thesis explores the experiences of Danish donor families and the context of organ donation in Denmark. Based on comprehensive ethnographic studies at Danish hospitals and interviews with health care professionals and donor families, readers are invited on a journey into the complex...... processes of facing brain death and deciding about organ donation. This study suggests that organ donation should be understood as a ‘strange figure’ challenging traditions and attitudes regarding the boundaries between life and death and the practices surrounding dead human bodies. Simultaneously, organ......, reinterpret and translate death and organ donation into something culturally acceptable and sense making. With chapters focusing analytically on the performance of trust, the transformative practices of hope, the aesthetization of ambiguous bodies, the sociality of exchangeable organs and the organ donation...

  1. Death by Propofol.

    Science.gov (United States)

    Diaz, James H; Kaye, Alan David

    2017-01-01

    Since its introduction in 1986, propofol ( two, 6-diisopropylphenol) , an intravenous sedative-hypnotic agent, has been utilized for the induction and maintenance of general anesthesia and conscious sedation in over 80 percent of cases; largely replacing thiopental ( sodium pentothal) over a decade ago. Unrestricted as a controlled substance, propofol's abuse potential emerged quickly and was highlighted by the death of pop singer, Michael Jackson, in 2009. In order to assess the epidemiological features of fatal propofol abuse, a descriptive analysis of the scientific literature was conducted using Internet search engines. Well-documented cases of fatal propofol abuse were stratified as unintentional or accidental deaths and as intentional deaths by suicides or homicides. Continuous variables were compared for differences by unpaired, two-tailed t-tests with statistical significance indicated by p-values less than 0.05. Of 21 fatal cases of propofol abuse, 18 (86 percent ) occurred in healthcare workers, mostly anesthesiologists and nurse anesthetists (n=14, 67 percent ). One case occurred in a layman who purchased propofol on the Internet. Seventeen deaths (81 percent ) were accidental; two were suicides (9.5 percent ) and two were homicides (9.5 percent ). Blood levels in intentional death cases were significantly greater than in accidental death cases (p less than 0.0001) all of which reflected initial therapeutic induction-level doses in the ranges of 2.0-2.5 mg/kg. Though lacking in analgesic effects, the abuse of propofol by young healthcare professionals, particularly operating room workers, has been significant; and likely underreported. Propofol is a dangerous drug with an evident abuse potential which often results in fatalities.

  2. Mechanisms by which acid precipitation produces embryonic death in aquatic vertebrates. Technical completion report, 1 May 1977-31 December 1980

    Energy Technology Data Exchange (ETDEWEB)

    Pough, F.H.

    1981-03-01

    Fourteen species of amphibians show a general similarity in their tolerance of acid media during embryonic development. More than 85% mortality is produced by pHs of 3.7 to 3.9 and more than 50% mortality occurs at pHs of 4.0 or less. Similar values have been reported for fishes. The sensitivity of amphibian embryos to acidity is greater in late stages of their development than it is during the initial cleavage of the embryos. The teratogenic effects of acidity appear to be the result of damage to the superficial tissues of the embryo. A similar response occurs in fish embryos. Because of the similarity of sensitivity and response to acidity of fishes and amphibians, the latter animals are suitable experimental models for investigations of the details of acid resistance. Controlled breedings of African clawed frogs (Xenopus laevis) indicated that the offspring of some pairs of parents were more resistant to acidity than those of other pairs. Wild populations of spotted salamanders (Ambystoma maculatum) breeding in some ponds in the Ithaca, New York, region have probably been exposed to increasingly acid conditions for the past three decades (10 or more generations). In the most acid ponds more than 70% of the embryos die before hatching. Despite the intensity and duration of this selection, it was not possible to demonstrate any difference in sensitivity to acidity between eggs collected from acidic and neutral breeding sites.

  3. [The death of Cleopatra].

    Science.gov (United States)

    Guillemain, Bernard

    2009-01-01

    The image of a queen bitten by a snake is controversial and the facts, such as the swiftness of her death and her servants, and scientific experiments are in favour of a deadly poisoning. The author reminds that in the ancient texts the snake had sacred virtues and it was a symbolic image to embellish the suicide of the one who was sentenced to death by the Romans. Octaves set up the myth of a fatal bite which became an iconographic image for the cinema.

  4. Extinction. Histories of death

    Directory of Open Access Journals (Sweden)

    Arkadiusz Żychliński

    2011-01-01

    Full Text Available One of the last great novels of José Saramago, Death with Interruptions, begins with an epigraph taken from Ludwig Wittgenstein: “If, for example, you were to think more deeply about death, then it would be truly strange if, in so doing, you did not encounter new images, new linguistic fields”. The aim of my paper is to ponder on what kind of a new language game the Portuguese writer is offering us in his book and how to interpret his investigations from the angle of another contemporary literary and philosophical thanatological discourses.

  5. Cardiorespiratory fitness and death from cancer

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Holtermann, Andreas; Bay, Hans

    2016-01-01

    OBJECTIVES: Poor cardiorespiratory fitness (CRF) is associated with death from cancer. If follow-up time is short, this association may be confounded by subclinical disease already present at the time of CRF assessment. This study investigates the association between CRF and death from cancer...... using a bicycle ergometer test and analysed in multivariable Cox models including conventional risk factors, social class and self-reported physical activity. Death from cancer and all-cause mortality was assessed using Danish national registers. Follow-up was 100% complete. RESULTS: In total, 5131 men...... were included, mean (SD) age 48.8 (5.4) years. During 44 years of follow-up, 4486 subjects died (87.4%), 1527 (29.8%) from cancer. In multivariable models, CRF was highly significantly inversely associated with death from cancer and all-cause mortality ((HR (95% CI)) 0.83 (0.77 to 0.90) and 0.89 (0...

  6. Physical Death in the Digital Age

    DEFF Research Database (Denmark)

    Gotved, Stine

    2016-01-01

    As the physical life is intrisically connected with online services and digital social networks, so is the physical death. This chapter describes the last journey, from the reluctant planning to the digital manifestations afterwards. Using a simple timelime (before, just around, and after...... the physical death of an individual), the digital possibilities in the different stages are presented. They range from the need for being prepared to the intricate questions of digital assets and inheritance, from the service of online undertakers to the shared memorials on social network sites. The truely...... cross-disciplinary research into death online is in the process of assembling as a field, thus reporting from the diverse and dynamic activity surrounding the physical death in the digital age....

  7. Teaching about the Death Penalty.

    Science.gov (United States)

    Ryan, John Paul; Eden, John Michael

    1998-01-01

    Examines the reasons for the death penalty, the reasons why the death penalty attracts so much attention, whether the death penalty is applied consistently, and the evidence that the application of the death penalty may be racially biased. Provides an accompanying article on "Teaching Ideas" by Ronald A. Banaszak. (CMK)

  8. Diagnosis of brain death

    Directory of Open Access Journals (Sweden)

    Calixto Machado

    2010-06-01

    Full Text Available Brain death (BD should be understood as the ultimate clinical expression of a brain catastrophe characterized by a complete and irreversible neurological stoppage, recognized by irreversible coma, absent brainstem reflexes, and apnea. The most common pattern is manifested by an elevation of intracranial pressure to a point beyond the mean arterial pressure, and hence cerebral perfusion pressure falls and, as a result, no net cerebral blood flow is present, in due course leading to permanent cytotoxic injury of the intracranial neuronal tissue. A second mechanism is an intrinsic injury affecting the nervous tissue at a cellular level which, if extensive and unremitting, can also lead to BD. We review here the methodology of diagnosing death, based on finding any of the signs of death. The irreversible loss of cardio-circulatory and respiratory functions can cause death only when ischemia and anoxia are prolonged enough to produce an irreversible destruction of the brain. The sign of such loss of brain functions, that is to say BD diagnosis, is fully reviewed.

  9. Optimal Aging and Death

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan; Strulik, Holger

    the representative consumer is subject to physiological aging. In modeling aging we draw on recent research in the fields of biology and medicine. The speed of the aging process, and thus the time of death, are endogenously determined by optimal health investments. We calibrate the model to US data and proceed...

  10. Digital language death.

    Directory of Open Access Journals (Sweden)

    András Kornai

    Full Text Available Of the approximately 7,000 languages spoken today, some 2,500 are generally considered endangered. Here we argue that this consensus figure vastly underestimates the danger of digital language death, in that less than 5% of all languages can still ascend to the digital realm. We present evidence of a massive die-off caused by the digital divide.

  11. Sudden Infant Death Syndrome.

    Science.gov (United States)

    Barnett, Henry L.; And Others

    There is a growing body of evidence that Sudden Infant Death Syndrome (SIDS) victims are not completely normal and healthy, as was once believed. A variety of new information from several disciplines strongly suggests that the infant who dies suddenly and unexpectedly may do so because of subtle developmental, neurologic, cardiorespiratory, and…

  12. Optimal Aging and Death

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Strulik, Holger

    2010-01-01

    This study introduces physiological aging into a simple model of optimal intertemporal consumption. In this endeavor we draw on the natural science literature on aging. According to the purposed theory, the speed of the aging process and the time of death are endogenously determined by optimal...

  13. The Death of Shankar

    DEFF Research Database (Denmark)

    Seeberg, Jens

    2013-01-01

    ) in Bhubaneswar, the capital city of Orissa. The chapter explores the heterogeneous and hierarchical composition of the basti and unfolds the case of the social exclusion and ultimate death of a patient with tuberculosis who belonged to the poorest section of the basti, called Pradhan sahi. The case of both...

  14. Death in Flames

    DEFF Research Database (Denmark)

    Harvig, Lise; Kveiborg, Jacob; Lynnerup, Niels

    2015-01-01

    This paper presents osteoarchaeological analyses of the human skeletal material from a burnt down house in Jutland, Denmark, dated to the first century bc. We describe how the osteological analyses of this complex site were approached and illustrate how we reconstructed the death of the human...

  15. Bee deaths need analysing

    NARCIS (Netherlands)

    Boonekamp, P.M.

    2011-01-01

    Alarm bells are ringing all over the world about the death of bee populations. Although it is not known exactly how severe the decline is, it is important to take the problem seriously. The signals are alarming and the bee is important, not just for natural ecosystems but also for the pollination of

  16. The Death Penalty.

    Science.gov (United States)

    Crockett, Mark

    1990-01-01

    Provides a lesson plan on the Eighth Amendment to the U.S. Constitution and the imposition of the death penalty. Focuses on the controversy concerning capital punishment and stimulates critical thinking in an analysis and discussion of eight hypothetical situations. Includes suggestions for readings, videotapes, and writing assignments. (NL)

  17. Death Penalty in America.

    Science.gov (United States)

    Clifford, Amie L.

    1997-01-01

    Examines the legal and moral issues, controversies, and unique trial procedures involved with the death penalty. Discusses the 1972 landmark Supreme Court decision that resulted in many states abolishing this punishment, only to reintroduce it later with different provisions. Reviews the controversial case of Sam Sheppard. (MJP)

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

    Science.gov (United States)

    Parnia, Sam

    2014-11-01

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

  19. Effects of Death Education on Fear of Death and Attitudes towards Death and Life.

    Science.gov (United States)

    Leviton, Dan; Fretz, Bruce

    1978-01-01

    Students in a death education course were compared with students of sex education and introductory psychology. After the death education course, students viewed death as more approachable, and wished to experience death in a more interpersonal as compared to a technological context. (Author)

  20. METHAPHYSICS OF DEATH PENALTY

    Directory of Open Access Journals (Sweden)

    V. E. Gromov

    2017-06-01

    Full Text Available Purpose. The paper studies the problem of death penalty justifiableness in terms of democratic society from the metaphysical viewpoint. Philosophical argumentation to justify death penalty is proposed as opposed to the common idea of inhuman and uncivilized nature of court practice of sentencing to death. The essence of the study is not to rehabilitate law-based murder but to explain dialectic relation of the degrees of moral responsibility of criminals and society nourishing evildoers. The author believes that refusal from death penalty under the pretence of rule of humanism is just a liberal façade, plausible excuse for defective moral state of the society which, rejecting its own guiltiness share as for current disregards of the law, does not grow but downgrades proper human dignity. Methodology. The author applies an approach of dialectic reflection being guided by the perception of unity, relativeness and complementarity of evil and good striving to determine efficient way of resolving their contradictions in the context of moral progress of the society. Originality. Proposing philosophic approach to a death penalty problem instead of legal one, the author is not going to discuss the role of horrification, control or cruelty of the measure of restraint; moreover, he does not consider the issue of its efficiency or inefficiency. The author also does not concern vexation of mind of a criminal sentenced to life imprisonment for “humanitarian” reasons. The purpose of the author is to demonstrate that aim of the punishment is to achieve justice which becomes spiritual challenge and moral recompense not only for the criminal but for the whole society. Conclusions. Crime is first of all a problem of a society; thus, criminal behaviour of certain individuals should only be considered through a prism of moral state of the whole community. Attitude to a death penalty is the problem of spirituality and its dramatic sophistication. The author

  1. Case-crossover analysis of heat-coded deaths and vulnerable subpopulations: Oklahoma, 1990-2011

    Science.gov (United States)

    Moore, Brianna F.; Brooke Anderson, G.; Johnson, Matthew G.; Brown, Sheryll; Bradley, Kristy K.; Magzamen, Sheryl

    2017-06-01

    The extent of the association between temperature and heat-coded deaths, for which heat is the primary cause of death, remains largely unknown. We explored the association between temperature and heat-coded deaths and potential interactions with various demographic and environmental factors. A total of 335 heat-coded deaths that occurred in Oklahoma from 1990 through 2011 were identified using heat-related International Classification of Diseases codes, cause-of-death nomenclature, and narrative descriptions. Conditional logistic regression models examined the association between temperature and heat index on heat-coded deaths. Interaction by demographic factors (age, sex, marital status, living alone, outdoor/heavy labor occupations) and environmental factors (ozone, PM10, PM2.5) was also explored. Temperatures ≥99 °F (the median value) were associated with approximately five times higher odds of a heat-coded death as compared to temperatures states implement or expand heat safety programs to protect vulnerable subpopulations, such as outdoor workers.

  2. AN AUDIT OF MATERNAL DEATHS

    Directory of Open Access Journals (Sweden)

    Basavana Gowda

    2015-03-01

    Full Text Available OBJECTIVES: A study of maternal death conducted to evaluate various factors responsible for maternal deaths. To identify complications in pregnancy, a childbirth which result in maternal death, and to identify opportunities for preventive intervention and understand the events leading to death; so that improving maternal health and reducing maternal mortality rate significantly. To analyze the causes and epidemiological amounts maternal mortality e.g. age parity, socioeconomic status and literacy. In order to reduce maternal mortality and to implement safe motherhood program and complications of pregnancy and to find out safe motherhood program. METHODS: The data collected was a retrograde by a proforma containing particulars of the diseased, detailed history and relatives were interviewed for additional information. The data collected was analysed. RESULTS: Maternal mortality rate in our own institution is 200/ 100,000 live births. Among 30 maternal deaths, 56% deaths (17 were among low socio - economic status, groups 60% deaths among unbooked 53.5% deaths more along illiterates evidenced by direct and indirect deaths about 25% of deaths were preventable. CONCLUSION: Maternal death is a great tragedy in the family life. It is crusade to know not just the medical cause of the death but the circumstances what makes these continued tragic death even more unacceptable is that deaths are largely preventable

  3. Death of the Moth

    Directory of Open Access Journals (Sweden)

    Virginia Woolf

    2013-01-01

    Full Text Available The image of moths gathering around a source of light recurs in Woolf’s private writings and becomes an import motif also in her novels and essays. It is most probably the description of moths in her sister’s letter that become an initial inspiration for writing of The Waves, Woolf’s most radical experiment in novelistic form, where she strives to create a subject-less perspective. On the other hand The Death of The Moth, a 1927 essay, whose first translation into Polish comes together with the present commentary from the translator, is a crystal-clear description of the world as seen by the writer/narrator at her desk, surrounded by exuberant life but witnessing death

  4. Gaddafi's Death Poses Challenges

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The death of Muammar Gaddafi marks a new era for Libya.It also poses a huge challenge for Libyan authorities dealing with tribal conflicts.He Wenping,a researcher with the Institute of West-Asian and African Studies at the Chinese Academy of Social Sciences,believes that Libya is in danger of falling into a period of internal strife and tribal conflict.

  5. Death, medicine & bioethics.

    Science.gov (United States)

    Hunt, G

    1994-12-01

    The assumptions of philosophy need scrutiny as much the assumptions of medicine do. Scrutiny shows that the philosophical method of bioethics is compromised, for it shares certain fundamental assumptions with medicine itself. To show this requires an unorthodox style of philosophy--a literary one. To show the compromised status of bioethics the paper discusses some seminal utilitarian discussions of the definition of death, of whether it is a bad thing, and of when it ought to occur.

  6. Report on the death of an Okapi

    NARCIS (Netherlands)

    Smits, G.M.; Misdorp, W.; Jacobi, E.F.

    1965-01-01

    A six to seven year-old female okapi died after a week of illness showing clinical signs of an acute infection of the respiratory tracts. Antibiotic therapy did not influence the course of the disease. The postmortem examination demonstrated the presence of acute laryngitis, tonsilitis, tracheo-bron

  7. The Interpretation of Cause of Death 53 Among Infants

    Directory of Open Access Journals (Sweden)

    Bengtsson, Magdalena

    2002-12-01

    Full Text Available Earlier studies on mortality in 18th and 19th century Sweden have discussed the validity of cause of death information. The fact that the Swedish clergy historically were responsible for the stipulation and reporting of causes of death has initiated a discussion on the medical competence of the clergy. Other issues concern the level of accomplishment in medical science and the effects of instructions and regulations on cause of death registration. This paper argues that cause of death analyses are quite useful for the understanding of mortality transitions if cause of death information is placed in its proper context and are combined with other kinds of mortality analyses. An awareness of 1 the conditions under which causes of death were stipulated, 2 what regulations were in effect at the particular time, and 3 the environmental and epidemiological changes provides good prerequisites for successful use of cause of death information.

  8. Heat Death Associations with the built environment, social vulnerability and their interactions with rising temperature.

    Science.gov (United States)

    Eisenman, David P; Wilhalme, Holly; Tseng, Chi-Hong; Chester, Mikhail; English, Paul; Pincetl, Stephanie; Fraser, Andrew; Vangala, Sitaram; Dhaliwal, Satvinder K

    2016-09-01

    In an extreme heat event, people can go to air-conditioned public facilities if residential air-conditioning is not available. Residences that heat slowly may also mitigate health effects, particularly in neighborhoods with social vulnerability. We explored the contributions of social vulnerability and these infrastructures to heat mortality in Maricopa County and whether these relationships are sensitive to temperature. Using Poisson regression modeling with heat-related mortality as the outcome, we assessed the interaction of increasing temperature with social vulnerability, access to publicly available air conditioned space, home air conditioning and the thermal properties of residences. As temperatures increase, mortality from heat-related illness increases less in census tracts with more publicly accessible cooled spaces. Mortality from all internal causes of death did not have this association. Building thermal protection was not associated with mortality. Social vulnerability was still associated with mortality after adjusting for the infrastructure variables. To reduce heat-related mortality, the use of public cooled spaces might be expanded to target the most vulnerable.

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

    Science.gov (United States)

    Khanna, Surbhi; Greyson, Bruce

    2014-12-01

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

  10. Most drug overdose deaths from nonprescription opioids

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-12-01

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

  11. Death Sentences: A Content Analysis of Children's Death Literature

    Science.gov (United States)

    Poling, Devereaux A.; Hupp, Julie M.

    2008-01-01

    A multidimensional concept of death must include biological, sociocultural, and emotional components. Children glean information about death in many ways, one of which is through books. In this study, the authors compared the 3 dimensions of death-related information (irreversibility, inevitability, nonfunctionality) in 24 young children's picture…

  12. A Death in the Family: Death as a Zen Concept

    Science.gov (United States)

    Black, Helen K.; Rubinstein, Robert L.

    2013-01-01

    This study is based on original research that explored family reaction to the death of an elderly husband and father. We interviewed 34 families (a family included a widow and two adult biological children) approximately 6 to 10 months after the death. In one-on-one interviews, we discussed family members' initial reaction to the death, how the…

  13. Stroke and cardiac cell death: Two peas in a pod.

    Science.gov (United States)

    Gonzales-Portillo, Chiara; Ishikawa, Hiroto; Shinozuka, Kazutaka; Tajiri, Naoki; Kaneko, Yuji; Borlongan, Cesar V

    2016-03-01

    A close pathological link between stroke brain and heart failure may exist. Here, we discuss relevant laboratory and clinical reports demonstrating neural and cardiac myocyte cell death following ischemic stroke. Although various overlapping risk factors exist between cerebrovascular incidents and cardiac incidents, stroke therapy has largely neglected the cardiac pathological consequences. Recent preclinical stroke studies have implicated an indirect cell death pathway, involving toxic molecules, that originates from the stroke brain and produces cardiac cell death. In concert, previous laboratory reports have revealed a reverse cell death cascade, in that cardiac arrest leads to ischemic cell death in the brain. A deeper understanding of the crosstalk of cell death pathways between stroke and cardiac failure will facilitate the development of novel treatments designed to arrest the global pathology of both diseases thereby improving the clinical outcomes of patients diagnosed with stroke and heart failure.

  14. RETROSPECTIVE REVIEW OF MATERNAL DEATH IN JIMMA ...

    African Journals Online (AJOL)

    User

    Hospital based reports in Addis and Jimma more than a decade ago also documented a ratio of 9.6 and 26 per 1000 ... There is no updated information on maternal death in the study area. ... This study was undertaken to analyze the current.

  15. Readmissions Complications and Deaths - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Readmissions Complications and Deaths measures - national data. This data set includes national-level data for 30-day death and readmission measures, the hip/knee...

  16. Readmissions Complications and Deaths - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Readmissions, Complications and Deaths - provider data. This data set includes provider data for 30-day death and readmission measures, the hip/knee complication...

  17. Readmissions Complications and Deaths - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Readmissions Complications and Deaths measures - state data. This data set includes state-level data for 30-day death and readmission measures, the hip/knee...

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

    Science.gov (United States)

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

    2015-01-01

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

  19. Study of maternal deaths in Kerian (1976 - 1980).

    Science.gov (United States)

    Yadav, H

    1982-06-01

    An investigation was conducted of all maternal deaths by residence which occurred in the district of Kerian, Malaysia over the 1976-1980 period. All female deaths between the years 15-45 were investigated to identify whether it was a maternal death due to obstetrical cause or otherwise. Each of the cases was investigated by the public health nurse, public health sister, and the medical officer of health before a report was made. All the maternal death reports from 1976-1980 were studied and a report compiled. The health infrastructure of Kerian district consists of 1 district hospital with 141 beds, 8 health centers, and 32 midwife clinics. The total number of deliveries in Kerian from 1976-1980 was 22,977. The hospital deliveries constituted 7040 (30.6%), the government midwives 6395 (27.8%), and traditional birth attendants (TBAs) 9505 (41.4%). The period 1976-1980 showed a decline in the various mortality rates. The infant mortality rate which is 27.11/1000 declined by 33% from 1976-1980 and toddler mortality rate declined by 37.7% from 1976-1980. The most significant decline was maternal mortality which declined from 1.89/1000 live births to 1.10/1000 live births which registered a 41.8% decline. There were a total of 35 maternal deaths registered from 1976-1980 in the district. Ethnically the Malays constituted 32 (91.4%) of all deaths and Chinese 2 (5.7%) of all deaths with Indians with 1 death (2.8%). Most of the women were from the lower income group. 19 (54.3%) of the women died at home, and 15 (42.8%) died in the hospitals. Most of the women died at gravida 6-9. Gravida 1 had 8 or 22.8% of all maternal deaths. Para 0 consisted of 9 (25.7%) of all maternal deaths and para 6 and above consisted of 11 (31.4%) of all maternal deaths. Women in the 31-40 year age group had 57.2% of the maternal deaths. PPH and PPH with retained placenta were the main causes of the maternal deaths, constituting 60% of the maternal deaths. In 1980 all 5 maternal deaths were due

  20. Eartkquake Death Tolls

    Science.gov (United States)

    Knopoff, Leon; Sornette, Didier

    1995-12-01

    In the risk and insurance literature, the (one-point) distributions of losses in natural disasters have been proposed to be characterized by “fat tail” power laws, i.e. very large destruction may occur with a non-vanishing rate. A naive hypothesis of uncorrelated Poissonian occurrence would suggest that the losses are solely characterized by the properties of the underlying power law distributions, i.e. the longer we wait, the more dramatic will be the largest disaster, which could be as much as a finite fraction of the total population or the total wealth of a country. We find indeed that the numbers Z of deaths in the very largest earthquakes of this century can be described by a power law distribution P(Z)simeq Z^{-(1+δ)} with δ=1.0±0.3, implying an unbounded behavior for the most devastating earthquakes. However, the distribution of the number of deaths per capita in each country in this century has a well-defined maximum value, suggesting that the naive extrapolation of the power law distribution is incorrect and that the understanding of correlations is necessary to ascertain the level of risk from natural disasters. The one-point distributions only provide an upper bound of the expected risk. We propose a speculative model to explain the correlations between deaths in large earthquakes and their countries of occurrence: we suggest that large ancient civilizations that have matured into large present-day populations were the beneficiaries of isolation from marauders due to the relative geographic protection by tectonic processes largely of an orogenic nature.

  1. Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States

    Science.gov (United States)

    Garcia, Macarena C; Faul, Mark; Massetti, Greta; Thomas, Cheryll C; Hong, Yuling; Bauer, Ursula E; Iademarco, Michael F

    2017-01-13

    In 2014, the all-cause age-adjusted death rate in the United States reached a historic low of 724.6 per 100,000 population (1). However, mortality in rural (nonmetropolitan) areas of the United States has decreased at a much slower pace, resulting in a widening gap between rural mortality rates (830.5) and urban mortality rates (704.3) (1). During 1999–2014, annual age-adjusted death rates for the five leading causes of death in the United States (heart disease, cancer, unintentional injury, chronic lower respiratory disease (CLRD), and stroke) were higher in rural areas than in urban (metropolitan) areas (Figure 1). In most public health regions (Figure 2), the proportion of deaths among persons aged leading causes that were potentially excess deaths was higher in rural areas compared with urban areas (Figure 3). Several factors probably influence the rural-urban gap in potentially excess deaths from the five leading causes, many of which are associated with sociodemographic differences between rural and urban areas. Residents of rural areas in the United States tend to be older, poorer, and sicker than their urban counterparts (3). A higher proportion of the rural U.S. population reports limited physical activity because of chronic conditions than urban populations (4). Moreover, social circumstances and behaviors have an impact on mortality and potentially contribute to approximately half of the determining causes of potentially excess deaths (5).

  2. Death In The Tropics

    Directory of Open Access Journals (Sweden)

    Trevor Burnard

    2012-06-01

    Full Text Available Review of: Mosquito Empires: Ecology and War in the Greater Caribbean, 1620-1914. J.R. Mcneill. New York: Cambridge University Press, 2010. xvi + 371 pp. (Paper US$ 24.99 Medicine in an Age of Commerce and Empire: Britain and its Tropical Colonies 1660-1830. Mark Harrison. Oxford: Oxford University Press, 2010. x + 353 pp. (Cloth £65.00 Death in the New World: Cross-Cultural Encounters, 1492-1800. Erik R. Seeman. Philadelphia: University of Pennsylvania Press, 2010. xii + 372 pp. (Cloth US$ 45.00

  3. Sudden Death of Entanglement

    CERN Document Server

    Yu, Ting

    2009-01-01

    A new development in the dynamical behavior of elementary quantum systems is the surprising discovery that correlation between two quantum units of information called qubits can be degraded by environmental noise in a way not seen previously in studies of dissipation. This new route for dissipation attacks quantum entanglement, the essential resource for quantum information as well as the central feature in the Einstein-Podolsky-Rosen so-called paradox and in discussions of the fate of Schr\\"{o}inger's cat. The effect has been labeled ESD, which stands for early-stage disentanglement or, more frequently, entanglement sudden death. We review recent progress in studies focused on this phenomenon.

  4. [The death of Ravel].

    Science.gov (United States)

    Kerner, D

    1975-04-04

    The composer Maurice Ravel (1875-1937) was chronically ill during the last five years of his life. He was suffering from Pick's astrophy, the first signs of which appeared in 1923 and 1927 and which were probably already reflected in the stereotypy of the "Bolero" of 1928. Transient apractic symptoms were prominent, later, difficulty in finding words, agraphia and alexia. Ravel left no completed composition after an accident to the head in 1932. Complete apathy and involutional phenomena characterize the period before the death of the master, who passed away a few days after a surgical operation on the brain.

  5. Sudden Infant Death Syndrome with Harlequin Fetus

    Directory of Open Access Journals (Sweden)

    Selahattin Katar

    2007-01-01

    Full Text Available The harlequin fetus, a severe variant of ichthyosis, occurs rarely, and these babies die within the first few days of life. Early retinoid therapy may improve the disorder and help increase survival rates. The exact cause of the sudden infant death syndrome of the suckling is not known and the incidence approximately is 0.1-0.3 %. In general, these babies looked well and healthy at the time of the sleeping but were found dead in their bed in the morning. We report a harlequin fetus with sudden infant death syndrome.

  6. Epidemiology of drowning deaths in the Philippines, 1980 to 2011

    Directory of Open Access Journals (Sweden)

    Rammell Eric Martinez

    2016-11-01

    Full Text Available Drowning kills 372 000 people yearly worldwide and is a serious public health issue in the Philippines. This study aims to determine if the drowning death rates in the Philippine Health Statistics (PHS reports from 1980 to 2011 were underestimated. A retrospective descriptive study was conducted to describe the trend of deaths caused by drowning in the Philippines from official and unofficial sources in the period 1980 to 2011. Information about deaths related to cataclysmic causes, particularly victims of storms and floods, and maritime accidents in the Philippines during the study period were reviewed and compared with the PHS drowning death data. An average of 2496 deaths per year caused by drowning were recorded in the PHS reports from 1980 to 2011 (range 671-3656. The average death rate was 3.5/100 000 population (range 1.3-4.7. An average of 4196 drowning deaths were recorded from 1980 to 2011 (range 1220 to 8788 when catacylsmic events and maritime accidents were combined with PHS data. The average death rate was 6/100 000 population (range 2.5-14.2. Our results showed that on average there were 1700 more drowning deaths per year when deaths caused by cataclysms and maritime accidents were added to the PHS data. This illustrated that drowning deaths were underestimated in the official surveillance data. Passive surveillance and irregular data management are contributing to underestimation of drowning in the Philippines. Additionally, deaths due to flooding, storms and maritime accidents are not counted as drowning deaths, which further contributes to the underestimation. Surveillance of drowning data can be improved using more precise case definitions and a multisectoral approach.

  7. Ocular microtremor in brain stem death

    Science.gov (United States)

    Bolger; Bojanic; Phillips; Sheahan; Coakley; Malone

    1999-06-01

    OBJECTIVE: This study was undertaken to establish whether measurement of ocular microtremor (OMT) activity could be used as a method to establish brain stem death. Presently, the diagnosis of brain stem death can be made using clinical criteria alone. OMT is a high-frequency, low-amplitude physiological tremor of the eye caused by impulses emanating from the brain stem. There have been a number of reports indicating that the recording of OMT may be useful in the assessment of comatose states and in establishing brain stem viability or death. METHODS: We obtained the OMT recordings of 32 patients suspected of having brain stem death using the piezoelectric strain gauge technique. This method involves mounting the piezoelectric probe in a headset and lowering the rubber-tipped end piece onto the anesthetized scleral surface of the subject. The signal produced is recorded on audiomagnetic tape and later played back and analyzed on an electrocardiographic tape analyzer. RESULTS: In 28 patients, initial clinical assessment confirmed the diagnosis of brain stem death and no OMT activity was recorded from these subjects. In three patients in whom initial clinical assessment demonstrated brain stem function, OMT activity was present; when brain stem death was subsequently diagnosed in these three patients, no OMT activity could be demonstrated. In the remaining patient, two of three OMT recordings demonstrated activity in spite of the absence of clinical evidence of brain stem function. A post mortem revealed bacterial cerebritis in this subject. CONCLUSION: The results suggest that OMT is a sensitive method of detecting brain stem life and that it could play an important role in the assessment of brain stem death.

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

    Directory of Open Access Journals (Sweden)

    Diego de Leo

    2015-10-01

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

  9. 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.

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

    Science.gov (United States)

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

    2011-01-01

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

  11. Forensic consideration of death in the bathtub.

    Science.gov (United States)

    Yoshioka, Naofumi; Chiba, Takashi; Yamauchi, Misa; Monma, Taeko; Yoshizaki, Katuaki

    2003-03-01

    About 100-120 cases of 'sudden death in bathroom' are reported every year in our prefecture, which is 8-10% of the total number of what is considered unnatural deaths. For reasons that are still unclear, the victims die while bathing in the bathtub. This baffling form of death occurs mostly in the winter season and 80-% of these are elderly persons. However, despite a full autopsy, it is sometimes still very difficult to determine the cause of death or the direct cause of drowning in the bathtub. To prevent others from this mysterious form of death and to determine the risk factors for the elderly while bathing, we examined several parameters such as physiological changes and biochemical blood analysis in a total of 54 volunteers during both the winter and summer seasons in Japan. We found that some of the elderly developed cardiac arrhythmia such as ventricular tachycardia, ventricular extrasystole, supraventricular extrasystole, and bradycardia. Also, decreases of systolic blood pressure during bathing were observed during this experiment. We conclude that the development of extrasysytole or ventricular tachycardia can be a stress involved in bathing. These changes might contribute to cardiac arrest or to drowning in the bathtub. Moreover, a sudden decrease of blood pressure is considered to be a risk factor of cerebrovascular accident.

  12. The social construction of 'dowry deaths'.

    Science.gov (United States)

    Belur, Jyoti; Tilley, Nick; Daruwalla, Nayreen; Kumar, Meena; Tiwari, Vinay; Osrin, David

    2014-10-01

    The classification of cause of death is real in its consequences: for the reputation of the deceased, for her family, for those who may be implicated, and for epidemiological and social research and policies and practices that may follow from it. The study reported here refers specifically to the processes involved in classifying deaths of women from burns in India. In particular, it examines the determination of 'dowry death', a class used in India, but not in other jurisdictions. Classification of death is situated within a framework of special legal provisions intended to protect vulnerable women from dowry-related violence and abuse. The findings are based on 33 case studies tracked in hospital in real time, and interviews with 14 physicians and 14 police officers with experience of dealing with burns cases. The formal class into which any given death is allocated is shown to result from motivated accounting processes representing the interests and resources available to the doctors, victims, victim families, the victim's husband and his family, and ultimately, the police. These processes may lead to biases in research and to injustice in the treatment of victims and alleged offenders. Suggestions are made for methods of ameliorating the risks. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Contribution of opiates in sudden asthma deaths.

    Science.gov (United States)

    Hlavaty, Leigh; Hansma, Patrick; Sung, LokMan

    2015-03-01

    Asthma is a common disease in the United States and is frequently encountered during medicolegal autopsies. Patients are often young and have a witnessed collapse or are found dead. Opiate abuse is also pervasive and is repeatedly seen in death investigations. All cases over a 7-year period involving asthma investigated at the Wayne County Medical Examiner's Office were reviewed for demographics, circumstances, autopsy toxicology findings, and cause and manner of death. Ninety-four cases met these criteria. Ten cases (10.5%) were positive for opiates, 8 listed drugs as the cause of death, and 2 listed asthma. Of cases with established asthma opiate positivity, 8 (80%) were found dead, and only one had a witnessed collapse. Compared with those without opiate abuse, asthmatic patients abusing opiates had a higher mean age, no reported respiratory symptoms immediately preceding death, and higher frequency of being found dead. A discernable difference exists between deaths in asthmatic patients in the presence of opiates and those without. These findings indicate that it may be possible to predict the presence of opiates given history investigation information, thereby focusing toxicology panels to promote cost-effective practices when ordering supportive tests.

  14. Apoyo nutricio en una mujer embarazada y con muerte cerebral: Informe de un caso y revisión de la literatura Nutritional support in a pregnant woman with brain death: Case report and literature review

    Directory of Open Access Journals (Sweden)

    G. F. Hurtado Torres

    2007-08-01

    Full Text Available La presencia de muerte cerebral en pacientes embarazadas representa una entidad catastrófica, aunque poco frecuente. Los objetivos para continuar manejo médico son: preservar la viabilidad y maduración del producto para lograr su vida extrauterina y considerar a la madre como potencial donador de órganos para trasplante; lo anterior basado en consideraciones éticas, deseos de la familia, condición del producto y edad gestacional. Con las estrategias de manejo actual en unidades de terapia intensiva es posible obtener este doble propósito, apoyados en informes de la literatura en los cuales se describe la obtención de resultados favorables. Los aspectos nutricios desempeñan un papel preponderante tanto para preservar la viabilidad y funcionalidad de órganos maternos así como para lograr el crecimiento y desarrollo del producto.The occurence of brain death represents a catastrophic entity althoug infrequent. The aim to continue medical management are focused in a double purpose: to preserve intrauterine product's life and fetal maduration until delivery and to consider the mother as a potential organ donor. Ethical considerations together with gestational age, product well being and relatives' wishes are cardinal for continuing medical support. Modern critical care units allow to obtain favourable results, supported in scientifical reports that describe successful outcomes. Nutritional aspects plays a cardinal role in the medical management, allowing to preserve mother's organs viability and also to preserve product's intrauterine growth and development.

  15. Risk factors and causes of sudden noncardiac death

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease. OBJECTIVE: The purpose of this stu...... of cardiac comorbidities. These data may guide future strategies for the follow-up of family members of nonautopsied sudden death victims, improve risk stratification, and influence public health strategies.......BACKGROUND: On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease. OBJECTIVE: The purpose of this study...... was to report the risk factors and causes of SNCD. METHODS: We conducted a retrospective, nationwide study including all deaths between 2000 and 2006 of individuals aged 1-35 years and all deaths between 2007 and 2009 of individuals aged 1-49 years. Two physicians identified all sudden death cases through...

  16. Talking about Death: Implementing Peer Discussion as a Coping Mechanism to Overcome Fears about Dissection, Death, and Dying

    Science.gov (United States)

    Kotze, Sanet Henriet; Mole, Calvin Gerald

    2013-01-01

    Many studies have reported on the perceptions of medical students toward dissection. It is important to understand the feelings and symptoms experienced during dissection so that they can be adequately handled. Prior to dissection, first year students are given lectures on aspects of dissection, death and dying, and death rituals in various…

  17. Talking about Death: Implementing Peer Discussion as a Coping Mechanism to Overcome Fears about Dissection, Death, and Dying

    Science.gov (United States)

    Kotze, Sanet Henriet; Mole, Calvin Gerald

    2013-01-01

    Many studies have reported on the perceptions of medical students toward dissection. It is important to understand the feelings and symptoms experienced during dissection so that they can be adequately handled. Prior to dissection, first year students are given lectures on aspects of dissection, death and dying, and death rituals in various…

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  19. Optimal Aging and Death

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Strulik, Holger

    2010-01-01

    This study introduces physiological aging into a simple model of optimal intertemporal consumption. In this endeavor we draw on the natural science literature on aging. According to the purposed theory, the speed of the aging process and the time of death are endogenously determined by optimal...... health investments. At the same time, physiological aspects of the aging process influence optimal savings and health investment. We calibrate the model for the average US male in 2000 and proceed to show that the calibrated model accounts well for the cross-country link between labor productivity...... and life expectancy in the same year ("the Preston curve"); cross-country income differences can explain differences in life expectancy at age 20 of up to a decade. Moreover, technological change in health care of about 1.1% per year can account for the observed shift in the Preston curve between 1980...

  20. Optimal Aging and Death

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Strulik, Holger

    2010-01-01

    This study introduces physiological aging into a simple model of optimal intertemporal consumption. In this endeavor we draw on the natural science literature on aging. According to the purposed theory, the speed of the aging process and the time of death are endogenously determined by optimal...... health investments. At the same time, physiological aspects of the aging process inuence optimal savings and health investment. We calibrate the model for the average US male in 2000 and proceed to show that the calibrated model accounts well for the cross-country link between labor productivity and life...... expectancy in the same year ("the Preston curve"); cross-country income differences can explain differences in life expectancy at age 20 of up to a decade. Moreover, technological change in health care of about 1.1% per year can account for the observed shift in the Preston curve between 1980 and 2000....

  1. Optimal Aging and Death

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Strulik, Holger

    2010-01-01

    and life expectancy in the same year ("the Preston curve"); cross-country income differences can explain differences in life expectancy at age 20 of up to a decade. Moreover, technological change in health care of about 1.1% per year can account for the observed shift in the Preston curve between 1980......This study introduces physiological aging into a simple model of optimal intertemporal consumption. In this endeavor we draw on the natural science literature on aging. According to the purposed theory, the speed of the aging process and the time of death are endogenously determined by optimal...... health investments. At the same time, physiological aspects of the aging process influence optimal savings and health investment. We calibrate the model for the average US male in 2000 and proceed to show that the calibrated model accounts well for the cross-country link between labor productivity...

  2. Death, time, and psychosis.

    Science.gov (United States)

    Lombardi, Riccardo

    2013-08-01

    Working through the awareness of death and the consciousness of time, it is hypothesized, plays a decisive role in the analytic process and in the mental growth of psychotic analysands, as well as in the integration of the psychotic areas in healthier patients. Clinical material is presented from a psychotic woman treated analytically, four sessions a week, for twelve years. The patient suffered several acute relapses, during which the analytic work was not interrupted. Her fourth psychotic episode in the course of analysis, which involved a delusion about gray men and the theft of time, is explored in particular depth. This phase fostered the patient's recognition of the value of time, together with the acquisition of her own center of psychosensory integration, the basis of an ability to learn from experience.

  3. Metalloproteins and neuronal death.

    Science.gov (United States)

    Brown, David R

    2010-03-01

    Neurodegenerative diseases include Alzheimer's and Parkinson's disease that are very common and other diseases that are notorious but occur less often such as Creutzfeldt-Jakob disease. In each case a protein is closely linked to the pathology of these diseases. These proteins include alpha-synuclein, the prion protein and Aβ. Despite first being discovered because of aggregates of these amyloidogenic proteins found in the brains of patients, these proteins all exist in the healthy brain where their normal function involves binding of metals. Recognition of these proteins as metalloproteins implies that the diseases they are associated with are possibly diseases with altered metal metabolism at their heart. This review considers the evidence that cell death in these diseases involves not just the aggregated proteins but also the metals they bind.

  4. Honor on Death Row

    Directory of Open Access Journals (Sweden)

    Judy Eaton

    2014-04-01

    Full Text Available The Southern United States is described as having a culture of honor, an argument that has been used to explain higher crime rates in the Southern United States than in the rest of the country. This research explored whether the combination of honor-related violence and traditional southern politeness norms is related to regional differences in the degree of remorse expressed by those who have committed violent crimes. It was proposed that different social norms regarding politeness and apologies in the Southern United States would be reflected in the narratives provided by offenders. The data came from the final statements that offenders on death row made before they were executed. Results showed that, compared with offenders executed in the non-Southern United States, offenders executed in the South more often apologized for their crimes in their final statements, but they were not necessarily more remorseful.

  5. Organ donations after death

    Directory of Open Access Journals (Sweden)

    Bernarda Logar

    2003-09-01

    Full Text Available The paper discusses public opinion on post-mortem organ donation, especially the difference between high support of public opinion to transplant activity, its general readiness to donate organs and the low number of signed organ donor cards. Through different approaches the article tries to point out possible factors relevant to the decision to donate organs. Early studies showed demographic variables and information as significant factors when deciding to donate organs after death. As there was not enough evidence that long-term effect through these factors is significant, the need for new investigation has grown. Social cognition theories helped understanding the difference mentioned above. It seems that the use of this approach might contribute to the understanding the problem and to delimit most useful factors when working with public.

  6. Drug overdose deaths--Florida, 2003-2009.

    Science.gov (United States)

    2011-07-08

    In the United States in 2007, unintentional poisonings were the second leading cause of injury death (after motor-vehicle crashes); approximately 93% of all unintentional poisoning deaths were caused by drug poisoning, also known as drug overdose. From 1990 to 2001 in Florida, the nonsuicidal poisoning death rate increased 325%. To characterize recent trends in drug overdose death rates in Florida, CDC analyzed data from the Florida Medical Examiners Commission. This report summarizes the results of that analysis, which found that, from 2003 to 2009, the number of annual deaths in which medical examiner testing showed lethal concentrations of one or more drugs increased 61.0%, from 1,804 to 2,905, and the death rate increased 47.5%, from 10.6 to 15.7 per 100,000 population. During 2003-2009, death rates increased for all substances except cocaine and heroin. The death rate for prescription drugs increased 84.2%, from 7.3 to 13.4 per 100,000 population. The greatest increase was observed in the death rate from oxycodone (264.6%), followed by alprazolam (233.8%) and methadone (79.2%). By 2009, the number of deaths involving prescription drugs was four times the number involving illicit drugs. These findings indicate the need to strengthen interventions aimed at reducing overdose deaths from prescription drugs in Florida. Medical examiner records are a timely, population-based source for data regarding overdose deaths from specific drugs. The data in this report and subsequent analyses can be used to design and measure the effectiveness of interventions.

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

    Science.gov (United States)

    Nadesan, K; Beng, O B

    2001-01-01

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

  8. A primatological perspective on death.

    Science.gov (United States)

    Anderson, James R

    2011-05-01

    Some questions that arise from observations of responses to dead and dying individuals by nonhuman primates are discussed, focusing on psychological issues. The phenomenon of transport and care of dead infants is reviewed, along with the consequences of the mother dying for orphaned offspring. It is argued that particular attention should be paid to how the context of a death affects individuals, for example, traumatic accidental or predation-induced death versus peaceful death following illness. Some primates kill others of their own or other species, which raises additional questions about death awareness and empathy. Observations from both the field and captivity can contribute toward a better understanding of the psychological meaning of death for primates. Some aspects of death awareness recognized by developmental psychologists might help guide research efforts in this area.

  9. Death and dying anxiety among elderly Arab Muslims in Israel.

    Science.gov (United States)

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

    2010-04-01

    Death and dying anxiety were examined among elderly Arab Muslims in Israel. A total of 145 people aged 60 and over were interviewed using a standardized questionnaire. Nursing home residents reported higher death anxiety than others; women and uneducated participants reported greater levels of fear of death and dying than others. There were no differences based on religiosity. Death anxiety was related to gender and education for elderly living in the community, but social support and self-esteem were additional correlates for those living in nursing homes. The results of this study indicate that fostering a sense that one has a supportive social and familial network is important in decreasing death and dying anxiety among elderly Arab people. It would also be beneficial to provide information and knowledge that might relieve some of the anxiety they experience.

  10. Parental divorce and parental death

    DEFF Research Database (Denmark)

    Marcussen, Jette; Thuen, Frode; Poul, Bruun

    2015-01-01

    The aim of this review was to identify research on children and adolescents who experience double bereavement, i.e. the experience of loss through parental divorce followed by either parental death or critical illness with imminent death. This knowledge may identify evidence to underpin knowledge......; challenges in both custodial and non-custodial parental death; risk of mental health problems, and the need of support and interventions....

  11. Projected temperature-related deaths in ten large U.S. metropolitan areas under different climate change scenarios.

    Science.gov (United States)

    Weinberger, Kate R; Haykin, Leah; Eliot, Melissa N; Schwartz, Joel D; Gasparrini, Antonio; Wellenius, Gregory A

    2017-10-01

    There is an established U-shaped association between daily temperature and mortality. Temperature changes projected through the end of century are expected to lead to higher rates of heat-related mortality but also lower rates of cold-related mortality, such that the net change in temperature-related mortality will depend on location. We quantified the change in heat-, cold-, and temperature-related mortality rates through the end of the century across 10 large US metropolitan areas. We applied location-specific projections of future temperature from over 40 downscaled climate models to exposure-response functions relating daily temperature and mortality in 10 US metropolitan areas to estimate the change in temperature-related mortality rates in 2045-2055 and 2085-2095 compared to 1992-2002, under two greenhouse gas emissions scenarios (RCP 4.5 and 8.5). We further calculated the total number of deaths attributable to temperature in 1997, 2050, and 2090 in each metropolitan area, either assuming constant population or accounting for projected population growth. In each of the 10 metropolitan areas, projected future temperatures were associated with lower rates of cold-related deaths and higher rates of heat-related deaths. Under the higher-emission RCP 8.5 scenario, 8 of the 10 metropolitan areas are projected to experience a net increase in annual temperature-related deaths per million people by 2086-2095, ranging from a net increase of 627 (95% empirical confidence interval [eCI]: 239, 1018) deaths per million in Los Angeles to a net decrease of 59 (95% eCI: -485, 314) deaths per million in Boston. Applying these projected temperature-related mortality rates to projected population size underscores the large public health burden of temperature. Increases in the heat-related death rate are projected to outweigh decreases in the cold-related death rate in 8 out of 10 cities studied under a high emissions scenario. Adhering to a lower greenhouse gas emissions

  12. 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 ...

  13. 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 ...

  14. 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 ...

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

    Data.gov (United States)

    U.S. Department of Health & Human Services — TABLE III. Deaths in 122 U.S. cities - 2014.122 Cities Mortality Reporting System. Each week, the vital statistics offices of 122 cities across the United States...

  16. The Fated Death of Tess

    Institute of Scientific and Technical Information of China (English)

    李莉

    2012-01-01

      The theme of this essay is about the fated deaths of Tess.The emphasis is‘inevitability’. Tess’s Death is mainly due to the social influence and man-made factors. Because of the low social status and moral conceptions, there is no living room left for Tess. Her parents push her get closer to her tragedy as well. Alec and Angel are the two persons who directly and indirectly cause Tess’s death. In addition, there are also some subjective causes for her doom. The symbolic red in the novel intentionally indicates the’inevitability’of her death.

  17. [Genetics of sudden unexplained death].

    Science.gov (United States)

    Campuzano, Oscar; Allegue, Catarina; Brugada, Ramon

    2014-03-20

    Sudden unexplained death is defined by death without a conclusive diagnosis after autopsy and it is responsible for a large percentage of sudden deaths. The progressive interaction between genetics and forensics in post-mortem studies has identified inheritable alterations responsible for pathologies associated with arrhythmic sudden death. The genetic diagnosis of the deceased enables the undertaking of preventive measures in family members, many of them asymptomatic but at risk. The implications of this multidisciplinary translational medical approach are complex, requiring the dedication of a specialized team. Copyright © 2013 Elsevier España, S.L. All rights reserved.

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

    Science.gov (United States)

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

    2008-02-01

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

  19. Death Becomes Her

    Directory of Open Access Journals (Sweden)

    Maja Sunčič

    2002-12-01

    Full Text Available The representation of women as quintessential villains in the Greek imagery makes the analysis of good or even ideal female characters a delicate task. The only foils to a gamut of women villains are but two good characters, Penelope and Alcestis. Of the two, only Alcestis can be examined in the carnivalesque context of comedy. Alcestis is excessively praised throughout the play, which at the time of carnival translates into swearing and slander. However, since each offense is nullified by the one that follows, the play can be resolved in a cheerful mood and with a great banquet. Heracles plays the role of a joker who appears to be a privileged character, allowed to say certain things in a way which confers immunity. In the funeral rites he restrains excessive grief and invites the mourning Admetus to enjoy life, love, food and drink. Untouched by pollution or sanctions despite a string of ritual offenses, the ideal woman Alcestis is portrayed as a comic female character who represents an ideal only in the carnivalesque time of laughter and rebirth. Outside the carnivalesque laughter it is immobility, silence and death that define the ideal woman.

  20. Parental relationship satisfaction after the death of a child.

    Science.gov (United States)

    Joronen, Katja; Kaunonen, Marja; Aho, Anna Liisa

    2016-09-01

    This study describes Finnish parents' (n = 461) parental relationship satisfaction and examines factors associated with relationship satisfaction after the death of a child in the family. This reported study is part of a broader investigation concerning parents' experiences after the death of a child. Most respondents were very (36%) or quite satisfied (49%) with their current relationship. Lower relationship satisfaction scores were reported by older respondents, people with poorer subjective health and people who had other living children. Causes of death other than stillbirth, need for marriage counselling and moderate or poor marital relationship of the respondents' own parents in childhood were also related to lower relationship satisfaction.

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

    DEFF Research Database (Denmark)

    Bjune, Thea; Risgaard, Bjarke; Kruckow, Line

    2017-01-01

    certificates and autopsy reports were retrieved and read to identify cases of sudden death and establish cause of death. All medico-legal autopsied SCD were included and toxicological reports collected. Positive toxicology was defined as the presence of any substance (licit and/or illicit). All toxicological...... findings had previously been evaluated not to have caused the death (i.e. lethal concentrations were excluded). We identified 620 medico-legal autopsied cases of SCD, of which 77% (n = 477) were toxicologically investigated post-mortem, and 57% (n = 270) had a positive toxicology profile. Sudden cardiac...

  2. Effects of Premature Parental Death on Subjective Life Expectancy, Death Anxiety, and Health Behavior.

    Science.gov (United States)

    Denes-Raj, Veronika; Ehrlichman, Howard

    1991-01-01

    Subjective life expectancy, death anxiety, and health behavior were assessed in college students (n=36) with at least one parent who died prematurely of illness (PD group) and students (n=36) with both parents alive (PA group). PD group estimated their life expectancy to be shorter than the PA; subgroup of PD reported poorer diet. (Author/ABL)

  3. Differences in heat-related mortality across four ecological regions with diverse urban, rural, and remote populations in British Columbia, Canada.

    Science.gov (United States)

    Henderson, Sarah B; Wan, Victoria; Kosatsky, Tom

    2013-09-01

    Temperature-mortality analyses are challenging in rural and remote communities with small populations, but this information is needed for climate change and emergency planning. The geographic health areas of British Columbia, Canada were aggregated into four ecoregions delineated by microclimatic conditions. Time series models were used to estimate the effect of maximum apparent temperature on daily non-traumatic mortality. The population of the coldest ecoregion was most sensitive to hot weather, while the population of the hottest ecoregion was least sensitive. The effects were consistently strongest in decedents aged less than 75 years. A province-wide total of 815 deaths was attributed to hot weather over the 25-year study period, with 735 deaths in the most populous ecoregion. The framework described could be adapted to other climatically variable regions with urban, rural, and remote populations.

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

    Science.gov (United States)

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

    2015-07-01

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

  5. Medical examiner and medical toxicologist agreement on cause of death

    Science.gov (United States)

    Manini, Alex F.; Nelson, Lewis S.; Olsen, Dean; Vlahov, David; Hoffman, Robert S.

    2014-01-01

    Poisoning is a significant public health threat as the second leading cause of injury-related death in the US. Disagreements on cause of death determination may have widespread implications across several realms of public health including policy and prevention efforts, interpretation of the poisoning literature, epidemiologic data analysis, medical-legal case outcomes, and individualized autopsy interpretation. We aimed to test agreement between the cause of death determined by the medical examiner (ME) and a medical toxicologist (MT) adjudication panel (MTAP) in cases of poisoning. This retrospective 7-year study evaluated all deaths attributed to poisoning in one large urban catchment area. Cross-matched data were obtained from Department of Vital Statistics and the Poison Control Center (PCC). Out of >380,000 deaths in the catchment area over the study period, there were 7050 poisonings in the Vital Statistics database and 414 deaths reported to PCC. Cross-matching yielded 321 cases for analysis. The ME and MTAP concurred on cause of death in 66%, which was only fair agreement (κ 0.25, CI 0.14–0.38). Factors associated with the likelihood of agreement were peri-mortem fire exposures, prehospital cardiac arrest, and timing of drug toxicity (chronic versus acute). In conclusion, agreement for poisoning cause of death between specialties was much lower than expected. We recommend an improved formal process of information sharing and consultation between specialties to assure that all existing information is analyzed thoroughly to enhance cause of death certainty. PMID:20655675

  6. Almost 19 million childhood injuries result in 11 thousand deaths.

    Science.gov (United States)

    Waldman, H B

    1996-01-01

    Details are provided from a series of government and private agency reports on the accidents and related deaths of children and the effectiveness of efforts being made to reduce the incidence of these tragedies. In 1992 there were 83,000 accidental deaths and more than 17 million disabling injuries in the United States costing $399 billion. The death rate was down 10 percent from 1991, and also the lowest recorded in recent years. Included in these statistics are 19 million injured children and 11 thousand dead children. The leading cause of death of children less than ten years of age was an unintentional injury. The author presents details on the accidents and related deaths, as well as the effectiveness of efforts to reduce the incidence of these accidents. From the youngest ages to the teen years, a greater number of males than females are injured and die from accident-related causes. The number of accidental deaths of children, ages five to nine years, almost equalled the number of deaths from natural causes. For children ten to fourteen years old, the number of accidental deaths was one third greater than the number from natural causes. Statistics regarding death and injury from motor vehicles, firearms, consumer products, and poison are presented.

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

    Directory of Open Access Journals (Sweden)

    Daniela Fargione

    2010-10-01

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

  8. Variability of undetermined manner of death classification in the US

    Science.gov (United States)

    Breiding, M J; Wiersema, B

    2006-01-01

    Objectives To better understand variations in classification of deaths of undetermined intent among states in the National Violent Death Reporting System (NVDRS). Design Data from the NVDRS and the National Vital Statistics System were used to compare differences among states. Main outcome measures Percentages of deaths assigned undetermined intent, rates of deaths of undetermined intent, rates of fatal poisonings broken down by cause of death, composition of poison types within the undetermined‐intent classification. Results Three states within NVDRS (Maryland, Massachusetts, and Rhode Island) evidenced increased numbers of deaths of undetermined intent. These same states exhibited high rates of undetermined death and, more specifically, high rates of undetermined poisoning deaths. Further, these three states evidenced correspondingly lower rates of unintentional poisonings. The types of undetermined poisonings present in these states, but not present in other states, are typically the result of a combination of recreational drugs, alcohol, or prescription drugs. Conclusions The differing classification among states of many poisoning deaths has implications for the analysis of undetermined deaths within the NVDRS and for the examination of possible/probable suicides contained within the undetermined‐ or accidental‐intent classifications. The NVDRS does not collect information on unintentional poisonings, so in most states data are not collected on these possible/probable suicides. The authors believe this is an opportunity missed to understand the full range of self‐harm deaths in the greater detail provided by the NVDRS system. They advocate a broader interpretation of suicide to include the full continuum of deaths resulting from self‐harm. PMID:17170172

  9. Death Drive in Tourism Studies

    NARCIS (Netherlands)

    Buda, Dorina

    2014-01-01

    The psychoanalytical concept of the death drive refers to a constant metapsychological force at the junction between life and death: it is not understood in a biological sense of physical demise of the body, nor in opposition to life. Geographies of tourist performances in places in the proximity of

  10. Studying Death: Problems of Methodology.

    Science.gov (United States)

    Simpson, Michael A.

    1980-01-01

    The methods and problems of research on the psychology of death include ethical difficulties, the conceptual poverty and oversimplification of most rating systems, and an overemphasis on anxiety and fear. The changes resulting from death education or therapy and their relation to modes of denial should be studied. (Author)

  11. Death Outlook and Social Issues.

    Science.gov (United States)

    Feifel, Herman; Schag, Daniel

    1980-01-01

    Examined the hypothesis that there is a relationship between outlook on death and orientation toward mercy killing, abortion, suicide, and euthanasia. Some relationships between death attitudes and perspectives on the social issues emphasized the need to consider specific circumstances as well as abstract concepts. (Author)

  12. Death Drive in Tourism Studies

    NARCIS (Netherlands)

    Buda, Dorina

    2014-01-01

    The psychoanalytical concept of the death drive refers to a constant metapsychological force at the junction between life and death: it is not understood in a biological sense of physical demise of the body, nor in opposition to life. Geographies of tourist performances in places in the proximity of

  13. Brain death: the European perspective.

    Science.gov (United States)

    Citerio, Giuseppe; Murphy, Paul G

    2015-04-01

    Some of the seminal steps toward the recognition and definition of brain death were European. There is a general consensus on both the medical concept of brain death in Europe as well as the minimum fundamental clinical standards that are required for its diagnosis-the absence of consciousness, brainstem reflexes, and the ability to breathe in the absence of reversible or confounding conditions. Two aspects of brain death determination are addressed in this article. The authors analyze how brain death is diagnosed across Europe, identifying both the similarities and differences that exist between countries (the latter mainly concerning ancillary tests, timing, and the number of physicians involved in the brain death determination). In addition, they describe the very considerable variations in when brain death determinations are made between and within individual European countries, and propose that they are due to differences in the end-of-life care practices in patients with irreversible brain injuries, medical attitudes, and organ donation practices. Although legislation is available to standardize the brain death diagnosis process in most individual European countries, there are still disparities across Europe as a whole. The current variation in practice makes a continental consensus for the definition of brain death imperative.

  14. Death Competence: An Ethical Imperative

    Science.gov (United States)

    Gamino, Louis A.; Ritter, R. Hal, Jr.

    2012-01-01

    The authors argued that death competence, defined as specialized skill in tolerating and managing clients' problems related to dying, death, and bereavement, is a necessary prerequisite for ethical practice in grief counseling. A selected review of the literature tracing the underpinnings of this concept reveals how a robust construct of death…

  15. Counselling via a "Death Perspective."

    Science.gov (United States)

    Seeman, Howard

    1986-01-01

    Points out the progress in the clinical literature in helping people deal with the event of death but argues there is great neglect in the literature regarding viewing death as a perspective, and its valuable clinical use. By referring to Heidegger's contributions to existential psychology, explains what is meant by this perspective and its…

  16. Exercises about death: facts, fiction, and values.

    Science.gov (United States)

    Corr, C A; Corr, D M

    1983-01-01

    Our concern in this paper is to examine exercises about death of the sort that are commonly used at the outset of death education courses and hospice training programs. We describe a variety of these exercises and report data from a representative sample of those which we have used in our own courses and workshops. Three issues are singled out for discussion: 1) compliance in the doing of these exercises; 2) content in the responses (especially as concerns timing or manner of death and focus of concern); and 3) interpretation of results (e.g., limitations of such exercises, shifts between expectations and desires, "realism," and alterations when additional considerations are introduced). Our conclusion is that we must be cautious in giving two much weight to the ostensible results of such exercises, either as regards personal significance or as research projects. Nevertheless, as we show, there is value in the process itself when seen in the light of a proper understanding of the goals of a death-related educational or training program.

  17. Imaging spectrum of sudden athlete cardiac death.

    LENUS (Irish Health Repository)

    Arrigan, M T

    2012-02-01

    Sudden athlete death (SAD) is a widely publicized and increasingly reported phenomenon. For many, the athlete population epitomize human physical endeavour and achievement and their unexpected death comes with a significant emotional impact on the public. Sudden deaths within this group are often without prior warning. Preceding symptoms of exertional syncope and chest pain do, however, occur and warrant investigation. Similarly, a positive family history of sudden death in a young person or a known family history of a condition associated with SAD necessitates further tests. Screening programmes aimed at detecting those at risk individuals also exist with the aim of reducing fatalities. In this paper we review the topic of SAD and discuss the epidemiology, aetiology, and clinical presentations. We then proceed to discuss each underlying cause, in turn discussing the pathophysiology of each condition. This is followed by a discussion of useful imaging methods with an emphasis on cardiac magnetic resonance and cardiac computed tomography and how these address the various issues raised by the pathophysiology of each entity. We conclude by proposing imaging algorithms for the investigation of patients considered at risk for these conditions and discuss the various issues raised in screening.

  18. [Psychosocial stress preceding drug-related deaths].

    Science.gov (United States)

    Kraus, L; Müller-Kalthoff, T

    2002-10-01

    This article analyses drug-related deaths in the German Federal States of Bavaria (Munich, Nuremberg and Augsburg counties) during 1999 and Baden-Wurttemberg (Stuttgart and Mannheim counties) during 1999 and in the first half of 2000. The persons who had been in contact with drug care services were studied for psychosocial stress preceding drug-related deaths. Epidemiological data from different sources (police, relatives, counselling centres, detoxification clinics, therapy and substitution treatment) were collated to estimate factors of psychosocial stress preceding drug deaths. The results in both Laender indicate high prevalence rates of a history of at least one non-fatal overdose (approx. 50%) or a suicide attempt (approx. 35%). More than 40% of the deceased had been suffering from at least one additional mental disorder, in most cases from depression. At least one critical life event (in most cases, a relapse) or a period of abstinence (i.e., due to imprisonment, therapy or detoxification) during the past three months before death was reported for more than half of the addicts. The results were discussed in the light of data on opiate users and the general population. Improved specialist training of therapeutic and medical workers as well as of any other co-operating professionals is considered a necessary prerequisite for an early detection of risk factors.

  19. Mephedrone (4-methylmethcathinone)-related deaths.

    Science.gov (United States)

    Maskell, Peter D; De Paoli, Giorgia; Seneviratne, Collin; Pounder, Derrick J

    2011-04-01

    Four deaths related to the drug 4-methylmethcathinone (mephedrone) are reported. Qualitative and quantitative analysis of mephedrone was performed by high-performance liquid chromatography-diode-array detection. Of the four deaths, one was attributed to the adverse effects of mephedrone, with cardiac fibrosis and atherosclerotic coronary artery disease as a contributing factor. A 49-year-old female insufflated mephedrone; analysis disclosed mephedrone in femoral venous blood (0.98 mg/L). The second death was attributed solely to mephedrone. A 19-year-old male took mephedrone as well as alcohol and "ecstasy"; analysis disclosed mephedrone (2.24 mg/L femoral venous blood) and 3-trifluoromethylphenylpiperazine (3-TFMPP). In the third fatality, a 55-year-old female was found dead in bed; the death was attributed to the combined effects of mephedrone and methadone. Analysis of femoral venous blood revealed the prescribed drugs diazepam, nordiazepam, olazepine, and chlorpromazine metabolites together with methadone (0.3 mg/L) and mephedrone (0.13 mg/L). In the fourth case, a 17-year-old male car driver was involved in a vehicular collision and died of multiple blunt force injuries. Analysis revealed mephedrone in femoral venous blood (0.24 mg/L).

  20. Maternal death monitoring analysis report of Siping City in the first half of 2014%四平市2014年上半年孕产妇死亡监测分析报告

    Institute of Scientific and Technical Information of China (English)

    李睿; 田雪; 安璐璐

    2014-01-01

    目的:对每例死亡孕产妇病例进行了认真评审、分析,为降低孕产妇死亡率提供科学依据。方法:收集四平市孕产妇死亡病例,明确根本死因,提出干预措施。结果:孕产妇死亡4例,死亡率62.06/10万。结论:采取干预措施,可有效降低孕产妇死亡率。%Objective:To carefully review and analyze every maternal death cases,and to provide a scientific basis for reducing maternal mortality.Methods:We selected the maternal death cases in Siping City,definited the primary cause of death,and proposed intervention measures.Results:Maternal death was 4 cases.The mortality rate was 62.06/100000.Conclusion:Taking intervention measures can effectively reduce the maternal mortality rate.

  1. Use of Rapid Ascertainment Process for Institutional Deaths (RAPID) to identify pregnancy-related deaths in tertiary-care obstetric hospitals in three departments in Haiti.

    Science.gov (United States)

    Boyd, Andrew T; Hulland, Erin N; Grand'Pierre, Reynold; Nesi, Floris; Honoré, Patrice; Jean-Louis, Reginald; Handzel, Endang

    2017-05-16

    Accurate assessment of maternal deaths is difficult in countries lacking standardized data sources for their review. As a first step to investigate suspected maternal deaths, WHO suggests surveillance of "pregnancy-related deaths", defined as deaths of women while pregnant or within 42 days of termination of pregnancy, irrespective of cause. Rapid Ascertainment Process for Institutional Deaths (RAPID), a surveillance tool, retrospectively identifies pregnancy-related deaths occurring in health facilities that may be missed by routine surveillance to assess gaps in reporting these deaths. We used RAPID to review pregnancy-related deaths in six tertiary obstetric care facilities in three departments in Haiti. We reviewed registers and medical dossiers of deaths among women of reproductive age occurring in 2014 and 2015 from all wards, along with any additional available dossiers of deaths not appearing in registers, to capture pregnancy status, suspected cause of death, and timing of death in relation to the pregnancy. We used capture-recapture analyses to estimate the true number of in-hospital pregnancy-related deaths in these facilities. Among 373 deaths of women of reproductive age, we found 111 pregnancy-related deaths, 25.2% more than were reported through routine surveillance, and 22.5% of which were misclassified as non-pregnancy-related. Hemorrhage (27.0%) and hypertensive disorders (18.0%) were the most common categories of suspected causes of death, and deaths after termination of pregnancy were statistically significantly more common than deaths during pregnancy or delivery. Data were missing at multiple levels: 210 deaths had an undetermined pregnancy status, 48.7% of pregnancy-related deaths lacked specific information about timing of death in relation to the pregnancy, and capture-recapture analyses in three hospitals suggested that approximately one-quarter of pregnancy-related deaths were not captured by RAPID or routine surveillance. Across six

  2. When Brain Death Belies Belief.

    Science.gov (United States)

    Yanke, Greg; Rady, Mohamed Y; Verheijde, Joseph L

    2016-12-01

    The case of Jahi McMath has reignited a discussion concerning how society should define death. Despite pronouncing McMath brain dead based on the American Academy of Neurology criteria, the court ordered continued mechanical ventilation to accommodate the family's religious beliefs. Recent case law suggests that the potential for a successful challenge to the neurologic criteria of death provisions of the Uniform Determination of Death Act are greater than ever in the majority of states that have passed religious freedom legislation. As well, because standard ethical claims regarding brain death are either patently untrue or subject to legitimate dispute, those whose beliefs do not comport with the brain death standard should be able to reject it.

  3. Estimating risks of perinatal death.

    Science.gov (United States)

    Smith, Gordon C S

    2005-01-01

    The relative and absolute risks of perinatal death that are estimated from observational studies are used frequently in counseling about obstetric intervention. The statistical basis for these estimates therefore is crucial, but many studies are seriously flawed. In this review, a number of aspects of the approach to the estimation of the risk of perinatal death are addressed. Key factors in the analysis include (1) the definition of the cause of the death, (2) differentiation between antepartum and intrapartum events, (3) the use of the appropriate denominator for the given cause of death, (4) the assessment of the cumulative risk where appropriate, (5) the use of appropriate statistical tests, (6) the stratification of analysis of delivery-related deaths by gestational age, and (7) the specific features of multiple pregnancy, which include the correct determination of the timing of antepartum stillbirth and the use of paired statistical tests when outcomes are compared in relation to the birth order of twin pairs.

  4. Encephalic death. ¿life or death? Ethic aspects.

    Directory of Open Access Journals (Sweden)

    Ariel Uriarte Méndez

    2006-12-01

    Full Text Available In this work a historical approach is made about the determination of death. Here is exposed how man has looked for objective criteria that allow him to state when a person has definitely died. A revision is made about the evolution of these criteria until reaching encephalic death, clinical situation that comes to light as a consequence of the intensive care development and that asks for a safe and opportune recognition due to its importance for organs donation. The encephalic death is considered by the scientific community as the subject’s death, which is supported by legislation of most countries including Cuba. This work offers data demonstrating that the criteria to define the irreversibility of encephalic functions, are safe. It is analyzed how the lack of unanimity of doctors to withdraw the assistance to a patient with encephalic death and declare him dead, shows the complexity of the theme in the sense that it implies an ethic problem. This is linked to the incomprehensible it may result to the family that a relative be dead having cardiac function. It is concluded that the concept of death is also sociocultural and that it has to be considered at the time of debating about the intensive care assistance withdrawal to a patient with encephalic death.

  5. Cause of Death Affects Racial Classification on Death Certificates

    Science.gov (United States)

    Noymer, Andrew; Penner, Andrew M.; Saperstein, Aliya

    2011-01-01

    Recent research suggests racial classification is responsive to social stereotypes, but how this affects racial classification in national vital statistics is unknown. This study examines whether cause of death influences racial classification on death certificates. We analyze the racial classifications from a nationally representative sample of death certificates and subsequent interviews with the decedents' next of kin and find notable discrepancies between the two racial classifications by cause of death. Cirrhosis decedents are more likely to be recorded as American Indian on their death certificates, and homicide victims are more likely to be recorded as Black; these results remain net of controls for followback survey racial classification, indicating that the relationship we reveal is not simply a restatement of the fact that these causes of death are more prevalent among certain groups. Our findings suggest that seemingly non-racial characteristics, such as cause of death, affect how people are racially perceived by others and thus shape U.S. official statistics. PMID:21298093

  6. Hemoperitoneo masivo consecutivo a perforación espontánea de la vesícula biliar: A propósito de un caso de muerte súbita Massive haemoperitoneum as a complication of spontaneous rupture of the gallbladder: Report of a sudden death

    Directory of Open Access Journals (Sweden)

    P.M. Garamendi

    2002-04-01

    Full Text Available Se presenta un caso de hemoperitoneo masivo consecutivo a perforación espontánea de la vesícula biliar asociada con colelitiasis, obstrucción del conducto cístico y colecistitis aguda hemorrágica que produjo como primera manifestación la muerte súbita en un varón adulto. En la literatura médica este tipo de situación clínica y anatomopatológica es excepcional. Los casos descritos de perforaciones espontáneas de la vesícula biliar con hemoperitoneo asociado son menos de 50 desde 1858. Desde 1952 solo existe otra referencia de 1991 de un hallazgo similar, aunque no asociado a colelitiasis, como causa de muerte súbita.We report a case of sudden death due to massive haemoperitoneum as a complication of spontaneous rupture of the gallbladder associated with cholelithiasis, obstruction of the cystic duct and acute haemorrhagic cholecystitis. Death occurred in an adult male previously asymptomatic. This is an unusual circumstance in the medical literature. Since 1858, less than 50 cases of spontaneous rupture of the gallbladder associated with haemoperitoneum have been reported. Since 1952, there is only one other case of sudden death with this clinical condition, reported in 1991, but not associated with cholelithiasis.

  7. The Effects of Selected Death Education Curriculum Models on Death Anxiety and Death Acceptance.

    Science.gov (United States)

    Combs, Don C.

    1981-01-01

    A comparison of the effects of didactic and experiential death education curriculums show no decrease in death anxiety from mid- to posttesting for any treatment group. Anxiety was increased from pre- to mid-testing for some students. Results may be due to model deficiencies. Further research is suggested. (JAC)

  8. Sudden and unexpected death from pituitary tumor apoplexy.

    Science.gov (United States)

    Shields, Lisa B E; Balko, M Gregory; Hunsaker, John C

    2012-01-01

    Pituitary tumor apoplexy refers to a clinical syndrome precipitated by the expansion of a pituitary adenoma by hemorrhage or infarction. Individuals may present with myriad signs, including sudden onset of severe headache, visual changes, altered mental status, cranial nerve palsies, and hormonal dysfunction. This disorder constitutes a medical emergency and warrants an expedited evaluation, diagnosis, and treatment to prevent the potential sequelae of permanent visual loss, endocrine abnormalities, or death. We report a case of sudden death from undiagnosed pituitary tumor apoplexy. The decedent was evaluated by medical personnel on three occasions in the week prior to her death for severe headache, nausea, vomiting, and photophobia. Postmortem examination demonstrated a hemorrhagic infarction of a pituitary adenoma with necrosis and expansion out of the sella turcica. The recognition of and treatment for a patient with pituitary tumor apoplexy requires a rapid multidisciplinary effort. Failure of prompt diagnosis may be fatal and require a medico-legal death investigation for sudden and unexpected death.

  9. Glutathione Efflux and Cell Death

    Science.gov (United States)

    2012-01-01

    Abstract Significance: Glutathione (GSH) depletion is a central signaling event that regulates the activation of cell death pathways. GSH depletion is often taken as a marker of oxidative stress and thus, as a consequence of its antioxidant properties scavenging reactive species of both oxygen and nitrogen (ROS/RNS). Recent Advances: There is increasing evidence demonstrating that GSH loss is an active phenomenon regulating the redox signaling events modulating cell death activation and progression. Critical Issues: In this work, we review the role of GSH depletion by its efflux, as an important event regulating alterations in the cellular redox balance during cell death independent from oxidative stress and ROS/RNS formation. We discuss the mechanisms involved in GSH efflux during cell death progression and the redox signaling events by which GSH depletion regulates the activation of the cell death machinery. Future Directions: The evidence summarized here clearly places GSH transport as a central mechanism mediating redox signaling during cell death progression. Future studies should be directed toward identifying the molecular identity of GSH transporters mediating GSH extrusion during cell death, and addressing the lack of sensitive approaches to quantify GSH efflux. Antioxid. Redox Signal. 17, 1694–1713. PMID:22656858

  10. Psychosocial Aspects of the Sudden Infant Death Syndrome ("Cot Death").

    Science.gov (United States)

    Bluglass, Kerry

    1981-01-01

    Reviews literature on reactions of parents and siblings to Sudden Infant Death Syndrome (SIDS). The prospects for prolonged, adverse reactions are considered, and professional concerns regarding abnormal adaptation are noted. (Author/DB)

  11. QALYs, euthanasia and the puzzle of death.

    Science.gov (United States)

    Barrie, Stephen

    2015-08-01

    This paper considers the problems that arise when death, which is a philosophically difficult concept, is incorporated into healthcare metrics, such as the quality-adjusted life year (QALY). These problems relate closely to the debate over euthanasia and assisted suicide because negative QALY scores can be taken to mean that patients would be 'better off dead'. There is confusion in the literature about the meaning of 0 QALY, which is supposed to act as an 'anchor' for the surveyed preferences on which QALYs are based. In the context of the debate over euthanasia, the QALY assumes an ability to make meaningful comparisons between life-states and death. Not only is this assumption questionable, but the ethical debate is much more broad than the question of whether death is preferable to a state of living. QALYs are derived from preferences about health states, so do not necessarily reflect preferences about events (eg, dying) or actions (eg, killing). This paper presents a new kind of problem for the QALY. As it stands, the QALY provides confused and unreliable information when it reports zero or negative values, and faces further problems when it appears to recommend death. This should preclude its use in the debate over euthanasia and assisted suicide. These problems only apply where the QALY involves or seems to involve a comparison between life-states and death, and are not relevant to the more general discussion of the use of QALYs as a tool for comparing the benefits derived from treatment options. 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.

  12. The diagnosis of brain death

    Directory of Open Access Journals (Sweden)

    Goila Ajay

    2009-01-01

    Full Text Available Physicians, health care workers, members of the clergy, and laypeople throughout the world have accepted fully that a person is dead when his or her brain is dead. Although the widespread use of mechanical ventilators and other advanced critical care services have transformed the course of terminal neurologic disorders. Vital functions can now be maintained artificially for a long period of time after the brain has ceased to function. There is a need to diagnose brain death with utmost accuracy and urgency because of an increased awareness amongst the masses for an early diagnosis of brain death and the requirements of organ retrieval for transplantation. Physicians need not be, or consult with, a neurologist or neurosurgeon in order to determine brain death. The purpose of this review article is to provide health care providers in India with requirements for determining brain death, increase knowledge amongst health care practitioners about the clinical evaluation of brain death, and reduce the potential for variations in brain death determination policies and practices amongst facilities and practitioners. Process for brain death certification has been discussed under the following: 1. Identification of history or physical examination findings that provide a clear etiology of brain dysfunction. 2. Exclusion of any condition that might confound the subsequent examination of cortical or brain stem function. 3. Performance of a complete neurological examination including the standard apnea test and 10 minute apnea test. 4. Assessment of brainstem reflexes. 5. Clinical observations compatible with the diagnosis of brain death. 6. Responsibilities of physicians. 7. Notify next of kin. 8. Interval observation period. 9. Repeat clinical assessment of brain stem reflexes. 10. Confirmatory testing as indicated. 11. Certification and brain death documentation.

  13. Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death

    Directory of Open Access Journals (Sweden)

    Makiko Naka Mieno

    2016-04-01

    Full Text Available Background: Cause of death (COD information taken from death certificates is often inaccurate and incomplete. However, the accuracy of Underlying CODs (UCODs recorded on death certificates has not been comprehensively described when multiple diseases are present. Methods: A total of 450 consecutive autopsies performed at a geriatric hospital in Japan between February 2000 and August 2002 were studied. We evaluated the concordance rate, sensitivity, and specificity of major UCODs (cancer, heart disease, and pneumonia reported on death certificates compared with a reference standard of pathologist assessment based on autopsy data and clinical records. Logistic regression analysis was performed to assess the effect of sex, age, comorbidity, and UCODs on misclassification. Results: The concordance rate was relatively high for cancer (81% but low for heart disease (55% and pneumonia (9%. The overall concordance rate was 48%. Sex and comorbidity did not affect UCOD misclassification rates, which tended to increase with patient age, although the association with age was also not significant. The strongest factor for misclassification was UCODs (P < 0.0001. Sensitivity and specificity for cancer were very high (80% and 96%, respectively, but sensitivity for heart disease and pneumonia was 60% and 46%, respectively. Specificity for each UCOD was more than 85%. Conclusions: Researchers should be aware of the accuracy of COD data from death certificates used as research resources, especially for cases of elderly patients with pneumonia.

  14. Is there science behind the near-death experience: Does human consciousness survives after death?

    Directory of Open Access Journals (Sweden)

    Pranab Kumar Bhattacharya

    2013-01-01

    Full Text Available Near death experiences (NDEs have been reported throughout world in essentially all cultures, including amongst the believers of the Hindu religion The contents of NDEs are independent of the gender, age, profession, religion, belief of soul, belief in angels of death or ghosts and belief in death kingdom and heaven, of people who experienced it. The frequency of occurrence is estimated to be between 5% to 48% in adults, and around 85% in children who experienced near-death situations. This frequency may be higher still, perhaps even 100 percent, were it not for the dreamlike and dissociative character of these experiences, and the amnesia-prone participation of the temporal lobe cortex of brain, causing a clear tendency to forget the NDE. A number of experiences can be very similar to NDEs, such as review of one′s life in this planet, or an out-of-body experience (OBE, in which the physical body and its surroundings are observed from various external vantage points, often from above, such that the body is passing through a deep dark tunnel, or seeing flash of light equal to thousands of sun for pure souls. The experience of seeing God and conversing with him, seeing alien lands, seeing dead relatives or someone′s future, can all be regarded as similar in nature. Many individuals have reported horror experiences as well. Numerous cases-are existing in which the reality of the the OBE-observation can be independently ′verified, by external conditions, situations, people, objects, etc. Even people who are non-religious, subsequent to NDE experiences have displayed a markedly decreased fear of death, and a corresponding increase in the belief in "life after death" and re-incarnation. Certain elements of NDE- experiences can be induced by drugs, such as hallucinogenic substances and anesthetic drugs like ketamine, and electrical stimulation of the right temporal lobe or the limbic system has also produced such effects. The possibility that the

  15. [Brain death--a certain sign of death].

    Science.gov (United States)

    Angstwurm, H

    1990-10-01

    Brain death means a complete and irreversible loss of all brain activity during intensive care with mechanical ventilation. On autopsy is seen an ischemic infarct of the whole brain following the stopped blood flow in the intracranial cavity after the elevation of the pressure. With brain death a human being loses two characteristics of its earthly life, the physical base needed for his spirit and his soul in this world, and the integration, the unity as the independent and self-contained organism.

  16. Antenatal cardiotocography and intrauterine death.

    Science.gov (United States)

    Solum, T; Sjöberg, N O

    1980-01-01

    The purpose of the present study was to elucidate the reliability of antenatal cardiotocography (CTG) in predicting fetal death. During a 4-year period, 1 455 patients eith risk pregnancies have been routinely monitored with antenatal CTG. The total number of tracings amounted to more than 10 000. Five cases of fetal death occurred, in all of which pathological CTG patterns were found. Our experience in the present study indicates that antenatal CTG is a reliable technique for the predicting of fetal death and its use should reduce fetal mortality rates.

  17. Sudden unexpected death in epilepsy: Evaluation of forensic autopsy cases.

    Science.gov (United States)

    Zhuo, Luo; Zhang, Yang; Zielke, H Ronald; Levine, Barry; Zhang, Xiang; Chang, Lin; Fowler, David; Li, Ling

    2012-11-30

    Epilepsy is a common chronic neurological disorder characterized by seizures. Mortality is significantly increased in patients with epilepsy. Sudden unexpected death in epilepsy (SUDEP) is the most common seizure-related category of death. A retrospective study of forensic autopsy cases from 2007 to 2009 at the Office of the Chief Medical Examiner (OCME) yielded a total of 104 sudden unexpected deaths directly or indirectly caused by an epilepsy/seizure disorder in the State of Maryland. Of these deaths, 74 cases met a general accepted definition of SUDEP. The age of SUDEP individuals ranged from 14 to 63 with the majority of subjects in the ages between 21 and 50 years (58 cases, 78.4%). Males were slightly more likely than females to die of SUDEP (male:female=1.5:1 based on the rate). The onset age of epilepsy was documented in 47.3% of cases (35/74) based on investigation and medical records. Of the 35 cases, 12 subjects had early onset epilepsy (onset ages 1-15 years) and 20 subjects had duration of epilepsy for more than 10 years. The majority of deaths (61 of the 74 cases, 82.4%) were unwitnessed. Death scene investigation showed that 71 deaths (95.9%) occurred inside their residence with 50 subjects (70.4%) found either in bed or on the bedroom floor near the bed. Forty-three out of 74 cases (58.1%) showed neuropathological lesions. Per history, 50 subjects were reported as being on anti-epileptic drugs (AEDs). However, postmortem toxicological analysis revealed that only 26 subjects (35.1%) had detectable AEDs. Of the 74 cases, seizure disorder or epilepsy was listed as primary cause of death in 66 cases and the term of SUDEP as official cause of death in only 8 cases. This report focuses on the characteristics of death scene investigation and postmortem examination findings of SUDEP cases.

  18. Cause-of-death ascertainment for deaths that occur outside hospitals in Thailand: application of verbal autopsy methods

    Directory of Open Access Journals (Sweden)

    Pattaraarchachai Junya

    2010-05-01

    Full Text Available Abstract Background Ascertainment of cause for deaths that occur in the absence of medical attention is a significant problem in many countries, including Thailand, where more than 50% of such deaths are registered with ill-defined causes. Routine implementation of standardized, rigorous verbal autopsy methods is a potential solution. This paper reports findings from field research conducted to develop, test, and validate the use of verbal autopsy (VA methods in Thailand. Methods International verbal autopsy methods were first adapted to the Thai context and then implemented to ascertain causes of death for a nationally representative sample of 11,984 deaths that occurred in Thailand in 2005. Causes of death were derived from completed VA questionnaires by physicians trained in ICD-based cause-of-death certification. VA diagnoses were validated in the sample of hospital deaths for which reference diagnoses were available from medical record review. Validated study findings were used to adjust VA-based causes of death derived for deaths in the study sample that had occurred outside hospitals. Results were used to estimate cause-specific mortality patterns for deaths outside hospitals in Thailand in 2005. Results VA-based causes of death were derived for 6,328 out of 7,340 deaths in the study sample that had occurred outside hospitals, constituting the verification arm of the study. The use of VA resulted in large-scale reassignment of deaths from ill-defined categories to specific causes of death. The validation study identified that VA tends to overdiagnose important causes such as diabetes, liver cancer, and tuberculosis, while undercounting deaths from HIV/AIDS, liver diseases, genitourinary (essential renal, and digestive system disorders. Conclusions The use of standard VA methods adapted to Thailand enabled a plausible assessment of cause-specific mortality patterns and a substantial reduction of ill-defined diagnoses. Validation studies

  19. Two programmed cell death systems in Escherichia coli: an apoptotic-like death is inhibited by the mazEF-mediated death pathway.

    Directory of Open Access Journals (Sweden)

    Ariel Erental

    Full Text Available In eukaryotes, the classical form of programmed cell death (PCD is apoptosis, which has as its specific characteristics DNA fragmentation and membrane depolarization. In Escherichia coli a different PCD system has been reported. It is mediated by the toxin-antitoxin system module mazEF. The E. coli mazEF module is one of the most thoroughly studied toxin-antitoxin systems. mazF encodes a stable toxin, MazF, and mazE encodes a labile antitoxin, MazE, which prevents the lethal effect of MazF. mazEF-mediated cell death is a population phenomenon requiring the quorum-sensing pentapeptide NNWNN designated Extracellular Death Factor (EDF. mazEF is triggered by several stressful conditions, including severe damage to the DNA. Here, using confocal microscopy and FACS analysis, we show that under conditions of severe DNA damage, the triggered mazEF-mediated cell death pathway leads to the inhibition of a second cell death pathway. The latter is an apoptotic-like death (ALD; ALD is mediated by recA and lexA. The mazEF-mediated pathway reduces recA mRNA levels. Based on these results, we offer a molecular model for the maintenance of an altruistic characteristic in cell populations. In our model, the ALD pathway is inhibited by the altruistic EDF-mazEF-mediated death pathway.

  20. Brought in Dead: An Avoidable Delay in Maternal Deaths.

    Science.gov (United States)

    Kumar, Aruna; Agrawal, Neha

    2016-10-01

    Maternal brought in dead are the patient who dies in the need of adequate medical care. These deaths are often not analyzed sincerely as they are not institutional deaths. Our aim is to find out actual life threatening cause of delay leading to death. Patients brought dead to casualty were seen by the doctors on duty in Department of Obstetrics and Gynaecology,Gandhi Medical College, Bhopal round the clock. Cause of death was analyzed by verbal autopsy of attendants and referral letter from the institute. In this analytical study a complete evaluation of brought deaths from January 2011 to Decmeber 2014 was done. A total of 64 brought in deaths were reported in this 4 year duration. Most common cause of death was postpartum hemorrhage (54.68 %) followed by hypertension (15.62 %) and the most common cause of delay was delay in getting adequate treatment (56.25 %). The brought in dead are the indicator of the three delays in getting health care. Challenges appear to be enormous to be tackled. Timely management proves to be critical in preventing maternal death. Thus it appears that community education about pregnancy and its complications, EmOC training at FRU and strict adherence to referral protocol may help us to reduce the brought dead burden.

  1. Phenoxide-bridged Zinc(II)-Bis(dipicolylamine) Probes for Molecular Imaging of Cell Death

    OpenAIRE

    Clear, Kasey J.; Harmatys, Kara M.; Rice, Douglas R.; Wolter, William R.; Suckow, Mark A.; Wang, Yuzhen; Rusckowski, Mary; Smith, Bradley D.

    2015-01-01

    Cell death is involved in many pathological conditions, and there is a need for clinical and preclinical imaging agents that can target and report cell death. One of the best known biomarkers of cell death is exposure of the anionic phospholipid phosphatidylserine (PS) on the surface of dead and dying cells. Synthetic zinc(II)-bis(dipicolylamine) (Zn2BDPA) coordination complexes are known to selectively recognize PS-rich membranes and act as cell death molecular imaging agents. However, there...

  2. Spinal reflexes in brain death.

    Science.gov (United States)

    Beckmann, Yesim; Çiftçi, Yeliz; Incesu, Tülay Kurt; Seçil, Yaprak; Akhan, Galip

    2014-12-01

    Spontaneous and reflex movements have been described in brain death and these unusual movements might cause uncertainties in diagnosis. In this study we evaluated the presence of spinal reflexes in patients who fulfilled the criteria for brain death. Thirty-two (22 %) of 144 patients presented unexpected motor movements spontaneously or during examinations. These patients exhibited the following signs: undulating toe, increased deep tendon reflexes, plantar responses, Lazarus sign, flexion-withdrawal reflex, facial myokymia, neck-arm flexion, finger jerks and fasciculations. In comparison, there were no significant differences in age, sex, etiology of brain death and hemodynamic laboratory findings in patients with and without reflex motor movement. Spinal reflexes should be well recognized by physicians and it should be born in mind that brain death can be determined in the presence of spinal reflexes.

  3. Introduction: Mediating and Remediating Death

    DEFF Research Database (Denmark)

    2014-01-01

    . These are analyzed through a vast number of theoretical and analytical perspectives in order to investigate how very diverse practices surrounding death and dying - mourning and commemoration, ritualization, politicization, re-enactment, traditionalization, activism or documentarism: private or public, offline...

  4. Sudden cardiac death in athletes

    Directory of Open Access Journals (Sweden)

    Fábio Camilo Pellegrino dos Santos

    2012-11-01

    Full Text Available ABSTRACT The most accepted definition of sudden cardiac death nowadays is an unexplained death occurred suddenly within one hour of symptom onset. If it was not witnessed, individuals need to had been observed for at least 24 hours before the event and should be discarded the possibility of non cardiac causes of sudden death, pulmonary embolism or extensive malignancy. The term athlete refers to individuals of any age who participate in collective or individual regular physical activity, as well as physical training program for regular competitions. The sudden death of a young athlete, whether amateur or professional, especially during competitions, is always dramatic, with strong negative social impact and in the media. The fact that sports are recommended as a formula for longevity and quality of life makes these events a cause for concern in sports and society in general.

  5. Brain death: the Asian perspective.

    Science.gov (United States)

    Chua, Hoe Chin; Kwek, Tong Kiat; Morihara, Hirofumi; Gao, Daiquan

    2015-04-01

    Asia is the largest and most populous continent in the world with people from many diverse ethnic groups, religions and government systems. The authors surveyed 14 countries accounting for the majority of Asia's population and found that, although the concept of brain death is widely accepted, there is wide variability in the criteria for certification. Although most Asian countries have adopted the "whole-brain" concept of brain death, most countries with past colonial links to the United Kingdom follow the UK "brainstem" concept of brain death. Despite this difference, most countries require only neurologic testing of irreversible coma and absent brainstem reflexes as criteria for certification of brain death. Variability exists in the number of personnel required, qualifications of certifying doctors, need for repeat examination, minimum time interval between examinations, and requirement for and choice of confirmatory tests.

  6. Death and conception.

    Science.gov (United States)

    Bahadur, G

    2002-10-01

    The complex moral, ethical and legal concerns that have arisen as a result of posthumous assisted reproduction (PAR) are examined in this report. Difficult questions such as what constitutes informed consent, and whether it is ethical to retrieve spermatozoa from patients who are in a coma, are considered. Legal issues, such as whether gametes can be considered as property and the need to clarify the legal definition of paternity in cases of children born in such circumstances, are also discussed, while other points regarding the advisability of PAR, respecting the wishes of the deceased donor and the need to protect the interests of the unborn child, are outlined. The motives of the gestating women, viewing their desire for PAR perhaps as part of the grieving process, and the effects on the children concerned are examined; it is concluded that there appears to be no adverse effect, but this finding might be premature. The report also asserts the need for responsible accounting on the part of fertility clinics, and calls for fairness, transparency and patience to help the bereaved reach an unbiased yet informed decision. This may be achieved by offering ample time for informed and support counselling. Finally, consideration should be expressed for the welfare of unborn child, in a balanced, pragmatic and sensible manner.

  7. Autoerotic death due to electrocution

    Directory of Open Access Journals (Sweden)

    Piotr Arkuszewski

    2014-08-01

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

  8. 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).

  9. Western Scientific Approaches to Near-Death Experiences

    Directory of Open Access Journals (Sweden)

    Bruce Greyson

    2015-11-01

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

  10. [The registration of deaths in Venezuela: an evaluation of coverage].

    Science.gov (United States)

    Bidegain, G; Lopez, D

    1987-08-01

    "This paper presents six indirect techniques for estimating the degree of death coverage as applied to vital statistics information in Venezuela between 1960 and 1982, collected by two public institutions, namely, the 'Oficina Central de Estadistica e Informatica' (OCEI) and the Ministry of Health and Social Assistance (MSAS).... The results show remarkable improvements in the death registry coverage for both institutions, that amount to 97 or 98 per cent at the beginning of the 80's. Nevertheless, great differences can be observed between them regarding both structure and volume of deaths by sex and age." Among the problems discussed are the impact of immigration and errors in age reporting. (SUMMARY IN ENG)

  11. Dowry Deaths: Response to Weather Variability in India☆

    Science.gov (United States)

    Sekhri, Sheetal; Storeygard, Adam

    2014-01-01

    We examine the effect of rainfall shocks on dowry deaths using data from 583 Indian districts for 2002–2007. We find that a one standard deviation decline in annual rainfall from the local mean increases reported dowry deaths by 7.8 percent. Wet shocks have no apparent effect. We examine patterns of other crimes to investigate whether an increase in general unrest during economic downturns explains the results but do not find supportive evidence. Women’s political representation in the national parliament has no apparent mitigating effect on dowry deaths. PMID:25386044

  12. Dowry Deaths: Response to Weather Variability in India.

    Science.gov (United States)

    Sekhri, Sheetal; Storeygard, Adam

    2014-11-01

    We examine the effect of rainfall shocks on dowry deaths using data from 583 Indian districts for 2002-2007. We find that a one standard deviation decline in annual rainfall from the local mean increases reported dowry deaths by 7.8 percent. Wet shocks have no apparent effect. We examine patterns of other crimes to investigate whether an increase in general unrest during economic downturns explains the results but do not find supportive evidence. Women's political representation in the national parliament has no apparent mitigating effect on dowry deaths.

  13. In the shadow of death.

    Science.gov (United States)

    Meissner, W W

    1995-08-01

    Death dogged Vincent's footsteps throughout his life, and formed a core component of his unconscious fantasy system. It cast a lugubrious shadow over all of his undertakings--he found little joy and less love in life. It found its way onto his canvases, both directly--the grinning death's head--and indirectly. It found expression in his portrayals of sowers and reapers, in his representations of trees--especially the highly symbolic treatments of cypresses--in the menacing crows hovering over storm-darkened fields of wheat, and finally in the images of Christ, suffering and dead, held in the embrace of a loving and grieving mother. If death was a bottomless pit that haunted him with its terrors, it was also a siren song that drew him ever closer to his destiny, ever closer to the edge of the pit. The power of that attraction lies in his identification with the dead Vincent whose place he had taken and whose name he bore. It was through that identification, and through the passageway of suffering and death that he would surcease in the arms of a loving and accepting mother whose warm embrace he had sought throughout his odyssey, but in vain. It was to be gained only in and through death. It was only through death that he would find rest from his pain and would gain the heavenly reward of his suffering in eternal love and bliss.

  14. Experimental observation of partial amplitude death in coupled chaotic oscillators

    Institute of Scientific and Technical Information of China (English)

    Liu Wei-Qing; Yang Jun-Zhong; Xiao Jing-Hua

    2006-01-01

    The dynamics of coupled Lorenz circuits is investigated experimentally. The partial amplitude death reported in Phys. Rev. E 72, 057201 (2005) is verified by physical experiments with electronic circuits. With the increase of coupling constant, the coupled circuits undergo the transition from the breakdown of both the reflection symmetry and the translational symmetry to the partial amplitude death. Its stability is also confirmed by analysing the effects of noise.

  15. Ten Leading Causes of Death and Injury

    Science.gov (United States)

    ... Drug Overdose Traumatic Brain Injury Violence Prevention Ten Leading Causes of Death and Injury Recommend on Facebook ... Treated in Hospital Emergency Departments, United States – 2014 Leading Causes of Death Charts Causes of Death by ...

  16. FastStats: Leading Causes of Death

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Leading Causes of Death Recommend on Facebook Tweet Share Compartir Number of deaths for leading causes of death Heart disease: 633,842 • Cancer: ...

  17. Death by information overload.

    Science.gov (United States)

    Hemp, Paul

    2009-09-01

    The value of information in the knowledge economy is indisputable, but so is its capacity to overwhelm consumers of it. HBR contributing editor Hemp reports on practical ways for individuals and organizations to avoid getting too much of a good thing. Ready access to useful information comes at a cost: As the volume increases, the line between the worthwhile and the distracting starts to blur. And ready access to you--via e-mail, social networking, and so on--exacerbates the situation: On average, Intel executives get 300 e-mails a day, and Microsoft workers need 24 minutes to return to work after each e-mail interruption. Clearly, productivity is taking a hit. Technological aids can help, such as e-mail management software for you, a message-volume regulation system for your organization, or even more-sophisticated solutions being developed by Microsoft, IBM, and others. Yet, battling technological interruptions on their own turf only goes so far. You also need to change your mind-set, perhaps by seeking help from personal-productivity experts or by simply accepting that you can't respond to every distraction that flits across your screen. Similarly, organizations must change their cultures, for instance by establishing clear e-communication protocols. In the end, only a multipronged approach will help you and your organization subdue the multiheaded monster of information overload. The secret is to manage the beast while still respecting it for the beautiful creature it is.

  18. Influenza Vaccine Effectiveness Against Pediatric Deaths: 2010-2014.

    Science.gov (United States)

    Flannery, Brendan; Reynolds, Sue B; Blanton, Lenee; Santibanez, Tammy A; O'Halloran, Alissa; Lu, Peng-Jun; Chen, Jufu; Foppa, Ivo M; Gargiullo, Paul; Bresee, Joseph; Singleton, James A; Fry, Alicia M

    2017-05-01

    Surveillance for laboratory-confirmed influenza-associated pediatric deaths since 2004 has shown that most deaths occur in unvaccinated children. We assessed whether influenza vaccination reduced the risk of influenza-associated death in children and adolescents. We conducted a case-cohort analysis comparing vaccination uptake among laboratory-confirmed influenza-associated pediatric deaths with estimated vaccination coverage among pediatric cohorts in the United States. Case vaccination and high-risk status were determined by case investigation. Influenza vaccination coverage estimates were obtained from national survey data or a national insurance claims database. We estimated odds ratios from logistic regression comparing odds of vaccination among cases with odds of vaccination in comparison cohorts. We used Bayesian methods to compute 95% credible intervals (CIs) for vaccine effectiveness (VE), calculated as (1 - odds ratio) × 100. From July 2010 through June 2014, 358 laboratory-confirmed influenza-associated pediatric deaths were reported among children aged 6 months through 17 years. Vaccination status was determined for 291 deaths; 75 (26%) received vaccine before illness onset. Average vaccination coverage in survey cohorts was 48%. Overall VE against death was 65% (95% CI, 54% to 74%). Among 153 deaths in children with underlying high-risk medical conditions, 47 (31%) were vaccinated. VE among children with high-risk conditions was 51% (95% CI, 31% to 67%), compared with 65% (95% CI, 47% to 78%) among children without high-risk conditions. Influenza vaccination was associated with reduced risk of laboratory-confirmed influenza-associated pediatric death. Increasing influenza vaccination could prevent influenza-associated deaths among children and adolescents. Copyright © 2017 by the American Academy of Pediatrics.

  19. Renal allografts from pediatric donors after cardiac death:One case report%儿童心脏死亡器官捐献与肾脏移植1例报告★

    Institute of Scientific and Technical Information of China (English)

    杨顺良; 郭君其; 张伟; 吴晓智; 高霞; 蔡锦全; 谭建明

    2013-01-01

    death legislation and diagnostic criteria, the Ministry of Health and the Red Cross Society of China have jointly promote the cardiac death organ donation. OBJECTIVE: To investigate the feasibility of organ donation from pediatric donors after cardiac death. METHODS: One case of organ donation from a pediatric donor at Fuzhou General Hospital of Nanjing Military Command of PLA was retrospectively analyzed combined with the analysis of the literatures. RESULTS AND CONCLUSION: A 4-year-old boy was independently diagnosed with brain death after cardiopulmonary resuscitation by two groups of specialists at an interval of 24 hours. The criteria included the Diagnostic Criteria for Brain Death (for adults), the Technological Specification for Brain Death (for adults) and atropine test results. The donor parents should be informed and consent with the donor programs and ful y expressed the donation wil ingness, and the program should be approved by the hospital ethics committee. The fol owing steps including donation application, approval, transportation, organ maintaining, mechanical support removal and organ recovery were conducted according to the organ donation guidelines in China after cardiac death. The warm ischemia time was 13 minutes. Two renal grafts were transplanted to two uremic recipients selected by age, weight and human leukocyte antigen matching. The left kidney recipient was a 13-year-old female patient and the right kidney recipient was a 35-year-old female patient. No complications such as delayed graft function, renal graft vascular thrombosis, urinary fistula or ureteral obstruction were observed. The graft length was increased from 7 cm postoperation to 10 cm at 1 year after operation, with negative proteinuria, serum creatinine of 60 μmol/L and estimated glomerular filtration rate was ranged from 70 to 150 mL/min. No long term complications such as serious infections, hypertension, diabetes, hyperlipidemia or liver dysfunction were observed. The

  20. Death of an infant involving benzocaine.

    Science.gov (United States)

    Logan, Barry K; Gordon, Ann Marie

    2005-11-01

    This report describes the death of a four-month-old Hispanic male which may be related to benzocaine toxicity. A toxicological evaluation revealed benzocaine at a concentration of 3.48 mg/L, and postmortem methemoglobin of 36% (normal 0.4-1.5). Methemoglobinemia is a complication of benzocaine toxicity. In light of the toxicology findings, the coroner investigated the source of the benzocaine and discovered that the child was treated with Zenith Goldline Allergen Ear Drops containing 0.25% w/v benzocaine and 5.4% w/v antipyrine. There was an admission by a caregiver that on the day prior to the child's death, he had been treated with three times the prescribed dose. Blood benzocaine concentrations in nine other unrelated cases were determined and concentrations ranged from benzocaine positive cases ranged from 6-69%; however, methemoglobin concentrations in postmortem cases are frequently elevated and should be interpreted with caution. The unknown significance of the benzocaine, and the circumstances of the case raise questions about the ultimate attribution of this death to SIDS.