Meaning of death: an exploration of perception of elderly in a Bangladeshi village.

PubMed

Joarder, Taufique; Cooper, Alicia; Zaman, Shahaduz

2014-09-01

The aim of this qualitative study was to explore the perceptions of meaning of death among the elderly in a Bangladeshi community, and to understand how the meaning of death affects one's overall well-being. Understandings of death were explored through the explanations respondents provided on the journey of the soul during lifetime and the afterlife, concepts of body-soul duality, and perceived "good" and "bad" deaths. The relationship to well-being was expressed in terms of longevity, anxiety/acceptance of death, and preferred circumstances for death. Seven in-depth interviews and one informal discussion session provided the bulk of the data, while Participatory Rapid Appraisal (PRA) tools, including daily routines and body mapping, supplemented our findings. Elderly members of the community had very specific ideas about the meaning of death, and provided clear explanations regarding the journey of the soul, drawing on ideas of body-soul duality to substantiate claims. Due to long coexistence fusion of Hindu and Muslim ideas around death was found. Anxiety/fear of death was associated with some secular issues, on the contrary the perception of longevity was found linked with spirituality. Insights revealed from this study of subtle differences in the perceptions regarding issues around death may aid the policy makers develop effective end-of-life interventions.

Growth and death of bacteria and fungi underlie rainfall-induced carbon dioxide pulses from seasonally dried soil.

PubMed

Blazewicz, Steven J; Schwartz, Egbert; Firestone, Mary K

2014-05-01

The rapid increase in microbial activity that occurs when a dry soil is rewetted has been well documented and is of great interest due to implications of changing precipitation patterns on soil C dynamics. Several studies have shown minor net changes in microbial population diversity or abundance following wet-up, but the gross population dynamics of bacteria and fungi resulting from soil wet-up are virtually unknown. Here we applied DNA stable isotope probing with H218O coupled with quantitative PCR to characterize new growth, survival, and mortality of bacteria and fungi following the rewetting of a seasonally dried California annual grassland soil. Microbial activity, as determined by CO2 production, increased significantly within three hours of wet-up, yet new growth was not detected until after three hours, suggesting a pulse of nongrowth activity immediately following wet-up, likely due to osmo-regulation and resuscitation from dormancy in response to the rapid change in water potential. Total microbial abundance revealed little change throughout the seven-day post-wet incubation, but there was substantial turnover of both bacterial and fungal populations (49% and 52%, respectively). New growth was linear between 24 and 168 hours for both bacteria and fungi, with average growth rates of 2.3 x 10(8) bacterial 16S rRNA gene copies x [g dry mass](-1) x h(-1) and 4.3 x 10(7) fungal ITS copies x [g dry mass](-1) x h(-1). While bacteria and fungi differed in their mortality and survival characteristics during the seven-day incubation, mortality that occurred within the first three hours was similar, with 25% and 27% of bacterial and fungal gene copies disappearing from the pre-wet community, respectively. The rapid disappearance of gene copies indicates that cell death, occurring either during the extreme dry down period (preceding five months) or during the rapid change in water potential due to wet-up, generates a significant pool of available C that likely contributes to the large pulse in CO2 associated with wet-up. A dynamic assemblage of growing and dying organisms controlled the CO2 pulse, but the balance between death and growth resulted in relatively stable total population abundances, even after a profound and sudden change in environment.

The Impact of Improving Suicide Death Classification in South Korea: A Comparison with Japan and Hong Kong

PubMed Central

Chan, Chee Hon; Caine, Eric D.; Chang, Shu Sen; Lee, Won Jin; Cha, Eun Shil; Yip, Paul Siu Fai

2015-01-01

Introduction The suicide rate of South Korea has increased dramatically during the past decades, as opposed to steadily decreasing trends in Japan and Hong Kong. Although the recent increase of suicide in South Korea may be related to changing socioeconomic conditions and other contextual factors, it may also reflect, in part, a reduction of misidentified suicide cases due to improving classification of manner of death. Method We compared the annual proportional change of suicide, undetermined death, and accidental death from South Korea with those of Japan and Hong Kong from 1992 to 2011; a greater proportional change of the manner-of-death categories during the period is indicative of a relatively less stable registration and hence a greater potential for misclassification bias on reported suicide trends. Subgroup analyses stratifying the deaths by methods were also conducted. To estimate the impact, the age-standardized rates of these three death categories in each site were calculated. Results We found that, during the 20-year observation period, the proportional change of suicide, undetermined death, and accidental death in South Korea was significantly greater than Japan and Hong Kong. Similar observations were made in subgroup analyses. While death rates of the three manners in Japan and Hong Kong generally moved in a parallel fashion, the increase of suicide in South Korea occurred concomitantly with a significant reduction of its accidental death rate. 43% of the increase in suicides could be attributed to the decrease in accidental deaths, while 57% of the increase could be due to fundamental causes. Conclusion Our data suggest that, during the mid-1990s and after, the increasing burden of suicide in South Korea initially was masked, in part, by misclassification. Thus, the later apparently rapid increase of suicides reflected steadily improving classification of manner of death, as well as a more fundamental increase in the suicide rate. PMID:25992879

The impact of improving suicide death classification in South Korea: a comparison with Japan and Hong Kong.

PubMed

Chan, Chee Hon; Caine, Eric D; Chang, Shu Sen; Lee, Won Jin; Cha, Eun Shil; Yip, Paul Siu Fai

2015-01-01

The suicide rate of South Korea has increased dramatically during the past decades, as opposed to steadily decreasing trends in Japan and Hong Kong. Although the recent increase of suicide in South Korea may be related to changing socioeconomic conditions and other contextual factors, it may also reflect, in part, a reduction of misidentified suicide cases due to improving classification of manner of death. We compared the annual proportional change of suicide, undetermined death, and accidental death from South Korea with those of Japan and Hong Kong from 1992 to 2011; a greater proportional change of the manner-of-death categories during the period is indicative of a relatively less stable registration and hence a greater potential for misclassification bias on reported suicide trends. Subgroup analyses stratifying the deaths by methods were also conducted. To estimate the impact, the age-standardized rates of these three death categories in each site were calculated. We found that, during the 20-year observation period, the proportional change of suicide, undetermined death, and accidental death in South Korea was significantly greater than Japan and Hong Kong. Similar observations were made in subgroup analyses. While death rates of the three manners in Japan and Hong Kong generally moved in a parallel fashion, the increase of suicide in South Korea occurred concomitantly with a significant reduction of its accidental death rate. 43% of the increase in suicides could be attributed to the decrease in accidental deaths, while 57% of the increase could be due to fundamental causes. Our data suggest that, during the mid-1990s and after, the increasing burden of suicide in South Korea initially was masked, in part, by misclassification. Thus, the later apparently rapid increase of suicides reflected steadily improving classification of manner of death, as well as a more fundamental increase in the suicide rate.

Earlier Endpoints Are Required for Hemorrhagic Shock Trials among Severely Injured Patients

PubMed Central

Fox, Erin E.; Holcomb, John B.; Wade, Charles E.; Bulger, Eileen M.; Tilley, Barbara C.

2016-01-01

Background Choosing the appropriate endpoint for a trauma hemorrhage control trial can determine the likelihood of its success. Recent Phase 3 trials and observational studies have used 24-hour and/or 30-day all-cause mortality as the primary endpoint and some have not used exception from informed consent (EFIC), resulting in multiple failed trials. Five recent high-quality prospective studies among 4,064 hemorrhaging trauma patients provide new evidence to support earlier primary endpoints. Methods The goal of this project was to determine the optimal endpoint for hemorrhage control trials using existing literature and new analyses of previously published data. Results Recent studies among bleeding trauma patients show that hemorrhagic deaths occur rapidly, at a high rate, and in a consistent pattern. Early preventable deaths among trauma patients are largely due to hemorrhage and the median time to hemorrhagic death from admission is 2.0-2.6 hours. Approximately 85% of hemorrhagic deaths occur within 6 hours. The hourly mortality rate due to traumatic injury decreases rapidly after enrollment from 4.6% per hour at 1 hour post-enrollment to 1% per hour at 6 hours to <0.1% per hour by 9 hours and thereafter. Early primary endpoints (within 6 hours) have critically important benefits for hemorrhage control trials, including being congruent with the median time to hemorrhagic death, biologic plausibility, and enabling the use of all-cause mortality, which is definitive and objective. Conclusions Primary endpoints should be congruent with the timing of the disease process. Therefore, if a resuscitation/hemorrhage control intervention is under study, a primary endpoint of all-cause mortality evaluated within the first 6 hours is appropriate. Before choosing the timing of the primary endpoint for a large multicenter trial, we recommend performing a Phase 2 trial under EFIC to better understand the effects of the hemorrhage control intervention and distribution of time to death. When early primary endpoints are used, patients should be monitored for multiple subsequent secondary safety endpoints, including 24 hour and 30 day all-cause mortality as well as the customary safety endpoints. PMID:28207628

Forensic molecular pathology of violent deaths.

PubMed

Maeda, Hitoshi; Zhu, Bao-li; Ishikawa, Takaki; Michiue, Tomomi

2010-12-15

In forensic pathology, while classical morphology remains a core procedure to investigate deaths, a spectrum of ancillary procedures has been developed and incorporated to detail the pathology. Among them, postmortem biochemistry is important to investigate the systemic pathophysiological changes involved in the dying process that cannot be detected by morphology. In addition, recent advances in molecular biology have provided a procedure to investigate genetic bases of diseases that might present with sudden death, which is called 'molecular autopsy'. Meanwhile, the practical application of RNA analyses to postmortem investigation has not been accepted due to rapid decay after death; however, recent experimental and practical studies using real-time reverse transcription-PCR have suggested that the relative quantification of mRNA transcripts can be applied in molecular pathology for postmortem investigation of deaths, which may be called 'advanced molecular autopsy'. In a broad sense, forensic molecular pathology implies applied medical sciences to investigate the genetic basis of diseases, and the pathophysiology of diseases and traumas leading to death at a biological molecular level in the context of forensic pathology. The possible applications include analyses of local pathology, including tissue injury, ischemia/hypoxia and inflammation at the site of insult or specific tissue damage from intoxication, systemic responses to violence or environmental hazards, disorders due to intoxication, and systemic pathophysiology of fatal process involving major life-support organs. A review of previous studies suggests that systematic postmortem quantitative analysis of mRNA transcripts can be established from multi-faceted aspects of molecular biology and incorporated into death investigations in forensic pathology, to support and reinforce morphological evidence. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Predicting the decomposition of Scots pine, Norway spruce, and birch stems in Finland.

PubMed

Mäkinen, Harri; Hynynen, Jari; Siitonen, Juha; Sievänen, Risto

2006-10-01

Models were developed for predicting the decomposition of dead wood for the main tree species in Finland, based on data collected from long-term thinning experiments in southern and central Finland. The decomposition rates were strongly related to the number of years after tree death. In contrast to previous studies, which have used the first-order exponential model, we found that the decomposition rate was not constant. Therefore, the Gompertz and Chapman-Richard's functions were fitted to the data. The slow initial decomposition period was mainly due to the fact that most dead trees remained standing as snags after their death. The initial period was followed by a period of rapid decomposition and, finally, by a period of moderately slow decomposition. Birch stems decomposed more rapidly than Scots pine and Norway spruce stems. Decomposition rates of Norway spruce stems were somewhat lower than those of Scots pine. Because the carbon concentration of decaying boles was relatively stable (about 50%) the rate of carbon loss follows that of mass loss. Models were also developed for the probability that a dead tree remains standing as a snag. During the first years after death, the probability was high. Thereafter, it decreased rapidly, the decrease being faster for birch stems than for Scots pine and Norway spruce stems. Almost all stems had fallen down within 40 years after their death. In Scots pine and Norway spruce, most snags remained hard and belonged to decay class 1. In birch, a higher proportion of snags belonged to the more advanced decay classes. The models provide a framework for predicting dead wood dynamics in managed as well as dense unthinned stands. The models can be incorporated into forest management planning systems, thereby facilitating estimates of carbon dynamics.

[Fatal outcome of an hydrogen sulfide poisoning].

PubMed

Querellou, E; Jaffrelot, M; Savary, D; Savry, C; Perfus, J-P

2005-10-01

We report a case of fatal outcome poisoning by massive exposure to hydrogen sulfide of a sewer worker. This rare event was associated with a moderate intoxication of two members of the rescue team. The death was due to asystole and massive lung oedema. Autopsy analysis showed diffuse necrotic lesions in lungs. Hydrogen sulfide is a direct and systemic poison, produced by organic matter decomposition. The direct toxicity mechanism is still unclear. The systemic toxicity is due to an acute toxicity by oxygen depletion at cellular level. It is highly diffusable and potentially very dangerous. At low concentration, rotten egg smell must trigger hydrogen sulfide suspicion since at higher concentration it is undetectable, making intoxication possible. In case of acute intoxication, there is an almost instantaneous cardiovascular failure and a rapid death. Hydrogen sulfide exposure requires prevention measures and more specifically the use of respiratory equipment for members of the rescue team.

[Start of PTB (Phthisis) mortality statistics in Japan (1)].

PubMed

Shimao, Tadao

2008-12-01

First "Statistics Annual", which included the population and vital statistics was published in Japan in 1882, and the numbers of death classified by major causes of death were tabulated by sex and age groups and by prefecture. Koch R reported the discovery of tubercle bacilli as the pathogen for TB in 1882, and since the latter half of 1883, the numbers of death due to PTB (Phthisis) were tabulated by prefecture, and by sex and age groups since 1884 annually except for 1885. Based on the population statistics and the numbers of PTB death, PTB (Phthisis) mortality was calculated by sex and age groups, and the results were shown in Table 1. PTB mortality per 100,000 increased from 78.2 in 1884 to 171.9 in 1899. Sex- and age-specific PTB mortality in 1884 showed a pattern increasing with age, and the PTB mortality of male was higher than that of female in adult as shown in Fig. 2. In 1889, low peak of mortality was seen in the age groups 15-19 and 20-29, and in these age groups, the PTB mortality was higher in female than in male. Such trend was seen more markedly in 1894 and 1899, while the rate was higher in male than in female in the age groups over 40. Trend of PTB mortality by sex and age groups was shown in Fig. 3. Rapid increase of PTB mortality in the age groups 10-14 and 20-29 could be explained by the rapid increase of young women workers in fast growing silk and spinning industries, but how rapid increase of PTB mortality in infants be explained? In "Statistics Annual", PTB (Phthisis) mortality rate by prefecture was printed, and the summarized table was shown in Table 2. The rates in 1883 and 1884 were calculated from the numbers of PTB death and the B-type population shown in the "Statistics Annual", which will be described in the next issue of this paper.

Xpert Flu for point-of-care diagnosis of human influenza in industrialized countries.

PubMed

Salez, Nicolas; Nougairede, Antoine; Ninove, Laetitia; Zandotti, Christine; de Lamballerie, Xavier; Charrel, Rémi N

2014-05-01

Respiratory infections, particularly those caused by influenza viruses, represent the third-most important cause of death in the world due to infectious diseases. Nevertheless, despite the enormous publicity attracted by epidemics due to these viruses, laboratory diagnosis, documentation and recording of respiratory diseases is still unsatisfactory. Available diagnostic tests capable of providing results rapidly are either limited and insufficiently sensitive or highly sensitive and specific but insufficiently rapid. Considerable investment and research efforts have been made towards the development of new diagnostics for influenza A and B viruses and the Xpert(®) Flu assay (Cepheid(®), CA, USA) has emerged as one of the most promising. In this article, we review current knowledge of the Xpert Flu test, discuss its potential value as a point-of-care test and outline the potential leads for future development.

What proportion of cancer deaths in the contemporary United States is attributable to cigarette smoking?

PubMed

Jacobs, Eric J; Newton, Christina C; Carter, Brian D; Feskanich, Diane; Freedman, Neal D; Prentice, Ross L; Flanders, W Dana

2015-03-01

The proportion of cancer deaths in the contemporary United States caused by cigarette smoking (the population attributable fraction [PAF]) is not well documented. The PAF of all cancer deaths due to active cigarette smoking among adults 35 years and older in the United States in 2010 was calculated using age- and sex-specific smoking prevalence from the National Health Interview Survey (NHIS) and age- and sex-specific relative risks from the Cancer Prevention Study-II (for ages 35-54 years) and from the Pooled Contemporary Cohort data set (for ages 55 years and older). The PAF for active cigarette smoking was 28.7% when estimated conservatively, including only deaths from the 12 cancers currently formally established as caused by smoking by the US Surgeon General. The PAF was 31.7% when estimated more comprehensively, including excess deaths from all cancers. These estimates do not include additional potential cancer deaths from environmental tobacco smoke or other type of tobacco use such as cigars, pipes, or smokeless tobacco. Cigarette smoking causes a large proportion of cancer deaths in the contemporary United States. Reducing smoking prevalence as rapidly as possible should be a top priority for the US public health efforts to prevent cancer deaths. Copyright © 2015 Elsevier Inc. All rights reserved.

An evaluation of childhood deaths in Turkey due to yellow phosphorus in firecrackers.

PubMed

Yilmaz, Riza; Yilmaz, Eyyüp; Ozdemir, Veli; Can, Muhammet; Pakis, Isil; Piskin, Ibrahim E; Dokgoz, Halis; Ozer, Erdal; Numanoglu, Kemal V

2015-05-01

Yellow phosphorus (YP) is a powerful protoplasmic poison used in the manufacturing of matches, pest poisons, firecrackers, firework cracker, lights for watches, military ammunition, and agriculture fertilizer. YP is extremely flammable and toxic and easily absorbed from the gastrointestinal tract. In this study, we examined childhood deaths from 1997 to 2012 resulting from the ingestion of firecrackers. The patients ranged from 2 to 15 years of age and were admitted to the hospital with a variety of symptoms. Those that presented with nausea, vomiting, and hypotension rapidly deteriorated and entered a coma. An autopsy was performed in all but one of the 16 cases reviewed. Macroscopically, the livers had a yellowish discoloration with petechial bleeding. Histopathologic examination revealed acute toxic hepatitis. In conclusion, these firecrackers are found in corner shops throughout Turkey, may cause death in children with little warning, and should be banned to prevent further deaths. © 2015 American Academy of Forensic Sciences.

Getting the “kill” into “shock and kill”: strategies to eliminate latent HIV

PubMed Central

Kim, Youry; Anderson, Jenny L.; Lewin, Sharon R.

2018-01-01

Despite the success of antiretroviral therapy (ART), there is currently no HIV cure and treatment is lifelong. HIV persists during ART due to long lived and proliferating latently infected CD4+ T-cells. One strategy to eliminate latency is to activate virus production using latency reversing agents (LRAs) with the goal of triggering cell death through virus-induced cytolysis or immune-mediated clearance. However, multiple studies have demonstrated that activation of viral transcription alone is insufficient to induce cell death and some LRAs may counteract cell death by promoting cell survival. Here, we review new approaches to induce death of latently infected cells through apoptosis and inhibition of pathways critical for cell survival, which are often hijacked by HIV proteins. Given advances in the commercial development of compounds that induce apoptosis in cancer chemotherapy, these agents could move rapidly into clinical trials, either alone or in combination with LRAs, to eliminate latent HIV infection. PMID:29324227

20 CFR 410.450 - Death due to pneumoconiosis, including statutory presumption.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Death due to pneumoconiosis, including... Death Due to Pneumoconiosis § 410.450 Death due to pneumoconiosis, including statutory presumption... at the time of his death, or whose death is determined to have been due to pneumoconiosis. (For...

20 CFR 410.450 - Death due to pneumoconiosis, including statutory presumption.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Death due to pneumoconiosis, including... Death Due to Pneumoconiosis § 410.450 Death due to pneumoconiosis, including statutory presumption... at the time of his death, or whose death is determined to have been due to pneumoconiosis. (For...

Ending of preventable deaths from pneumonia and diarrhoea: an achievable goal.

PubMed

Chopra, Mickey; Mason, Elizabeth; Borrazzo, John; Campbell, Harry; Rudan, Igor; Liu, Li; Black, Robert E; Bhutta, Zulfiqar A

2013-04-27

Global under-5 mortality has fallen rapidly from 12 million deaths in 1990, to 6·9 million in 2011; however, this number still falls short of the target of a two-thirds reduction or a maximum of 4 million deaths by 2015. Acceleration of reductions in deaths due to pneumonia and diarrhoea, which together account for about 2 million child deaths every year, is essential if the target is to be met. Scaling up of existing interventions against the two diseases to 80% and immunisation to 90% would eliminate more than two-thirds of deaths from these two diseases at a cost of US$6·715 billion by 2025. Modelling in this report shows that if all countries could attain the rates of decline of the regional leaders, then cause-specific death rates of fewer than three deaths per 1000 livebirths from pneumonia and less than one death per 1000 livebirths from diarrhoea could be achieved by 2025. These rates are those at which preventable deaths have been avoided. Increasing of awareness of the size of the problem; strengthening of leadership, intersectoral collaboration, and resource mobilisation; and increasing of efficiency through the selection of the optimum mix of a growing set of cost-effective interventions depending on local contexts are the priority actions needed to achieve the goal of ending preventable deaths from pneumonia and diarrhoea by 2025. Copyright © 2013 Elsevier Ltd. All rights reserved.

Seven cases of fatal aconite poisoning: forensic experience in China.

PubMed

Liu, Qian; Zhuo, Luo; Liu, Liang; Zhu, Shaohua; Sunnassee, Ananda; Liang, Man; Zhou, Lan; Liu, Yan

2011-10-10

This paper presents seven fatal cases of aconite poisoning encountered in the Tongji Center for Medicolegal Expertise in Hubei (TCMEH), China, from 1999 to 2008 retrospectively. In six of the cases, deaths occurred after drinking homemade medicated liquor containing aconite, and in one case death was due to ingestion of traditional Chinese medication containing aconite. Forensic autopsy and pathological examinations ruled out the presence of physical trauma or life-threatening diseases. Diagnosis of aconite poisoning was made after postmortem toxicological analysis. Animal experiment was performed in one case demonstrating that the medicated liquor could cause death rapidly. We present the autopsy and histopathological findings, toxicological analysis, and results of animal experiment done on samples from those seven cases. As an important herbal Chinese medicine, Aconitum species deserve special attention, especially because it contains poisonous alkaloids. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Global alert to avian influenza virus infection: From H5N1 to H7N9

PubMed Central

Poovorawan, Yong; Pyungporn, Sunchai; Prachayangprecha, Slinporn; Makkoch, Jarika

2013-01-01

Outbreak of a novel influenza virus is usually triggered by mutational change due to the process known as ‘antigenic shift’ or re-assortment process that allows animal-to-human or avian-to-human transmission. Birds are a natural reservoir for the influenza virus, and subtypes H5, H7, and H9 have all caused outbreaks of avian influenza in human populations. An especially notorious strain is the HPAI influenza virus H5N1, which has a mortality rate of approximately 60% and which has resulted in numerous hospitalizations, deaths, and significant economic loss. In March 2013, in Eastern China, there was an outbreak of the novel H7N9 influenza virus, which although less pathogenic in avian species, resulted in 131 confirmed cases and 36 deaths in humans over a two-month span. The rapid outbreak of this virus caused global concern but resulted in international cooperation to control the outbreak. Furthermore, cooperation led to valuable research-sharing including genome sequencing of the virus, the development of rapid and specific diagnosis, specimen sharing for future studies, and vaccine development. Although a H7N9 pandemic in the human population is possible due to its rapid transmissibility and extensive surveillance, the closure of the live-bird market will help mitigate the possibility of another H7N9 outbreak. In addition, further research into the source of the outbreak, pathogenicity of the virus, and the development of specific and sensitive detection assays will be essential for controlling and preparing for future H7N9 outbreaks. PMID:23916331

Ricin detection: tracking active toxin.

PubMed

Bozza, William P; Tolleson, William H; Rivera Rosado, Leslie A; Zhang, Baolin

2015-01-01

Ricin is a plant toxin with high bioterrorism potential due to its natural abundance and potency in inducing cell death. Early detection of the active toxin is essential for developing appropriate countermeasures. Here we review concepts for designing ricin detection methods, including mechanism of action of the toxin, advantages and disadvantages of current detection assays, and perspectives on the future development of rapid and reliable methods for detecting ricin in environmental samples. Published by Elsevier Inc.

Rapid Point of Care Detection of HPV-Associated Malignancies | Division of Cancer Prevention

Cancer.gov

Despite the development of effective human papillomavirus (HPV) vaccines, it has been estimated that there will be over 200,000 new cases and over 100,000 deaths due to cervical cancer by 2020 in India, which has 25% of the global burden of cases. Cervical cancer screening by Pap smears and HPV DNA testing has become standard of care in the US and Europe, but has been too

Rapid Resolution of Grief with IV Infusion of Ketamine: A Unique Phenomenological Experience

PubMed Central

Gowda, Mahesh Ramanna; Srinivasa, Preethi; Kumbar, Prabha S.; Ramalingaiah, Vinay Hosagavi; Muthyalappa, Chandrashekar; Durgoji, Sumit

2016-01-01

Ketamine, a primarily FDA-approved anaesthetic agent is also used as recreational drug. Based on preclinical findings and later the clinical observations it is noted to have rapid antidepressant effect due to its mechanisms related to NMDA antagonism. In spite of established evidence of ketamine being effective in depression with significant role in treatment resistant cases as well, there was absolute dearth of literature regarding its utility in grief-related disorders. In this context we present a case of 28-year-old graduate male who presented to us in complicated grief following death of his wife due to obstetric complications. With the patient and immediate family members consenting for use of ketamine as off-label use, patient had single IV infusion of ketamine following which he had unique phenomenological experience ultimately resolving his grief in few minutes. Through this case we highlight the enormous therapeutic promise of ketamine in complicated grief. PMID:27011405

20 CFR 718.205 - Death due to pneumoconiosis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Death due to pneumoconiosis. 718.205 Section... DEATH DUE TO PNEUMOCONIOSIS Determining Entitlement to Benefits § 718.205 Death due to pneumoconiosis. (a) Benefits are provided to eligible survivors of a miner whose death was due to pneumoconiosis. In...

20 CFR 718.205 - Death due to pneumoconiosis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Death due to pneumoconiosis. 718.205 Section... OR DEATH DUE TO PNEUMOCONIOSIS Determining Entitlement to Benefits § 718.205 Death due to pneumoconiosis. (a) Benefits are provided to eligible survivors of a miner whose death was due to pneumoconiosis...

20 CFR 718.205 - Death due to pneumoconiosis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Death due to pneumoconiosis. 718.205 Section... OR DEATH DUE TO PNEUMOCONIOSIS Determining Entitlement to Benefits § 718.205 Death due to pneumoconiosis. (a) Benefits are provided to eligible survivors of a miner whose death was due to pneumoconiosis...

20 CFR 718.205 - Death due to pneumoconiosis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Death due to pneumoconiosis. 718.205 Section... OR DEATH DUE TO PNEUMOCONIOSIS Determining Entitlement to Benefits § 718.205 Death due to pneumoconiosis. (a) Benefits are provided to eligible survivors of a miner whose death was due to pneumoconiosis...

20 CFR 718.205 - Death due to pneumoconiosis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Death due to pneumoconiosis. 718.205 Section... OR DEATH DUE TO PNEUMOCONIOSIS Determining Entitlement to Benefits § 718.205 Death due to pneumoconiosis. (a) Benefits are provided to eligible survivors of a miner whose death was due to pneumoconiosis...

[Sudden cardiac death, a major scientific challenge].

PubMed

Haissaguerre, Michel; Hocini, Meleze; Sacher, Frédéric; Shah, Ashok

2010-06-01

Sudden death is responsible for 350,000 deaths each year in Europe, or 1000 deaths each day, equivalent to the combined mortality from the most lethal cancers (breast, lung and colorectal). Unfortunately, sudden death is widely considered to be "natural", being due to unknown but critical cardiac disorders leading to sudden arrest of cardiac activity. Awareness of its potential preventability is inadequate. Indeed, 80% of cases of sudden death are associated with extremely rapid heartbeats, an "electric tornado" called ventricular fibrillation, caused by ultrarapid firing of ectopic foci or chaotic wave propagation. This arrhythmia strikes like lightning Although it can be associated with myocardial infarction, most victims have structurally normal or slightly altered hearts. The cells which cause this ultrarapid firing originate from the Purkinje system, which constitutes just a fraction (2%) of total cardiac mass. This is borne out by the fact that the risk of fatal arrhythmic events can be reduced by focal thermoablation. What is most important is to identify subjects at risk of such events. It has been suggested that there exists an unidentified subclinical electrical disharmony, which converts into a tornado of ultimately fatal clinical events at a certain threshold level. High-resolution bioelectrical cardiac mapping, functional imaging, and treatment of electrical field disorders are major scientific challenges given their complexity, intraindividual dynamics and interindividual variability.

Prophylaxis and Immunization in Mice by Use of Virus-Free Defective T Particles to Protect Against Intracerebral Infection by Vesicular Stomatitis Virus

PubMed Central

Doyle, Michael; Holland, John J.

1973-01-01

Defective interfering T particles of vesicular stomatitis virus provide remarkable protection against viral disease and death when introduced intracerebrally in large numbers along with an otherwise rapidly fatal low dose of standard infectious virus. This profound prophylactic effect of defective T particles is due to homologous autointerference since it is serotype-specific and interferon is not induced. This protective effect can be demonstrated only with preparations of T particles that have been purified completely free of infectious virions. When pure T particles are injected intracerebrally along with large doses of infectious virus, they convert an otherwise rapidly fatal disease process to a slowly progressing virus infection that generally terminates in death after many days of wasting disease and paralysis. Intracerebral injection of virus-free T particles alone is apparently innocuous to mice and stimulates immunity to massive doses of homologous infectious virus. In vitro, virus-free T particles at extremely high multiplicities depress cellular RNA and protein synthesis and kill BHK21 cells in culture, but do not exhibit such effects at moderately high multiplicities. PMID:4352972

Quantifying Limits on Replication, Death, and Quiescence of Mycobacterium tuberculosis in Mice

PubMed Central

McDaniel, Margaret M.; Krishna, Nitin; Handagama, Winode G.; Eda, Shigetoshi; Ganusov, Vitaly V.

2016-01-01

When an individual is exposed to Mycobacterium tuberculosis (Mtb) three outcomes are possible: bacterial clearance, active disease, or latent infection. It is generally believed that most individuals exposed to Mtb become latently infected and carry the mycobacteria for life. How Mtb is maintained during this latent infection remains largely unknown. During an Mtb infection in mice, there is a phase of rapid increase in bacterial numbers in the murine lungs within the first 3 weeks, and then bacterial numbers either stabilize or increase slowly over the period of many months. It has been debated whether the relatively constant numbers of bacteria in the chronic infection result from latent (dormant, quiescent), non-replicating bacteria, or whether the observed Mtb cell numbers are due to balance between rapid replication and death. A recent study of mice, infected with a Mtb strain carrying an unstable plasmid, showed that during the chronic phase, Mtb was replicating at significant rates. Using experimental data from this study and mathematical modeling we investigated the limits of the rates of bacterial replication, death, and quiescence during Mtb infection of mice. First, we found that to explain the data the rates of bacterial replication and death could not be constant and had to decrease with time since infection unless there were large changes in plasmid segregation probability over time. While a decrease in the rate of Mtb replication with time since infection was expected due to depletion of host's resources, a decrease in the Mtb death rate was counterintuitive since Mtb-specific immune response, appearing in the lungs 3–4 weeks after infection, should increase removal of bacteria. Interestingly, we found no significant correlation between estimated rates of Mtb replication and death suggesting the decline in these rates was driven by independent mechanisms. Second, we found that the data could not be explained by assuming that bacteria do not die, suggesting that some removal of bacteria from lungs of these mice had to occur even though the total bacterial counts in these mice always increased over time. Third and finally, we showed that to explain the data the majority of bacterial cells (at least ~60%) must be replicating in the chronic phase of infection further challenging widespread belief of nonreplicating Mtb in latency. Our predictions were robust to some changes in the structure of the model, for example, when the loss of plasmid-bearing cells was mainly due to high fitness cost of the plasmid. Further studies should determine if more mechanistic models for Mtb dynamics are also able to accurately explain these data. PMID:27379030

Life and death of female gametes during oogenesis and folliculogenesis.

PubMed

Krysko, Dmitri V; Diez-Fraile, Araceli; Criel, Godelieve; Svistunov, Andrei A; Vandenabeele, Peter; D'Herde, Katharina

2008-09-01

The vertebrate ovary is an extremely dynamic organ in which excessive or defective follicles are rapidly and effectively eliminated early in ontogeny and thereafter continuously throughout reproductive life. More than 99% of follicles disappear, primarily due to apoptosis of granulosa cells, and only a minute fraction of the surviving follicles successfully complete the path to ovulation. The balance between signals for cell death and survival determines the destiny of the follicles. An abnormally high rate of cell death followed by atresia can negatively affect fertility and eventually lead irreversibly to premature ovarian failure. In this review we provide a short overview of the role of programmed cell death in prenatal differentiation of the primordial germ cells and in postnatal folliculogenesis. We also discuss the issue of neo-oogenesis. Next, we highlight molecules involved in regulation of granulosa cell apoptosis. We further discuss the potential use of scores for apoptosis in granulosa cells and characteristics of follicular fluid as prognostic markers for predicting the outcome of assisted reproduction. Potential therapeutic strategies for combating premature ovarian failure are also addressed.

Rapid death of duck cells infected with influenza: a potential mechanism for host resistance to H5N1.

PubMed

Kuchipudi, Suresh V; Dunham, Stephen P; Nelli, Rahul; White, Gavin A; Coward, Vivien J; Slomka, Marek J; Brown, Ian H; Chang, Kin Chow

2012-01-01

Aquatic birds are the natural reservoir for most subtypes of influenza A, and a source of novel viruses with the potential to cause human pandemics, fatal zoonotic disease or devastating epizootics in poultry. It is well recognised that waterfowl typically show few clinical signs following influenza A infection, in contrast, terrestrial poultry such as chickens may develop severe disease with rapid death following infection with highly pathogenic avian influenza. This study examined the cellular response to influenza infection in primary cells derived from resistant (duck) and susceptible (chicken) avian hosts. Paradoxically, we observed that duck cells underwent rapid cell death following infection with low pathogenic avian H2N3, classical swine H1N1 and 'classical' highly pathogenic H5N1 viruses. Dying cells showed morphological features of apoptosis, increased DNA fragmentation and activation of caspase 3/7. Following infection of chicken cells, cell death occurred less rapidly, accompanied by reduced DNA fragmentation and caspase activation. Duck cells produced similar levels of viral RNA but less infectious virus, in comparison with chicken cells. Such rapid cell death was not observed in duck cells infected with a contemporary Eurasian lineage H5N1 fatal to ducks. The induction of rapid death in duck cells may be part of a mechanism of host resistance to influenza A, with the loss of this response leading to increased susceptibility to emergent strains of H5N1. These studies provide novel insights that should help resolve the long-standing enigma of host-pathogen relationships for highly pathogenic and zoonotic avian influenza.

20 CFR 718.303 - Death from a respirable disease.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Death from a respirable disease. 718.303... OR DEATH DUE TO PNEUMOCONIOSIS Presumptions Applicable to Eligibility Determinations § 718.303 Death... death was due to pneumoconiosis. (2) Under this presumption, death shall be found due to a respirable...

Role of cyclophilin D-dependent mitochondrial permeability transition in glutamate-induced calcium deregulation and excitotoxic neuronal death

PubMed Central

Li, Viacheslav; Brustovetsky, Tatiana; Brustovetsky, Nickolay

2009-01-01

In the present study we tested the hypothesis that the cyclophilin D-dependent (CyD) mitochondrial permeability transition (CyD-mPT) plays an important role in glutamate-triggered delayed calcium deregulation (DCD) and excitotoxic neuronal death. We used cultured cortical neurons from wild-type C57BL/6 and cyclophilin D knockout mice (Ppif-/-). Induction of the mPT was identified by following the rapid secondary acidification of mitochondrial matrices monitored with mitochondrially targeted pH-sensitive yellow fluorescent protein. Suppression of the CyD-mPT due to genetic CyD ablation deferred DCD and mitochondrial depolarization, and increased the survival rate after exposure of neurons to 10μM glutamate, but not to 100μM glutamate. Ca2+ influx into Ppif-/- neurons was not diminished in comparison with WT neurons judging by 45Ca accumulation. In both types of neurons, 100μM glutamate produced greater Ca2+ influx than 10μM glutamate. We hypothesize that greater Ca2+ influx produced by higher glutamate rapidly triggered the CyD-independent mPT in both WT and Ppif-/- neurons equalizing their responses to supra-physiologic excitotoxic insults. In neurons exposed to moderate but pathophysiologically-relevant glutamate concentrations, an induction of the CyD-mPT appears to play an important role in mitochondrial injury contributing to DCD and cell death. PMID:19236863

In vitro efficiency and mechanistic role of indocyanine green as photodynamic therapy agent for human melanoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mamoon, A.M.; Miller, L.; Gamal-Eldeen, A. M.

2009-05-02

Photodynamic therapy (PDT) is a promising treatment for superficial cancer. However, poor therapeutic results have been reported for melanoma, due to the high melanin content. Indocyanine green (ICG) has near infrared absorption (700-800 nm) and melanins do not absorb strongly in this area. This study explores the efficiency of ICG as a PDT agent for human melanoma, and its mechanistic role in the cell death pathway. Human skin melanoma cells (Sk-Mel-28) were incubated with ICG and exposed to a low power Ti:Sapphire laser. Synchrotron-assisted Fourier transform infrared microspectroscopy and hierarchical cluster analysis were used to assess the cell damage andmore » changes in lipid, protein, and nucleic acids. The cell death pathway was determined by analysis of cell viability and apoptosis and necrosis markers. In the cell death pathway, {sup 1}O{sub 2} generation evoked rapid multiple consequences that trigger apoptosis after laser exposure for only 15min including the release of cytochrome c, the activation of total caspases, caspase-3, and caspase-9, the inhibition of NF-{Kappa}B P65, and the enhancement of DNA fragmentation, and histone acetylation. ICG/PDT can efficiently and rapidly induce apoptosis in human melanoma cells and it can be considered as a new therapeutic approach for topical treatment of melanoma.« less

Age-specific mortality patterns in Central Mozambique during and after the end of the Civil War.

PubMed

Noden, Bruce H; Pearson, R John C; Gomes, Aurelio

2011-05-26

In recent years, vigorous debate has developed concerning how conflicts contribute to the spread of infectious diseases, and in particular, the role of post-conflict situations in the epidemiology of HIV/AIDS. This study details the age-specific mortality patterns among the population in the central provincial capital of Beira, Mozambique, during and after the Mozambican civil war which ended in 1992. Data was collected from the death register at Beira's Central Hospital between 1985 and 2003 and descriptively analyzed. The data show two distinct periods: before and after the peace agreements in 1992. Before 1992 (during the civil war), the main impact of mortality was on children below 5 years of age, including still births, accounting for 58% of all deaths. After the war ended in 1992, the pattern shifted dramatically and rapidly to the 15-49 year old age group which accounted for 49% of all deaths by 2003. As under-5 mortality rates were decreasing at the end of the conflict, rates for 24-49 year old adults began to dramatically increase due to AIDS. This study demonstrates that strategies can be implemented during conflicts to decrease mortality rates in one vulnerable population but post-conflict dynamics can bring together other factors which contribute to the rapid spread of other infectious diseases in other vulnerable populations.

A case report for fatal Churg-Strauss syndrome complications: first reported death due to rapid progression of prominently huge hepatic capsular hematoma and multi-system organ hemorrhage

PubMed Central

Qian, Jiejing; Tong, Hongyan; Chen, Feifei; Mai, Wenyuan; Lou, Yinjun; Jin, Jie

2014-01-01

Churg-Strauss syndrome (CSS) is a rare disease that has an extremely low incidence rate. CSS prognosis is good, in general; and there are no reports of multiple-organ hemorrhage in CSS. We report a unique case of CSS, wherein, an elderly man experienced multiple organ hemorrhage -- a particularly huge hematoma under the capsule of the liver and poor prognosis. PMID:25419420

Toward an Effective Long-Term Strategy for Preventing Motor Vehicle Crashes and Injuries

PubMed Central

Mawson, Anthony R.; Walley, E. Kenneth

2014-01-01

Casualties due to motor vehicle crashes (MVCs) include some 40,000 deaths each year in the United States and one million deaths worldwide. One strategy that has been recommended for improving automobile safety is to lower speed limits and enforce them with speed cameras. However, motor vehicles can be hazardous even at low speeds whereas properly protected human beings can survive high-speed crashes without injury. Emphasis on changing driver behavior as the focus for road safety improvements has been largely unsuccessful; moreover, drivers today are increasingly distracted by secondary tasks such as cell phone use and texting. Indeed, the true limiting factor in vehicular safety is the capacity of human beings to sense and process information and to make rapid decisions. Given that dramatic reductions in injuries and deaths from MVCs have occurred over the past century due to improvements in safety technology, despite increases in the number of vehicles on the road and miles driven per vehicle, we propose that an effective long-term strategy for reducing MVC-related injury would be continued technological innovation in vehicle design, aimed at progressively removing the driver from routine operational decision-making. Once this is achieved, high rates of speed could be achieved on open highways, with minimal risk of crashes and injury to occupants and pedestrians. PMID:25116634

Toward an effective long-term strategy for preventing motor vehicle crashes and injuries.

PubMed

Mawson, Anthony R; Walley, E Kenneth

2014-08-11

Casualties due to motor vehicle crashes (MVCs) include some 40,000 deaths each year in the United States and one million deaths worldwide. One strategy that has been recommended for improving automobile safety is to lower speed limits and enforce them with speed cameras. However, motor vehicles can be hazardous even at low speeds whereas properly protected human beings can survive high-speed crashes without injury. Emphasis on changing driver behavior as the focus for road safety improvements has been largely unsuccessful; moreover, drivers today are increasingly distracted by secondary tasks such as cell phone use and texting. Indeed, the true limiting factor in vehicular safety is the capacity of human beings to sense and process information and to make rapid decisions. Given that dramatic reductions in injuries and deaths from MVCs have occurred over the past century due to improvements in safety technology, despite increases in the number of vehicles on the road and miles driven per vehicle, we propose that an effective long-term strategy for reducing MVC-related injury would be continued technological innovation in vehicle design, aimed at progressively removing the driver from routine operational decision-making. Once this is achieved, high rates of speed could be achieved on open highways, with minimal risk of crashes and injury to occupants and pedestrians.

Associations and Trends in Cause-Specific Rates of Death Among Persons Reported with HIV Infection, 23 U.S. Jurisdictions, Through 2011.

PubMed

Adih, William K; Selik, Richard M; Hall, H Irene; Babu, Aruna Surendera; Song, Ruiguang

2016-01-01

Published death rates for persons with HIV have not distinguished deaths due to HIV from deaths due to other causes. Cause-specific death rates would allow better assessment of care needs. Using data reported to the US national HIV surveillance system, we examined a) associations between selected decedent characteristics and causes of death during 2007-2011, b) trends in rates of death due to underlying causes among persons with AIDS during 1990-2011, and among all persons with diagnosed HIV infection (with or without AIDS) during 2000-2011. During 2007-2011, non-HIV-attributable causes of death with the highest rates per 1,000 person-years were heart disease (2.0), non-AIDS cancers other than lung cancer (1.4), and accidents (0.8). During 1990-2011, among persons with AIDS, the annual rate of death due to HIV-attributable causes decreased by 89% (from 122.0 to 13.2), and the rate due to non-HIV-attributable-causes decreased by 57% (from 20.0 to 8.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 11% to 43%. During 2000-2011, among persons with HIV infection, the rate of death due to HIV-attributable causes decreased by 69% (from 26.4 to 8.3), and the rate due to non-HIV-attributable causes decreased by 28% (from 10.5 to 7.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 25% to 48%. Among HIV-infected persons, as rates of death due to HIV-attributable causes decreased, rates due to non-HIV-attributable causes also decreased, but the percentages of deaths due to non-HIV-attributable causes, such as heart disease and non-AIDS cancers increased.

An analysis of possible mechanisms of unexpected death occurring in hydatid disease (echinococcosis).

PubMed

Byard, Roger W

2009-07-01

Most cases of hydatid disease in human populations are due to Echinococcus granulosus. The hydatid life cycle involves passage between definitive hosts such as dogs and intermediate hosts such as sheep. Humans become accidental intermediate hosts following ingestion of food or water contaminated with eggs or by contact with infected dogs. Although hydatid disease may remain asymptomatic, occasional cases of sudden and unexpected death present to autopsy. Causes of rapid clinical decline involve a wide range of mechanisms including anaphylaxis (with or without cyst rupture), cardiac outflow obstruction or conduction tract disturbance, pulmonary and cerebral embolism, pericarditis, cardiac tamponade, myocardial ischemia, pulmonary hypertension, peritonitis, hollow organ perforation, intracerebral mass effect, obstructive hydrocephalus, seizures, cerebral ischemia/infarction, and pregnancy complications. The autopsy assessment of cases therefore requires careful examination of all organ systems for characteristic cystic lesions, as multiorgan involvement is common, with integration of findings so that possible mechanisms of death can be determined. Measurement of serum tryptase and specific IgE levels should be undertaken for possible anaphylaxis.

New Ceratocystis species associated with rapid death of Metrosideros polymorpha in Hawai`i

USDA-ARS?s Scientific Manuscript database

The native 'ohi'a lehua (Metrosideros polymorpha) has cultural, biological and ecological significance to Hawai'i, but it is seriously threatened by a disease commonly referred to as rapid 'ohi'a death (ROD). Preliminary investigations showed that a Ceratocystis species similar to C. fimbriata sensu...

Autopsy discoveries of death from malaria.

PubMed

Menezes, Ritesh G; Pant, Sadip; Kharoshah, Magdy A; Senthilkumaran, Subramanian; Arun, M; Nagesh, K R; Bhat, Nishanth B; Mahadeshwara Prasad, D R; Karki, Raj Kumar; Subba, S H; Fazil, Abul

2012-05-01

Malaria inflicts a huge health care burden in terms of mortality and morbidity worldwide. There has been evidence in the literature where many unexpected/unexplained deaths turned out to be related to malaria on autopsy. The aim of this study is to review autopsy diagnosed malaria related deaths in the literature with due stress to its biologic and forensic aspects. A meticulous literature search was performed for "sudden malaria death", "malaria death postmortem diagnosis" and "unexplained death malaria" across PubMed, SCOPUS, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine, British Nursing Index, CINAHL, EMBASE, Ovid-MEDLINE and Google Scholar. All the literature was thoroughly reviewed and analyzed with reference to the type of study, location, travel history, age, gender, circumstance of death, method of diagnosis, species involved, chemoprophylaxis usage and take home message from the particular study. Plasmodium falciparum was responsible in most of the cases. The symptoms mimicked influenza in most of the case reports. Travel to endemic areas was common to most of the victims. The travelers were from all over the world including USA, France, Switzerland, Spain, Portugal, Germany and Asia (China and Japan). Vascular congestion with the presence of malarial pigment laden RBCs in capillaries of various organs was the major histopathology finding. Such lesions were found in the brains of all subjects (100%), liver of 78% of the cases, spleen in 67%, lungs in 56% and myocardium in 43% of the cases. Peripheral smear and rapid diagnostic test was of great aid to the autopsy in many cases. PCR was used for diagnosis as well as exclusion of possibility of co-infection with other species in case of Plasmodium knowlesi related death. The postmortem and histopathology findings in this case were similar to P. falciparum except for the fact that brain sections were negative for intracellular adhesion molecule-1. Chemoprophylaxis was not taken by the victims except for two in whom history of chloroquine based chemoprophylaxis was mentioned. Given the worldwide prevalence of the disease, increasing international travel and rapidly developing drug resistance, malaria will continue to be an important disease and should be considered in all cases of unexpected deaths particularly in malaria endemic regions or in presence of travel history to endemic regions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Leaving Sweden behind: Gains in life expectancy in Canada.

PubMed

Auger, Nathalie; Le Serbon, Emilie; Rostila, Mikael

2015-06-01

Sweden and Canada are known for quality of living and exceedingly high life expectancy, but recent data on how these countries compare are lacking. We measured life expectancy in Canada and Sweden during the past decade, and identified factors responsible for changes over time. We calculated life expectancy at birth for Canada and Sweden annually from 2000 to 2010, and determined the ages and causes of death responsible for the gap between the two countries using Arriaga's method. We determined how population growth, ageing, and mortality influenced the number of deaths over time. During 2000-2010, life expectancy in Canada caught up with Sweden for men, and surpassed Sweden by 0.4 years for women. Sweden lost ground owing to a slower reduction in circulatory and tumour mortality after age 65 years compared with Canada. Nonetheless, population ageing increased the number of deaths in Canada, especially for mental and nervous system disorders. In Sweden, the number of deaths decreased. In only one decade, life expectancy in Canada caught up and surpassed Sweden due to rapid improvements in circulatory and tumour mortality. Population ageing increased the number of deaths in Canada, potentially stressing the health care system more than in Sweden. © 2015 the Nordic Societies of Public Health.

Synergistic Anticancer Action of Lysosomal Membrane Permeabilization and Glycolysis Inhibition.

PubMed

Kosic, Milica; Arsikin-Csordas, Katarina; Paunovic, Verica; Firestone, Raymond A; Ristic, Biljana; Mircic, Aleksandar; Petricevic, Sasa; Bosnjak, Mihajlo; Zogovic, Nevena; Mandic, Milos; Bumbasirevic, Vladimir; Trajkovic, Vladimir; Harhaji-Trajkovic, Ljubica

2016-10-28

We investigated the in vitro and in vivo anticancer effect of combining lysosomal membrane permeabilization (LMP)-inducing agent N-dodecylimidazole (NDI) with glycolytic inhibitor 2-deoxy-d-glucose (2DG). NDI-triggered LMP and 2DG-mediated glycolysis block synergized in inducing rapid ATP depletion, mitochondrial damage, and reactive oxygen species production, eventually leading to necrotic death of U251 glioma cells but not primary astrocytes. NDI/2DG-induced death of glioma cells was partly prevented by lysosomal cathepsin inhibitor E64 and antioxidant α-tocopherol, suggesting the involvement of LMP and oxidative stress in the observed cytotoxicity. LMP-inducing agent chloroquine also displayed a synergistic anticancer effect with 2DG, whereas glucose deprivation or glycolytic inhibitors iodoacetate and sodium fluoride synergistically cooperated with NDI, thus further indicating that the anticancer effect of NDI/2DG combination was indeed due to LMP and glycolysis block. The two agents synergistically induced ATP depletion, mitochondrial depolarization, oxidative stress, and necrotic death also in B16 mouse melanoma cells. Moreover, the combined oral administration of NDI and 2DG reduced in vivo melanoma growth in C57BL/6 mice by inducing necrotic death of tumor cells, without causing liver, spleen, or kidney toxicity. Based on these results, we propose that NDI-triggered LMP causes initial mitochondrial damage that is further increased by 2DG due to the lack of glycolytic ATP required to maintain mitochondrial health. This leads to a positive feedback cycle of mitochondrial dysfunction, ATP loss, and reactive oxygen species production, culminating in necrotic cell death. Therefore, the combination of LMP-inducing agents and glycolysis inhibitors seems worthy of further exploration as an anticancer strategy. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

Circulating cell-free DNA: an up-coming molecular marker in exercise physiology.

PubMed

Breitbach, Sarah; Tug, Suzan; Simon, Perikles

2012-07-01

The phenomenon of circulating cell-free DNA (cfDNA) concentrations is of importance for many biomedical disciplines including the field of exercise physiology. Increases of cfDNA due to exercise are described to be a potential hallmark for the overtraining syndrome and might be related to, or trigger adaptations of, immune function induced by strenuous exercise. At the same time, exercise provides a practicable model for studying the phenomenon of cfDNA that is described to be of pathophysiological relevance for different topics in clinical medicine like autoimmune diseases and cancer. In this review, we are summarizing the current knowledge of exercise-based acute and chronic alterations in cfDNA levels and their physiological significance. The effects of acute exercise on cfDNA concentrations have been investigated in resistance exercises and in continuous, stepwise and interval endurance exercises of different durations. cfDNA concentrations peaked immediately after acute exercise and showed a rapid return to baseline levels. Typical markers of skeletal muscle damage (creatine kinase, uric acid, C-reactive protein) show delayed kinetics compared with the cfDNA peak response. Exercise parameters such as intensity, duration or average energy expenditure do not explain the extent of increasing cfDNA concentrations after strenuous exercise. This could be due to complex processes inside the human organism during and after physical activity. Therefore, we hypothesize composite effects of different physiological stress parameters that come along with exercise to be responsible for increasing cfDNA concentrations. We suggest that due to acute stress, cfDNA levels increase rapidly by a spontaneous active or passive release mechanism that is not yet known. As a result of the rapid and parallel increase of cfDNA and lactate in an incremental treadmill test leading to exhaustion within 15-20 minutes, it is unlikely that cfDNA is released into the plasma by typical necrosis or apoptosis of cells in acute exercise settings. Recently, rapid DNA release mechanisms of activated immune-competent cells like NETosis (pathogen-induced cell death including the release of neutrophil extracellular traps [NETs]) have been discovered. cfDNA accumulations might comprise a similar kind of cell death including trap formation or an active release of cfDNA. Just like chronic diseases, chronic high-intensity resistance training protocols induced persistent increases of cfDNA levels. Chronic, strenuous exercise protocols, either long-duration endurance exercise or regular high-intensity workouts, induce chronic inflammation that might lead to a slow, constant release of DNA. This could be due to mechanisms of cell death like apoptosis or necrosis. Yet, it has neither been implicated nor proven sufficiently whether cfDNA can serve as a marker for overtraining. The relevance of cfDNA with regard to overtraining status, performance level, and the degree of physical exhaustion still remains unclear. Longitudinal studies are required that take into account standardized and controlled exercise, serial blood sampling, and large and homogeneous cohorts of different athletic achievement. Furthermore, it is important to establish standardized laboratory procedures for the measurement of genomic cfDNA concentrations by quantitative real-time polymerase chain reaction (PCR). We introduce a new hypothesis based on acute exercise and chronic exposure to stress, and rapid active and passive chronic release of cfDNA fragments into the circulation.

Leading causes of death from injury and poisoning by age, sex and urban/rural areas in Tianjin, China 1999-2006.

PubMed

Jiang, Guohong; Choi, Bernard C K; Wang, Dezheng; Zhang, Hui; Zheng, Wenlong; Wu, Tongyu; Chang, Gai

2011-05-01

Injury and poisoning are a growing public health concern in China due to rapid economic growth, which has resulted in many cases with an injury-prone environment, such as overcrowded traffic, booming construction, and work-related stress. This study investigates the distribution and trends of deaths from injury and poisoning in Tianjin, China, by age, sex and urban/rural status, from 1999 to 2006. The study used data from the all-cause mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention (CDC). Each death certificate recorded 53 variables. Cause of death was coded using the International Classification of Diseases (ICD). Standardized mortality rates and proportions of deaths were analyzed. Traffic accidents, suicide, poisoning, drowning and fall were the leading causes of fatal injuries in Tianjin from 1999 to 2006. Injury mortality rates were high in males, in rural areas, and in the older age groups. Despite low injury mortality rates, injury accounted for close to 50% of all deaths amongst the 5-29 year age group. Traffic accident mortality rates increased, although not significantly so, during the period from 1999 to 2006. Injury prevention and control is a high public health priority in Tianjin. Our detailed table on the number of deaths by causes of fatal injuries and by age group provides important information to set prevention strategies in the nurseries, schools, workplace and seniors homes. 2009 Elsevier Ltd. All rights reserved.

Associations and Trends in Cause-Specific Rates of Death Among Persons Reported with HIV Infection, 23 U.S. Jurisdictions, Through 2011

PubMed Central

Adih, William K.; Selik, Richard M.; Hall, H. Irene; Babu, Aruna Surendera; Song, Ruiguang

2016-01-01

Background: Published death rates for persons with HIV have not distinguished deaths due to HIV from deaths due to other causes. Cause-specific death rates would allow better assessment of care needs. Methods: Using data reported to the US national HIV surveillance system, we examined a) associations between selected decedent characteristics and causes of death during 2007-2011, b) trends in rates of death due to underlying causes among persons with AIDS during 1990-2011, and among all persons with diagnosed HIV infection (with or without AIDS) during 2000-2011. Results: During 2007-2011, non-HIV-attributable causes of death with the highest rates per 1,000 person-years were heart disease (2.0), non-AIDS cancers other than lung cancer (1.4), and accidents (0.8). During 1990-2011, among persons with AIDS, the annual rate of death due to HIV-attributable causes decreased by 89% (from 122.0 to 13.2), and the rate due to non-HIV-attributable-causes decreased by 57% (from 20.0 to 8.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 11% to 43%. During 2000-2011, among persons with HIV infection, the rate of death due to HIV-attributable causes decreased by 69% (from 26.4 to 8.3), and the rate due to non-HIV-attributable causes decreased by 28% (from 10.5 to 7.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 25% to 48%. Conclusion: Among HIV-infected persons, as rates of death due to HIV-attributable causes decreased, rates due to non-HIV-attributable causes also decreased, but the percentages of deaths due to non-HIV-attributable causes, such as heart disease and non-AIDS cancers increased. PMID:27708746

Factors promoting resident deaths at aged care facilities in Japan: a review.

PubMed

Sugimoto, Kentaro; Ogata, Yasuko; Kashiwagi, Masayo

2018-03-01

Due to an increasingly ageing population, the Japanese government has promoted elderly deaths in aged care facilities. However, existing facilities were not designed to provide resident end-of-life care and the proportion of aged care facility deaths is currently less than 10%. Consequently, the present review evaluated the factors that promote aged care facility resident deaths in Japan from individual- and facility-level perspectives to exploring factors associated with increased resident deaths. To achieve this, MEDLINE, CINAHL, Web of Science and Ichushi databases were searched on 23 January 2016. Influential factors were reviewed for two healthcare services (insourcing and outsourcing facilities) as well as external healthcare agencies operating outside facilities. Of the original 2324 studies retrieved, 42 were included in analysis. Of these studies, five focused on insourcing, two on outsourcing, seven on external agencies and observed facility/agency-level factors. The other 28 studies identified individual-level factors related to death in aged care facilities. The present review found that at both facility and individual levels, in-facility resident deaths were associated with healthcare service provision, confirmation of resident/family end-of-life care preference and staff education. Additionally, while outsourcing facilities did not require employment of physicians/nursing staff to accommodate resident death, these facilities required visits by physicians and nursing staff from external healthcare agencies as well as residents' healthcare input. This review also found few studies examining outsourcing facilities. The number of healthcare outsourcing facilities is rapidly increasing as a result of the Japanese government's new tax incentives. Consequently, there may be an increase in elderly deaths in outsourcing healthcare facilities. Accordingly, it is necessary to identify the factors associated with residents' deaths at outsourcing facilities. © 2016 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

Maternal death from stroke: a thirty year national retrospective review.

PubMed

Foo, Lin; Bewley, Susan; Rudd, Anthony

2013-12-01

In the United Kingdom (UK), the maternal mortality rate from stroke is reported at 0.3/100,000 deliveries, but only antenatal data have previously been reviewed. We hypothesise that the true rate is much higher due to a propensity for stroke occurring in the post-partum period, and that the rate will rise in parallel with trends of increasing maternal age and medical co-morbidities. Our objectives are to investigate the UK stroke mortality rate in pregnancy and the puerperium, and to examine temporal changes in fatal maternal strokes over a 30 year period. Retrospective review of stroke-related maternal deaths reported to the UK confidential enquiries into maternal death between 1979 and 2008, encompassing 21,514,457 maternities. In accordance with the ICD.10 classification, cases were divided into direct or indirect deaths. Late and coincidental deaths were not included in analyses. Lessons from sub-standard care associated with maternal death from stroke were collated. In 1979-2008 there were 347 maternal deaths from stroke: 139 cases were direct deaths, i.e. the fatal stroke was a direct result of pregnancy. The incidence of fatal stroke is relatively constant at 1.61/100,000 maternities, with a 13.9% (95% CI 12.6-15.3) proportional mortality rate. Intracranial haemorrhage was the single greatest cause of maternal death from stroke. This is the largest UK study examining the incidence of fatal maternal stroke in pregnancy and the puerperium. Our results highlight the high proportion of women who die from stroke in the puerperium. Sub-standard care featured especially in regard to management of dangerously high systolic blood pressure levels. These deaths highlight the importance of education in managing rapid-onset hypertension and superimposed coagulopathies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

20 CFR 410.458 - Irrebuttable presumption of death due to pneumoconiosis-survivor's claim.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Irrebuttable presumption of death due to... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.458 Irrebuttable presumption of death due to pneumoconiosis—survivor's...

Forensic standardizations in torture and death in custody investigations

PubMed Central

2012-01-01

Torture and death in custody have incurred rapid development as juridical subject in recent years in Europe, with the implementation of the European Convention of Human Rights. Evaluation of sufferance severity, which is the consequence of pathology with chronic evolution, the predictability of decompensation of a subclinical pathology, and translating these medical information on a scale measuring the severity of detention consequences, are all challenges for the modern detention healthcare system, in which most allegations of torture are due to lack of appropriate medical treatment administered to inmates. Where ethics are concerned, the main data difficulties are addressed in ethical conflicts between officials and experts of the parties and also between experts and judiciary officials who handle cases of torture or death in detention; this is why standardization is very important in such cases both in clinical expertise and in autopsies or exhumations. Discussions: We must improve the forensic expertise methodology, the process of collecting data with statistical purposes, and sound evaluation criteria, all in a strong connection with the need for a balanced legal framework applied in the case of civil compensations granted after death in custody, and the biunique relation between medico-legal expertise and case investigation has to be standardized. PMID:24265878

Fetal electrocardiograph

NASA Astrophysics Data System (ADS)

Rios, Heriberto; Andrade, Armando; Puente, Ernestina; Lizana, Pablo R.; Mendoza, Diego

2002-11-01

The high intra-uterine death rate is due to failure in appropriately diagnosing some problems in the cardiobreathing system of the fetus during pregnancy. The electrocardiograph is one apparatus which might detect problems at an early stage. With electrodes located near the womb and uterus, in a way similar to the normal technique, the detection of so-called biopotential differences, caused by concentrations of ions, can be achieved. The fetal electrocardiograph is based on an ultrasound technique aimed at detecting intrauterine problems in pregnant women, because it is a noninvasive technique due to the very low level of ultrasound power used. With this system, the following tests can be done: Heart movements from the ninth week onwards; Rapid and safe diagnosis of intrauterine fetal death; Location and size of the placenta. The construction of the fetal electrocardiograph requires instrument level components directly mounted on the printed circuit board, in order to avoid stray capacitance in the cabling which prevents the detection of the E.C.G. activity. The low cost of the system makes it affordable to low budget institutions; in contrast, available commercial systems are priced in U.S. Dollars. (To be presented in Spanish.)

Genetic testing and genetic counseling in patients with sudden death risk due to heritable arrhythmias.

PubMed

Spoonamore, Katherine G; Ware, Stephanie M

2016-03-01

Sudden cardiac death due to heritable ventricular arrhythmias is an important cause of mortality, especially in young healthy individuals. The identification of the genetic basis of Mendelian diseases associated with arrhythmia has allowed the integration of this information into the diagnosis and clinical management of patients and at-risk family members. The rapid expansion of genetic testing options and the increasing complexity involved in the interpretation of results creates unique opportunities and challenges. There is a need for competency to incorporate genetics into clinical management and to provide appropriate family-based risk assessment and information. In addition, disease-specific genetic knowledge is required to order and correctly interpret and apply genetic testing results. Importantly, genetic diagnosis has a critical role in the risk stratification and clinical management of family members. This review summarizes the approach to genetic counseling and genetic testing for inherited arrhythmias and highlights specific genetic principles that apply to long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

[Regulatory mechanisms in focal cerebral ischemia. New possibilities in neuroprotective therapy].

PubMed

Nagy, Zoltán; Simon, László; Bori, Zoltán

2002-03-20

Permanent or temporary disruption of cerebral blood flow rapidly depletes brain regions of their limited energy reserves (glycogen, glucose, oxygen, ATP) leading to an energy crisis. Tissue damage occurs due to the energy crisis. The central part of the damage, the ischaemic "core" region is surrounded by zones of the shell-like penumbra. Necrotic, as well as apoptotic cell death could be identified in the penumbra. Going away from the ischaemic core different neurochemical processes are occurring by space and time. "Immediate early response" genes (c-fos, fos-B, c-Jun, krox 20, 24) are activated, heatshock proteins (hsp 70, 72, HSF, HSE, HIF), cytokines (TNF-alpha, IL-1 beta), inflammatory factors (COX), adhesion and glial factors (ICAM-1, ELAM-1, P-selectin), vasoactive factors (IL-6, -10, PAF), reactive oxigen radicals and connected factors (O2, OH, NO, NOS, SOD) are produced within minutes and hours. Cell deaths, necrosis and apoptosis due to the activation of calpains, caspases and nucleases occur in days. In parallel, growth factors and plasticity proteins (BDNF, NGF, TGF-beta, VEGF, PDGF, GAP-43) are activated as a basis of functional rehabilitation.

3-Bromopyruvate induces rapid human prostate cancer cell death by affecting cell energy metabolism, GSH pool and the glyoxalase system.

PubMed

Valenti, Daniela; Vacca, Rosa A; de Bari, Lidia

2015-12-01

3-bromopyruvate (3-BP) is an anti-tumour drug effective on hepatocellular carcinoma and other tumour cell types, which affects both glycolytic and mitochondrial targets, depleting cellular ATP pool. Here we tested 3-BP on human prostate cancer cells showing, differently from other tumour types, efficient ATP production and functional mitochondrial metabolism. We found that 3-BP rapidly induced cultured androgen-insensitive (PC-3) and androgen-responsive (LNCaP) prostate cancer cell death at low concentrations (IC(50) values of 50 and 70 μM, respectively) with a multimodal mechanism of action. In particular, 3-BP-treated PC-3 cells showed a selective, strong reduction of glyceraldeide 3-phosphate dehydrogenase activity, due to the direct interaction of the drug with the enzyme. Moreover, 3-BP strongly impaired both glutamate/malate- and succinate-dependent mitochondrial respiration, membrane potential generation and ATP synthesis, concomitant with the inhibition of respiratory chain complex I, II and ATP synthase activities. The drastic reduction of cellular ATP levels and depletion of GSH pool, associated with significant increase in cell oxidative stress, were found after 3-BP treatment of PC-3 cells. Interestingly, the activity of both glyoxalase I and II, devoted to the elimination of the cytotoxic methylglyoxal, was strongly inhibited by 3-BP. Both N-acetylcysteine and aminoguanidine, GSH precursor and methylglyoxal scavenger, respectively, prevented 3-BP-induced PC-3 cell death, showing that impaired cell antioxidant and detoxifying capacities are crucial events leading to cell death. The provided information on the multi-target cytotoxic action of 3-BP, finally leading to PC-3 cell necrosis, might be useful for future development of 3-BP as a therapeutic option for prostate cancer treatment.

Lung cancer epidemiology: contemporary and future challenges worldwide.

PubMed

Didkowska, Joanna; Wojciechowska, Urszula; Mańczuk, Marta; Łobaszewski, Jakub

2016-04-01

Over the last century, lung cancer from the rarest of diseases became the biggest cancer killer of men worldwide and in some parts of the world also of women (North America, East Asia, Northern Europe, Australia and New Zealand). In 2012 over 1.6 million of people died due to lung cancer. The cause-effect relationship between tobacco smoking and lung cancer occurrence has been proven in many studies, both ecological and clinical. In global perspective one can see the increasing tobacco consumption trend followed by ascending trends of lung cancer mortality, especially in developing countries. In some more developed countries, where the tobacco epidemics was on the rise since the beginning of the 20th century and peaked in its mid, in male population lung cancer incidence trend reversed or leveled off. Despite predicted further decline of incidence rates, the absolute number of deaths will continue to grow in these countries. In the remaining parts of the world the tobacco epidemics is still evolving what brings rapid increase of the number of new lung cancer cases and deaths. Number of lung cancer deaths worldwide is expected to grow up to 3 million until 2035. The figures will double both in men (from 1.1 million in 2012 to 2.1 million in 2035) and women (from 0.5 million in 2012 to 0.9 million in 2035) and the two-fold difference between sexes will persist. The most rapid increase is expected in Africa region (AFRO) and East Mediterranean region (EMRO). The increase of the absolute number of lung cancer deaths in more developed countries is caused mostly by population aging and in less developed countries predominantly by the evolving tobacco epidemic.

Magnitude of discordance between registry data and death certificate when evaluating leading causes of death in dialysis patients.

PubMed

Lafrance, Jean-Philippe; Rahme, Elham; Iqbal, Sameena; Leblanc, Martine; Pichette, Vincent; Elftouh, Naoual; Vallée, Michel

2013-03-27

Discordance between dialysis registry and death certificate reported death has been demonstrated. Since cause of death is measured using registry data in dialysis patients and death certificate data in the general population, comparisons of cause of death proportions between dialysis patients and the general population may be biased. Our aim was to compare the proportion of deaths attributed to cardiovascular disease (CVD), malignancy, and infections between patients receiving dialysis and the general population using death certificates for both, and to quantify the magnitude of discrepancy between registry and death certificate estimates in dialysis patients. A retrospective cohort study of 5858 patients initiating maintenance dialysis between 2001 and 2007 was conducted. Cause of death was obtained from both registry and death certificate data for dialysis patients, and from death certificate data for the general population. Compared to the general population, use of death certificate data in dialysis patients resulted in smaller differences in the proportion of deaths attributed to CVD or infection than that from the registry. In the general population, the proportion of deaths due to CVD is 29.3% for men and 28.2% for women, and the proportion of deaths due to infection is 3.3% for men and 3.6% for women. For men, the proportion of deaths in dialysis patients due to CVD using registry data is 41.5%, compared with a proportion of 32.1% using death certificate data. Similarly for women, the proportion of deaths due to CVD using registry data is 35.2% and that using death certificate data 24.3%. The proportion of deaths due to infection in dialysis patients follows the same pattern: for men, the proportion of deaths due to infection using registry data is 9.9% and that from death certificate data at 5.0%; while for women the proportions are 11.6% and 4.8%, respectively. While absolute cause-specific mortality rates did differ, evaluation of causes of death using death certificate in dialysis patients in Quebec revealed that they do not have substantially different proportion of death due to CVD or infections than the general population. Infections appeared to be a frequent complication leading to death, suggesting that infections are an important target to consider for reducing mortality in dialysis populations.

78 FR 48456 - Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-08

... Customs Broker Licenses Due to Death of the License Holder AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION: Customs broker license cancellation due to death of the broker... without prejudice due to the death of the license holders. SUPPLEMENTARY INFORMATION: Notice is hereby...

The Impact of HIV, an Antiretroviral Programme and Tuberculosis on Mortality in South African Platinum Miners, 1992–2010

PubMed Central

Lim, Megan S. C.; Dowdeswell, Robert J.; Murray, Jill; Field, Nigel; Glynn, Judith R.; Sonnenberg, Pam

2012-01-01

Background HIV and tuberculosis (TB) are the most common causes of death in South Africa. Antiretroviral therapy (ART) programmes should have had an impact on mortality rates. This study describes the impact of HIV, a Wellness (HIV/ART) programme and TB on population-wide trends in mortality and causes of death among South African platinum miners, from before the HIV epidemic into the ART era. Methodology/Principal Findings Retrospective analysis was conducted using routinely-collected data from an open cohort. Mortality and causes of death were determined from multiple sources, including cardiorespiratory autopsy records. All-cause and cause-specific mortality rates were calculated by calendar year. 41,665 male miners were observed for 311,938 person years (py) with 3863 deaths. The all-cause age-standardised mortality rate increased from 5.9/1000py in 1992 to 20.2/1000py in 2002. Following ART rollout in 2003, annual mortality rates fluctuated between 12.4/1000py and 19.3/1000py in the subsequent 7 years. Half of all deaths were HIV-related and 21% were caused by TB. Half (50%) of miners who died of HIV after ART rollout had never been registered on the Wellness programme. TB was the most common cause of death in HIV positive miners, increasing from 28% of deaths in the pre-ART period to 41% in the post-ART period. Conclusions/Significance This population-based cohort experienced a rapid increase in mortality from 1996 to 2003 due to increases in HIV and TB mortality. Following ART rollout there was a decrease in mortality, but a steady decrease has not been sustained. Possible explanations for these trends include the changing composition of the workforce, maturation of the HIV epidemic, insufficient uptake of ART and an increase in the proportion of deaths due to TB. In order to make a significant and sustained reduction in mortality in this population, expanding and integrating HIV and TB care and treatment is essential. PMID:22761688

Mortality outcomes for Chinese and Japanese immigrants in the USA and countries of origin (Hong Kong, Japan): a comparative analysis using national mortality records from 2003 to 2011.

PubMed

Hastings, Katherine G; Eggleston, Karen; Boothroyd, Derek; Kapphahn, Kristopher I; Cullen, Mark R; Barry, Michele; Palaniappan, Latha P

2016-10-28

With immigration and minority populations rapidly growing in the USA, it is critical to assess how these populations fare after immigration, and in subsequent generations. Our aim is to compare death rates and cause of death across foreign-born, US-born and country of origin Chinese and Japanese populations. We analysed all-cause and cause-specific age-standardised mortality rates and trends using 2003-2011 US death record data for Chinese and Japanese decedents aged 25 or older by nativity status and sex, and used the WHO Mortality Database for Hong Kong and Japan decedents in the same years. Characteristics such as age at death, absolute number of deaths by cause and educational attainment were also reported. We examined a total of 10 458 849 deaths. All-cause mortality was highest in Hong Kong and Japan, intermediate for foreign-born, and lowest for US-born decedents. Improved mortality outcomes and higher educational attainment among foreign-born were observed compared with developed Asia counterparts. Lower rates in US-born decedents were due to decreased cancer and communicable disease mortality rates in the US heart disease mortality was either similar or slightly higher among Chinese-Americans and Japanese-Americans compared with those in developed Asia counterparts. Mortality advantages in the USA were largely due to improvements in cancer and communicable disease mortality outcomes. Mortality advantages and higher educational attainments for foreign-born populations compared with developed Asia counterparts may suggest selective migration. Findings add to our limited understanding of the racial and environmental contributions to immigrant health disparities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Education level and mortality in systemic lupus erythematosus (SLE): evidence of underascertainment of deaths due to SLE in ethnic minorities with low education levels.

PubMed

Ward, Michael M

2004-08-15

To determine if socioeconomic status, as measured by education level, is associated with mortality due to systemic lupus erythematosus (SLE), and to determine if these associations differ among ethnic groups. Sex- and race-specific mortality rates due to SLE by education level were computed for persons age 25-64 years using US Multiple Causes of Death data from 1994 to 1997. SLE-specific mortality rates were compared with all-cause mortality rates in 1997 to determine if the association between education level and mortality in SLE was similar to that in other causes of death. Among whites, the risk of death due to SLE was significantly higher among those with lower levels of education, and the risk gradient closely paralleled the 1997 all-cause mortality risks by education level. However, in African American women and men and Asian/Pacific Islander women, the risk of death due to SLE was lower among those with lower education levels, contrary to the associations between education level and all-cause mortality in these groups. Comparing the distribution of education levels among deaths due to SLE and all deaths in 1997, persons with lower education levels were underrepresented among deaths due to SLE in African Americans and Asian/Pacific Islanders. Among whites, higher education levels are associated with lower mortality due to SLE. These associations were not present in ethnic minorities, likely due to underascertainment of deaths due to SLE in less-well educated persons. This underascertainment may be due to underreporting of SLE on death certificates, but may also represent underdiagnosis of SLE in ethnic minorities with low education levels.

20 CFR 416.1334 - Termination due to death of recipient.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Termination due to death of recipient. 416... FOR THE AGED, BLIND, AND DISABLED Suspensions and Terminations § 416.1334 Termination due to death of... effective with the month after the month of death. ...

20 CFR 410.401 - Scope of subpart D.

Code of Federal Regulations, 2011 CFR

2011-04-01

...-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.401 Scope of subpart... of his death, or whether his death was due to pneumoconiosis. (b) Pneumoconiosis defined... basis for application of the statutory presumption of disability or death due to pneumoconiosis under...

20 CFR 416.1334 - Termination due to death of recipient.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Termination due to death of recipient. 416... FOR THE AGED, BLIND, AND DISABLED Suspensions and Terminations § 416.1334 Termination due to death of... effective with the month after the month of death. ...

20 CFR 416.1334 - Termination due to death of recipient.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Termination due to death of recipient. 416... FOR THE AGED, BLIND, AND DISABLED Suspensions and Terminations § 416.1334 Termination due to death of... effective with the month after the month of death. ...

Longevity in Slovenia: Past and potential gains in life expectancy by age and causes of death.

PubMed

Lotrič Dolinar, Aleša; Došenović Bonča, Petra; Sambt, Jože

2017-06-01

In Slovenia, longevity is increasing rapidly. From 1997 to 2014, life expectancy at birth increased by 7 and 5 years for men and women, respectively. This paper explores how this gain in life expectancy at birth can be attributed to reduced mortality from five major groups of causes of death by 5-year age groups. It also estimates potential future gains in life expectancy at birth. The importance of the five major causes of death was analysed by cause-elimination life tables. The total elimination of individual causes of death and a partial hypothetical adjustment of mortality to Spanish levels were analysed, along with age and cause decomposition (Pollard). During the 1997-2014 period, the increase in life expectancy at birth was due to lower mortality from circulatory diseases (ages above 60, both genders), as well as from lower mortality from neoplasms (ages above 50 years) and external causes (between 20 and 50 years) for men. However, considering the potential future gains in life expectancy at birth, by far the strongest effect can be attributed to lower mortality due to circulatory diseases for both genders. If Spanish mortality rates were reached, life expectancy at birth would increase by more than 2 years, again mainly because of lower mortality from circulatory diseases in very old ages. Life expectancy analyses can improve evidence-based decision-making and allocation of resources among different prevention programmes and measures for more effective disease management that can also reduce the economic burden of chronic diseases.

Rapid Detection of an ABT-737-Sensitive Primed for Death State in Cells Using Microplate-Based Respirometry

PubMed Central

Clerc, Pascaline; Carey, Gregory B.; Mehrabian, Zara; Wei, Michael; Hwang, Hyehyun; Girnun, Geoffrey D.; Chen, Hegang; Martin, Stuart S.; Polster, Brian M.

2012-01-01

Cells that exhibit an absolute dependence on the anti-apoptotic BCL-2 protein for survival are termed “primed for death” and are killed by the BCL-2 antagonist ABT-737. Many cancers exhibit a primed phenotype, including some that are resistant to conventional chemotherapy due to high BCL-2 expression. We show here that 1) stable BCL-2 overexpression alone can induce a primed for death state and 2) that an ABT-737-induced loss of functional cytochrome c from the electron transport chain causes a reduction in maximal respiration that is readily detectable by microplate-based respirometry. Stable BCL-2 overexpression sensitized non-tumorigenic MCF10A mammary epithelial cells to ABT-737-induced caspase-dependent apoptosis. Mitochondria within permeabilized BCL-2 overexpressing cells were selectively vulnerable to ABT-737-induced cytochrome c release compared to those from control-transfected cells, consistent with a primed state. ABT-737 treatment caused a dose-dependent impairment of maximal O2 consumption in MCF10A BCL-2 overexpressing cells but not in control-transfected cells or in immortalized mouse embryonic fibroblasts lacking both BAX and BAK. This impairment was rescued by delivering exogenous cytochrome c to mitochondria via saponin-mediated plasma membrane permeabilization. An ABT-737-induced reduction in maximal O2 consumption was also detectable in SP53, JeKo-1, and WEHI-231 B-cell lymphoma cell lines, with sensitivity correlating with BCL-2:MCL-1 ratio and with susceptibility (SP53 and JeKo-1) or resistance (WEHI-231) to ABT-737-induced apoptosis. Multiplexing respirometry assays to ELISA-based determination of cytochrome c redistribution confirmed that respiratory inhibition was associated with cytochrome c release. In summary, cell-based respiration assays were able to rapidly identify a primed for death state in cells with either artificially overexpressed or high endogenous BCL-2. Rapid detection of a primed for death state in individual cancers by “bioenergetics-based profiling” may eventually help identify the subset of patients with chemoresistant but primed tumors who can benefit from treatment that incorporates a BCL-2 antagonist. PMID:22880001

38 CFR 3.800 - Disability or death due to hospitalization, etc.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Disability or death due... Benefits § 3.800 Disability or death due to hospitalization, etc. This section applies to claims received... 3.363. (a) Where disease, injury, death or the aggravation of an existing disease or injury occurs...

38 CFR 3.800 - Disability or death due to hospitalization, etc.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Disability or death due... Benefits § 3.800 Disability or death due to hospitalization, etc. This section applies to claims received... 3.363. (a) Where disease, injury, death or the aggravation of an existing disease or injury occurs...

38 CFR 3.800 - Disability or death due to hospitalization, etc.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Disability or death due... Benefits § 3.800 Disability or death due to hospitalization, etc. This section applies to claims received... 3.363. (a) Where disease, injury, death or the aggravation of an existing disease or injury occurs...

38 CFR 3.800 - Disability or death due to hospitalization, etc.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Disability or death due... Benefits § 3.800 Disability or death due to hospitalization, etc. This section applies to claims received... 3.363. (a) Where disease, injury, death or the aggravation of an existing disease or injury occurs...

Global earthquake casualties due to secondary effects: A quantitative analysis for improving rapid loss analyses

USGS Publications Warehouse

Marano, K.D.; Wald, D.J.; Allen, T.I.

2010-01-01

This study presents a quantitative and geospatial description of global losses due to earthquake-induced secondary effects, including landslide, liquefaction, tsunami, and fire for events during the past 40 years. These processes are of great importance to the US Geological Survey's (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system, which is currently being developed to deliver rapid earthquake impact and loss assessments following large/significant global earthquakes. An important question is how dominant are losses due to secondary effects (and under what conditions, and in which regions)? Thus, which of these effects should receive higher priority research efforts in order to enhance PAGER's overall assessment of earthquakes losses and alerting for the likelihood of secondary impacts? We find that while 21.5% of fatal earthquakes have deaths due to secondary (non-shaking) causes, only rarely are secondary effects the main cause of fatalities. The recent 2004 Great Sumatra-Andaman Islands earthquake is a notable exception, with extraordinary losses due to tsunami. The potential for secondary hazards varies greatly, and systematically, due to regional geologic and geomorphic conditions. Based on our findings, we have built country-specific disclaimers for PAGER that address potential for each hazard (Earle et al., Proceedings of the 14th World Conference of the Earthquake Engineering, Beijing, China, 2008). We will now focus on ways to model casualties from secondary effects based on their relative importance as well as their general predictability. ?? Springer Science+Business Media B.V. 2009.

UPDATE ON THE GLOBAL BURDEN OF ISCHAEMIC AND HAEMORRHAGIC STROKE IN 1990–2013: THE GBD 2013 STUDY

PubMed Central

Feigin, Valery L.; Krishnamurthi, Rita; Parmar, Priya; Norrving, Bo; Mensah, George A.; Bennett, Derrick A.; Barker-Collo, Suzanne; Moran, Andrew; Sacco, Ralph L.; Truelsen, Thomas; Davis, Stephen; Pandian, Jeyaraj Durai; Naghavi, Mohsen; Forouzanfar, Mohammad H.; Nguyen, Grant; Johnson, Catherine O.; Vos, Theo; Meretoja, Atte; Murray, Christopher; Roth, Gregory A.; Thrift, Amanda; Banerjee, Amitava; Kengne, Andre Pascal; Misganaw, Awoke; Kissela, Brett M.; Wolfe, Charles; Yu, Chuanhua; Anderson, Craig; Kim, Daniel; Rojas-Rueda, David; Tanne, David; Tirschwell, David Lawrence; Nand, Devina; Kazi, Dhruv S.; Pourmalek, Farshad; Catalá-López, Ferrán; Abd-Allah, Foad; Gankpé, Fortuné; deVeber, Gabrielle; Donnan, Geoffrey; Hankey, Graeme J.; Christensen, Hanne K.; Campos-Nonato, Ismael; Shiue, Ivy; Fernandes, Jefferson G.; Jonas, Jost B.; Sheth, Kevin; Kim, Yunjin; Dokova, Klara; Stroumpoulis, Konstantinos; Sposato, Luciano A.; Bahit, Maria Cecilia; Geleijnse, Johanna M.; Mackay, Mark T.; Mehndiratta, Man Mohan; Endres, Matthias; Giroud, Maurice; Brainin, Michael; Kravchenko, Michael; Piradov, Michael; Soljak, Michael; Liu, Ming; Connor, Myles; Venketasubramanian, Narayanaswamy; Bornstein, Natan; Shamalov, Nikolay; Roy, Nobhojit; Cabral, Norberto; Beauchamp, Norman J.; Lavados, Pablo M.; Jeemon, Panniyammakal; Lotufo, Paulo A.; Chowdhury, Rajiv; Sahathevan, Ramesh; Hamadeh, Randah R.; Malekzadeh, Reza; Gillium, Richard; Westerman, Ronny; Akinyemi, Rufus Olusola; Salman, Rustam Al-Shahi; Dharmaratne, Samath D.; Basu, Sanjay; Abera, Semaw Ferede; Kosen, Soewarta; Sampson, Uchechukwu K. A.; Caso, Valeria; Vlassov, Vasiliy; Melaku, Yohannes Adama; Kokubo, Yoshiohiro; Shinohara, Yukito; Varakin, Yuri; Wang, Wenzhi

2015-01-01

Background Global stroke epidemiology is changing rapidly. Although age-standardised rates of stroke mortality have decreased worldwide in the past two decades, the absolute numbers of people who have a stroke every year, live with the consequences of stroke, and die from their stroke are increasing. Regular updates on the current level of stroke burden are important for advancing our knowledge on stroke epidemiology and facilitate organization and planning of evidence-based stroke care. Objectives To estimate incidence, prevalence, mortality, disability-adjusted life-years (DALYs) and years lived with disability (YLDs), and their trends for ischaemic stroke (IS) and haemorrhagic stroke (HS) for 188 countries from 1990–2013. Methodology Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated using all available data on mortality and stroke incidence, prevalence and excess mortality. Statistical models and country-level covariate data were employed and all rates were age-standardised to a global population. All estimated were produced with 95% uncertainty intervals (UI). Results In 2013, there were globally almost 25.7 million stroke survivors (71% with IS), 6.5 million deaths from stroke (51% died from IS), 113 million DALYs due to stroke (58% due to IS), and 10.3 million new strokes (67% IS). Over the 1990–2013 period, there was a significant increase in the absolute number of DALYs due to IS, and of deaths from IS and HS, survivors and incident events for both IS and HS. The preponderance of the burden of stroke continued to reside in developing countries, comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs. Globally, the proportional contribution of stroke-related DALYs and deaths due to stroke compared to all diseases increased from 1990 (3.54% [95% UI 3.11–4.00%] and 9.66% [95% UI 8.47–10.70%]) to 2013 (4.62% [95% UI 4.01–5.30%] and 11.75% [95% UI 10.45–13.31%], respectively), but there was a diverging trend in developed and developing countries with a significant increase in DALYs and deaths in developing countries, and no measurable change in the proportional contribution of DALYs and deaths from stroke in developed countries. Conclusion Global stroke burden continues to increase globally. More efficient stroke prevention and management strategies are urgently needed to halt and eventually reverse the stroke pandemic, while universal access to organized stroke services should be a priority. PMID:26505981

Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study.

PubMed

Feigin, Valery L; Krishnamurthi, Rita V; Parmar, Priya; Norrving, Bo; Mensah, George A; Bennett, Derrick A; Barker-Collo, Suzanne; Moran, Andrew E; Sacco, Ralph L; Truelsen, Thomas; Davis, Stephen; Pandian, Jeyaraj Durai; Naghavi, Mohsen; Forouzanfar, Mohammad H; Nguyen, Grant; Johnson, Catherine O; Vos, Theo; Meretoja, Atte; Murray, Christopher J L; Roth, Gregory A

2015-01-01

Global stroke epidemiology is changing rapidly. Although age-standardized rates of stroke mortality have decreased worldwide in the past 2 decades, the absolute numbers of people who have a stroke every year, and live with the consequences of stroke or die from their stroke, are increasing. Regular updates on the current level of stroke burden are important for advancing our knowledge on stroke epidemiology and facilitate organization and planning of evidence-based stroke care. This study aims to estimate incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013. Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated using all available data on mortality and stroke incidence, prevalence and excess mortality. Statistical models and country-level covariate data were employed, and all rates were age-standardized to a global population. All estimates were produced with 95% uncertainty intervals (UIs). In 2013, there were globally almost 25.7 million stroke survivors (71% with IS), 6.5 million deaths from stroke (51% died from IS), 113 million DALYs due to stroke (58% due to IS) and 10.3 million new strokes (67% IS). Over the 1990-2013 period, there was a significant increase in the absolute number of DALYs due to IS, and of deaths from IS and HS, survivors and incident events for both IS and HS. The preponderance of the burden of stroke continued to reside in developing countries, comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs. Globally, the proportional contribution of stroke-related DALYs and deaths due to stroke compared to all diseases increased from 1990 (3.54% (95% UI 3.11-4.00) and 9.66% (95% UI 8.47-10.70), respectively) to 2013 (4.62% (95% UI 4.01-5.30) and 11.75% (95% UI 10.45-13.31), respectively), but there was a diverging trend in developed and developing countries with a significant increase in DALYs and deaths in developing countries, and no measurable change in the proportional contribution of DALYs and deaths from stroke in developed countries. Global stroke burden continues to increase globally. More efficient stroke prevention and management strategies are urgently needed to halt and eventually reverse the stroke pandemic, while universal access to organized stroke services should be a priority. © 2015 S. Karger AG, Basel.

Vaccination and 30-Day Mortality Risk in Children, Adolescents, and Young Adults.

PubMed

McCarthy, Natalie L; Gee, Julianne; Sukumaran, Lakshmi; Weintraub, Eric; Duffy, Jonathan; Kharbanda, Elyse O; Baxter, Roger; Irving, Stephanie; King, Jennifer; Daley, Matthew F; Hechter, Rulin; McNeil, Michael M

2016-03-01

This study evaluates the potential association of vaccination and death in the Vaccine Safety Datalink (VSD). The study cohort included individuals ages 9 to 26 years with deaths between January 1, 2005, and December 31, 2011. We implemented a case-centered method to estimate a relative risk (RR) for death in days 0 to 30 after vaccination.Deaths due to external causes (accidents, homicides, and suicides) were excluded from the primary analysis. In a secondary analysis, we included all deaths regardless of cause. A team of physicians reviewed available medical records and coroner's reports to confirm cause of death and assess the causal relationship between death and vaccination. Of the 1100 deaths identified during the study period, 76 (7%) occurred 0 to 30 days after vaccination. The relative risks for deaths after any vaccination and influenza vaccination were significantly lower for deaths due to nonexternal causes (RR 0.57, 95% confidence interval [CI] 0.38-0.83, and RR 0.44, 95% CI 0.24-0.80, respectively) and deaths due to all causes (RR 0.72, 95% CI 0.56-0.91, and RR 0.44, 95% CI 0.28-0.65). No other individual vaccines were significantly associated with death. Among deaths reviewed, 1 cause of death was unknown, 25 deaths were due to nonexternal causes, and 34 deaths were due to external causes. The causality assessment found no evidence of a causal association between vaccination and death. Risk of death was not increased during the 30 days after vaccination, and no deaths were found to be causally associated with vaccination. Copyright © 2016 by the American Academy of Pediatrics.

[Thrombotic Microangiopathies].

PubMed

Schubert, Jörg; Dechant, Michael

2018-06-01

Thrombotic microangiopathies are almost devastating diseases leading to death at high frequency if untreated. They consist of at least five distinct entities, TTP, HUS, aHUS, TMA due to drug interference, systemic disease or post therapy TMA. Around 10 years ago there was only one established therapeutic approach as plasmapheresis. Meanwhile, there are new drugs been licensed or within licensing process. Patients with atypical HUS can be treated successfully by the Complement inhibitor Eculizumab. In addition, there is a new inhibitor of von-Willebrand-Polymerisation available. Caplacizumab provides a significantly better remission and decrease in TMA-related death. For therapy associated TMA as VOD/SOS Defibrotide could be established within a phase III study to significantly improve outcomes. In order to select these new medical approaches individual diagnostic parameters need to be established in order to rapidly distinguish between the TMA entities and start targeted therapy. © Georg Thieme Verlag KG Stuttgart · New York.

SYTO probes: markers of apoptotic cell demise.

PubMed

Wlodkowic, Donald; Skommer, Joanna

2007-10-01

As mechanistic studies on tumor cell death advance towards their ultimate translational goal, there is a need for specific, rapid, and high-throughput analytical tools to detect diverse cell demise modes. Patented DNA-binding SYTO probes, for example, are gaining increasing interest as easy-to-use markers of caspase-dependent apoptotic cell death. They are proving convenient for tracking apoptosis in diverse hematopoietic cell lines and primary tumor samples, and, due to their spectral characteristics, appear to be useful for the development of multiparameter flow cytometry assays. Herein, several protocols for multiparametric assessment of apoptotic events using SYTO probes are provided. There are protocols describing the use of green fluorescent SYTO 16 and red fluorescent SYTO 17 dyes in combination with plasma membrane permeability markers. Another protocol highlights the multiparametric use of SYTO 16 dye in conjunction with the mitochondrial membrane potential sensitive probe, tetramethylrhodamine methyl ester (TMRM), and the plasma membrane permeability marker, 7-aminoactinomycin D (7-AAD).

38 CFR 3.813 - Interim benefits for disability or death due to chloracne or porphyria cutanea tarda.

Code of Federal Regulations, 2010 CFR

2010-07-01

... rates that dependency and indemnity compensation would be payable if the death were service-connected... disability or death due to chloracne or porphyria cutanea tarda. 3.813 Section 3.813 Pensions, Bonuses, and... Indemnity Compensation Special Benefits § 3.813 Interim benefits for disability or death due to chloracne or...

38 CFR 3.813 - Interim benefits for disability or death due to chloracne or porphyria cutanea tarda.

Code of Federal Regulations, 2013 CFR

2013-07-01

... rates that dependency and indemnity compensation would be payable if the death were service-connected... disability or death due to chloracne or porphyria cutanea tarda. 3.813 Section 3.813 Pensions, Bonuses, and... Indemnity Compensation Special Benefits § 3.813 Interim benefits for disability or death due to chloracne or...

38 CFR 3.813 - Interim benefits for disability or death due to chloracne or porphyria cutanea tarda.

Code of Federal Regulations, 2011 CFR

2011-07-01

... rates that dependency and indemnity compensation would be payable if the death were service-connected... disability or death due to chloracne or porphyria cutanea tarda. 3.813 Section 3.813 Pensions, Bonuses, and... Indemnity Compensation Special Benefits § 3.813 Interim benefits for disability or death due to chloracne or...

38 CFR 3.813 - Interim benefits for disability or death due to chloracne or porphyria cutanea tarda.

Code of Federal Regulations, 2012 CFR

2012-07-01

... rates that dependency and indemnity compensation would be payable if the death were service-connected... disability or death due to chloracne or porphyria cutanea tarda. 3.813 Section 3.813 Pensions, Bonuses, and... Indemnity Compensation Special Benefits § 3.813 Interim benefits for disability or death due to chloracne or...

38 CFR 3.813 - Interim benefits for disability or death due to chloracne or porphyria cutanea tarda.

Code of Federal Regulations, 2014 CFR

2014-07-01

... rates that dependency and indemnity compensation would be payable if the death were service-connected... disability or death due to chloracne or porphyria cutanea tarda. 3.813 Section 3.813 Pensions, Bonuses, and... Indemnity Compensation Special Benefits § 3.813 Interim benefits for disability or death due to chloracne or...

[End of life in France].

PubMed

Vacheron, André

2013-01-01

Two major changes in end-of-life management have occured in recent decades: first, because of the increase in life expectancy and the resulting aging of the population, most deaths now involve old or very old people; second, more than two-thirds of deaths occur in a hospital or an institution. Our fellow citizens are afraid of suffering and death. They wish for a peaceful death, as rapid as possible and, in recent surveys, say they favour euthanasia. Yet euthanasia is illegal in France and in most other Western countries (with the exception of the Benelux nations). Palliative care ensures dignity in death, without anxiety of suffering, and is expanding rapidly in France. Léonetti's law of 22 April 2005 ensures the protection of the weakest, who should never be considered unworthy of life, yet is poorly known to the public and even to physicians. It now needs to be applied in practice.

Suicide history and mortality: a follow-up of a national cohort in the United States.

PubMed

Al-Sayegh, Hasan; Lowry, Joseph; Polur, Ram N; Hines, Robert B; Liu, Fengqi; Zhang, Jian

2015-01-01

Little is known about the cause-specific deaths among young suicide attempters from the general population, and the time window for intervention to reduce the elevated rate of death was unclear. We analyzed a nationally representative sample of young adults (17-39 years old) who participated in the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) and were followed up with vital status through December 31, 2006. The history of attempted suicide was associated with an increased rate for all-cause death (HR = 1.52 [95% CI = 0.92-2.52]) with borderline statistical significance. Previous suicide attempters experienced a 3-fold (HR = 2.68[=1.01-7.09]) increased rate for cardiovascular diseases (CVD), and a 7-fold (HR = 7.10 [95% CI = 1.37-36.9]) increased rate of death due to completed suicide compared with non-attempters. The survival curves of the attempters declined rapidly for the first 3 years of follow-up, and the distance between curves remained consistent starting from the third year to the end of the follow-up. Prevention services should be tailored not only for suicide, but also for cardiovascular diseases among populations with suicidal tendency, and the service should be intensified within first 3 years after suicidal behaviors occur.

Coniferyl Aldehyde Attenuates Radiation Enteropathy by Inhibiting Cell Death and Promoting Endothelial Cell Function

PubMed Central

Son, Yeonghoon; Jang, Jun-Ho; Lee, Yoon-Jin; Kim, Sung-Ho; Ko, Young-Gyo; Lee, Yun-Sil; Lee, Hae-June

2015-01-01

Radiation enteropathy is a common complication in cancer patients. The aim of this study was to investigate whether radiation-induced intestinal injury could be alleviated by coniferyl aldehyde (CA), an HSF1-inducing agent that increases cellular HSP70 expression. We systemically administered CA to mice with radiation enteropathy following abdominal irradiation (IR) to demonstrate the protective effects of CA against radiation-induced gastrointestinal injury. CA clearly alleviated acute radiation-induced intestinal damage, as reflected by the histopathological data and it also attenuated sub-acute enteritis. CA prevented intestinal crypt cell death and protected the microvasculature in the lamina propria during the acute and sub-acute phases of damage. CA induced HSF1 and HSP70 expression in both intestinal epithelial cells and endothelial cells in vitro. Additionally, CA protected against not only the apoptotic cell death of both endothelial and epithelial cells but also the loss of endothelial cell function following IR, indicating that CA has beneficial effects on the intestine. Our results provide novel insight into the effects of CA and suggest its role as a therapeutic candidate for radiation-induced enteropathy due to its ability to promote rapid re-proliferation of the intestinal epithelium by the synergic effects of the inhibition of cell death and the promotion of endothelial cell function. PMID:26029925

Necroptosis in cardiovascular disease - a new therapeutic target.

PubMed

Gupta, Kartik; Phan, Noel; Wang, Qiwei; Liu, Bo

2018-05-01

Contrary to the apoptosis-necrosis binary view of cell death, recent experimental evidence demonstrates that several forms of necrosis, represented by necroptosis, are regulated or programmed in nature. Multiple death stimuli known to be associated with cardiovascular disease are capable of causing either apoptosis or necroptosis. Whether a cell dies from apoptosis or necroptosis has distinct consequences on inflammation. It is known that apoptosis, a non-lytic form of death mediated by the caspase family of proteases, does not generally evoke an immune response. Necroptosis, on the other hand, is a lytic form of cell death. Due to the rapid loss of plasma membrane integrity, cells dying from necroptosis release proinflammatory intracellular contents and subsequently cause inflammation. Our review delineates various genetic and biochemical evidence that demonstrates a compelling role of necroptosis in the pathogenesis and/or progression of cardiovascular disease including myocardial infarction, atherosclerosis, and aortic aneurysm. Through recent studies of necroptosis in cardiovascular diseases, we attempt to discuss the role of necroptosis in vascular inflammation as well as the potential of necroptosis inhibitors in future clinical management of cardiovascular events. Inhibiting necroptosis in the vasculature has an overall protective role and necroptosis may represent a new therapeutic target to prevent the development and progression of cardiovascular diseases. Copyright © 2018 Elsevier Ltd. All rights reserved.

Irradiation with visible light enhances the antibacterial toxicity of silver nanoparticles produced by laser ablation

NASA Astrophysics Data System (ADS)

Ratti, Matthew; Naddeo, J. J.; Tan, Yuying; Griepenburg, Julianne C.; Tomko, John; Trout, Cory; O'Malley, Sean M.; Bubb, Daniel M.; Klein, Eric A.

2016-04-01

The rise of antibiotic-resistant bacteria is a rapidly growing global health concern. According to the Center for Disease Control, approximately 2 million illnesses and 23,000 deaths per year occur in the USA due to antibiotic resistance. In recent years, there has been a surge in the use of metal nanoparticles as coatings for orthopedic implants, wound dressings, and food packaging, due to their antimicrobial properties. In this report, we demonstrate that the antibacterial efficacy of silver nanoparticles (AgNPs) is enhanced with exposure to light from the visible spectrum. We find that the increased toxicity is due to augmented silver ion release and bacterial uptake. Interestingly, silver ion toxicity does not appear to depend on the formation of reactive oxygen species. Our findings provide a novel paradigm for using light to regulate the toxicity of AgNPs which may have a significant impact in the development of new antimicrobial therapeutics.

Could chest wall rigidity be a factor in rapid death from illicit fentanyl abuse?

PubMed

Burns, Glenn; DeRienz, Rebecca T; Baker, Daniel D; Casavant, Marcel; Spiller, Henry A

2016-06-01

There has been a significant spike in fentanyl-related deaths from illicit fentanyl supplied via the heroin trade. Past fentanyl access was primarily oral or dermal via prescription fentanyl patch diversion. One factor potentially driving this increase in fatalities is the change in route of administration. Rapid intravenous (IV) fentanyl can produce chest wall rigidity. We evaluated post-mortem fentanyl and norfentanyl concentrations in a recent surge of lethal fentanyl intoxications. Fentanyl related deaths from the Franklin County coroner's office from January to September 2015 were identified. Presumptive positive fentanyl results were confirmed by quantitative analysis using liquid chromatography tandem mass spectrometry (LC/MS/MS) and were able to quantify fentanyl, norfentanyl, alfentanyl, and sufentanyl. 48 fentanyl deaths were identified. Mean fentanyl concentrations were 12.5 ng/ml, (range 0.5 ng/ml to >40 ng/ml). Mean norfentanyl concentrations were 1.9 ng/ml (range none detected to 8.3 ng/ml). No appreciable concentrations of norfentanyl could be detected in 20 of 48 cases (42%) and were less than 1 ng/ml in 25 cases (52%). Elevated fentanyl concentrations did not correlate with rises in norfentanyl levels. In several cases fentanyl concentrations were strikingly high (22 ng/ml and 20 ng/ml) with no norfentanyl detected. The lack of any measurable norfentanyl in half of our cases suggests a very rapid death, consistent with acute chest rigidity. An alternate explanation could be a dose-related rapid onset of respiratory arrest. Deaths occurred with low levels of fentanyl in the therapeutic range (1-2 ng/ml) in apparent non-naïve opiate abusers. Acute chest wall rigidity is a well-recognized complication in the medical community but unknown within the drug abuse community. The average abuser of illicit opioids may be unaware of the increasing fentanyl content of their illicit opioid purchase. In summary we believe sudden onset chest wall rigidity may be a significant and previously unreported factor leading to an increased mortality, from illicit IV fentanyl use. Fentanyl and norfentanyl ratios and concentrations suggest a more rapid onset of death given the finding of fentanyl without norfentanyl in many of the fatalities. Chest wall rigidity may help explain the cause of death in these instances, in contrast to the typical opioid-related overdose deaths. Intravenous heroin users should be educated regarding this potentially fatal complication given the increasingly common substitution and combination with heroin of fentanyl.

The 2007 annual report of the Regional Infant and Child Mortality Review Committee.

PubMed

Randall, Brad; Wilson, Ann L

2008-08-01

The mission of the Regional Infant and Child Mortality Review Committee (RICMRC) is to review infant and child deaths so that information can be transformed into action to protect young lives. The 2007 review area includes South Dakota's Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hansen, Miner and Brookings counties. Although there were no deaths in 2007 that met the criteria of the Sudden Infant Death Syndrome (SIDS) in our region, there were three infant deaths associated with unsafe sleeping environments (including adult co-sleeping) that either caused or potentially may have caused these infants' deaths. We need to continue to promote the "Back to Sleep" campaign message of not only placing infants to sleep on their backs, but also making sure infants are put down to sleep on safe, firm sleeping surfaces and that they are appropriately dressed for the ambient temperature. Parents need to be aware of the potential hazards of co-sleeping with their infants. Compared to nine such deaths in 2006, only four deaths in 2007 involved motor-vehicle crashes, none of which were alcohol related. Two drowning deaths illustrated the rapidity in which even momentary caregiver distractions can lead to deaths in children in and around water. Since 1997 the Regional Infant and Child Mortality Review Committee (RICMRC) has sought to achieve its mission to "review infant and child deaths so that information can be transformed into action to protect young lives." For 2007, the committee reviewed 25 deaths from Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hansen, Miner and Brookings counties that met the following criteria: Children under the age of 18 dying subsequent to hospital discharge following delivery. Children who either died in these counties from causes sustained in them, or residents who died elsewhere from causes sustained in the 10-county region. The report that follows reviews the committee's activities for 2007. No deaths meeting the criteria for Sudden Infant Death Syndrome (SIDS) occurred in the review region. The committee has observed a stable decline in the number of deaths due to the SIDS as compared to the eight SIDS or possible SIDS deaths occurring in 1999. Unfortunately, however, there were three infant deaths in SIDS-like settings where asphyxia could not be excluded. Although the committee strives to be consistent year to year in its investigation protocols, we have noticed that the number of deaths classified as "undetermined" has been increasing over the last few years (starting in 1997: 1, 2, 1, 0, 2, 1, 2, 0, 5, 4, 5). Although it is possible that deaths certified as SIDS in earlier years may now be classified as undetermined due to asphyxial risks, we may also be seeing an increase in infants sleeping in unsafe environments. Our data may be mirroring a national trend amongst death investigators to increasingly recognize asphyxial risks in infant death scenes. Infants co-sleeping with adults (two deaths in 2007) may represent a risk factor not as frequently seen as in prior years. We will watch this trend closely in the future. The Committee strenuously advocates that the Back to Sleep message include placing infants on their back to sleep, avoiding soft bedding for infants, making parents aware of the potential hazards of co-sleeping with young infants, and eliminating both pre- and post-delivery fetal/infant cigarette smoke exposure. a decrease in youth motor-vehicle crash deaths to four versus the nine seen in 2006.2 Three of those dying in motor-vehicle crashes in 2007 were not wearing seat belts. The committee continues to feel that some of these deaths could have been prevented had these children been wearing a seat belt. Compared to four alcohol-related motor-vehicle crash fatalities in 2006, no deaths in 2007 were alcohol related. The committee, however, is painfully aware that even one crash involving multiple occupants can rapidly skew the apparent improvements in 2007 in the wrong direction. In 2007, two youths, both with disabilities, drown. One drown in a bath tub and the other in an outdoor pool. It is unfortunate that these deaths bring home the message that even the smallest, momentary lapses in supervision of these children can have fatal consequences. Fortunately, the child and infant homicide rate in our region is very low. Unfortunately, however, one infant did die as a result of being assaulted and shaken by one of its parents. There remains a need for the community at large, and the medical community specifically, to address issues of parental anger management, particularly when caregiver frustration is directed at children.

South African child deaths 1990–2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?

PubMed Central

Kerber, Kate J.; Lawn, Joy E.; Johnson, Leigh F.; Mahy, Mary; Dorrington, Rob E.; Phillips, Heston; Bradshaw, Debbie; Nannan, Nadine; Msemburi, William; Oestergaard, Mikkel Z.; Walker, Neff P.; Sanders, David; Jackson, Debra

2013-01-01

Objective: To analyse trends in under-five mortality rate in South Africa (1990–2011), particularly the contribution of AIDS deaths. Methods: Three nationally used models for estimating AIDS deaths in children were systematically reviewed. The model outputs were compared with under-five mortality rate estimates for South Africa from two global estimation models. All estimates were compared with available empirical data. Results: Differences between the models resulted in varying point estimates for under-five mortality but the trends were similar, with mortality increasing to a peak around 2005. The three models showing the contribution of AIDS suggest a maximum of 37–39% of child deaths were due to AIDS in 2004–2005 which has since declined. Although the rate of progress from 1990 is not the 4.4% needed to meet Millennium Development Goal 4 for child survival, South Africa's average annual rate of under-five mortality decline between 2006 and 2011 was between 6.3 and 10.2%. Conclusion: In 2005, South Africa was one of only four countries globally with an under-five mortality rate higher than the 1990 Millennium Development Goal baseline. Over the past 5 years, the country has achieved a rate of child mortality reduction exceeded by only three other countries. This rapid turnaround is likely due to scale-up of prevention of mother-to-child transmission of HIV, and to a lesser degree, the expanded roll-out of antiretroviral therapy. Emphasis on these programmes must continue, but failure to address other aspects of care including integrated high-quality maternal and neonatal care means that the decline in child mortality could stall. PMID:23863402

[Hyponatremia in emergency admissions - often dangerous].

PubMed

Fenske, W

2017-10-01

Hyponatremia is the most common electrolyte disorder in clinical practice and associated with increased morbidity and mortality, independent of underlying disease. Untreated acute hyponatremia can cause substantial morbidity and mortality as a result of osmotically induced cerebral edema whilst over rapid correction of chronic hyponatremia can cause serious neurologic impairment and death resulting from osmotic demyelination. Still hyponatremia is often neglected and insufficiently addressed, most likely due to limited understanding of its pathophysiological mechanisms. Being familiar with only few basic principles of body fluid regulation may be a worthwhile investment into the clinical career and save patients' lives.

Sources and Sinks: A Stochastic Model of Evolution in Heterogeneous Environments

NASA Astrophysics Data System (ADS)

Hermsen, Rutger; Hwa, Terence

2010-12-01

We study evolution driven by spatial heterogeneity in a stochastic model of source-sink ecologies. A sink is a habitat where mortality exceeds reproduction so that a local population persists only due to immigration from a source. Immigrants can, however, adapt to conditions in the sink by mutation. To characterize the adaptation rate, we derive expressions for the first arrival time of adapted mutants. The joint effects of migration, mutation, birth, and death result in two distinct parameter regimes. These results may pertain to the rapid evolution of drug-resistant pathogens and insects.

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

PubMed

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

2015-04-01

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

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

PubMed Central

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

2015-01-01

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

Growth, Survival, and Death of Bacteria and Fungi Following Wet-up of Seasonally Dried Soil Revealed by Heavy Water Stable Isotope Probing

NASA Astrophysics Data System (ADS)

Blazewicz, S.; Nuccio, E. E.; Lim, H.; Schwartz, E.; Brodie, E.; Firestone, M.

2013-12-01

The rapid increase in microbial activity that occurs when a dry soil is rewetted has been well documented and is of great interest due to implications of changing precipitation patterns on soil C dynamics. Several studies have shown minor net changes in microbial population diversity or abundance following wet-up, but the gross population dynamics of bacteria and fungi resulting from soil wet-up are virtually unknown due to the technical difficulties associated with such measurements. Here we applied DNA stable isotope probing with H218O coupled with quantitative PCR and high throughput sequencing of bacterial 16S rRNA genes to characterize taxonomic composition of bacteria and to describe new growth, survival, and mortality of bacteria and fungi following the rewetting of a seasonally dried California annual grassland soil. Total microbial abundance revealed little change throughout the 7-day post-wet incubation, but there was substantial turnover of both bacterial and fungal populations (49 and 52% respectively). New growth was linear between 24 and 168 hours for both bacteria and fungi with average growth rates of 2.3 x 108 bacterial 16S rRNA gene copies gdw-1 h-1 and 4.3 x 107 fungal ITS copies gdw-1 h-1. While bacteria and fungi differed in their mortality and survival characteristics during the 7-day incubation, mortality that occurred within the first 3 hours was similar with 25 and 27% of bacterial and fungal gene copies disappearing from the pre-wet community, respectively. The rapid disappearance of gene copies indicates that cell death, occurring either during the extreme dry down period (preceding 5 months) or during the rapid change in water-potential due to wet-up, generates a significant pool of available C that likely contributes to the large pulse in CO2 associated with wet-up. Sequential bacterial growth patterns observed at the phylum and order levels suggest that an ecologically coherent response was observable at coarse taxonomic levels with growth isolated to a limited number of orders within the first 24 hours, whereas the majority of growing organisms were detected between 24-72 hours post wet-up. Temporal changes in community composition suggest a degree of resilience in response to this abrupt environmental change; composition of new growth first diverges from the original community composition but eventually a trajectory towards the original composition was observed. A dynamic assemblage of growing and dying organisms controlled the CO2 pulse, but the balance between death and growth resulted in relatively stable total population abundances even after a profound and sudden change in environment.

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

PubMed Central

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

2014-01-01

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

A systematic review exploring the relationship between infection and sudden unexpected death between 2000 and 2016: A forensic perspective.

PubMed

Kruger, Mia M; Martin, Lorna J; Maistry, Sairita; Heathfield, Laura J

2018-05-21

Death due to infectious diseases is a major health concern worldwide. This is of particular concern in developing countries where poor-socio economic status and a lack of healthcare resources contribute to the high burden of disease. In some cases death due to infection can be acute and aggressive, and death may occur without a diagnosis whilst the person is still alive. These deaths may ultimately lead to a medico-legal autopsy being performed. There are various mechanisms by which sudden death due to infection may occur. In addition, there are many risk factors associated with sudden death due to infection, which differ between infants and older individuals. However, it is unclear which pathogens and risk factors are most frequently associated with sudden death due to infection. Therefore a systematic review of articles and case reports published between 1 January 2000 and 30 June 2016 was undertaken in order to (1) explore the relationship between pathogens and their causative role and (2) identify the relationship between predisposing and/or risk factors associated with sudden death due to infection. Major databases were searched and after critical appraisal 143 articles were identified. It was found that respiratory infections and deaths involving bacterial pathogens were most commonly associated with these deaths. In addition the most common risk factors in infants were exposure to tobacco smoke and co-sleeping. In adults the most common risk factors were co-morbid conditions and illnesses. This information aids in a better understanding of these deaths and highlights the need for more research in this field, particularly in developing countries. Copyright © 2018 Elsevier B.V. All rights reserved.

A fatal case of severe neck abscess due to a third branchial cleft fistula: morphologic and immunohistochemical analyses.

PubMed

Tong, Fang; Liang, Yue; Khan, Muhammad Fasahat; Zhang, Lin; Li, Wenhe; Mahmoodurrahman, Mohammed; Zhou, Yiwu

2016-09-15

Branchial cleft anomalies constitute a frequently encountered and commonly non-lethal disease in otolaryngology, and result from aberrant embryonic development. The third branchial cleft fistula is one of the four known specific types of branchial cleft anomalies, and always presents as recurrent neck abscess and suppurative thyroiditis. Here, we report an unexpected death due to severe neck infection following a third branchial cleft fistula. A 19-year-old man was sent to the hospital with a 1-week history of recurrent left-sided neck abscess, and was scheduled for incision and drainage of the abscess. However, before the surgery was performed, the man's condition deteriorated and he died. A review of his medical history showed that he had undergone a previous incision and drainage for a neck abscess 2 years ago. Postmortem examination revealed that the fatal neck abscess was induced by a third branchial cleft fistula. We conclude that a histopathological examination of neck tissue combined with a detailed review of medical history and examination of ultrasonographic and CT images can provide a rapid and accurate diagnosis of third branchial cleft fistula. This common, non-lethal disease can potentially lead to death if the neck infection is not properly diagnosed and treated. In medico-legal practice, medical examiners should be aware of this condition, as this knowledge would be important in the diagnosis of the cause of death.

[Tuberculosis pulmonum--"threaten us of epidemic"?].

PubMed

Chyczewska, Elzbieta

2008-01-01

Tuberculosis (TB) remains a deadly infectious disease affecting millions of people worldwide with 95% of cases and 98% of deaths occuring in developing countries (9 milion new cases, 1 million deaths annually) vs.WHO. Tuberculosis is on the increase in developed countries, because of AIDS, the use of immunosuppresive drugs which depress the host defence mechanism, decreased socioeconomic conditions, as well as increased immigration of persons from areas of high endemicity. The major reason for this increase was because of rapid rise in cases from sub-Saharan Africa (due to AIDS) nad Russia. Incidense of tuberculosis in Poland 2007--the number of notified cases was 8014. Pulmonary cases represented 92.7% of total all TB cases and 628 cases of extrapulmonary TB. Chidren TB cases represented 0.9% (74 cases) of all cases notified in Poland. The incidence of tuberculosis increases with age from 1.1 in children do 41.2 among 65 and older. The incidence of men (31.5) was two times higher than in women--14.5 per 100 000 respectivly. There were 716 deaths due to pulmonary TB and 23 from extrapulmonary TB. Multidrug resistance (MDR) of Mycobacterium tuberculosis is a major therapeutic problem, in the world, with a high mortality and occurs mainly in HIV-infected patients. The WHO estimates that around 50 million people are infected with MDR-TB! WHO suggest that a greater investment in the establishment treatment strategy of DOTS (Directly Observed Treatment Short-course) into all posible regions.

Leading medical causes of mortality among male prisoners in Texas, 1992--2003.

PubMed

Harzke, Amy J; Baillargeon, Jacques G; Kelley, Michael F; Pruitt, Sandi L; Pulvino, John S; Paar, David P

2011-07-01

Data from the Texas prison system and the Texas Vital Statistics Bureau were used to identify and assess the leading medical causes of death from 1992 to 2003 among male prisoners in Texas (N = 4,026). The leading medical causes of death were infection, cancer, cardiovascular disease (CVD), liver disease, and respiratory disease. Of these, only cancer showed a significant average annual increase in crude death rates (2.5% [0.2% to 4.9%]). Among prisoners aged 55 to 84 years, crude average annual death rates due to cancer and CVD were high and substantially exceeded death rates due to other causes. Among prisoners aged 25 to 44 years, crude average annual death rates due to infection exceeded death rates due to other causes. Continued improvements in the prevention, screening, and treatment of these conditions are warranted in correctional health care settings.

The epidemiology of 'bewitchment' as a lay-reported cause of death in rural South Africa.

PubMed

Fottrell, Edward; Tollman, Stephen; Byass, Peter; Golooba-Mutebi, Frederick; Kahn, Kathleen

2012-08-01

Cases of premature death in Africa may be attributed to witchcraft. In such settings, medical registration of causes of death is rare. To fill this gap, verbal autopsy (VA) methods record signs and symptoms of the deceased before death as well as lay opinion regarding the cause of death; this information is then interpreted to derive a medical cause of death. In the Agincourt Health and Demographic Surveillance Site, South Africa, around 6% of deaths are believed to be due to 'bewitchment' by VA respondents. Using 6874 deaths from the Agincourt Health and Socio-Demographic Surveillance System, the epidemiology of deaths reported as bewitchment was explored, and using medical causes of death derived from VA, the association between perceptions of witchcraft and biomedical causes of death was investigated. The odds of having one's death reported as being due to bewitchment is significantly higher in children and reproductive-aged women (but not in men) than in older adults. Similarly, sudden deaths or those following an acute illness, deaths occurring before 2001 and those where traditional healthcare was sought are more likely to be reported as being due to bewitchment. Compared with all other deaths, deaths due to external causes are significantly less likely to be attributed to bewitchment, while maternal deaths are significantly more likely to be. Understanding how societies interpret the essential factors that affect their health and how health seeking is influenced by local notions and perceived aetiologies of illness and death could better inform sustainable interventions and health promotion efforts.

The epidemiology of ‘bewitchment’ as a lay-reported cause of death in rural South Africa

PubMed Central

Tollman, Stephen; Byass, Peter; Golooba-Mutebi, Frederick; Kahn, Kathleen

2011-01-01

Background Cases of premature death in Africa may be attributed to witchcraft. In such settings, medical registration of causes of death is rare. To fill this gap, verbal autopsy (VA) methods record signs and symptoms of the deceased before death as well as lay opinion regarding the cause of death; this information is then interpreted to derive a medical cause of death. In the Agincourt Health and Demographic Surveillance Site, South Africa, around 6% of deaths are believed to be due to ‘bewitchment’ by VA respondents. Methods Using 6874 deaths from the Agincourt Health and Socio-Demographic Surveillance System, the epidemiology of deaths reported as bewitchment was explored, and using medical causes of death derived from VA, the association between perceptions of witchcraft and biomedical causes of death was investigated. Results The odds of having one's death reported as being due to bewitchment is significantly higher in children and reproductive-aged women (but not in men) than in older adults. Similarly, sudden deaths or those following an acute illness, deaths occurring before 2001 and those where traditional healthcare was sought are more likely to be reported as being due to bewitchment. Compared with all other deaths, deaths due to external causes are significantly less likely to be attributed to bewitchment, while maternal deaths are significantly more likely to be. Conclusions Understanding how societies interpret the essential factors that affect their health and how health seeking is influenced by local notions and perceived aetiologies of illness and death could better inform sustainable interventions and health promotion efforts. PMID:21515546

[Epidemiological transition in Latin America: a comparison of four countries].

PubMed

Albala, C; Vio, F; Yáñez, M

1997-06-01

In the last decade, Latin America has experienced important transformations in its health conditions, due to demographic changes and a rapid urbanization process. To analyze socioeconomic, demographic and epidemiological changes in Chile, Guatemala, Mexico and Uruguay and relate them to the different stages in the demographic and epidemiological transition of these countries. Data was obtained from official information of local and international organizations such as Pan-American Health Organization, United Nations, Latin American Center for Demography (CELADE) and World Bank. Guatemala is in a pre-transition stage with a high proportion of communicable diseases as causes of death (61%) as compared with Mexico (22%), Chile (13%) and Uruguay (7%). Mexico is in a prolonged transition situation and Chile is close to Uruguay in a post-transitional stage. Despite decreasing rates of mortality, the proportion of deaths represented by chronic diseases and injuries has increased to over 30% in all countries, except Uruguay. Adjusted mortality rates for cardiovascular diseases are lower in Latin American countries, as compared to Canada. However, excepting Guatemala, there are differences in the pattern of cardiovascular disease, with a higher mortality due to cerebrovascular and a lower mortality due to coronary artery diseases. An increment in non communicable diseases is expected for the next decades in Latin America. Analysis of demographic and epidemiological transition is crucial to define health policies and to adequate health systems to the new situations.

Thermolysin damages animal life through degradation of plasma proteins enhanced by rapid cleavage of serpins and activation of proteases.

PubMed

Kong, Lulu; Lu, Anrui; Guan, Jingmin; Yang, Bing; Li, Muwang; Hillyer, Julián F; Ramarao, Nalini; Söderhäll, Kenneth; Liu, Chaoliang; Ling, Erjun

2015-01-01

Thermolysin, a metallopeptidase secreted by pathogenic microbes, is concluded as an important virulence factor due to cleaving purified host proteins in vitro. Using the silkworm Bombyx mori as a model system, we found that thermolysin injection into larvae induces the destruction of the coagulation response and the activation of hemolymph melanization, which results in larval death. Thermolysin triggers the rapid degradation of insect and mammalian plasma proteins at a level that is considerably greater than expected in vitro and/or in vivo. To more specifically explore the mechanism, thermolysin-induced changes to key proteins belonging to the insect melanization pathway were assessed as a window for observing plasma protein cleavage. The application of thermolysin induced the rapid cleavage of the melanization negative regulator serpin-3, but did not directly activate the melanization rate-limiting enzyme prophenoloxidase (PPO) or the terminal serine proteases responsible for PPO activation. Terminal serine proteases of melanization are activated indirectly after thermolysin exposure. We hypothesize that thermolysin induces the rapid degradation of serpins and the activation of proteases directly or indirectly, boosting uncontrolled plasma protein degradation in insects and mammalians. © 2014 Wiley Periodicals, Inc.

Medical homicide and extreme negligence.

PubMed

Duncanson, Emily; Richards, Virginia; Luce, Kasey M; Gill, James R

2009-03-01

Deaths that occur during medical care for the treatment of a disease are rarely certified as homicides. Some "medical" deaths, however, have been criminally prosecuted for manslaughter, reckless endangerment, or reckless homicide. We describe 5 deaths due to medical complications that underwent criminal prosecution. Three of the deaths were certified as homicides. Deaths certified as homicides due to the actions (or inactions) of a caregiver occur in 3 circumstances. The first is when the medical caregiver intentionally causes the death of the patient. The second is a death due to treatment by an unlicensed fraud or quack. The final circumstance is due to extreme medical negligence that involves a gross and wanton disregard for the well-being of the patient and is the most controversial in the medical community. The law defines reckless endangerment as the conscious disregard of a known substantial likelihood of injury to the patient. Criminal neglect typically is defined as the failure to provide timely, safe, adequate, and appropriate services, treatment, and/or care to a patient. In instances of extreme medical negligence, a homicide manner of death is appropriate because the fatality is due to the criminal acts (or inactions) of another. It also furthers one of the major goals of the medicolegal death investigation system, which is to safeguard the public health.

[Differences between immediate and 30-day deaths due to traffic injuries according to forensic sources].

PubMed

Barbería, Eneko; Suelves, Josep M; Xifró, Alexandre; Medallo, Jordi

2015-09-01

To study immediate (same day of the collision) and delayed (within 30 days of the collision) deaths due to traffic injuries in Catalonia (Spain) according to forensic sources and to assess the differences between the two kinds of deaths. An observational study was conducted of all the traffic accident deaths registered in the Institute of Legal Medicine of Catalonia between January 1(st) 2005 and December 31(st) 2014. Data analysis was performed using the SPSS v.18.0 statistical package. Comparisons of proportions were based on the χ(2) test. During the study period, 4044 deaths due to traffic injuries were recorded. Deaths within 30 days included more women, minors, elderly people, and pedestrians than immediate deaths. Traffic injury deaths in the 30 days following a crash differ from immediate deaths. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Spatio-temporal Variations and Source Contributions of China's Premature Deaths Attributable to Ambient PM2.5

NASA Astrophysics Data System (ADS)

Rong, X.; Wang, H.

2016-12-01

With rapid economic growth, China has witnessed increasingly frequent and severe haze and smog episodes over the past decade, posing serious health impacts to the Chinese population, especially those in densely populated city clusters. Quantifications of the spatial and temporal variations of health impacts attributed to ambient fine particulate matter (PM2.5) are not only important for designing effective strategies in mitigating the health damage of air pollution, but also provide valuable references for other developing regions in the world. In this study, we evaluated the spatial distribution of premature deaths in China between 2000 and 2014 attributed to ambient PM2.5 in accord with Global Burden of Disease (GBD) based on a high resolution population density map, satellite retrieved PM2.5 concentration, and provincial health data. An Integrated Exposure Response (IER) model was applied to analyze the premature deaths for four leading causes (ischemic heart disease (IHD), chronic obstructive pulmonary disease (COPD), lung cancer (LC), stroke) in China. The contributions of emission sources to air pollution and related mortality burdens across China were further evaluated by incorporating CMAQ model. Our results suggest that China's anthropogenic ambient PM2.5 led to 1,255,400 premature deaths in 2010, 42% higher than the level in 2000. Besides the increased PM2.5 concentration, rapid urbanization has been attracting large population migration into the more developed eastern coastal urban areas, intensifying the overall health impacts. Our analysis implies that the health burdens were exacerbated in some developing inner provinces with high population density (e.g. Henan, Anhui, Sichuan) because of the relocation of more polluting and resource-intensive industries into these regions. China's regulations on PM2.5 should not be loosened on inner provinces to avoid such national level environmental inequities, and furthermore policies should be designed to form incentive mechanisms to transfer advanced technologies of production and emissions control from the coastal regions to the interior regions. Finally, we discussed the contributions of various emission sources (e.g., power plant, transportation, industries, residential) to premature deaths due to ambient PM2.5 across China.

Prognostic implications of Q waves at presentation in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: An analysis of the HORIZONS-AMI study.

PubMed

Kosmidou, Ioanna; Redfors, Björn; Crowley, Aaron; Gersh, Bernard; Chen, Shmuel; Dizon, José M; Embacher, Monica; Mehran, Roxana; Ben-Yehuda, Ori; Mintz, Gary S; Stone, Gregg W

2017-11-01

Presence of Q waves on the presenting electrocardiogram (ECG) in patients with ST-segment elevation myocardial infarction (STEMI) has been associated with worse prognosis; however, whether the prognostic value of Q waves is influenced by baseline characteristics and/or rapidity of revascularization based on the guideline-based metric of door-to-balloon time remains unknown. We hypothesized that Q waves in the presenting ECG will be predictive of long term mortality regardless of time to reperfusion. The Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial enrolled 3602 patients with STEMI undergoing primary percutaneous coronary intervention. We stratified patients without prior history of myocardial infarction or coronary revascularization according to presence or absence of pathological Q waves on their presenting ECG. Associations between Q waves, death, and cardiovascular outcomes within 3 years were assessed using Cox proportional hazards regression. Among 2723 patients with evaluable ECGs, 1084 (39.8%) had Q waves on their presenting ECG. Male sex and time from symptom onset to balloon inflation were independent predictors of presence of Q waves. Patients with Q waves had higher adjusted risks of all-cause death (adjusted hazard ratio: 1.45, 95% confidence interval: 1.02-2.05, P = 0.04) and cardiac death (adjusted hazard ratio: 1.72, 95% confidence interval: 1.08-2.72, P = 0.02). The association between Q waves and cardiac death was consistent regardless of sex, diabetes status, target vessel, or door-to-balloon time (P interaction > 0.4 for all). Presence of Q waves on the presenting ECG in patients undergoing primary percutaneous coronary intervention due to STEMI is an independent predictor of mortality and adds prognostic value, regardless of sex or rapidity of revascularization. © 2017 Wiley Periodicals, Inc.

Rapid and sensitive detection of synthetic cannabinoids AMB-FUBINACA and α-PVP using surface enhanced Raman scattering (SERS)

NASA Astrophysics Data System (ADS)

Islam, Syed K.; Cheng, Yin Pak; Birke, Ronald L.; Green, Omar; Kubic, Thomas; Lombardi, John R.

2018-04-01

The application of surface enhanced Raman scattering (SERS) has been reported as a fast and sensitive analytical method in the trace detection of the two most commonly known synthetic cannabinoids AMB-FUBINACA and alpha-pyrrolidinovalerophenone (α-PVP). FUBINACA and α-PVP are two of the most dangerous synthetic cannabinoids which have been reported to cause numerous deaths in the United States. While instruments such as GC-MS, LC-MS have been traditionally recognized as analytical tools for the detection of these synthetic drugs, SERS has been recently gaining ground in the analysis of these synthetic drugs due to its sensitivity in trace analysis and its effectiveness as a rapid method of detection. This present study shows the limit of detection of a concentration as low as picomolar for AMB-FUBINACA while for α-PVP, the limit of detection is in nanomolar concentration using SERS.

38 CFR 38.618 - Findings concerning commission of a capital crime where a person has not been convicted due to...

Code of Federal Regulations, 2010 CFR

2010-07-01

... commission of a capital crime where a person has not been convicted due to death or flight to avoid... of a capital crime where a person has not been convicted due to death or flight to avoid prosecution... unavailability for trial due to death or flight to avoid prosecution, the cemetery director, with the assistance...

Cardiovascular disease mortality and years of life lost attributable to non-optimal systolic blood pressure and hypertension in northeastern Iran.

PubMed

Sepanlou, Sadaf G; Newson, Roger B; Poustchi, Hossein; Malekzadeh, Masoud M; Rezanejad Asl, Parisa; Etemadi, Arash; Khademi, Hooman; Islami, Farhad; Pourshams, Akram; Pharoah, Paul D; Abnet, Christian C; Brennan, Paul; Bofetta, Paolo; Dawsey, Sanford M; Kamangar, Farin; Malekzadeh, Reza

2015-03-01

High blood pressure is the second most important risk factor of cardiovascular diseases (CVDs) in Iran. It is imperative to estimate the burden of CVDs that can be averted if high blood pressure is controlled at the population level. The aim of the current study was to estimate the avertable CVD mortality in the setting of Golestan Cohort Study (GCS). Over 50,000 participants were recruited and followed for a median of 7 years. The exposures of interest in this study were non-optimal systolic blood pressure (SBP) and hypertension measured at baseline. Deaths by cause have been precisely recorded. The Population Attributable Fraction (PAF) of deaths and Years of Life Lost (YLLs) due to CVDs attributable to exposures of interest were calculated. Overall, 223 deaths due to ischemic heart disease (IHD), 207 deaths due to cerebrovascular accidents (CVA), and 460 deaths due to all CVDs could be averted if the SBP of all subjects in the study were optimal. Similarly, 5,560 YLLs due to IHD, 4,771 YLLs due to CVA, and 11,135 YLLs due to CVDs could be prevented if SBP were optimal. In all age groups, the avertable deaths and YLLs were higher due to IHD compared with CVA. Deaths and YLLs attributable to non-optimal SBP in women were less than men. A very large proportion of CVD deaths can be averted if blood pressure is controlled in Iran. Effective interventions in primary and secondary health care setting are mandatory to be implemented as early as possible.

Species selection for the design of gold nanobioreactor by photosynthetic organisms

NASA Astrophysics Data System (ADS)

Dahoumane, Si Amar; Djediat, Chakib; Yéprémian, Claude; Couté, Alain; Fiévet, Fernand; Coradin, Thibaud; Brayner, Roberta

2012-06-01

The design of cell-based bioreactors for inorganic particles formation requires both a better understanding of the underlying processes and the identification of most suitable organisms. With this purpose, the process of Au3+ incorporation, intracellular reduction, and Au0 nanoparticle release in the culture medium was compared for four photosynthetic microorganisms, Klebsormidium flaccidum and Cosmarium impressulum green algae, Euglena gracilis euglenoid and Anabaena flos- aquae cyanobacteria. At low gold content, the two green algae show maintained photosynthetic activity and recovered particles (ca. 10 nm in size) are similar to internal colloids, indicating a full biological control over the whole process. In similar conditions, the euglenoid exhibits a rapid loss of biological activity, due to the absence of protective extracellular polysaccharide, but could grow again after an adaptation period. This results in a larger particle size dispersity but larger reduction yield. The cyanobacteria undergo rapid cell death, due to their prokaryotic nature, leading to high gold incorporation rate but poor control over released particle size. Similar observations can be made after addition of a larger gold salt concentration when all organisms rapidly die, suggesting that part of the process is not under biological control anymore but also involves extracellular chemical reactions. Overall, fruitful information on the whole biocrystallogenesis process is gained and most suitable species for further bioreactor design can be identified, i.e., green algae with external coating.

Retroperitoneal Necrotizing Fasciitis Masquerading as Perianal Abscess - Rare and Perilous.

PubMed

Amaranathan, Anandhi; Sahoo, Ashok Kumar; Barathi, Deepak; Shankar, Gomathi; Sistla, Sarath Chandra

2017-01-17

Necrotizing fasciitis is one of the uncommon presentations of a rapidly spreading subcutaneous tissue infection. Although the actual cause is unclear in many cases, most of them are due to the rapid proliferation of microorganisms. Retroperitoneal necrotizing fasciitis is extremely rare. It is a potentially lethal infection that requires immediate and aggressive surgical care. Early diagnosis is the key to a better prognosis. The possibility of retroperitoneal necrotizing fasciitis should be suspected in patients with symptoms of sepsis that are disproportionate to clinical findings. The rapid deterioration of the patient also gives a clue towards the diagnosis. We report a 35-year-old male with perianal abscess who had been progressed to retroperitoneal necrotizing fasciitis. The patient was managed successfully with aggressive debridement and drainage after laparotomy. Appropriate antibiotics were used to combat the sepsis. The patient recovered well at follow up, three months after discharge. Another patient, a 45-year-old male with a retroperitoneal abscess, progressed to retroperitoneal necrotizing fasciitis, and extra peritoneal drainage and debridement was done. Antibiotics depending upon the culture and sensitivity were used to control sepsis. But the patient succumbed to death 45 days after surgery due to uncontrolled sepsis. Necrotizing fasciitis of any anatomical site needs aggressive surgical care with early intervention. But retroperitoneal necrotizing fasciitis needs an extra effort for diagnosis. After diagnosis, it needs timely surgical intervention and appropriate antibiotic therapy for the recovery of the patients.

Changing clinical scenario in Chandipura virus infection.

PubMed

Sudeep, A B; Gurav, Y K; Bondre, V P

2016-06-01

Chandipura virus (CHPV) (Vesiculovirus: Rhabdoviridae) garnered global attention as an emerging neurotropic pathogen inflicting high mortality in children within 24 h of commencement of symptoms. The 2003-2004 outbreaks in Central India witnessed case fatality rates ranging from 56-75 per cent in Andhra Pradesh and Gujarat with typical encephalitic symptoms. Due to the acute sickness and rapid deterioration, the precise mechanism of action of the virus is still unknown. Recent studies have shown increased expression of CHPV phosphoprotein upto 6 h post infection (PI) demonstrating CHPV replication in neuronal cells and the rapid destruction of the cells by apoptosis shed light on the probable mechanism of rapid death in children. Phlebotomine sandflies are implicated as vectors due to their predominance in endemic areas, repeated virus isolations and their ability to transmit the virus by transovarial and venereal routes. Significant contributions have been made in the development of diagnostics and prophylactics, vaccines and antivirals. Two candidate vaccines, viz. a recombinant vaccine and a killed vaccine and siRNAs targeting P and M proteins have been developed and are awaiting clinical trials. Rhabdomyosarcoma and Phlebotomus papatasi cell lines as well as embryonated chicken eggs have been found useful in virus isolation and propagation. Despite these advancements, CHPV has been a major concern in Central India and warrants immediate attention from virologists, neurologists, paediatricians and the government for containing the virus.

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

PubMed

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.

Cystine uptake through the cystine/glutamate antiporter xCT triggers glioblastoma cell death under glucose deprivation.

PubMed

Goji, Takeo; Takahara, Kazuhiko; Negishi, Manabu; Katoh, Hironori

2017-12-01

Oncogenic signaling in cancer cells alters glucose uptake and utilization to supply sufficient energy and biosynthetic intermediates for survival and sustained proliferation. Oncogenic signaling also prevents oxidative stress and cell death caused by increased production of reactive oxygen species. However, elevated glucose metabolism in cancer cells, especially in glioblastoma, results in the cells becoming sensitive to glucose deprivation ( i.e. in high glucose dependence), which rapidly induces cell death. However, the precise mechanism of this type of cell death remains unknown. Here, we report that glucose deprivation alone does not trigger glioblastoma cell death. We found that, for cell death to occur in glucose-deprived glioblastoma cells, cystine and glutamine also need to be present in culture media. We observed that cystine uptake through the cystine/glutamate antiporter xCT under glucose deprivation rapidly induces NADPH depletion, reactive oxygen species accumulation, and cell death. We conclude that although cystine uptake is crucial for production of antioxidant glutathione in cancer cells its transport through xCT also induces oxidative stress and cell death in glucose-deprived glioblastoma cells. Combining inhibitors targeting cancer-specific glucose metabolism with cystine and glutamine treatment may offer a therapeutic approach for glioblastoma tumors exhibiting high xCT expression. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

Programmed cell death of tobacco BY-2 cells induced by still culture conditions is affected by the age of the culture under agitation.

PubMed

Hiraga, Asahi; Kaneta, Tsuyoshi; Sato, Yasushi; Sato, Seiichi

2010-01-25

Evans Blue staining indicated that actively growing tobacco BY-2 cells in the exponential phase died more rapidly than quiescent cells in the stationary phase when the cells cultured under agitation were placed under still conditions. Fifty percent cell death was induced at about 18, 26, 80 and 140 h for early, mid, late exponential- and stationary-phase cells, respectively. Actively growing cells became TUNEL (transferase-mediated dUTP nick end labelling)-positive more rapidly than quiescent cells, suggesting that the cell death evaluated by Evans Blue is accompanied by DNA cleavages. Electrophoresis of genomic DNA showed a typical 'DNA laddering' pattern formed by multiples of about 200 bp internucleosomal units. Chromatin condensation was first detected at least within 24 h by light microscopy, and then cell shrinkage followed. These findings suggest that the death of BY-2 cells induced by still conditions is PCD (programmed cell death).

20 CFR 410.410 - Total disability due to pneumoconiosis, including statutory presumption.

Code of Federal Regulations, 2011 CFR

2011-04-01

... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.410 Total disability due to pneumoconiosis, including statutory... their death. (For benefits to the eligible survivors of miners whose deaths are determined to have been...

20 CFR 410.410 - Total disability due to pneumoconiosis, including statutory presumption.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.410 Total disability due to pneumoconiosis, including statutory... their death. (For benefits to the eligible survivors of miners whose deaths are determined to have been...

Last glacial megafaunal death assemblage and early human occupation at Lake Menindee, southeastern Australia

NASA Astrophysics Data System (ADS)

Cupper, Matthew L.; Duncan, Jacqui

2006-09-01

The Tedford subfossil locality at Lake Menindee preserves a diverse assemblage of marsupials, monotremes and placental rodents. Of the 38 mammal taxa recorded at the site, almost a third are of extinct megafauna. Some of the bones are articulated or semi-articulated and include almost complete skeletons, indicating that aeolian sediments rapidly buried the animals following death. New optical ages show the site dates to the early part of the last glacial (55,700 ± 1300 yr weighted mean age). This is close to the 51,200-39,800 yr Australia-wide extinction age for megafauna suggested by Roberts et al. [2001, Science 292:1888-1892], but like all previous researchers, we cannot conclusively determine whether humans were implicated in the deaths of the animals. Although an intrusive hearth at the site dating to 45,100 ± 1400 yr ago is the oldest evidence of human occupation of the Darling River, no artifacts were identified in situ within the sub-fossil-bearing unit. Non-anthropogenic causes, such as natural senescence or ecosystem stress due to climatic aridity, probably explain the mortality of the faunal assemblage at Lake Menindee.

Predictors of In-Hospital Mortality After Rapid Response Team Calls in a 274 Hospital Nationwide Sample.

PubMed

Shappell, Claire; Snyder, Ashley; Edelson, Dana P; Churpek, Matthew M

2018-07-01

Despite wide adoption of rapid response teams across the United States, predictors of in-hospital mortality for patients receiving rapid response team calls are poorly characterized. Identification of patients at high risk of death during hospitalization could improve triage to intensive care units and prompt timely reevaluations of goals of care. We sought to identify predictors of in-hospital mortality in patients who are subjects of rapid response team calls and to develop and validate a predictive model for death after rapid response team call. Analysis of data from the national Get with the Guidelines-Medical Emergency Team event registry. Two-hundred seventy four hospitals participating in Get with the Guidelines-Medical Emergency Team from June 2005 to February 2015. 282,710 hospitalized adults on surgical or medical wards who were subjects of a rapid response team call. None. The primary outcome was death during hospitalization; candidate predictors included patient demographic- and event-level characteristics. Patients who died after rapid response team were older (median age 72 vs 66 yr), were more likely to be admitted for noncardiac medical illness (70% vs 58%), and had greater median length of stay prior to rapid response team (81 vs 47 hr) (p < 0.001 for all comparisons). The prediction model had an area under the receiver operating characteristic curve of 0.78 (95% CI, 0.78-0.79), with systolic blood pressure, time since admission, and respiratory rate being the most important variables. Patients who die following rapid response team calls differ significantly from surviving peers. Recognition of these factors could improve postrapid response team triage decisions and prompt timely goals of care discussions.

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

PubMed

Watanabe, Shinya; Nagai, Takashi

2009-06-01

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

75 FR 11899 - Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... DEPARTMENT OF HOMELAND SECURITY Customs and Border Protection Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder AGENCY: U.S. Customs and Border Protection, U.S... broker licenses and any and all permits have been cancelled due to the death of the broker: License Name...

76 FR 22912 - Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder AGENCY: U.S. Customs and Border Protection, DHS... have been cancelled due to the death of the broker: Name License No. Port name Leandro U. Guevarra...

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

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false When does SVB entitlement end due to death... CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Termination § 408.816 When does SVB entitlement end due to death? Your SVB entitlement ends with the month in which you die. Payments are terminated...

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

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When does SVB entitlement end due to death... CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Termination § 408.816 When does SVB entitlement end due to death? Your SVB entitlement ends with the month in which you die. Payments are terminated...

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

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false When does SVB entitlement end due to death... CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Termination § 408.816 When does SVB entitlement end due to death? Your SVB entitlement ends with the month in which you die. Payments are terminated...

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

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false When does SVB entitlement end due to death... CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Termination § 408.816 When does SVB entitlement end due to death? Your SVB entitlement ends with the month in which you die. Payments are terminated...

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

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false When does SVB entitlement end due to death... CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Termination § 408.816 When does SVB entitlement end due to death? Your SVB entitlement ends with the month in which you die. Payments are terminated...

A district confidential enquiry into deaths due to asthma.

PubMed Central

Wareham, N. J.; Harrison, B. D.; Jenkins, P. F.; Nicholls, J.; Stableforth, D. E.

1993-01-01

BACKGROUND--The aim was to establish a continuing district based confidential enquiry into deaths from asthma. METHODS--A confidential enquiry was conducted in an English health district. Subjects comprised 24 residents of the Norwich health district aged between 16 and 65 years who had died between 1988 and 1991 with asthma as the principal cause of death. RESULTS--Twenty one of the patients (88%) died away from hospital. Overall the routine asthma management was appropriate in all respects in only four patients. In five cases the drug treatment was considered inappropriate, in 10 cases (42%) there was no written evidence that the patient had received advice and education, and only six cases had a written management plan. In 17 patients (71%) the fatal attack of asthma developed rapidly (in under three hours). The medical care during the final attack was found to have been inappropriate in six cases. Seventeen cases (71%) had psychological or social factors that were considered to have been of potential importance. CONCLUSIONS--This study has shown the feasibility of organising a confidential enquiry into asthma deaths within a health district. The distinguishing features of such an enquiry are that it is continuing, that the quality of care given to those patients who died is compared against a recognised standard, and that there is a structured system for feeding back the conclusions of the enquiry to the local medical community. PMID:8296254

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

PubMed

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

2017-10-01

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

Life expectancy for community-based patients with heart failure from time of diagnosis.

PubMed

James, Stephanie; Barton, David; O'Connell, Eoin; Voon, Victor; Murtagh, Gillian; Watson, Chris; Murphy, Theodore; Prendiville, Brian; Brennan, David; Hensey, Mark; O'Neill, Louisa; O'Hanlon, Rory; Waterhouse, Deirdre; Ledwidge, Mark; Gallagher, Joseph; McDonald, Kenneth

2015-01-15

Heart failure has been demonstrated in previous studies to have a dismal prognosis. However, the modern-day prognosis of patients with new onset heart failure diagnosed in the community managed within a disease management programme is not known. The purpose of this study is to report on prognosis of patients presenting with new onset heart failure in the community who are subsequently followed in a disease management program. A review of patients referred to a rapid access heart failure diagnostic clinic between 2002 and 2012 was undertaken. Details of diagnosis, demographics, medical history, medications, investigations and mortality data were analysed. A total of 733 patients were seen in Rapid Access Clinic for potential new diagnosis of incident of heart failure. 38.9% (n=285) were diagnosed with heart failure, 40.7% (n=116) with HF-REF and 59.3% (n=169) with HF-PEF. There were 84 (29.5%) deaths in the group of patients diagnosed with heart failure; 41 deaths (35.3%) occurred in patients with HF-REF and 43 deaths (25.4%) occurred in patients with HF-PEF. In patients with heart failure, 52.4% (n=44) died from cardiovascular causes. 63.8% of HF patients were alive after 5 years resulting on average in a month per year loss of life expectancy over that period compared with aged matched simulated population. In this community-based cohort, the prognosis of heart failure was better than reported in previous studies. This is likely due to the impact of prompt diagnosis, the improvement in therapies and care within a disease management structure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of bortezomib in cardiac Al amyloidosis: a report of two cases.

PubMed

Nigrelli, Santi; Curciarello, Giuseppe; Ballo, Piercarlo; Michelassi, Stefano; Pizzarelli, Francesco

2014-01-01

Cardiac involvement is a major prognostic determinant in patients with primary AL amyloidosis. The clinical results of standard therapeutic approaches are suboptimal. It has been recently shown that bortezomib, an inhibitor of the proteasome, can induce rapid favourable responses in AL amyloidosis improving cardiac function and survival. Herein we report on two patients with cardiac amyloidosis treated by bortezomib who experienced partial or total remission of hematologic disease and of cardiac involvement. However, death of one patient, suffering from chronic kidney disease stage 5, due to fulminant respiratory syndrome suggests the need for caution in bortezomib use if patients have this comorbid condition.

Effectiveness of Bortezomib in Cardiac AL Amyloidosis: A Report of Two Cases

PubMed Central

Nigrelli, Santi; Curciarello, Giuseppe; Ballo, Piercarlo; Michelassi, Stefano; Pizzarelli, Francesco

2014-01-01

Cardiac involvement is a major prognostic determinant in patients with primary AL amyloidosis. The clinical results of standard therapeutic approaches are suboptimal. It has been recently shown that bortezomib, an inhibitor of the proteasome, can induce rapid favourable responses in AL amyloidosis improving cardiac function and survival. Herein we report on two patients with cardiac amyloidosis treated by bortezomib who experienced partial or total remission of hematologic disease and of cardiac involvement. However, death of one patient, suffering from chronic kidney disease stage 5, due to fulminant respiratory syndrome suggests the need for caution in bortezomib use if patients have this comorbid condition. PMID:24715916

Envenomation by Micrurus coral snakes in the Brazilian Amazon region: report of two cases.

PubMed

Pardal, Pedro Pereira de Oliveira; Pardal, Joseana Silva de Oliveira; Gadelha, Maria Apolônia da Costa; Rodrigues, Líliam da Silva; Feitosa, Darlan Tavares; Prudente, Ana Lúcia da Costa; Fan, Hui Wen

2010-01-01

Two cases of proven coral snake bites were reported in Belém, Pará State, Brazil. The first case was a severe one caused by Micrurus surinamensis. The patient required mechanical ventilation due to acute respiratory failure. The second case showed just mild signs of envenomation caused by Micrurus filiformis. Both patients received specific Micrurus antivenom and were discharged without further complications. Coral snake bites are scarcely reported in the Amazon region and there is a broad spectrum of clinical manifestations, varying from extremely mild to those which may rapidly lead to death if the patient is not treated as soon as possible.

Ebolavirus and Haemorrhagic Syndrome

PubMed Central

Matua, Gerald A.; Van der Wal, Dirk M.; Locsin, Rozzano C.

2015-01-01

The Ebola virus is a highly virulent, single-stranded ribonucleic acid virus which affects both humans and apes and has fast become one of the world’s most feared pathogens. The virus induces acute fever and death, with haemorrhagic syndrome occurring in up to 90% of patients. The known species within the genus Ebolavirus are Bundibugyo, Sudan, Zaïre, Reston and Taï Forest. Although endemic in Africa, Ebola has caused worldwide anxiety due to media hype and concerns about its international spread, including through bioterrorism. The high fatality rate is attributed to unavailability of a standard treatment regimen or vaccine. The disease is frightening since it is characterised by rapid immune suppression and systemic inflammatory response, causing multi-organ and system failure, shock and often death. Currently, disease management is largely supportive, with containment efforts geared towards mitigating the spread of the virus. This review describes the classification, morphology, infective process, natural ecology, transmission, epidemic patterns, diagnosis, clinical features and immunology of Ebola, including management and epidemic containment strategies. PMID:26052448

AKT1 provides an essential survival signal required for differentiation and stratification of primary human keratinocytes.

PubMed

Thrash, Barry R; Menges, Craig W; Pierce, Robert H; McCance, Dennis J

2006-04-28

Keratinocyte differentiation and stratification are complex processes involving multiple signaling pathways, which convert a basal proliferative cell into an inviable rigid squame. Loss of attachment to the basement membrane triggers keratinocyte differentiation, while in other epithelial cells, detachment from the extracellular matrix leads to rapid programmed cell death or anoikis. The potential role of AKT in providing a survival signal necessary for stratification and differentiation of primary human keratinocytes was investigated. AKT activity increased during keratinocyte differentiation and was attributed to the specific activation of AKT1 and AKT2. Targeted reduction of AKT1 expression, but not AKT2, by RNA interference resulted in an abnormal epidermis in organotypic skin cultures with a thin parabasal region and a pronounced but disorganized cornified layer. This abnormal stratification was due to significant cell death in the suprabasal layers and was alleviated by caspase inhibition. Normal expression patterns of both early and late markers of keratinocyte differentiation were also disrupted, producing a poorly developed stratum corneum.

Ebolavirus and Haemorrhagic Syndrome.

PubMed

Matua, Gerald A; Van der Wal, Dirk M; Locsin, Rozzano C

2015-05-01

The Ebola virus is a highly virulent, single-stranded ribonucleic acid virus which affects both humans and apes and has fast become one of the world's most feared pathogens. The virus induces acute fever and death, with haemorrhagic syndrome occurring in up to 90% of patients. The known species within the genus Ebolavirus are Bundibugyo, Sudan, Zaïre, Reston and Taï Forest. Although endemic in Africa, Ebola has caused worldwide anxiety due to media hype and concerns about its international spread, including through bioterrorism. The high fatality rate is attributed to unavailability of a standard treatment regimen or vaccine. The disease is frightening since it is characterised by rapid immune suppression and systemic inflammatory response, causing multi-organ and system failure, shock and often death. Currently, disease management is largely supportive, with containment efforts geared towards mitigating the spread of the virus. This review describes the classification, morphology, infective process, natural ecology, transmission, epidemic patterns, diagnosis, clinical features and immunology of Ebola, including management and epidemic containment strategies.

77 FR 16249 - Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-20

... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder AGENCY: U.S. Customs and Border Protection, U.S... broker licenses and any and all permits have been cancelled due to the death of the broker: Name License...

77 FR 45648 - Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder AGENCY: U.S. Customs and Border Protection, U.S... broker licenses and any and all permits have been cancelled due to the death of the broker: Name License...

76 FR 44033 - Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder AGENCY: U.S. Customs and Border Protection, U.S... broker licenses and any and all permits have been cancelled due to the death of the broker: License Name...

76 FR 2918 - Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-18

... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Notice of Cancellation of Customs Broker Licenses Due to Death of the License Holder AGENCY: U.S. Customs and Border Protection, U.S... broker license and any and all permits have been cancelled due to the death of the broker: Name License...

20 CFR 410.458 - Irrebuttable presumption of death due to pneumoconiosis-survivor's claim.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Irrebuttable presumption of death due to pneumoconiosis-survivor's claim. 410.458 Section 410.458 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.458...

Singh's verbal autopsy questionnaire for the assessment of causes of death, social autopsy, tobacco autopsy and dietary autopsy, based on medical records and interview.

PubMed

Singh, Ram B; Fedacko, Jan; Vargova, Viola; Kumar, Adarsh; Mohan, Varun; Pella, Daniel; De Meester, Fabien; Wilson, Douglas

2011-08-01

The exact causes of death in India are not known because autopsy studies are difficult to conduct due to religious considerations. There are rapid changes in diet and lifestyle amongst social classes causing changes in the pattern of risk factors and mortality. In the present study, we attempt to develop a verbal autopsy questionnaire based on medical records and interview of a family member, for the assessment of causes of death, social class, tobacco consumption and dietary intakes among urban decedents in north India. For the period 1999-2001, we studied the randomly selected records of death of 2222 (1385 men and 837 women) decedents, aged 25-64 years, out of 3034 death records overall from the records at the Municipal Corporation, Moradabad. Families of these decedents were contacted individually to find out the causes of death, by scientist- administered, informed-consented, verbal autopsy questionnaire, completed with the help of the spouse and local treating doctor practicing in the appropriate health care region. Clinical data and causes of death were assessed by a questionnaire based on available hospital records and a modified WHO verbal autopsy questionnaire. Dietary intakes of the dead individuals were estimated by finding out the food intake of the spouse from 3-day dietary diaries and by asking probing questions about differences in food intake by the decedents. Tobacco consumption of the victim was studied by a questionnaire administered to family members. Social classes were assessed by a questionnaire based on attributes of per capita income, occupation, education, housing and ownership of consumer luxury items in the household. The diagnoses of overweight and obesity were based on the new WHO and International College of Nutrition criteria. Cardiac diseases (23.4%, n = 520) including coronary artery disease (10%), valvular heart disease (7.2%, n = 160), diabetic heart disease (2.2%, n = 49), sudden cardiac death and inflammatory cardiac disease, each (2.0%, n = 44) were the most common causes of deaths as reported using the modified verbal autopsy questionnaire. Brain diseases including stroke (7.8%, n = 175) and inflammatory brain disease were reported amongst 1.9% (n = 42) victims.Thus, NCDs (37.0%, n = 651); circulatory diseases (31.2%, n = 695) including stroke and cardiac diseases, and malignant neoplasms (5.8%, n = 131) emerged as the most common causes of death. Injury and accidents (14.0%, n = 313) including fire, falls and poisonings were also common. Miscellaneous causes of death were observed amongst 8.5% (n = 189) of victims. Pregnancy and perinatal causes (0.72%, n = 15) were not commonly recorded in our study. Renal diseases (11.2%, n = 250), pulmonary diseases (22.3%, n = 495) and liver diseases (4.8%, n =107) were also commonly recorded causes of death. It is clear that causes of death related to various body systems can be more accurately assessed by the modified verbal autopsy questionnaire. Circulatory diseases as the cause of mortality were significantly more common among higher social classes (1-3) than in lower social classes (4 and 5) who died more often, due to infections. Death due to coronary disease, stroke, hypertension, diabetes and obesity were significantly more common among higher social classes 1-3 and among victims with higher body mass index (BMI) compared to social class 4 and 5 who had lower BMI. This study indicates that causes of death, social class, tobacco and dietary intakes, can be accurately assessed by a modified verbal autopsy questionnaire based on medical records and by interview of family members. Circulatory diseases, injury-accidents and maligant diseases have become the major causes of death in India, apart from infections.

Burden of Mortality Attributable to Diagnosed Diabetes: A Nationwide Analysis Based on Claims Data From 65 Million People in Germany.

PubMed

Jacobs, Esther; Hoyer, Annika; Brinks, Ralph; Kuss, Oliver; Rathmann, Wolfgang

2017-12-01

In Germany, as in many other countries, nationwide data on mortality attributable to diagnosed diabetes are not available. This study estimated the absolute number of excess deaths associated with diabetes (all types) and type 2 diabetes in Germany. A prevalence approach that included nationwide routine data from 64.9 million people insured in the German statutory health insurance system in 2010 was used for the calculation. Because nationwide data on diabetes mortality are lacking in Germany, the mortality rate ratio from the Danish National Diabetes Register was used. The absolute number of excess deaths associated with diabetes was calculated as the number of deaths due to diabetes minus the number of deaths due to diabetes with a mortality that was as high as in the population without diabetes. Furthermore, the mortality population-attributable fraction was calculated. A total of 174,627 excess deaths were due to diabetes in 2010, including 137,950 due to type 2 diabetes. Overall, 21% of all deaths in Germany were attributable to diabetes and 16% were attributable to type 2 diabetes. Most of the excess deaths (34% each) occurred in the 70- to 89-year-old age-group. In this first nationwide calculation of excess deaths related to diabetes in Germany, the results suggest that the official German estimates that rely on information from death certificates are grossly underestimated. Countries without national cohorts or diabetes registries could easily use this method to estimate the number of excess deaths due to diabetes. © 2017 by the American Diabetes Association.

77 FR 69665 - Agency Forms Submitted for OMB Review, Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-20

...), benefits that may be due on the death of a railroad employee or a survivor annuitant include (1) a lump-sum death benefit (2) a residual lump-sum payment (3) accrued annuities due but unpaid at death, and (4... notification of the death of a railroad employee or survivor annuitant, an RRB field office utilizes Form RL-94...

Two cases of death due to plastic bag suffocation.

PubMed

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.

Deaths and years of life lost due to suboptimal breast-feeding among children in the developing world: a global ecological risk assessment.

PubMed

Lauer, Jeremy A; Betrán, Ana Pilar; Barros, Aluísio J D; de Onís, Mercedes

2006-09-01

We estimate attributable fractions, deaths and years of life lost among infants and children < or = 2 years of age due to suboptimal breast-feeding in developing countries. We compare actual practices to a minimum exposure pattern consisting of exclusive breast-feeding for infants < or = 6 months of age and continued breast-feeding for older infants and children < or = 2 years of age. For infants, we consider deaths due to diarrhoeal disease and lower respiratory tract infections, and deaths due to all causes are considered in the second year of life. Outcome measures are attributable fractions, deaths, years of life lost and offsetting deaths potentially caused by mother-to-child transmission of HIV through breast-feeding. Developing countries. Infants and children < or = 2 years of age. Attributable fractions for deaths due to diarrhoeal disease and lower respiratory tract infections are 55% and 53%, respectively, for the first six months of infancy, 20% and 18% for the second six months, and are 20% for all-cause deaths in the second year of life. Globally, as many as 1.45 million lives (117 million years of life) are lost due to suboptimal breast-feeding in developing countries. Offsetting deaths caused by mother-to-child transmission of HIV through breast-feeding could be as high as 242,000 (18.8 million years of life lost) if relevant World Health Organization recommendations are not followed. The size of the gap between current practice and recommendations is striking when one considers breast-feeding involves no out-of-pocket costs, that there exists universal consensus on best practices, and that implementing current international recommendations could potentially save 1.45 million children's lives each year.

Is oxygen required before atropine administration in organophosphorus or carbamate pesticide poisoning? – A cohort study

PubMed Central

Konickx, L. A.; Bingham, K.

2014-01-01

Background Early and adequate atropine administration in organophosphorus (OP) or carbamate insecticide poisoning improves outcome. However, some authors advise that oxygen must be given before atropine due to the risk of inducing ventricular dysrhythmias in hypoxic patients. Because oxygen is frequently unavailable in district hospitals of rural Asia, where the majority of patients with insecticide poisoning present, this guidance has significant implications for patient care. The published evidence for this advice is weak. We therefore performed a patient cohort analysis to look for early cardiac deaths in patients poisoned by anticholinesterase pesticides. Methods We analysed a prospective Sri Lankan cohort of OP or carbamate-poisoned patients treated with early atropine without the benefit of oxygen for evidence of early deaths. The incidence of fatal primary cardiac arrests within 3 h of admission was used as a sensitive (but non-specific) marker of possible ventricular dysrhythmias. Results The cohort consisted of 1957 patients. The incidence of a primary cardiac death within 3 h of atropine administration was 4 (0.2%) of 1957 patients. The majority of deaths occurred at a later time point from respiratory complications of poisoning. Conclusion We found no evidence of a high number of early deaths in an observational study of 1957 patients routinely given atropine before oxygen that might support guidance that oxygen must be given before atropine. The published literature indicates that early and rapid administration of atropine during resuscitation is life-saving. Therefore, whether oxygen is available or not, early atropinisation of OP- and carbamate-poisoned patients should be performed. PMID:24810796

Evaluation of rapid progressors in HIV infection as an extreme phenotype.

PubMed

Olson, Ashley D; Guiguet, Marguerite; Zangerle, Robert; Gill, John; Perez-Hoyos, Santiago; Lodi, Sara; Ghosn, Jade; Dorrucci, Maria; Johnson, Anne; Sannes, Mette; Moreno, Santiago; Porter, Kholoud

2014-09-01

Rapid CD4 cell loss represents an HIV phenotype used to identify causal variants of accelerated disease progression. The optimal rate and threshold for identifying this extreme phenotype in recently infected individuals is unclear. Using a cohort of patients with known dates of HIV-1 seroconversion (SC), CASCADE (Concerted Action on SeroConversion on AIDS and Death in Europe), we identified proportions experiencing nadir CD4 cell levels within 1 year of SC, and assessed their mean AIDS-free survival time at 10-year follow-up and hazard of AIDS/death, compared with those whose CD4 remained >500 cells per cubic millimeter. Follow-up was censored at December 31, 1996 to avoid bias due to combination antiretroviral therapy initiation. Of 4876 individuals, 2.8%, 7.3%, and 24.9% experienced ≥1 CD4 <100, 200, and 350 cells per cubic millimeter, respectively, within 1 year of SC. Minimum CD4 levels of 30, 166, 231, and 506 cells per cubic millimeter were experienced during this period by 1%, 5%, 10%, and 50% of individuals, respectively. Mean (95% confidence interval) AIDS-free survival at 10 years follow-up was 2.9 (2.3 to 3.6), 5.5 (5.0 to 6.1), 6.7 (6.5 to 7.0), 7.4 (7.2 to 7.6), and 8.1 (7.9 to 8.3), for those with minimum counts ≤100, 100-200, 200-350, 350-500, >500 cells per cubic millimeter, respectively. Using counts of >500 cells per cubic millimeter as reference, the hazard ratios (95% confidence interval) of AIDS/death were 15.0 (11.9 to 18.9), 3.6 (2.9 to 4.5), 2.1 (1.8 to 2.4), and 1.5 (1.3 to 1.7), respectively. The hazard ratio increased to 37.5 (26.5 to 53.1) when a minimum CD4 count <100 was confirmed within 1 year of SC. At least 1 CD4 ≤100 cells per cubic millimeter within the first year of SC identifies a rare group of individuals at high risk of disease progression and could form the basis for defining the rapid progressor phenotype.

Spatial distribution of deaths due to Alzheimer's disease in the state of São Paulo, Brazil.

PubMed

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

2014-01-01

Alzheimer's disease is a common cause of dementia and identifying possible spatial patterns of mortality due to this disease may enable preventive actions. The objective of this study was to identify spatial distribution patterns of mortality due to Alzheimer's disease in the state of São Paulo. Ecological and exploratory study conducted in all municipalities in the state of São Paulo. Data on Alzheimer's disease mortality in the state of São Paulo between 2004 and 2009 were obtained from DATASUS (the Department of Informatics in the Brazilian Ministry of Health). Death rates per 100,000 inhabitants were then calculated and spatial analysis was performed by constructing a death rate map, global Moran index and local Moran index, which were used to obtain the Moran map. The kernel technique was also applied. The Terra View 4.0.0 software was used. 13,030 deaths due to Alzheimer were reported in the state of São Paulo (rate of 5.33 deaths/100,000 inhabitants). São José do Rio Preto, Ribeirão Preto, Bauru and Araçatuba had higher rates. The Moran index was I = 0.085 (P < 0.002). The Moran map identified 42 municipalities that merit intervention and the kernel estimator identified a high density of deaths in the northwestern region of the state. Higher densities of deaths due to Alzheimer were concentrated more to the north and northwest of the state of São Paulo. It was possible to identify municipalities that have priority for interventions to reduce the death rates due to this disease.

Decomposition and N cycling changes in redwood forests caused by sudden oak death

Treesearch

Richard C. Cobb; David M. Rizzo

2012-01-01

Phytophthora ramorum is an emergent pathogen in redwood forests which causes the disease sudden oak death. Although the disease does not kill coast redwood (Sequoia sempervirens), extensive and rapid mortality of tanoak (Notholithocarpus densiflorus) has removed this...

Expression of heat shock proteins (hsp) 27 and 70 in various organ systems in cases of death due to fire.

PubMed

Doberentz, E; Genneper, L; Böker, D; Lignitz, E; Madea, B

2014-11-01

The expression of heat shock proteins (hsp) increases in case of variable types of endogenous and exogenous cellular stress, as for example thermal stress. Immunohistochemical staining with hsp antibodies can visualize these stress proteins. Fifty-three cases of death due to heat and a control group of 100 deaths without any antemortem thermic stress were examined regarding hsp27 and hsp70 expression in myocardial, pulmonary, and renal tissues. The results revealed a correlation between hsp expression, survival time, and cause of death. In cases of death due to fire, the expression of hsp is more extensive than in the control group, especially in pulmonary and renal tissues. The immunohistochemical investigation of an hsp expression can support the proof of vitality in cases of death related to fire.

Rapid Identification of Legionella Pathogenicity by Surface-Enhanced Raman Spectroscopy.

PubMed

Li, Jing; Qin, Tian; Jia, Xiao Xiao; Deng, Ai Hua; Zhang, Xu; Fan, Wen Hui; Huo, Shuai Dong; Wen, Ting Yi; Liu, Wen Jun

2015-06-01

To establish Surface-enhanced Raman Spectroscopy (SERS) can be used as a rapid and reliable method to distinguish virulent strain and mild strain of L. pneumophila. Mortality data were collected from company departments through administrative documents, death certificates, etc. Trend analyses of cancer mortality were performed on the basis of 925 cancer deaths between 2001 and 2010. Our results indicated that the peaks of high virulence strains reached ⋝4000. This criterion was verified by subsequent cell experiments. In addition, we also conducted SERS rapid identification on the virulence of several collected clinical strains and obtained accurate results. The present study indicates that the established SERS protocol can be used as a rapid and reliable method to distinguish virulent and mildly virulent strains of L. pneumophila, which can be further used in clinical samples. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

[Causes of the people death from drunkenness and alcoholism].

PubMed

Erokhin, Iu A; Paukov, V S; Kirillov, Iu A

2012-01-01

We analyzed causes of 1008 people death, who abused by alcohol. Among them 2 groups were separated out: people died due to drunkenness and due to alcoholism. The structure of the death was similar in the both groups, however depended on alcoholism stages. The major cause of the death in group of drunkenness people was acute heart insufficiency, less commonly--lung pathology, and very rarely--brain vessels pathology and liver cirrhosis. In group of people, who died due to alcoholism, lung pathology was the major cause of these deaths, acute heart insufficiency was occurred less commonly, and very rare brain pathology because of delirium tremens or alcohol withdrawal syndrome, as so liver cirrhosis with complications. Hemorrhagic pancreonecrosis after alcoholic excess was found out in both groups, but it was more often in people, who died due to drunkenness. Obtained results show importance of chronic alcoholism identification as a disease with several stages including drunkenness and alcoholism.

The timing and cause of megafauna mass deaths at Lancefield Swamp, south-eastern Australia

NASA Astrophysics Data System (ADS)

Dortch, Joe; Cupper, Matt; Grün, Rainer; Harpley, Bernice; Lee, Kerrie; Field, Judith

2016-08-01

Lancefield Swamp, south-eastern Australia, was one of the earliest sites to provoke interest in Pleistocene faunal extinctions in Sahul (Pleistocene Australia-New Guinea). The systematic investigation of the deposit in the early 1970s identified megafaunal remains dominated by the 100-200 kg kangaroo Macropus giganteus titan. Associated radiocarbon ages indicated that the species was extant until c.30,000 BP, suggesting significant overlap with human settlement of Sahul. This evidence was inconsistent with contemporary models of rapid human-driven extinctions. Instead, researchers inferred ecological tethering of fauna at Lancefield Swamp due to intense drought precipitated localised mass deaths, consistent with Late Pleistocene climatic variability. Later investigations in another part of the swamp, the Mayne Site, remote to the initial investigations, concluded that mass flow disturbed this area, and Electron Spin Resonance (ESR) analyses on megafauna teeth returned wide-ranging ages. To clarify site formation processes and dating of Lancefield Swamp, we excavated new test-pits next to previous trenches in the Classic and Mayne Sites. We compared absolute chronologies for sediments and teeth, sedimentology, palaeo-topography, taphonomy, and macropod age at death across the swamp. Luminescence dating of sediments and ESR analysis of teeth returned ages between c.80,000 and 45,000 years ago. We found no archaeological remains in the bone beds, and evidence of carnivore activity and fluvial action, in the form of reactivated spring flow. The latter disturbed limited parts of the site and substantial areas of the bone beds remained intact. The faunal assemblage is dominated by megafaunal adult Macropus, consistent with mass die-offs due to severe drought. Such droughts appear to have recurred over millennia during the climatic variability of Marine Isotope Stages 4 and 3. These events began tens of millennia before the first appearance of Aboriginal people in Sahul and only the very youngest fossil deposits could be coeval with the earliest human arrivals. Therefore, anthropogenic causes cannot be implicated in most if not all of mass deaths at the site. Climatic and environmental changes were the main factors in site formation and megafauna deaths at Lancefield Swamp.

A case of probable labetalol induced hyperkalaemia in pre-eclampsia.

PubMed

Thomas, Binny; Abdul Rouf, P V; El Kassem, Wessam; Al Hail, Moza; Stewart, Derek; Tharannum, Asma; Ahmed, Afif; Al Saadi, Muna

2014-12-01

Hyperkalemia can cause altered cardiac electrical conduction resulting in death. We describe a case of a 23-year old pregnant patient who presented with severe epigastric pain and vomiting. She was severely pre- eclamptic and received initial treatment with intravenous labetalol and decision was taken to deliver. She quickly became hyperkalaemic (serum potassium level 6.4 mmol/L) and labetalol was discontinued and intravenous hydralazine commenced. Post-surgery, her potassium levels were normal but due to rapidly rising blood pressure labetalol was recommenced, resulting in elevated potassium levels. Labetolol was discontinued, hydralazine prescribed, and potassium levels normalised. The adverse reaction was classified as 'probably' due to labetolol using the Naranjo Adverse Drug Reaction scale. This is the first reported case of labetolol induced hyperkalaemia in pregnancy, with life threatening consequences and hence all health professionals should be alert to this potential effect.

By the Numbers: Mortality Burden of Heart Disease and Cancer, 1950-2014.

PubMed

2016-10-01

Although the number of deaths due to heart disease began a relatively steady decline in the 1990s, it remains the leading cause of death overall in the United States, followed by cancer. However, the gap between them has narrowed greatly since 1950, and in 2014, cancer deaths outnumbered deaths due to heart disease in 22 states. ©2016 American Association for Cancer Research.

Colloid cyst of the third ventricle, hypothalamus, and heart: a dangerous link for sudden death

PubMed Central

2012-01-01

Abstract Colloid cysts are rare congenital, intracranial neoplasms, commonly located in the third ventricle. Colloid cysts are endodermal congenital malformations. The cysts commonly range in size from 1–2 cm in diameter, although large cysts >3 cm in size have been reported. The components of the cyst include an outer fibrous capsule over an inner epithelium. The epithelium is usually a single layer of mucin-producing or ciliated cells. Such cysts contain mucoid and gelatinous material, which is positive for both Periodic acid Schiff (PAS) and mucicarmen staining. Although colloid cysts usually represent histopathologically benign neoplasms, they can result in sudden, unexpected and potentially lethal complications. The mechanism(s) of death is still a controversial subject and several mechanisms have been postulated to explain the sudden onset of severe symptoms and of fatal rapid deterioration in patients with colloid cysts. In this case, macroscopic and histological findings addressed the diagnosis of colloid cyst of the third ventricle with diffuse myocardial injury (coagulative myocytolysis or contraction band necrosis, CBN) and led us to conclude that acute cardiac arrest due to hypothalamus stimulation in the context of colloid cyst of the third ventricle was the cause of death. As the hypothalamic structures which are involved in neuroendocrine and autonomic regulation playing a key role in cardiovascular control are located close to the walls of the third ventricle which is the most frequent anatomical site of colloid cyst, this may suggest that reflex cardiac effects due to the compression of the hypothalamic cardiovascular regulatory centers by the cyst explain the sudden death in patients harboring a colloid cyst when signs of hydrocephalus or brain herniation are lacking. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4915842848034158 PMID:23078815

Environment, cancer and inequalities-The urgent need for prevention.

PubMed

Vineis, Paolo; Fecht, Daniela

2018-06-11

The proportion of total deaths attributable to environmental factors is estimated to be 23% of global deaths and 22% of global disability-adjusted life years (DALYs) according to one review. These estimates encompass all environmental agents including infectious agents but excluding behavioural factors. The authors of the review also estimated that 16% (95% CI: 7-41%) of cancer deaths are attributable to environmental risk factors (and 36% [95% CI: 17-52%] for lung cancer). In this article, we focus on the reasons why epidemiology is often unable to account for the whole burden of environmental carcinogens. The experience of air pollution is particularly instructive. While in the 1970s and early 1980s, air pollution was considered as a relatively marginal exposure in terms of attributable risks, the most recent estimate is that it accounts for 7.6% of global deaths and 4.2% of global DALYs world-wide (with East and South Asia accounting for 59% of the total). According to a review, ambient fine particulate matter air pollution contributed to 17.1% of ischaemic heart disease, 14.2% of cerebrovascular disease, 16.5% of lung cancer, 24.7% of low respiratory infections, and 27.1% of COPD mortality in 2015. Estimates for cancer as a whole are not available. The change in appreciation of the role of air pollution has been mainly due to the refinement of exposure assessment methods and the new generations of longitudinal studies. Mechanistic evidence via omic technologies is now rapidly increasing, thus lending credibility to previous epidemiological ('black box') associations. Much less is known about other environmental contaminants, some of which are widespread and pervasive, thus suggesting the need for the same rigourous methods as those applied to air pollution. Finally, a crucial issue remains inequality across different population groups, with uneven exposure to hazards and acquired susceptibilities due to multiple concomitant exposures and poorer health status. Copyright © 2018. Published by Elsevier Ltd.

Years of Life Lost (YLL) in Colombia 1998-2011: Overall and Avoidable Causes of Death Analysis

PubMed Central

Castillo-Rodríguez, Liliana; Díaz-Jiménez, Diana; Castañeda-Orjuela, Carlos; De la Hoz-Restrepo, Fernando

2015-01-01

Objective Estimate the Years of Life Lost (YLL) for overall and avoidable causes of death (CoD) in Colombia for the period 1998-2011. Methods From the reported deaths to the Colombian mortality database during 1998-2011, we classified deaths from avoidable causes. With the reference life table of the Global Burden of Disease (GBD) 2010 study, we estimated the overall YLL and YLL due to avoidable causes. Calculations were performed with the difference between life expectancy and the age of death. Results are reported by group of cause of death, events, sex, year and department. Comparative analysis between number of deaths and YLL was carried out. Results A total of 83,856,080 YLL were calculated in Colombia during period 1998-2011, 75.9% of them due to avoidable CoD. The year 2000 reported the highest number of missed YLL by both overall and avoidable CoD. The departments with the highest YLL rates were Caquetá, Guaviare, Arauca, Meta, and Risaralda. In men, intentional injuries and cardiovascular and circulatory diseases had the higher losses, while in women YLL were mainly due to cardiovascular and circulatory diseases. Conclusions The public health priorities should focus on preventing the loss of YLL due to premature death and differentiated interventions by sex. PMID:25942009

Transient bacterial contamination of the dual-porosity aquifer at Walkerton, Ontario, Canada

NASA Astrophysics Data System (ADS)

Worthington, Stephen R. H.; Smart, C. Christopher

2017-06-01

Contamination of the Paleozoic carbonate aquifer at Walkerton (Ontario, Canada) by pathogenic bacteria following heavy rain in May 2000 resulted in 2,300 illnesses and seven deaths. Subsequent tracer testing showed that there was rapid groundwater flow in the aquifer, and also rapid exchange between the aquifer and the ground surface. Electrical conductivity (EC) profiling during a 3-day pumping test showed that most flow was through bedding-plane fractures spaced about 10 m apart, that there were substantial contrasts in EC in the major fracture flows, and that there were rapid changes over time. Total coliform sampling revealed transient groundwater contamination, particularly after heavy rain and lasting up to a few days. These characteristics can be understood in terms of the dual-porosity nature of the aquifer. Most of the storage is in the matrix, but this can be considered to be static in the short term. Almost all transport is through the fracture network, which has rapid groundwater flow (˜100 m/day) and rapid transmission of pressure pulses due to the high hydraulic diffusivity. Rapid recharge can occur through thin and/or fractured overburden and at spring sites where flow is reversed by pumping during episodes of surface flooding. These characteristics facilitated the ingress of surface-derived bacteria into the aquifer, and their rapid transport within the aquifer to pumping wells. Bacterial presence is common in carbonate aquifers, and this can be explained by the well-connected, large-aperture fracture networks in these dual-porosity aquifers, even though many, such as at Walkerton, lack karst landforms.

The 2008 Cholera Epidemic in Zimbabwe: Experience of the icddr,b Team in the Field

PubMed Central

Bardhan, Pradip Kumar; Iqbal, Anwarul; Mazumder, Ramendra Nath; Khan, Azharul Islam; Islam, Md. Sirajul; Siddique, Abul Kasem; Cravioto, Alejandro

2011-01-01

During August 2008–June 2009, an estimated 95,531 suspected cases of cholera and 4,282 deaths due to cholera were reported during the 2008 cholera outbreak in Zimbabwe. Despite the efforts by local and international organizations supported by the Zimbabwean Ministry of Health and Child Welfare in the establishment of cholera treatment centres throughout the country, the case-fatality rate (CFR) was much higher than expected. Over two-thirds of the deaths occurred in areas without access to treatment facilities, with the highest CFRs (>5%) reported from Masvingo, Manicaland, Mashonaland West, Mashonaland East, Midland, and Matabeleland North provinces. Some factors attributing to this high CFR included inappropriate cholera case management with inadequate use of oral rehydration therapy, inappropriate use of antibiotics, and a shortage of experienced healthcare professionals. The breakdown of both potable water and sanitation systems and the widespread contamination of available drinking-water sources were also considered responsible for the rapid and widespread distribution of the epidemic throughout the country. Training of healthcare professionals on appropriate cholera case management and implementation of recommended strategies to reduce the environmental contamination of drinking-water sources could have contributed to the progressive reduction in number of cases and deaths as observed at the end of February 2009. PMID:22106761

Terrorism, civil war and related violence and substance use disorder morbidity and mortality: a global analysis.

PubMed

Kerridge, Bradley T; Khan, Maria R; Rehm, Jürgen; Sapkota, Amir

2014-03-01

The purpose of this study is to examine associations between deaths owing to terrorism, civil war, and one-sided violence from 1994-2000 and substance use disorder disability-adjusted life years (DALYs). The relationship between terrorism, and related violence and substance use disorder morbidity and mortality among World Health Organization Member States in 2002, controlling for adult per capita alcohol consumption, illicit drug use, and economic variables at baseline in 1994. Deaths as a result of terrorism and related violence were related to substance use disorder DALYs: a 1.0% increase in deaths as a result of terrorism, war and one-sided violence was associated with an increase of between 0.10% and 0.12% in alcohol and drug use disorder DALYs. Associations were greater among males and 15-44 year-old. Terrorism, war and one-sided violence may influence morbidity and mortality attributable to substance use disorders in the longer-term suggests that more attention to be given to rapid assessment and treatment of substance use disorders in conflict-affected populations with due consideration of gender and age differences that may impact treatment outcomes in these settings. Priorities should be established to rebuild substance abuse treatment infrastructures and treat the many physical and mental comorbid disorders. Copyright © 2014. Published by Elsevier Ltd.

Lifespan extension by dietary intervention in a mouse model of Cockayne syndrome uncouples early postnatal development from segmental progeria.

PubMed

Brace, Lear E; Vose, Sarah C; Vargas, Dorathy F; Zhao, Shuangyun; Wang, Xiu-Ping; Mitchell, James R

2013-12-01

Cockayne syndrome (CS) is a rare autosomal recessive segmental progeria characterized by growth failure, lipodystrophy, neurological abnormalities, and photosensitivity, but without skin cancer predisposition. Cockayne syndrome life expectancy ranges from 5 to 16 years for the two most severe forms (types II and I, respectively). Mouse models of CS have thus far been of limited value due to either very mild phenotypes, or premature death during postnatal development prior to weaning. The cause of death in severe CS models is unknown, but has been attributed to extremely rapid aging. Here, we found that providing mutant pups with soft food from as late as postnatal day 14 allowed survival past weaning with high penetrance independent of dietary macronutrient balance in a novel CS model (Csa(-/-) | Xpa(-/-)). Survival past weaning revealed a number of CS-like symptoms including small size, progressive loss of adiposity, and neurological symptoms, with a maximum lifespan of 19 weeks. Our results caution against interpretation of death before weaning as premature aging, and at the same time provide a valuable new tool for understanding mechanisms of progressive CS-related progeroid symptoms including lipodystrophy and neurodysfunction. © 2013 the Anatomical Society and John Wiley & Sons Ltd.

The epidemiological transition in Antananarivo, Madagascar: an assessment based on death registers (1900–2012)

PubMed Central

Masquelier, Bruno; Waltisperger, Dominique; Ralijaona, Osée; Pison, Gilles; Ravélo, Arsène

2014-01-01

Background Madagascar today has one of the highest life expectancies in sub-Saharan Africa, despite being among the poorest countries in the continent. There are relatively few detailed accounts of the epidemiological transition in this country due to the lack of a comprehensive death registration system at the national level. However, in Madagascar’s capital city, death registration was established around the start of the 20th century and is now considered virtually complete. Objective We provide an overview of trends in all-cause and cause-specific mortality in Antananarivo to document the timing and pace of the mortality decline and the changes in the cause-of-death structure. Design Death registers covering the period 1976–2012 were digitized and the population at risk of dying was estimated from available censuses and surveys. Trends for the period 1900–1976 were partly reconstructed from published sources. Results The crude death rate stagnated around 30‰ until the 1940s in Antananarivo. Mortality declined rapidly after the World War II and then resurged again in the 1980s as a result of the re-emergence of malaria and the collapse of Madagascar’s economy. Over the past 30 years, impressive gains in life expectancy have been registered thanks to the unabated decline in child mortality, despite political instability, a lasting economic crisis and the persistence of high rates of chronic malnutrition. Progress in adult survival has been more modest because reductions in infectious diseases and diseases of the respiratory system have been partly offset by increases in cardiovascular diseases, neoplasms, and other diseases, particularly at age 50 years and over. Conclusions The transition in Antananarivo has been protracted and largely dependent on anti-microbial and anti-parasitic medicine. The capital city now faces a double burden of communicable and non-communicable diseases. The ongoing registration of deaths in the capital generates a unique database to evaluate the performance of the health system and measure intervention impacts. PMID:24848650

Nonclinical evaluation of the potential for mast cell activation by an erythropoietin analog

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weaver, James L., E-mail: James.Weaver@fda.hhs.gov; Boyne, Michael, E-mail: mboyne@biotechlogic.com; Pang, Eric, E-mail: Eric.Pang@fda.hhs.gov

The erythropoietin analog peginesatide was withdrawn from marketing due to unexpected severe anaphylactic reactions associated with administration of the multi-use formulation. The adverse events occurred rapidly following the first ever administration of the drug with most affected patients becoming symptomatic in less than 30 min. This is most consistent with an anaphylactoid reaction due to direct activation of mast cells. Laboratory evaluation was undertaken using rat peritoneal mast cells as the model system. Initial studies showed that high concentrations of the formulated drug as well as formulated vehicle alone could cause mast cell degranulation as measured by histamine release. Themore » purified active drug was not able to cause histamine release whereas the vehicle filtrate and lab created drug vehicle were equally potent at causing histamine release. Individual formulations of vehicle leaving one component out showed that histamine release was due to phenol. Dose response studies with phenol showed a very sharp dose response curve that was similar in three buffer systems. Cellular analysis by flow cytometry showed that the histamine release was not due to cell death, and that changes in light scatter parameters consistent with degranulation were rapidly observed. Limited testing with primary human mast cells showed a similar dose response of histamine release with exposure to phenol. To provide in vivo confirmation, rats were injected with vehicle formulated with various concentrations of phenol via a jugular vein cannula. Significant release of histamine was detected in blood samples taken 2 min after dosing at the highest concentrations tested. - Highlights: • Peginesatide caused severe anaphylactoid reactions in 0.2% of patients. • Both formulated drug and vehicle cause degranulation of rat mast cells. • Phenol was identified as the vehicle component causing degranulation. • Human mast cells show similar dose response to phenol as rat mast cells. • Histamine release could be caused in vivo in rats by rapid phenol injection.« less

Cancer as a cause of death among people with AIDS in the United States

PubMed Central

Simard, Edgar P.; Engels, Eric A.

2010-01-01

Background People with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS), are at increased risk for cancer. Highly active antiretroviral therapy [(HAART), widely available since 1996] has resulted in dramatic declines in AIDS-related deaths. Methods We evaluated cancer as a cause of death in a U.S. registry-based cohort of 83,282 people with AIDS (1980–2006). Causes of death due to AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) were assessed. We evaluated mortality rates and the fraction of deaths due to cancer. Poisson regression assessed rates according to calendar year of AIDS onset. Results Overall mortality declined from 302 (1980–1989), to 140 (1990–1995), to 29 per 1,000 person-years (1996–2006). ADC mortality declined from 2.95 (1980–1989) to 0.65 per 1,000 person-years (1996–2006) (P<0.01), but the fraction of ADC-deaths increased from 1.05% to 2.47%, due to declines in other AIDS-related deaths. Non-Hodgkin lymphoma was the commonest cancer-related cause of death (36% during 1996–2006). Likewise, NADC mortality declined from 2.21 to 0.84 per 1,000 person-years (1980–1989 vs. 1996–2006, P<0.05), but the fraction of NADC-deaths increased to 3.16% during 1996–2006. Lung cancer was the most common NADC cause of death (21% of cancer-related deaths in 1996–2006). Conclusions Cancer mortality declined in the HAART era, but due to declining mortality from AIDS, cancers account for a growing fraction of deaths. Improved cancer prevention and treatment, particularly for non-Hodgkin lymphoma and lung cancer, would reduce mortality among people with AIDS. PMID:20825305

Acute selenium toxicosis in polo ponies.

PubMed

Desta, Belainesh; Maldonado, Gizela; Reid, Herman; Puschner, Birgit; Maxwell, James; Agasan, Alice; Humphreys, Leigh; Holt, Thomas

2011-05-01

Just prior to an international polo event, 21 horses from one team exhibited clinical signs of central nervous system disturbance, hyperexcitability, sweating, ataxia, tachycardia, dyspnea, pyrexia, and rapid death. The suspected cause of this peracute onset of illness and death included intentional contamination of feed or iatrogenic administration of performance-enhancing drugs resulting in a severe adverse reaction. Six horses were submitted to the Bronson Animal Disease Diagnostic Laboratory for necropsy and toxicological examination. The clinical signs and sudden death, the similarity to earlier work by the lead author of selenium toxicosis in calves, as well as published reports, prompted investigators to focus on selenium testing. Sixty-four hours following receipt, the laboratory detected toxic selenium concentrations in the tissues of these animals. Following further investigation of the case by regulatory officials, it was determined that all affected horses had received an intravenous injection of a compounded "vitamin/mineral" supplement just prior to the onset of signs. The compounded supplement contained toxic levels of selenium. The present report illustrates the in-depth laboratory investigation of the cause of acute death in 6 polo ponies due to selenium toxicosis. In addition to solving this high profile case, the toxic levels of selenium found in livers (6.13 ± 0.31 mg/kg wet weight), kidneys (6.25 ± 0.3 mg/kg wet weight), and sera (1.50 ± 0.11 µg/ml) of these affected animals may provide important diagnostic criteria for future interpretations of selenium concentrations in tissues of horses. © 2011 The Author(s)

Years of life lost of inhabitants of rural areas in Poland due to premature mortality caused by external reasons of death 1999-2012.

PubMed

Bryła, Marek; Maniecka-Bryła, Irena; Burzyńska, Monika; Pikala, Małgorzata

2016-12-23

External causes of death are the third most common causes of death, after cardiovascular diseases and malignant neoplasms, in inhabitants of Poland. External causes of death pose the greatest threat to people aged 5-44, which results in a great number of years of life lost. The aim of the study is the analysis of years of life lost due to external causes of death among rural inhabitants in Poland, particularly due to traffic accidents and suicides. The study material included a database created on the basis of 2,100,785 certificates of rural inhabitants in Poland in the period 1999-2012. The SEYLL p (Standard Expected Years of Life Lost per living person) and the SEYLL d (per death) indices were used to determine years of life lost due to external causes of death. Joinpoint models were used to analyze time trends. In the period 1999-2012, 151,037 rural inhabitants died due to external causes, including 27.2% due to traffic accidents and 25.2% due to suicides. In 2012, the SEYLL p was 1,817 per 100,000 males and 298 per 100,000 females. Among males, suicides (SEYLL p = 633 years per 100,000) and traffic accidents (SEYLL p = 473 years per 100,000) contributed to the largest number of years of life lost. Among females, SEYLLp values were: 109 years due to traffic accidents and 69 years due to suicides (per 100,000). Among males, SEYLL p values started to decrease in 2008 at the average annual rate of 3.2%. In the group of females in the period 1999-2012, SEYLL p values were decreasing by 2.4% per year. The decreasing trend of the number of lost years of life due to external causes among rural inhabitants does not apply to suicides among men. The SEYLL p due to this group of causes has been steadily increasing since 1999. Analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes.

[Caring for families of charcoal-burning suicide patients].

PubMed

Pien, Feng-Chen; Feng, Hsin-Pei; Tzeng, Wen-Chii

2013-12-01

Charcoal-burning is the second major cause of suicide death in Taiwan. Predicting the variable damage and sequelae in this suicide mode is difficult due to the rapid combination of carbon monoxide with red blood cells. Delayed neuropsychological sequelae (DNS) may result in significantly extended recovery times, causing additional stress to the family. Nurses may help increase family understanding and support and guide family members to more positive intra-family interactions, shared perspectives on the recovery process, and resource seeking behavior by depicting subsequent family life and helping the entire family develop coping strategies those allow all members to effect cognitive, emotional and behavioral change. This result may help families of attempted suicide individuals recover successfully.

The Confluence of Stereotactic Ablative Radiotherapy and Tumor Immunology

PubMed Central

Finkelstein, Steven Eric; Timmerman, Robert; McBride, William H.; Schaue, Dörthe; Hoffe, Sarah E.; Mantz, Constantine A.; Wilson, George D.

2011-01-01

Stereotactic radiation approaches are gaining more popularity for the treatment of intracranial as well as extracranial tumors in organs such as the liver and lung. Technology, rather than biology, is driving the rapid adoption of stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), in the clinic due to advances in precise positioning and targeting. Dramatic improvements in tumor control have been demonstrated; however, our knowledge of normal tissue biology response mechanisms to large fraction sizes is lacking. Herein, we will discuss how SABR can induce cellular expression of MHC I, adhesion molecules, costimulatory molecules, heat shock proteins, inflammatory mediators, immunomodulatory cytokines, and death receptors to enhance antitumor immune responses. PMID:22162711

Motor vehicle injuries in Qatar: time trends in a rapidly developing Middle Eastern nation.

PubMed

Mamtani, Ravinder; Al-Thani, Mohammed H; Al-Thani, Al-Anoud Mohammed; Sheikh, Javaid I; Lowenfels, Albert B

2012-04-01

Despite their wealth and modern road systems, traffic injury rates in Middle Eastern countries are generally higher than those in Western countries. The authors examined traffic injuries in Qatar during 2000-2010, a period of rapid population growth, focusing on the impact of speed control cameras installed in 2007 on overall injury rates and mortality. During the period 2000-2006, prior to camera installation, the mean (SD) vehicular injury death rate per 100,000 was 19.9±4.1. From 2007 to 2010, the mean (SD) vehicular death rates were significantly lower: 14.7±1.5 (p=0.028). Non-fatal severe injury rates also declined, but mild injury rates increased, perhaps because of increased traffic congestion and improved notification. It is possible that speed cameras decreased speeding enough to affect the death rate, without affecting overall injury rates. These data suggest that in a rapidly growing Middle Eastern country, photo enforcement (speed) cameras can be an important component of traffic control, but other measures will be required for maximum impact.

Motor vehicle injuries in Qatar: time trends in a rapidly developing Middle Eastern nation

PubMed Central

Al-Thani, Mohammed H; Al-Thani, Al-Anoud Mohammed; Sheikh, Javaid I; Lowenfels, Albert B

2011-01-01

Despite their wealth and modern road systems, traffic injury rates in Middle Eastern countries are generally higher than those in Western countries. The authors examined traffic injuries in Qatar during 2000–2010, a period of rapid population growth, focusing on the impact of speed control cameras installed in 2007 on overall injury rates and mortality. During the period 2000–2006, prior to camera installation, the mean (SD) vehicular injury death rate per 100 000 was 19.9±4.1. From 2007 to 2010, the mean (SD) vehicular death rates were significantly lower: 14.7±1.5 (p=0.028). Non-fatal severe injury rates also declined, but mild injury rates increased, perhaps because of increased traffic congestion and improved notification. It is possible that speed cameras decreased speeding enough to affect the death rate, without affecting overall injury rates. These data suggest that in a rapidly growing Middle Eastern country, photo enforcement (speed) cameras can be an important component of traffic control, but other measures will be required for maximum impact. PMID:21994881

Opioid Deaths in Milwaukee County, Wisconsin 2013-2017: The Primacy of Heroin and Fentanyl.

PubMed

Peterson, Brian L; Schreiber, Sara; Fumo, Nicole; Brooke Lerner, E

2018-04-23

Heroin and fentanyl are the overwhelming and increasing cause of opioid deaths in Milwaukee County, Wisconsin. We reviewed all drug and opioid deaths from 2013 to 2017 to delineate the specific opioid drugs involved and changes in their incidence. From 2013 to 2017, 980 deaths were due to opioids, rising from 184 in 2013 to 337 in 2017. In 2017, opioid deaths exceeded combined non-natural deaths from homicide and suicide. Illicit heroin and fentanyl/analogs caused 84% of opioid deaths and 80% of drug deaths, with no increase in deaths due to oral prescription drugs such as oxycodone and hydrocodone. Any approach to decreasing this dramatic increase in opioid deaths should first focus on interdicting the supply and cheap availability of these illicit opioids. Fentanyl and its analogs represent the most deadly opioids and the greatest threat to human life in our population. © 2018 American Academy of Forensic Sciences.

Unintentional asphyxia, SIDS, and medically explained deaths: a descriptive study of outcomes of child death review (CDR) investigations following sudden unexpected death in infancy.

PubMed

Garstang, Joanna; Ellis, Catherine; Griffiths, Frances; Sidebotham, Peter

2016-12-01

A comprehensive child death review (CDR) program was introduced in England and Wales in 2008, but as yet data have only been analyzed at a local level, limiting the learning from deaths. The aim of this study is to describe the profile of causes and risk factors for sudden unexpected death in infancy (SUDI) as determined by the new CDR program. This was a descriptive outcome study using data from child death overview panel Form C for SUDI cases dying during 2010-2012 in the West Midlands region of England. The main outcome measures were: cause of death, risk factors and potential preventability of death, and determination of deaths probably due to unintentional asphyxia. Data were obtained for 65/70 (93 %) SUDI cases. 20/65 (31 %) deaths were initially categorized as due to medical causes; 21/65 (32 %) as SIDS; and 24/65 (37 %) as undetermined. Reanalysis suggested that 2/21 SIDS and 7/24 undetermined deaths were probably due to unintentional asphyxia, with 6 of these involving co-sleeping and excessive parental alcohol consumption. Deaths classified as "undetermined" had significantly higher total family and environmental risk factor scores (mean 2.6, 95 % CI 2.0-3.3) compared to those classified as SIDS (mean 1.6, 95 % CI 1.2-1.9), or medical causes for death (mean 1.1, 95 % CI 0.8-1.3). 9/20 (47 %) of medical deaths, 19/21 (90 %) SIDS, and 23/24 (96 %) undetermined deaths were considered to be potentially preventable. There were inadequacies in medical provision identified in 5/20 (25 %) of medically explained deaths. The CDR program results in detailed information about risk factors for SUDI cases but failed to recognize deaths probably due to unintentional asphyxia. The misclassification of probable unintentional asphyxial deaths and SIDS as "undetermined deaths" is likely to limit learning from these deaths and inhibit prevention strategies. Many SUDI occurred in families with mental illness, substance misuse and chaotic lifestyles and most in unsafe sleep environments. This knowledge could be used to better target safe sleep advice for vulnerable families and prevent SUDI in the future.

[Perinatal mortality due to congenital syphilis: a quality-of-care indicator for women's and children's healthcare].

PubMed

Saraceni, Valéria; Guimarães, Maria Helena Freitas da Silva; Theme Filha, Mariza Miranda; Leal, Maria do Carmo

2005-01-01

Syphilis is a persistent cause of perinatal mortality in Rio de Janeiro, Brazil, where this study was performed using data from the mortality data system and investigational reports for fetal and neonatal deaths, mandatory in municipal maternity hospitals. From 1996 to 1998, 13.1% of fetal deaths and 6.5% of neonatal deaths in municipal maternity hospitals were due to congenital syphilis. From 1999 to 2002, the proportions were 16.2% and 7.9%, respectively. For the city of Rio de Janeiro as a whole from 1999 and 2002, the proportions were 5.4% of fetal deaths and 2.2% of neonatal deaths. The perinatal mortality rate due to congenital syphilis remains stable in Rio de Janeiro, despite efforts initiated with congenital syphilis elimination campaigns in 1999 and 2000. We propose that the perinatal mortality rate due to congenital syphilis be used as an impact indicator for activities to control and eliminate congenital syphilis, based on the investigational reports for fetal and neonatal deaths. Such reports could be extended to the surveillance of other avoidable perinatal disease outcomes.

Disability Rating, Age at Death, and Cause of Death in U.S. Veterans with Service-Connected Conditions.

PubMed

Maynard, Charles; Trivedi, Ranak; Nelson, Karin; Fihn, Stephan D

2018-03-26

The association between disability and cause of death in Veterans with service-connected disabilities has not been studied. The objective of this study was to compare age at death, military service and disability characteristics, including disability rating, and cause of death by year of birth. We also examined cause of death for specific service-connected conditions. This study used information from the VETSNET file, which is a snapshot of selected items from the Veterans Benefits Administration corporate database. We also used the National Death Index (NDI) for Veterans which is part of the VA Suicide Data Repository. In VETSNET, there were 758,324 Veterans who had a service-connected condition and died between the years 2004 and 2014. Using the scrambled social security number to link the two files resulted in 605,493 (80%) deceased Veterans. Age at death, sex, and underlying cause of death were obtained from the NDI for Veterans and military service characteristics and types of disability were acquired from VETSNET. We constructed age categories corresponding to period of service; birth years 1938 and earlier corresponded to Korea and World War II ("oldest"), birth years 1939-1957 to the Vietnam era ("middle"), and birth years 1958 and later to post Vietnam, Gulf War, and the more recent conflicts in Iraq and Afghanistan ("youngest"). Sixty-two percent were in the oldest age category, 34% in the middle group, and 4% in the youngest one. The overall age at death was 75 ± 13 yr. Only 1.6% of decedents were women; among women 25% were in the youngest age group, while among men only 4% were in the youngest group. Most decedents were enlisted personnel, and 60% served in the U.S. Army. Nearly 61% had a disability rating of >50% and for the middle age group 54% had a disability rating of 100%. The most common service-connected conditions were tinnitus, hearing loss, and post-traumatic stress disorder (PTSD). In the oldest group, nearly half of deaths were due to cancer or cardiovascular conditions and <2% were due to external causes. In the youngest group, cardiovascular disease and cancer accounted for about 1/3 of deaths, whereas external causes or deaths due to accidents, suicide, or assault accounted for nearly 33% of deaths. For Veterans with service-connected PTSD or major depression; 6.5% of deaths were due to external causes whereas for Veterans without these conditions, only 3.1% were due to external causes. The finding of premature death due to external causes in the youngest age group as well as the finding of higher proportions of external causes in those with PTSD or major depression should be of great concern to those who care for Veterans.

Trends in hospitalizations and mortality from asthma in Costa Rica over a 12- to 15-year period.

PubMed

Soto-Martínez, Manuel; Avila, Lydiana; Soto, Natalia; Chaves, Albin; Celedón, Juan C; Soto-Quiros, Manuel E

2014-01-01

Little is known about trends in morbidity and/or mortality due to asthma in Latin America. To examine trends in hospitalizations and mortality due to asthma from 1997-2000 to 2011 in Costa Rica. The rates of hospitalization due to asthma were calculated for each sex in 3 age groups from 1997 to 2011. The number of deaths due to asthma was first calculated for all groups and then for each sex in 3 age groups from 2000 to 2011. All analyses were conducted over the entire period and separately for the periods before and after a National Asthma Program (NAP) in 2003. Data also were available for prescriptions for beclomethasone since 2004. All analyses were conducted by using Epi Info. Substantial reductions were found in hospitalizations and deaths due to asthma in Costa Ricans (eg, from 25 deaths in 2000 to 5 deaths in 2011). Although, the percentage decrement in the rates of hospitalization for asthma in subjects <20 years old was similar before and after the NAP, the reduction in both deaths due to asthma and rates of asthma hospitalizations in older subjects were more pronounced after the NAP, when prescriptions for beclomethasone were also increased by approximately 129%. In Costa Rica, there was a marked decrement in hospitalizations and mortality due to asthma from 1997-2000 to 2011. In younger subjects, this is likely due to guidelines that, since 1988, recommend inhaled corticosteroids for persistent asthma. In older adults, the NAP probably enhanced reductions in hospitalizations and deaths due to asthma through inhaled corticosteroid use. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Injury Deaths among People with Epilepsy in Rural Bangladesh

PubMed Central

Mateen, Farrah J.; Shinohara, Russell T.; Alam, Nurul; Black, Robert E.; Streatfield, Peter K.

2012-01-01

Background Accidental death in people with epilepsy (PWE) has been described in high income settings where the relative risk of death is known to be higher than in the standard population. Population-based studies of injury deaths among PWE in developing countries are uncommon. Methods A population-based verbal autopsy study in Matlab, Bangladesh, performed at a health and demographic surveillance system site (mean population 223,886 in 142 villages), was used to assess the possible causes of all deaths. All cases of accidental injury (2005–2008) were evaluated and compared between people with and without a diagnosis of epilepsy. Results There were 12 accidental deaths among PWE (8 female, age range 12–58 years old) out of a total of 316 deaths due to accidental injuries (3.8% of all injury deaths). Causes of mortality were drowning (n=10) and burns (n=2). The proportion of deaths due to drowning among PWE was significantly higher than that of the standard population (83% (10/12) vs. 7% (21/304), relative risk 12.6 (95% CI, 7.7–20.7, p<0.0001)). Mortality due to injury in PWE occurred at a younger age compared to people without epilepsy (mean difference 20.7 years (95% CI 6.7, 34.3), p<0.004). Conclusions There is a high proportion of accidental deaths due to drowning in PWE in Bangladesh compared to the standard population. Given the risk of seasonal flooding and low level of formal education, programs targeting water safety for PWE at all ages should be emphasized, appropriate for level of ability. PMID:22341966

Suicide and undetermined violent deaths in Malaysia, 1966-1990: evidence for the misclassification of suicide statistics.

PubMed

Maniam, T

1995-01-01

Suicide statistics are generally recognised to be unreliable. This study of the reported rates of suicide in West Malaysia between 1966-1990 shows that the mean crude suicide rate between 1966-1974 was 6.1 per 100,000, but had dropped drastically between 1975-1990 to a mean of 1.6 per 100,000. Three lines of evidence are presented to show that this reduction in the suicide rate is due to a systematic misclassification of medically certified suicides as deaths due to undetermined violent deaths (which refers to violent deaths not known to be accidentally or deliberately inflicted). Firstly, the large drop in reported suicide rates corresponds closely to an increase in the rate of deaths due to undetermined violent deaths. There is a highly positive negative correlation between the two rates (coefficient of correlation, r = -0.9). Secondly, the misclassification appears to be mainly a problem with the medically certified deaths which follow the ICD classification. The mean ratio of uncertified to certified suicides before 1975 was 0.8, but from 1975 onwards the mean was 3.1. This is in contrast to the corresponding ratio for deaths due to all accidents which has remained fairly constant throughout these years. Thirdly, the race and sex differences for the rates of undetermined violent deaths are identical to those of suicide. Taking the misclassification into account the corrected suicide rate for West Malaysia is estimated to be between 8-13 per 100,000 since 1982.

Did death certificates and a death review process agree on lung cancer cause of death in the National Lung Screening Trial?

PubMed

Marcus, Pamela M; Doria-Rose, Vincent Paul; Gareen, Ilana F; Brewer, Brenda; Clingan, Kathy; Keating, Kristen; Rosenbaum, Jennifer; Rozjabek, Heather M; Rathmell, Joshua; Sicks, JoRean; Miller, Anthony B

2016-08-01

Randomized controlled trials frequently use death review committees to assign a cause of death rather than relying on cause of death information from death certificates. The National Lung Screening Trial, a randomized controlled trial of lung cancer screening with low-dose computed tomography versus chest X-ray for heavy and/or long-term smokers ages 55-74 years at enrollment, used a committee blinded to arm assignment for a subset of deaths to determine whether cause of death was due to lung cancer. Deaths were selected for review using a pre-determined computerized algorithm. The algorithm, which considered cancers diagnosed during the trial, causes and significant conditions listed on the death certificate, and the underlying cause of death derived from death certificate information by trained nosologists, selected deaths that were most likely to represent a death due to lung cancer (either directly or indirectly) and deaths that might have been erroneously assigned lung cancer as the cause of death. The algorithm also selected deaths that might be due to adverse events of diagnostic evaluation for lung cancer. Using the review cause of death as the gold standard and lung cancer cause of death as the outcome of interest (dichotomized as lung cancer versus not lung cancer), we calculated performance measures of the death certificate cause of death. We also recalculated the trial primary endpoint using the death certificate cause of death. In all, 1642 deaths were reviewed and assigned a cause of death (42% of the 3877 National Lung Screening Trial deaths). Sensitivity of death certificate cause of death was 91%; specificity, 97%; positive predictive value, 98%; and negative predictive value, 89%. About 40% of the deaths reclassified to lung cancer cause of death had a death certificate cause of death of a neoplasm other than lung. Using the death certificate cause of death, the lung cancer mortality reduction was 18% (95% confidence interval: 4.2-25.0), as compared with the published finding of 20% (95% confidence interval: 6.7-26.7). Death review may not be necessary for primary-outcome analyses in lung cancer screening trials. If deemed necessary, researchers should strive to streamline the death review process as much as possible. © The Author(s) 2016.

Causes of death in hospitalised HIV-infected patients at a National Referral Centre in Singapore: a retrospective review from 2008 to 2010.

PubMed

Wong, Chen Seong; Lo, Francis A; Cavailler, Philippe; Ng, Oon Tek; Lee, Cheng Chuan; Leo, Yee Sin; Chua, Arlene C

2012-12-01

Highly active antiretroviral therapy (HAART) has improved outcomes for individuals infected with human immunodeficiency virus (HIV). This study describes the causes of death in hospitalised HIV-positive patients from 2008 to 2010 in Tan Tock Seng Hospital, the national referral centre for HIV management in Singapore. Data were retrospectively collected from HIV-positive patients who died in Tan Tock Seng Hospital from January 2008 to December 2010. Sixty-seven deaths occurred in the study period. A majority of patients died of non-acquired immune deficiency syndrome (AIDS)-defining illnesses (54.7%). The median CD4 count was 39.5 (range, 20.0 to 97.0), and 7 patients had HIV viral loads of <200 copies/mL. There were 27 deaths due to opportunistic infections, 27 due to non AIDS-defining infections, 4 due to non AIDS-associated malignancies. This study also describes 3 deaths due to cardiovascular events, and 1 due to hepatic failure. Patients who had virologic suppression were more likely to die from non AIDS-defining causes. Causes of death in HIV-positive patients have changed in the HAART era. More research is required to further understand and address barriers to testing and treatment to further improve outcomes in HIV/AIDS.

Transition of population reproduction patterns in China.

PubMed

Zhou, X

1985-04-01

Rapid and drastic changes have taken place in the population reproduction pattern in China over the last 3 decades during which the traditional pattern of high birth rate and death rate gave way to the modern pattern of low birth rate and death rate. Man's capacity to reduce disease incidence and to lower mortality rates relies directly on the economic development of the society that makes the necessary conditions availiable to him. The drastic drop of the mortality rate in China since 1949 is not a result of the "propagation of Western medical knowledge and technology" alone; it is mainly an upshot of the changes in the social, political, and economic spheres that have taken place in the country. In the recent 10 years, China has brought down its birth rate and put population growth under plans, reflecting a deepening understanding of the objective laws in the realm of population development. This understanding includes the following aspects: 1) multiplication of human numbers is not the sole purpose of population growth, 2) the establishment of the socialist system has accelerated the mortality rate decline without being able to bring down the birth rate rapidly, and 3) population growth must be subjected to planning. With these points of understanding gradually deepened, China has made full use of its socialist institutional advantages to bring down its birth rate in a short time. The credit of the successful completion of fertility transition is due to China's advanced production relations and superior social system.

Induction of Mitotic Cell Death by Overriding G2/M Checkpoint in Endometrial Cancer Cells with Non-functional p53

PubMed Central

Meng, Xiangbing; Laidler, Laura L.; Kosmacek, Elizabeth A.; Yang, Shujie; Xiong, Zhi; Zhu, Danlin; Wang, Xinjun; Dai, Donghai; Zhang, Yuping; Wang, Xiaofang; Brachova, Pavla; Albitar, Lina; Liu, Dawei; Ianzini, Fiorenza; Mackey, Michael A.; Leslie, Kimberly K.

2012-01-01

Objective Endometrial tumors with non-functional p53, such as serous uterine endometrial carcinomas, are aggressive malignancies with a poor outcome, yet they have an Achilles’ heel: due to loss of p53 function, these tumors may be sensitive to treatments which abrogate the G2/M checkpoint. Our objective was to exploit this weakness to induce mitotic cell death using two strategies: (1) EGFR inhibitor gefitinib combined with paclitaxel to arrest cells at mitosis, or (2) BI2536, an inhibitor of polo-like kinase 1 (PLK1), to block PLK1 activity. Methods We examined the impact of combining gefitinib and paclitaxel or PLK1 inhibitor on expression of G2/M checkpoint controllers, cell viability, and cell cycle progression in endometrial cancer cells with mutant p53. Results In cells lacking normal p53 activity, each treatment activated CDC25C and inactivated Wee1, which in turn activated cdc2 and sent cells rapidly through the G2/M checkpoint and into mitosis. Live cell imaging demonstrated irreversible mitotic arrest and eventual cell death. Combinatorial therapy with paclitaxel and gefitinib was highly synergistic and resulted in a 10-fold reduction in the IC50 for paclitaxel, from 14 nM as a single agent to 1.3 nM in the presence of gefitinib. However, BI2536 alone at low concentrations (5 nM) was the most effective treatment and resulted in massive mitotic cell death. In a xenograft mouse model with p53-deficient cells, low dose BI2536 significantly inhibited tumor growth. Conclusions These findings reveal induction of mitotic cell death as a therapeutic strategy for endometrial tumors lacking functional p53. PMID:23146687

20 CFR 410.412 - “Total disability” defined.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.412...”; see §§ 410.424 through 410.426); and (2) His impairment can be expected to result in death, or has... be considered to have been totally disabled due to pneumoconiosis at the time of his death, if at the...

Towards an Inclusive and Evidence-Based Definition of the Maternal Mortality Ratio: An Analysis of the Distribution of Time after Delivery of Maternal Deaths in Mexico, 2010-2013

PubMed Central

Fritz, Jimena; Olvera, Marisela; Torres, Luis M.; Lozano, Rafael

2016-01-01

Progress towards the Millennium Development Goal No. 5 was measured by an indicator that excluded women who died due to pregnancy and childbirth after 42 days from the date of delivery. These women suffered from what are defined as late deaths and sequelae-related deaths (O96 and O97 respectively, according to the International Classification of Diseases, 10th revision). Such deaths end up not being part of the numerator in the calculation of the Maternal Mortality Ratio (MMR), the indicator that governments and international agencies use for reporting. The issue is not trivial since these deaths account for a sizeable fraction of all maternal deaths in the world and show an upward trend over time in many countries. The aim of this study was to analyze empirical data on maternal deaths that occurred between 2010 and 2013 in Mexico, linking databases of the Deliberate Search and Reclassification of Maternal Deaths (BIRMM) and the Birth Information Subsystem (SINAC) of the Ministry of Health. Data were analyzed by negative binomial regression, survival analysis and multiple cause analysis. While the reported MMR decreased by 5% per year between 2010 and 2013, the MMR due to late and sequelae-related deaths doubled from 3.5 to 7 per 100,000 live-births in 2013 (p <0.01). A survival analysis of all maternal deaths revealed nothing particular around the 42 day threshold, other than the exclusion of 18% of women who died due to childbirth in 2013. The multiple cause analysis showed a strong association between the excluded deaths and obstetric causes. It is suggested to review the construction of the MMR to make it a more inclusive and dignified measurement of maternal mortality by including all deaths due to pregnancy and childbirth into the Maternal Death definition. PMID:27310260

The mortality profile of black Seventh-Day Adventists residing in metropolitan Atlanta: a pilot study.

PubMed

Murphy, F G; Blumenthal, D S; Dickson-Smith, J; Peay, R P

1990-08-01

Mortality information was gathered for 110 Black Seventh-day Adventist members of seven churches in Metropolitan Atlanta, Georgia during the period 1980-87. Seventy-seven percent of the deaths were due to cardiovascular diseases; 8 percent due to cancer, the second leading cause of death. The cancer rate is extremely low in comparison to the proportion of deaths due to cardiovascular diseases. Subsequent research on this population will take into consideration lifestyle factors which could contribute to this finding.

Disaster-related fatalities among US citizens traveling abroad.

PubMed

Partridge, Robert; Bouslough, David; Proano, Lawrence

2013-01-01

To describe the locations and risk of death associated with natural disaster fatalities for US citizens traveling abroad. A retrospective database review of US citizen disaster deaths occurring worldwide. None. Information on fatalities due to disasters was abstracted from the US Department of State Web site reporting deaths of US citizens abroad by non-natural causes from October 2002 through June 2012. The main outcome measures were the frequency of disaster deaths and countries where disasters occurred. Descriptive statistics and rates were used to evaluate the study data. There were 7,963 total non-natural deaths of US citizens traveling abroad during the study period. Of these, 163 (2.0 percent) were disaster-related deaths, involving 19 disaster events in 15 countries. Only two disaster-related events resulted in more than two deaths of US travelers-the 2010 earthquake in Haiti causing 121 fatalities (74.2 percent of disaster deaths), and the 2004 tsunami in Thailand causing 22 fatalities (13.5 percent of disaster deaths). The approximate annual mean death rate for US citizen travelers as a result of disaster events is 0.27 deaths/1 million travelers, compared with 1.4 deaths/1 million residents due to disaster annually within the United States. The risk of disaster-related fatality is low for US citizens traveling abroad. Although disaster-related death among travelers is unpredictable, during a period of almost 10 years, there was only one reported death due to disaster in the five countries most frequently visited by US travelers. Further investigation may identify population-, seasonal-, country-, or location-specific risks from which prevention strategies can be developed.

HIV in Southern Africa.

PubMed

Hensle, K

1998-01-01

This article discusses transmission of HIV/AIDS in Southern Africa. Five of the six countries with the highest rates of HIV infection in the world during the 1990s are in Southern Africa. Projected life expectancies are dropping due to AIDS. The population at risk is aged 15-40 years. 93-95% of all HIV infections in this age group in sub-Saharan Africa are transmitted heterosexually; by 1996, 50% were women. The second most common mode of transmission is perinatal. In Botswana, HIV infection rates increased from 6% to 30% during 1991-93 among pregnant women at prenatal clinics. 43% were HIV positive in Francistown, Botswana. Populations are vulnerable to HIV infections when risk taking sexual behavior is practiced. Risk taking sexual behavior has increased due to social, cultural, and family uprooting; lower access to health and social services; and gender imbalances among domestic and international migrant populations. Women are at risk due to their inability to ask their partners to practice safer sex. Migrants' travel to job opportunities in urban areas and neighboring countries encourages the practice of several sexual partners. The rapid spread is also attributed to a special viral subtype C that spreads more rapidly through vaginal intercourse. Treatment with AZT during pregnancy reduces transmission to infants by 66%. Breast feeding transmits HIV from mothers to infants. Social instability and civil conflicts contribute to the spread. Expensive, time consuming infrastructure development is necessary to combat AIDS. Misinformation and inaction will only lead to more deaths.

Risk Factors and Control Strategies for the Rapidly Rising Rate of Breast Cancer in Korea

PubMed Central

Park, Sue K.; Kim, Yeonju; Kang, Daehee; Jung, En-Joo

2011-01-01

Due to the aging population and tremendous changes in life style over the past decades, cancer has been the leading cause of death in Korea. The incidence rate of breast cancer is the second highest in Korea, and it has shown an annual increase of 6.8% for the past 6 years. The major risk factors of breast cancer in Korean women are as follows: Early menarche, late menopause, late full-term pregnancy (FTP), and low numbers of FTP. Height and body mass index increased the risk of breast cancer in postmenopausal women only. There are ethnic variations in breast cancer due to the differences in genetic susceptibility or exposure to etiologic agent. With the epidemiological evidences on the possibility of further increase of breast cancer in Korea, the Korean Government began implementing the National Cancer Screening Program against breast cancer in 2002. Five-year survival rates for female breast cancer have improved significantly from 78.0% in early 1993-1995 to 90.0% in 2004-2008. This data indicate that improvement of the survival rate may be partially due to the early diagnosis of breast cancer as well as the increased public awareness about the significance of early detection and organized cancer screening program. The current primary prevention programs are geared towards strengthening national prevention campaigns. In accordance with the improvement in 5-year survival rate, the overall cancer mortality has started to decrease. However, breast cancer death rate and incidence rates are still increasing, which need further organized effort by the Korean Government. PMID:21847401

Energy deprivation by silibinin in colorectal cancer cells

PubMed Central

Raina, Komal; Agarwal, Chapla; Wadhwa, Ritambhara; Serkova, Natalie J.; Agarwal, Rajesh

2013-01-01

Small molecules with the potential to initiate different types of programmed cell death could be useful ‘adjunct therapy’ where current anticancer modalities fail to generate significant activity due to a defective apoptotic machinery or resistance of cancer cells to the specific death mechanism induced by that treatment. The current study identified silibinin, for the first time, as one such natural agent, having dual efficacy against colorectal cancer (CRC) cells. First, silibinin rapidly induced oxidative stress in CRC SW480 cells due to reactive oxygen species (ROS) generation with a concomitant dissipation of mitchondrial potential (ΔΨm) and cytochrome c release leading to mild apoptosis as a biological effect. However, with increased exposure to silibinin, cytoplasmic vacuolization intensified within the cells followed by sequestration of the organelles, which inhibits the further release of cytochrome c. Interestingly, this decrease in apoptotic response correlated with increased autophagic events as evidenced by tracking the dynamics of LC3-II within the cells. Mechanistic studies revealed that silibinin strongly inhibited PIK3CA-AKT–MTOR but activated MAP2K1/2-MAPK1/3 pathways for its biological effects. Corroborating these effects, endoplasmic reticulum stress was generated and glucose uptake inhibition as well as energy restriction were induced by silibinin, thus, mimicking starvation-like conditions. Further, the cellular damage to tumor cells by silibinin was severe and irreparable due to sustained interference in essential cellular processes such as mitochondrial metabolism, phospholipid and protein synthesis, suggesting that silibinin harbors a deadly ‘double-edged sword’ against CRC cells thereby further advocating its clinical effectiveness against this malignancy. PMID:23445752

Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 - 10 States, July-December 2016.

PubMed

O'Donnell, Julie K; Halpin, John; Mattson, Christine L; Goldberger, Bruce A; Gladden, R Matthew

2017-11-03

Preliminary estimates of U.S. drug overdose deaths exceeded 60,000 in 2016 and were partially driven by a fivefold increase in overdose deaths involving synthetic opioids (excluding methadone), from 3,105 in 2013 to approximately 20,000 in 2016 (1,2). Illicitly manufactured fentanyl, a synthetic opioid 50-100 times more potent than morphine, is primarily responsible for this rapid increase (3,4). In addition, fentanyl analogs such as acetylfentanyl, furanylfentanyl, and carfentanil are being detected increasingly in overdose deaths (5,6) and the illicit opioid drug supply (7). Carfentanil is estimated to be 10,000 times more potent than morphine (8). Estimates of the potency of acetylfentanyl and furanylfentanyl vary but suggest that they are less potent than fentanyl (9). Estimates of relative potency have some uncertainty because illicit fentanyl analog potency has not been evaluated in humans. This report describes opioid overdose deaths during July-December 2016 that tested positive for fentanyl, fentanyl analogs, or U-47700, an illicit synthetic opioid, in 10 states participating in CDC's Enhanced State Opioid Overdose Surveillance (ESOOS) program.* Fentanyl analogs are similar in chemical structure to fentanyl but not routinely detected because specialized toxicology testing is required. Fentanyl was detected in at least half of opioid overdose deaths in seven of 10 states, and 57% of fentanyl-involved deaths also tested positive for other illicit drugs, such as heroin. Fentanyl analogs were present in >10% of opioid overdose deaths in four states, with carfentanil, furanylfentanyl, and acetylfentanyl identified most frequently. Expanded surveillance for opioid overdoses, including testing for fentanyl and fentanyl analogs, assists in tracking the rapidly changing illicit opioid market and informing innovative interventions designed to reduce opioid overdose deaths.

Biomechanical analysis on stent materials used as cardiovascular implants

NASA Astrophysics Data System (ADS)

Kumar, Vasantha; Ramesha, C. M.; Sajjan, Sudheer S.

2018-04-01

Atherosclerosis is the most common cause of death in the world, accounting for 48% of all deaths in the world. Atherosclerosis, also known as coronary artery disease occurs when excess cholesterol attaches itself to the walls of blood vessels. Coronary stent implantation is one of the most important procedures to treating coronary artery disease such atherosclerosis. Due to its efficiency, flexibility and simplicity, the use of coronary stents procedures has increased rapidly. In order to have better output of stent implantation, it is needed to study and analyze the biomechanical behavior of this device before manufacturing and put into use. Biomaterials are commonly used for medical application in cardiovascular stent implantation. A biomaterial is a non-viable material used as medical implant, so it is intended to interact with biological system. In this paper, an explicit dynamic analysis is used for analyzing the biomechanical behavior of cardiovascular stent by using finite element analysis tool, ABAQUS 6.10. Results showed that a best suitable biomaterial for cardiovascular stent implants, which exhibits an outstanding biocompatibility and biomechanical characteristics will be aimed at which will be quite useful to the human beings worldwide.

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

PubMed

Rigouzzo, A; Tessier, V; Zieleskiewicz, L

2017-12-01

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

Preventing Death and Serious Injury from Falling Trees and Branches

ERIC Educational Resources Information Center

Brookes, Andrew

2007-01-01

Of 128 outdoor education related deaths examined since 1960, 14 have been due to falling trees or branches. This article examines the grounds on which death or serious injury due to falling trees or branches can be regarded as an inherent risk in outdoor education, and the extent to which such incidents can be regarded as preventable. It compares…

Smart, Injury-Triggered Therapy for Ocular Trauma

DTIC Science & Technology

2016-10-01

prognosis due to retinal cell death , scar formation, and lack of functional regeneration. Proliferative vitreoretinopathy (PVR), a form of intraocular...Proteases, Metalloproteinases, Cell death , Gene Therapy 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME...vision has a poor prognosis due to retinal cell death , scar formation, and lack of functional regeneration. Proliferative vitreoretinopathy (PVR), a

Spatial pattern and temporal trend of mortality due to tuberculosis 10

PubMed Central

de Queiroz, Ana Angélica Rêgo; Berra, Thaís Zamboni; Garcia, Maria Concebida da Cunha; Popolin, Marcela Paschoal; Belchior, Aylana de Souza; Yamamura, Mellina; dos Santos, Danielle Talita; Arroyo, Luiz Henrique; Arcêncio, Ricardo Alexandre

2018-01-01

ABSTRACT Objectives: To describe the epidemiological profile of mortality due to tuberculosis (TB), to analyze the spatial pattern of these deaths and to investigate the temporal trend in mortality due to tuberculosis in Northeast Brazil. Methods: An ecological study based on secondary mortality data. Deaths due to TB were included in the study. Descriptive statistics were calculated and gross mortality rates were estimated and smoothed by the Local Empirical Bayesian Method. Prais-Winsten’s regression was used to analyze the temporal trend in the TB mortality coefficients. The Kernel density technique was used to analyze the spatial distribution of TB mortality. Results: Tuberculosis was implicated in 236 deaths. The burden of tuberculosis deaths was higher amongst males, single people and people of mixed ethnicity, and the mean age at death was 51 years. TB deaths were clustered in the East, West and North health districts, and the tuberculosis mortality coefficient remained stable throughout the study period. Conclusions: Analyses of the spatial pattern and temporal trend in mortality revealed that certain areas have higher TB mortality rates, and should therefore be prioritized in public health interventions targeting the disease. PMID:29742272

Dying for work: The magnitude of US mortality from selected causes of death associated with occupation.

PubMed

Steenland, Kyle; Burnett, Carol; Lalich, Nina; Ward, Elizabeth; Hurrell, Joseph

2003-05-01

Deaths due to occupational disease and injury place a heavy burden on society in terms of economic costs and human suffering. We estimate the annual deaths due to selected diseases for which an occupational association is reasonably well established and quantifiable, by calculation of attributable fractions (AFs), with full documentation; the deaths due to occupational injury are then added to derive an estimated number of annual deaths due to occupation. Using 1997 US mortality data, the estimated annual burden of occupational disease mortality resulting from selected respiratory diseases, cancers, cardiovascular disease, chronic renal failure, and hepatitis is 49,000, with a range from 26,000 to 72,000. The Bureau of Labor Statistics estimates there are about 6,200 work-related injury deaths annually. Adding disease and injury data, we estimate that there are a total of 55,200 US deaths annually resulting from occupational disease or injury (range 32,200-78,200). Our estimate is in the range reported by previous investigators, although we have restricted ourselves more than others to only those diseases with well-established occupational etiology, biasing our estimates conservatively. The underlying assumptions and data used to generate the estimates are well documented, so our estimates may be updated as new data emerges on occupational risks and exposed populations, providing an advantage over previous studies. We estimate that occupational deaths are the 8th leading cause of death in the US, after diabetes (64,751) but ahead of suicide (30,575), and greater than the annual number of motor vehicle deaths per year (43,501). Copyright 2003 Wiley-Liss, Inc.

Statistical analyses in Swedish randomised trials on mammography screening and in other randomised trials on cancer screening: a systematic review

PubMed Central

Boniol, Mathieu; Smans, Michel; Sullivan, Richard; Boyle, Peter

2015-01-01

Objectives We compared calculations of relative risks of cancer death in Swedish mammography trials and in other cancer screening trials. Participants Men and women from 30 to 74 years of age. Setting Randomised trials on cancer screening. Design For each trial, we identified the intervention period, when screening was offered to screening groups and not to control groups, and the post-intervention period, when screening (or absence of screening) was the same in screening and control groups. We then examined which cancer deaths had been used for the computation of relative risk of cancer death. Main outcome measures Relative risk of cancer death. Results In 17 non-breast screening trials, deaths due to cancers diagnosed during the intervention and post-intervention periods were used for relative risk calculations. In the five Swedish trials, relative risk calculations used deaths due to breast cancers found during intervention periods, but deaths due to breast cancer found at first screening of control groups were added to these groups. After reallocation of the added breast cancer deaths to post-intervention periods of control groups, relative risks of 0.86 (0.76; 0.97) were obtained for cancers found during intervention periods and 0.83 (0.71; 0.97) for cancers found during post-intervention periods, indicating constant reduction in the risk of breast cancer death during follow-up, irrespective of screening. Conclusions The use of unconventional statistical methods in Swedish trials has led to overestimation of risk reduction in breast cancer death attributable to mammography screening. The constant risk reduction observed in screening groups was probably due to the trial design that optimised awareness and medical management of women allocated to screening groups. PMID:26152677

Addressing maternal deaths due to violence: the Illinois experience.

PubMed

Koch, Abigail R; Geller, Stacie E

2017-11-01

Homicide, suicide, and substance abuse accounted for nearly one fourth of all pregnancy-associated deaths in Illinois from 2002 through 2013. Maternal mortality review in Illinois has been primarily focused on obstetric and medical causes and little is known about the circumstances surrounding deaths due to homicide, suicide, and substance abuse, if they are pregnancy related, and if the deaths are potentially preventable. To address this issue, we implemented a process to form a second statewide maternal mortality review committee for deaths due to violence in late 2014. We convened a stakeholder group to accomplish 3 tasks: (1) identify appropriate committee members; (2) identify potential types and sources of information that would be required for a meaningful review of violent maternal deaths; and (3) revise the Maternal Mortality Review Form. Because homicide, suicide, and substance abuse are closely linked to the social determinants of health, the review committee needed to have a broad membership with expertise in areas not required for obstetric maternal mortality review, including social service and community organizations. Identifying additional sources of information is critical; the state Violent Death Reporting System, case management data, and police and autopsy reports provide contextual information that cannot be found in medical records. The stakeholder group revised the Maternal Mortality Review Form to collect information relevant to violent maternal deaths, including screening history and psychosocial history. The form guides the maternal mortality review committee for deaths due to violence to identify potentially preventable factors relating to the woman, her family, systems of care, the community, the legal system, and the institutional environment. The committee has identified potential opportunities to decrease preventable death requiring cooperation with social service agencies and the criminal justice system in addition to the physical and mental health care systems. Illinois has demonstrated that by engaging appropriate members and expanding the information used, it is possible to conduct meaningful reviews of these deaths and make recommendations to prevent future deaths. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of environmental factors on child survival in Bangladesh: a case control study.

PubMed

Hoque, B A; Chakraborty, J; Chowdhury, J T; Chowdhury, U K; Ali, M; el Arifeen, S; Sack, R B

1999-03-01

The need for further studies on relationships between deaths and environmental variables has been reported in the literature. This case-control study was, therefore, carried out to find out the associations between several social and environmental variables and deaths of children due to infectious diseases such as those leading to diarrhoea, acute respiratory infection, measles and other diseases. Six hundred and twenty-five deaths (cases) and an equal number of matched living children (controls) aged 1-59 months, were studied in rural Matlab. An analysis of crude and adjusted odds ratio showed differential associations. Sources of drinking water, amount of stored water, conditions of latrines, number of persons sleeping with the child and the type of cooking site were statistically significantly associated with deaths due to infectious diseases after controlling for breast feeding, immunization, and the family size. Significant associations were also observed between: (i) the sources of drinking water and deaths due to ARI, and (ii) conditions of latrines and deaths due to diarrhoeal diseases, after controlling for the confounding variables. Several other environmental factors also showed associations with these various death groups, but they were not statistically significant. The size of the samples in death groups (small) and the prevalence of more or less homogeneous environmental health conditions probably diminished the magnitude of the effects. The results of the study reconfirm the importance of environmental health intervention in child survival, irrespective of breast-feeding, immunization, and selected social variables.

Effect of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality: A PRISMA-compliant cumulative meta-analysis of randomized controlled trials.

PubMed

Zhang, Sui-Liang; Chen, Ting-Song; Ma, Chen-Yun; Meng, Yong-Bin; Zhang, Yu-Fei; Chen, Yi-Wei; Zhou, Yu-Hao

2016-08-01

Observational studies have suggested that vitamin B supplementation is associated with cancer risk, but this association remains controversial. A pooled data-based meta-analysis was conducted to summarize the evidence from randomized controlled trials (RCTs) investigating the effects of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality. PubMed, EmBase, and the Cochrane Library databases were searched to identify trials to fit our analysis through August 2015. Relative risk (RR) was used to measure the effect of vitamin B supplementation on the risk of cancer incidence, death due to cancer, and total mortality using a random-effect model. Cumulative meta-analysis, sensitivity analysis, subgroup analysis, heterogeneity tests, and tests for publication bias were also conducted. Eighteen RCTs reporting the data on 74,498 individuals were included in the meta-analysis. Sixteen of these trials included 4103 cases of cancer; in 6 trials, 731 cancer-related deaths occurred; and in 15 trials, 7046 deaths occurred. Vitamin B supplementation had little or no effect on the incidence of cancer (RR: 1.04; 95% confidence interval [CI]: 0.98-1.10; P = 0.216), death due to cancer (RR, 1.05; 95% CI: 0.90-1.22; P = 0.521), and total mortality (RR, 1.00; 95% CI: 0.94-1.06; P = 0.952). Upon performing a cumulative meta-analysis for cancer incidence, death due to cancer, and total mortality, the nonsignificance of the effect of vitamin B persisted. With respect to specific types of cancer, vitamin B supplementation significantly reduced the risk of skin melanoma (RR, 0.47; 95% CI: 0.23-0.94; P = 0.032). Vitamin B supplementation does not have an effect on cancer incidence, death due to cancer, or total mortality. It is associated with a lower risk of skin melanoma, but has no effect on other cancers.

Modulation of apoptosis sensitivity through the interplay with autophagic and proteasomal degradation pathways

PubMed Central

Delgado, M E; Dyck, L; Laussmann, M A; Rehm, M

2014-01-01

Autophagic and proteasomal degradation constitute the major cellular proteolysis pathways. Their physiological and pathophysiological adaptation and perturbation modulates the relative abundance of apoptosis-transducing proteins and thereby can positively or negatively adjust cell death susceptibility. In addition to balancing protein expression amounts, components of the autophagic and proteasomal degradation machineries directly interact with and co-regulate apoptosis signal transduction. The influence of autophagic and proteasomal activity on apoptosis susceptibility is now rapidly gaining more attention as a significant modulator of cell death signalling in the context of human health and disease. Here we present a concise and critical overview of the latest knowledge on the molecular interplay between apoptosis signalling, autophagy and proteasomal protein degradation. We highlight that these three pathways constitute an intricate signalling triangle that can govern and modulate cell fate decisions between death and survival. Owing to rapid research progress in recent years, it is now possible to provide detailed insight into the mechanisms of pathway crosstalk, common signalling nodes and the role of multi-functional proteins in co-regulating both protein degradation and cell death. PMID:24457955

Infant Deaths Due To Herpes Simplex Virus, Congenital Syphilis, and HIV in New York City.

PubMed

Sampath, Amitha; Maduro, Gil; Schillinger, Julia A

2016-04-01

Neonatal infection with herpes simplex virus (HSV) is not a nationally reportable disease; there have been few population-based measures of HSV-related infant mortality. We describe infant death rates due to neonatal HSV as compared with congenital syphilis (CS) and HIV, 2 reportable, perinatally transmitted diseases, in New York City from 1981 to 2013. We identified neonatal HSV-, CS-, and HIV-related deaths using International Classification of Diseases (ICD) codes listed on certificates of death or stillbirth issued in New York City. Deaths were classified as HSV-related if certificates listed (1) any HSV ICD-9/ICD-10 codes for deaths ≤42 days of age, (2) any HSV ICD-9/ICD-10 codes and an ICD code for perinatal infection for deaths at 43 to 365 days of age, or (3) an ICD-10 code for congenital HSV. CS- and HIV-related deaths were those listing any ICD code for syphilis or HIV. There were 34 deaths due to neonatal HSV (0.82 deaths per 100 000 live births), 38 from CS (0.92 per 100 000), and 262 from HIV (6.33 per 100 000). There were no CS-related deaths after 1996, and only 1 HIV-related infant death after 2004. The neonatal HSV-related death rate during the most recent decade (2004-2013) was significantly higher than in previous years. The increasing neonatal HSV-related death rate may reflect increases in neonatal herpes incidence; an increasing number of pregnant women have never had HSV type 1 and are therefore at risk of acquiring infection during pregnancy and transmitting to their infant. Copyright © 2016 by the American Academy of Pediatrics.

Sudden Death in Young People--Heart Problems Often Blamed

MedlinePlus

Sudden death in young people: Heart problems often blamed Sudden death in young people is rare, but those at ... causes and treatments. By Mayo Clinic Staff Sudden death in people younger than 35, often due to ...

Characteristics of sites and trees affected by rapid white oak mortality as reported by forestry professionals in Missouri

Treesearch

Sharon E. Reed; James T. English; Rose-Marie Muzika; John M. Kabrick; Simeon. Wright

2017-01-01

A new syndrome was named rapid white oak mortality in 2011 to describe the rapid death of white oak trees (Quercus alba L.) within one growing season. A survey with 24 questions about stand and site characteristics, site history, and symptoms was distributed to forestry professionals to gather information about the new syndrome. Sixty-three reports...

National and subnational all-cause and cause-specific child mortality in China, 1996-2015: a systematic analysis with implications for the Sustainable Development Goals.

PubMed

He, Chunhua; Liu, Li; Chu, Yue; Perin, Jamie; Dai, Li; Li, Xiaohong; Miao, Lei; Kang, Leni; Li, Qi; Scherpbier, Robert; Guo, Sufang; Rudan, Igor; Song, Peige; Chan, Kit Yee; Guo, Yan; Black, Robert E; Wang, Yanping; Zhu, Jun

2017-02-01

China has achieved Millennium Development Goal 4 to reduce under-5 mortality rate by two-thirds between 1990 and 2015. In this study, we estimated the national and subnational levels and causes of child mortality in China annually from 1996 to 2015 to draw implications for achievement of the SDGs for China and other low-income and middle-income countries. In this systematic analysis, we adjusted empirical data on levels and causes of child mortality collected in the China Maternal and Child Health Surveillance System to generate representative estimates at the national and subnational levels. In adjusting the data, we considered the sampling design and probability, applied smoothing techniques to produce stable trends, fitted livebirth and age-specific death estimates to natvional estimates produced by the UN for international comparison, and partitioned national estimates of infrequent causes produced by independent sources to the subnational level. Between 1996 and 2015, the under-5 mortality rate in China declined from 50·8 per 1000 livebirths to 10·7 per 1000 livebirths, at an average annual rate of reduction of 8·2%. However, 181 600 children still died before their fifth birthday, with 93 400 (51·5%) deaths occurring in neonates. Great inequity exists in child mortality across regions and in urban versus rural areas. The leading causes of under-5 mortality in 2015 were congenital abnormalities (35 700 deaths, 95% uncertainty range [UR] 28 400-45 200), preterm birth complications (30 900 deaths, 24 200-40 800), and injuries (26 600 deaths, 21 000-33 400). Pneumonia contributed to a higher proportion of deaths in the western region of China than in the eastern and central regions, and injury was a main cause of death in rural areas. Variations in cause-of-death composition by age were also examined. The contribution of preterm birth complications to mortality decreased after the neonatal period; congenital abnormalities remained an important cause of mortality throughout infancy, whereas the contribution of injuries to mortality increased after the first year of life. China has achieved a rapid reduction in child mortality in 1996-2015. The decline has been widespread across regions, urban and rural areas, age groups, and cause-of-death categories, but great disparities remain. The western region and rural areas and especially western rural areas should receive most attention in improving child survival through enhanced policy and programmes in the Sustainable Development Goals era. Continued investment is crucial in primary and secondary prevention of deaths due to congenital abnormalities, preterm birth complications, and injuries nationally, and of deaths due to pneumonia in western rural areas. The study also has implications for improving child survival and civil registration and vital statistics in other low-income and middle-income countries. Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

The mortality profile of black Seventh-Day Adventists residing in metropolitan Atlanta: a pilot study.

PubMed Central

Murphy, F G; Blumenthal, D S; Dickson-Smith, J; Peay, R P

1990-01-01

Mortality information was gathered for 110 Black Seventh-day Adventist members of seven churches in Metropolitan Atlanta, Georgia during the period 1980-87. Seventy-seven percent of the deaths were due to cardiovascular diseases; 8 percent due to cancer, the second leading cause of death. The cancer rate is extremely low in comparison to the proportion of deaths due to cardiovascular diseases. Subsequent research on this population will take into consideration lifestyle factors which could contribute to this finding. PMID:2368863

Roles of glucose in photoreceptor survival.

PubMed

Chertov, Andrei O; Holzhausen, Lars; Kuok, Iok Teng; Couron, Drew; Parker, Ed; Linton, Jonathan D; Sadilek, Martin; Sweet, Ian R; Hurley, James B

2011-10-07

Vertebrate photoreceptor neurons have a high demand for metabolic energy, and their viability is very sensitive to genetic and environmental perturbations. We investigated the relationship between energy metabolism and cell death by evaluating the metabolic effects of glucose deprivation on mouse photoreceptors. Oxygen consumption, lactate production, ATP, NADH/NAD(+), TCA cycle intermediates, morphological changes, autophagy, and viability were evaluated. We compared retinas incubated with glucose to retinas deprived of glucose or retinas treated with a mixture of mitochondrion-specific fuels. Rapid and slow phases of cell death were identified. The rapid phase is linked to reduced mitochondrial activity, and the slower phase reflects a need for substrates for cell maintenance and repair.

Rapid population growth.

PubMed

1972-01-01

At the current rate of population growth, world population by 2000 is expected to reach 7 billion or more, with developing countries accounting for some 5.4 billion, and economically advanced nations accounting for 1.6 billion. 'Population explosion' is the result of falling mortality rates and continuing high birth rates. Many European countries, and Japan, have already completed what is termed as demographic transition, that is, birth rates have fallen to below 20 births per 1000 population, death rates to 10/1000 population, and annual growth rates are 1% or less; annual growth rates for less developed countries ranged from 2 to 3.5%. Less developed countries can be divided into 3 groups: 1) countries with both high birth and death rates; 2) countries with high birth rates and low death rates; and 3) countries with intermediate and declining birth rates and low death rates. Rapid population growth has serious economic consequences. It encourages inequities in income distribution; it limits rate of growth of gross national product by holding down level of savings and capital investments; it exerts pressure on agricultural production and land; and it creates unemployment problems. In addition, the quality of education for increasing number of chidren is adversely affected, as high proportions of children reduce the amount that can be spent for the education of each child out of the educational budget; the cost and adequacy of health and welfare services are affected in a similar way. Other serious consequences of rapid population growth are maternal death and illness, and physical and mental retardation of children of very poor families. It is very urgent that over a billion births be prevented in the next 30 years to reduce annual population growth rate from the current 2% to 1% per year.

Expressions of Mast Cell Tryptase and Brain Natriuretic Peptide in Myocardium of Sudden Death due to Hypersensitivity and Coronary Atherosclerotic Heart Disease.

PubMed

Shi, J R; Tian, C J; Zeng, Q; Guo, X J; Lu, J; Gao, C R

2016-06-01

To explore the value of mast cell tryptase and brain natriuretic peptide（BNP） in the differential diagnostic of sudden death due to hypersensitivity and coronary atherosclerotic heart disease. Totally 30 myocardial samples were collected from the autopsy cases in the Department of Forensic Pathology, Shanxi Medical University during 2010-2015. All samples were divided into three groups： death of craniocerebral injury group, sudden death of hypersensitivity group and sudden death of coronary atherosclerotic heart disease group, 10 cases in each group. Mast cell tryptase and BNP in myocardium were detected by immunofluorescence staining and Western Blotting. Immunofluorescence staining showed that the positive staining mast cell tryptase appeared in myocardium of sudden death of hypersensitivity group and coronary atherosclerotic heart disease group. Among the three groups, the expression of mast cell tryptase showed significantly differences through pairwise comparison （ P <0.05）; The expression level of BNP in sudden death of coronary atherosclerotic heart disease group were significantly higher than the sudden death of hypersensitivity group and death of craniocerebral injury group （ P <0.05）. The difference of the expression level of BNP between the sudden death of hypersensitivity group and the death of craniocerebral injury group had no statistical significance （ P >0.05）. The combined detection of the mast cell tryptase and BNP in myocardium is expected to provide help for the forensic differential diagnosis of sudden death due to hypersensitivity and coronary atherosclerotic heart disease. Copyright© by the Editorial Department of Journal of Forensic Medicine

Mortality investigation of workers in an electromagnetic pulse test program.

PubMed

Muhm, J M

1992-03-01

A standardized mortality ratio study of 304 male employees of an electromagnetic pulse (EMP) test program was conducted. Outcomes were ascertained by two methods: the World Health Organization's underlying cause of death algorithm; and the National Center for Health Statistics' algorithm to identify multiple listed causes of death. In the 3362 person-years of follow-up, there was one underlying cause of death due to leukemia compared with with 0.2 expected (standard mortality ratio [SMR] = 437, 95% confidence interval [CI] = 11-2433), and two multiple listed causes of death due to leukemia compared with 0.3 expected (SMR = 775, 95% CI = 94-2801). Although the study suggested an association between death due to leukemia and employment in the EMP test program, firm conclusions could not be drawn because of limitations of the study. The findings warrant further investigation in an independent cohort.

20 CFR 410.490 - Interim adjudicatory rules for certain part B claims filed by a miner before July 1, 1973, or by...

Code of Federal Regulations, 2011 CFR

2011-04-01

... AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to... the Black Lung Act of 1972, the Congress noted that adjudication of the large backlog of claims... pneumoconiosis, or to have been totally disabled due to pneumoconiosis at the time of his death, or his death...

20 CFR 410.490 - Interim adjudicatory rules for certain part B claims filed by a miner before July 1, 1973, or by...

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to... the Black Lung Act of 1972, the Congress noted that adjudication of the large backlog of claims... pneumoconiosis, or to have been totally disabled due to pneumoconiosis at the time of his death, or his death...

20 CFR 10.902 - Does every employee's death due to injuries incurred in connection with his or her service with...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Does every employee's death due to injuries incurred in connection with his or her service with an Armed Force in a contingency operation qualify for... connection with his or her service with an Armed Force in a contingency operation qualify for the death...

A cohort study to analyze the risk of venous thromboembolism mortality in patients admitted to the general medicine department, tan tock seng hospital, singapore.

PubMed

Sule, Ashish Anil; Chin, Tay Jam; Sinnathamby, Letchumi; Lee, Hwei Khien; Earnest, Arul

2011-06-01

The purpose of this study was to assess the risk of venous thromboembolism (VTE) in patients admitted to the Tan Tock Seng Hospital (TTSH), Singapore during October and November 2009. The primary outcome assessed was mortality due to VTE, or development of deep vein thrombosis or pulmonary embolism (PE) within 3 months from the day of admission. Both univariate and multivariate analyses were performed for all-cause mortality and deaths associated with PE. Seven hundred twenty-one patients admitted to the 5th floor of the General Medicine Department, TTSH, during the 2 months were analyzed. There were 368 (51.04%) female patients and 353 (48.96%) male patients. As per race distribution, 566 (78.50%) patients were Chinese, 100 (13.86%) patients were Malaysians, 46 (6.38%) patients were Indians, and 9 (1.26%) were other races. Four hundred ninety-two (68.24%) were independent for activities of daily living (ADL) and 229 (31.76%) were dependent for all ADL. There were in all 42 deaths. There were definite PE deaths in 2 (4.76%) patients, probable PE deaths in 3 (7.14%) patients, and suspected PE deaths in 8 (19.05%) patients. Twenty (47.62%) deaths were due to pneumonia, 3 (7.14%) deaths were due to urinary tract infections, and 4 (9.52%) deaths were due to other infections. Two (4.76%) deaths were due to myocardial infarction. The risk of VTE was high in acutely ill patients admitted to the General Medicine Department, TTSH, Singapore. The factors that predispose patients to a very high risk are ADL dependence, acute heart failure, past history of VTE, or if they are clinically dehydrated and have acute renal failure. This warrants increased awareness and need for VTE prophylaxis.

Children and Death.

ERIC Educational Resources Information Center

Brennan, Andrew J. J.

Health professionals and educators should develop their abilities to educate about death and to comfort the bereaved. Due to lower death rates, the lack of philosophical religious views, and distorted perceptions of death contributed by television, death has become a mystery instead of a segment of the common experience. Particularly when a child…

Public Health Concerns Associated with the New York City Blackout of 1977.

PubMed

Imperato, Pascal James

2016-08-01

The 1977 New York City blackout began at 9:36 p.m. on 13 July and lasted some 25 h until 10:39 p.m. on 14 July. The New York City Department of Health rapidly set up a Blackout Contingency Plan, established priorities, and mobilized its staff to address remedial interventions. Top priorities included water supplies, sewage disposal, perishable food supplies, hospital and emergency room services, solid waste disposal, beach contamination with untreated sewage , and assisting those on electrically powered home life support systems. The 1977 blackout occurred during an extended heat wave. An analysis of total deaths and deaths due to pulmonary and cardiovascular/renal diseases by day correlated with temperatures. However, there was no direct correlation with the blackout itself, in part perhaps because of the confounding influence of high temperatures. The increase of deaths on very hot days outside of the blackout period lends strong support to the relationship between increased deaths and high ambient temperatures. The 1977 New York City blackout was distinguished from those of 1965 and 2003 by violence, arson, and looting that occurred in several areas. These acts resulted in 204 civilian injuries, 436 police injuries, 80 firefighter injuries, and 1037 fires. The violence, arson, and looting caused extensive long-term physical and functional damage to certain areas of two boroughs of the city, Brooklyn and the Bronx. Although the New York City Department of Health had not previously established a disaster preparedness plan, its professionals quickly rose to the occasion because they were able to draw upon vast public health practice experience and ingenuity.

Contribution of the ethics committee of the French Intensive Care Society to describing a scenario for implementing organ donation after Maastricht type III cardiocirculatory death in France

PubMed Central

2012-01-01

French law allows organ donation after death due to cardiocirculatory arrest. In the Maastricht classification, type III non-heart-beating donors are those who experience cardiocirculatory arrest after the withdrawal of life-sustaining treatments. French authorities in charge of regulating organ donation (Agence de la Biomédecine, ABM) are considering organ collection from Maastricht type III donors. We describe a scenario for Maastricht type III organ donation that fully complies with the ethical norms governing care to dying patients. That organ donation may occur after death should have no impact on the care given to the patient and family. The dead-donor rule must be followed scrupulously: the organ retrieval procedure must neither cause nor hasten death. The decision to withdraw life-sustaining treatments, withdrawal modalities, and care provided to the patient and family must adhere strictly to the requirements set forth in patient-rights legislation (the 2005 Léonetti law in France) and should not be influenced in any way by the possibility of organ donation. A major ethical issue regarding the family is how best to transition from discussing treatment-withdrawal decisions to discussing possible organ retrieval for donation should the patient die rapidly after treatment withdrawal. Close cooperation between the healthcare team and the organ retrieval team is crucial to minimize the distress of family members during this transition. Modalities for implementing Maastricht type III organ donation are discussed here, including the best location for withdrawing life-sustaining treatments (operating room or intensive care unit). PMID:22747673

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

PubMed

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

2017-06-29

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

Donation after cardio-circulatory death liver transplantation

PubMed Central

Le Dinh, Hieu; de Roover, Arnaud; Kaba, Abdour; Lauwick, Séverine; Joris, Jean; Delwaide, Jean; Honoré, Pierre; Meurisse, Michel; Detry, Olivier

2012-01-01

The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families. Since then, DCD organ procurement and transplantation activities have rapidly expanded, particularly for non-vital organs, like kidneys. In liver transplantation (LT), DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction, more frequent vascular and ischemia-type biliary lesions, higher rates of re-listing and re-transplantation and lower graft survival, which are obviously due to the inevitable warm ischemia occurring during the declaration of death and organ retrieval process. Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results, and some of them have found their way from pre-clinical success into clinical reality. The future of DCD-LT is promising. Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category III DCD donors), better donor and recipient matching (high risk donors to low risk recipients), use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion, normothermic machine perfusion, venous systemic oxygen persufflation), and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT. PMID:22969222

Respiratory Emergencies and Management of Mining Accidents

PubMed Central

Özmen, İpek; Aksoy, Emine

2015-01-01

The rapid detection of the reasons for mining accidents that lead to emergency situations is vital for search and rescue work. The control of fire and gas leakage provides an immediate approach for rescue works for deaths or injuries and the detection of who needs resuscitation outside of the mine. The evacuation and recovery operations should be directed by continuous monitoring of the mine environment due to fire and explosion risks. The main toxic gases in mines are carbon monoxide (CO) and carbon dioxide (CO2); the flammable gases are methane (CH4), CO, and hydrogen (H2); the suffocating gases are CO2, nitrogen (N20), and CH4; and the toxic gases are CO, nitrogen oxides (NOx), and hydrogen sulfide (H2S). PMID:29404110

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

PubMed

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

2015-11-01

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

Risk factors associated with the different categories of piglet perinatal mortality in French farms.

PubMed

Pandolfi, F; Edwards, S A; Robert, F; Kyriazakis, I

2017-02-01

We aimed to identify mortality patterns and to establish risk factors associated with different categories of piglet perinatal mortality in French farms. At farm level, the analyses were performed on data from 146 farms that experienced perinatal mortality problems. At piglet level, the analyses were performed on data from 155 farms (7761 piglets). All data were collected over a period of 10 years (2004-14) by a consulting company, using a non-probability sampling at farm level and a random sampling at sow level. Six main categories of mortality, determined by standardised necropsy procedure, represented 84.5% of all the perinatal deaths recorded. These six categories were, in order of significance: Death during farrowing, Non- viable, Early sepsis, Mummified, Crushing and Starvation. At farm level, the percentage of deaths due to starvation was positively correlated to the percentage of deaths due to crushing and the percentage of deaths during farrowing (r>0.30, P<0.05) .The percentage of deaths due to crushing was negatively correlated to the percentage of deaths due to early sepsis (r<-0.30, P<0.05) and positively correlated to the deaths due to acute disease (r>0.30, P<0.05). Patterns of perinatal mortality at farm level were identified using a principal component analysis. Based on these, the farms could be classified, using ascending hierarchical classification, into three different clusters, highlighting issues that underlie farm differences. Risk factors were compared at piglet level for the different categories of death. Compared to other categories of death, deaths during farrowing were significantly fewer during the night than during the day. Compared to other categories of death, the likelihood of non-viable piglets tended to be higher in summer than other seasons. A smaller number of deaths in the litter was also identified for the piglets classified as non-viable or mummified. For the six main categories of perinatal mortality, the piglets which died from a specific category tended to have more littermates which died from the same category. Parity and litter size also had more significant effects on certain categories of death compared to others. The study provides novel information on the risk factors associated with specific categories of piglet perinatal mortality. The classification of farms into the 3 different clusters could lead to a more targeted management of perinatal mortality on individual farms. Copyright © 2016 Elsevier B.V. All rights reserved.

Surveillance of deaths caused by arboviruses in Brazil: from dengue to chikungunya

PubMed Central

Cavalcanti, Luciano Pamplona de Góes; Freitas, André Ricardo Ribas; Brasil, Patrícia; da Cunha, Rivaldo Venâncio

2017-01-01

Did death occur DUE TO dengue, or in a patient WITH dengue virus infection? It seems a matter of semantics, but in fact, it underscores how challenging it is to distinguish whether the disease contributed to death, or was itself the underlying cause of death. Can a death be attributed to chikungunya virus, when some deaths occur after the acute phase? Did the virus decompensate the underlying diseases, leading to death? Did prolonged hospitalisation lead to infection, resulting in the patient’s progression to death? Were there iatrogenic complications during patient care? The dengue question, for which there has not yet been a definitive response, resurfaces prominently under the chikungunya surveillance scenario. We are facing an epidemic of a disease that seems to be more lethal than previously thought. The major challenge ahead is to investigate deaths suspected of occurring due to arbovirus infections and to understand the role of each infection in the unfavourable outcome. PMID:28767985

Absence of cell surface expression of human ACE leads to perinatal death

PubMed Central

Michaud, Annie; Acharya, K. Ravi; Masuyer, Geoffrey; Quenech'du, Nicole; Gribouval, Olivier; Morinière, Vincent; Gubler, Marie-Claire; Corvol, Pierre

2014-01-01

Renal tubular dysgenesis (RTD) is a recessive autosomal disease characterized most often by perinatal death. It is due to the inactivation of any of the major genes of the renin-angiotensin system (RAS), one of which is the angiotensin I-converting enzyme (ACE). ACE is present as a tissue-bound enzyme and circulates in plasma after its solubilization. In this report, we present the effect of different ACE mutations associated with RTD on ACE intracellular trafficking, secretion and enzymatic activity. One truncated mutant, R762X, responsible for neonatal death was found to be an enzymatically active, secreted form, not inserted in the plasma membrane. In contrast, another mutant, R1180P, was compatible with life after transient neonatal renal insufficiency. This mutant was located at the plasma membrane and rapidly secreted. These results highlight the importance of tissue-bound ACE versus circulating ACE and show that the total absence of cell surface expression of ACE is incompatible with life. In addition, two missense mutants (W594R and R828H) and two truncated mutants (Q1136X and G1145AX) were also studied. These mutants were neither inserted in the plasma membrane nor secreted. Finally, the structural implications of these ACE mutations were examined by molecular modelling, which suggested some important structural alterations such as disruption of intra-molecular non-covalent interactions (e.g. salt bridges). PMID:24163131

Retrospective Validation of a Surveillance System for Unexplained Illness and Death: New Haven County, Connecticut

PubMed Central

Kluger, Michael D.; Sofair, Andre N.; Heye, Constance J.; Meek, James I.; Sodhi, Rajesh K.; Hadler, James L.

2001-01-01

Objectives. This study investigated retrospective validation of a prospective surveillance system for unexplained illness and death due to possibly infectious causes. Methods. A computerized search of hospital discharge data identified patients with potential unexplained illness and death due to possibly infectious causes. Medical records for such patients were reviewed for satisfaction of study criteria. Cases identified retrospectively were combined with prospectively identified cases to form a reference population against which sensitivity could be measured. Results. Retrospective validation was 41% sensitive, whereas prospective surveillance was 73% sensitive. The annual incidence of unexplained illness and death due to possibly infectious causes during 1995 and 1996 in the study county was conservatively estimated to range from 2.7 to 6.2 per 100 000 residents aged 1 to 49 years. Conclusions. Active prospective surveillance for unexplained illness and death due to possibly infectious causes is more sensitive than retrospective surveillance conducted through a published list of indicator codes. However, retrospective surveillance can be a feasible and much less labor-intensive alternative to active prospective surveillance when the latter is not possible or desired. PMID:11499106

Rapid Assessment of Environmental Health Impacts for Policy Support: The Example of Road Transport in New Zealand

PubMed Central

Briggs, David; Mason, Kylie; Borman, Barry

2015-01-01

An integrated environmental health impact assessment of road transport in New Zealand was carried out, using a rapid assessment. The disease and injury burden was assessed from traffic-related accidents, air pollution, noise and physical (in)activity, and impacts attributed back to modal source. In total, road transport was found to be responsible for 650 deaths in 2012 (2.1% of annual mortality): 308 from traffic accidents, 283 as a result of air pollution, and 59 from noise. Together with morbidity, these represent a total burden of disease of 26,610 disability-adjusted life years (DALYs). An estimated 40 deaths and 1874 DALYs were avoided through active transport. Cars are responsible for about 52% of attributable deaths, but heavy goods vehicles (6% of vehicle kilometres travelled, vkt) accounted for 21% of deaths. Motorcycles (1 per cent of vkt) are implicated in nearly 8% of deaths. Overall, impacts of traffic-related air pollution and noise are low compared to other developed countries, but road accident rates are high. Results highlight the need for policies targeted at road accidents, and especially at heavy goods vehicles and motorcycles, along with more general action to reduce the reliance on private road transport. The study also provides a framework for national indicator development. PMID:26703699

Rapid Assessment of Environmental Health Impacts for Policy Support: The Example of Road Transport in New Zealand.

PubMed

Briggs, David; Mason, Kylie; Borman, Barry

2015-12-22

An integrated environmental health impact assessment of road transport in New Zealand was carried out, using a rapid assessment. The disease and injury burden was assessed from traffic-related accidents, air pollution, noise and physical (in)activity, and impacts attributed back to modal source. In total, road transport was found to be responsible for 650 deaths in 2012 (2.1% of annual mortality): 308 from traffic accidents, 283 as a result of air pollution, and 59 from noise. Together with morbidity, these represent a total burden of disease of 26,610 disability-adjusted life years (DALYs). An estimated 40 deaths and 1874 DALYs were avoided through active transport. Cars are responsible for about 52% of attributable deaths, but heavy goods vehicles (6% of vehicle kilometres travelled, vkt) accounted for 21% of deaths. Motorcycles (1 per cent of vkt) are implicated in nearly 8% of deaths. Overall, impacts of traffic-related air pollution and noise are low compared to other developed countries, but road accident rates are high. Results highlight the need for policies targeted at road accidents, and especially at heavy goods vehicles and motorcycles, along with more general action to reduce the reliance on private road transport. The study also provides a framework for national indicator development.

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

PubMed

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

2016-04-01

The objective of this study was to analyze the deaths caused by non-AIDS diseases in a cohort of HIV-infected patients treated between 1998 and 2011. Information on the causes of death was collected retrospectively, and then classified according to the deaths code (CoDe) algorithm. Patient characteristics and causes of death were compared for two periods: 1998-2004 and 2005-2011. A total of 159 out of the 1070 patients cared for in study period died, 56 (35%) due to AIDS events and 86 (54%) due to non-AIDS events (NAEs); in 17 (11%) the cause of death could not be determined. Overall, the main causes of death were infections (32%), cancer (17%), and unnatural deaths (17%). There was lower mortality from AIDS-related conditions during the second period (18.5% vs 47%; P<.001) and higher mortality from NAEs (68% vs 45%; P=.006). There was a very sharp increase in non-AIDS-defining cancers (18.5% vs 2.1%, p=001), and increased deaths from cardiovascular disease (9.2% vs 2.1%, P=.06). Patients who died in the second period were older, and had a better immunological and virological status at cohort entry and before death. They received antiretroviral therapy (ART) more often and were more often virologically suppressed before death (61.5% vs 24%; P=.001). Non-AIDS-defining cancers, unnatural deaths, and cardiovascular diseases are now major causes of death in patients with HIV. In recent years the majority of deceased patients are on ART and with virological suppression. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Birth Order and Injury-Related Infant Mortality in the U.S.

PubMed

Ahrens, Katherine A; Rossen, Lauren M; Thoma, Marie E; Warner, Margaret; Simon, Alan E

2017-10-01

The purpose of this study was to evaluate the risk of death during the first year of life due to injury, such as unintentional injury and homicide, by birth order in the U.S. Using national birth cohort-linked birth-infant death data (births, 2000-2010; deaths, 2000-2011), risks of infant mortality due to injury in second-, third-, fourth-, and fifth or later-born singleton infants were compared with first-born singleton infants. Risk ratios were estimated using log-binomial models adjusted for maternal age, marital status, race/ethnicity, and education. The statistical analyses were conducted in 2016. Approximately 40%, 32%, 16%, 7%, and 4% of singleton live births were first, second, third, fourth, and fifth or later born, respectively. From 2000 to 2011, a total of 15,866 infants died as a result of injury (approximately 1,442 deaths per year). Compared with first-born infants (2.9 deaths per 10,000 live births), second or later-born infants were at increased risk of infant mortality due to injury (second, 3.6 deaths; third, 4.2 deaths; fourth, 4.8 deaths; fifth or later, 6.4 deaths). The corresponding adjusted risk ratios were as follows: second, 1.84 (95% CI=1.76, 1.91); third, 2.42 (95% CI=2.30, 2.54); fourth, 2.96 (95% CI=2.77, 3.16); and fifth or later, 4.26 (95% CI=3.96, 4.57). Singleton infants born second or later were at increased risk of mortality due to injury during their first year of life in the U.S. This study's findings highlight the importance of investigating underlying mechanisms behind this increased risk. Published by Elsevier Inc.

Preventable causes of death in Wisconsin, 2004.

PubMed

Vila, Peter M; Booske, Bridget C; Wegner, Mark V; Remington, Patrick L

2007-10-01

While heart disease, cancer, and injuries are leading proximate causes of death, research has demonstrated that about half of all deaths in the United States are actually due to preventable causes, including tobacco use, poor diet, and physical inactivity. Using state vital statistics data and findings from national studies, we report on the trends in the preventable causes of death in Wisconsin from 1992 to 2004. The leading proximate causes of death in Wisconsin were obtained from Wisconsin Interactive Statistics on Health (WISH) data derived from individual death certificates. Information on the preventable causes of death was either obtained from the underlying cause information on the death certificate or from peer-reviewed epidemiologic studies. While the overall age-adjusted death rate declined from 837 to 744 per 100,000 from 1992 to 2004, the top 10 causes of death remain largely unchanged. Nearly half of the deaths in Wisconsin in 2004 resulted from 11 preventable causes, similar to the findings in 1992. Epidemiologic research demonstrates that nearly half of all deaths in Wisconsin are due to preventable causes. Programs and policies must continue to address these preventable causes of disease if Wisconsin is to meet its goal of promoting and protecting population health.

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

PubMed

Malta, Deborah Carvalho; França, Elisabeth; Abreu, Daisy Maria Xavier; Perillo, Rosângela Durso; Salmen, Maíra Coube; Teixeira, Renato Azeredo; Passos, Valeria; Souza, Maria de Fátima Marinho; Mooney, Meghan; Naghavi, Mohsen

2017-01-01

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

A real-time reporting system of causes of death or reasons for euthanasia: A model for monitoring mortality in domesticated cats in Taiwan.

PubMed

Huang, Wei-Hsiang; Liao, Albert Taiching; Chu, Pei-Yi; Yen, I-Feng; Liu, Chen-Hsuan

2017-02-01

A novel, real-time mortality recording system was designed to collect mortality data in companion animals from veterinary hospitals in Taiwan. This retrospective study aims to introduce the system, and to utilize the data collected for further investigation of the lifespan and mortality of the domesticated cat population stratified by demographic variables. Our data revealed that 1325 domesticated cats were acquired between 2012 and 2014. The median age of the study population was 8.0 years (IQR 3.0-13.0; range 0.0-22.7). Neutered and purebred cats lived longer. The most common causes of death were renal and urologic disorders, followed by neoplasia, infection, cardiovascular disorders, and trauma. Independent factors for common causes were surveyed. Advanced age and neutering was found to be associated with death due to renal and urologic disorders as well as with neoplasia. In contrast, younger age was found to be associated with death due to trauma and infection; being unneutered and living in the capital city were found to be associated with death due to trauma. Being male or purebred was found to be associated with death due to cardiovascular disorders. Copyright © 2016 Elsevier B.V. All rights reserved.

Acute brain herniation from lead toxicity.

PubMed

Berkowitz, Sheldon; Tarrago, Rod

2006-12-01

A 4-year-old black boy was admitted to the hospital with vomiting, low-grade fever, and dehydration that were thought to be caused by viral gastroenteritis. He proceeded over the next 12 hours to rapidly deteriorate with brain herniation leading to brain death. The ultimate cause of death was found to be acute lead intoxication from a swallowed foreign body.

UK asbestos imports and mortality due to idiopathic pulmonary fibrosis.

PubMed

Barber, C M; Wiggans, R E; Young, C; Fishwick, D

2016-03-01

Previous studies have demonstrated that the rising mortality due to mesothelioma and asbestosis can be predicted from historic asbestos usage. Mortality due to idiopathic pulmonary fibrosis (IPF) is also rising, without any apparent explanation. To compare mortality due to these conditions and examine the relationship between mortality and national asbestos imports. Mortality data for IPF and asbestosis in England and Wales were available from the Office for National Statistics. Data for mesothelioma deaths in England and Wales and historic UK asbestos import data were available from the Health & Safety Executive. The numbers of annual deaths due to each condition were plotted separately by gender, against UK asbestos imports 48 years earlier. Linear regression models were constructed. For mesothelioma and IPF, there was a significant linear relationship between the number of male and female deaths each year and historic UK asbestos imports. For asbestosis mortality, a similar relationship was found for male but not female deaths. The annual numbers of deaths due to asbestosis in both sexes were lower than for IPF and mesothelioma. The strength of the association between IPF mortality and historic asbestos imports was similar to that seen in an established asbestos-related disease, i.e. mesothelioma. This finding could in part be explained by diagnostic difficulties in separating asbestosis from IPF and highlights the need for a more accurate method of assessing lifetime occupational asbestos exposure. © Crown copyright 2015.

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

Reasons for not reporting deaths: a qualitative study in rural Vietnam.

PubMed

Huy, Tran Quang; Johansson, Annika; Long, Nguyen Hoang

2007-01-01

This qualitative study explores socio-cultural and health systems factors that may impact on death reporting by lay people to registry systems at the commune level. Information on local perceptions of death and factors influencing death reporting were gathered through nine focus group discussions with people of different religions and ethnic affiliations in a rural district of northern Vietnam. Participants classified deaths as "elderly deaths," "young deaths," and "child deaths." Child deaths, including newborn deaths, used to be considered punishment for sins committed by ancestors, but this is no longer the case. Concepts of the human soul and afterlife differ between the Catholic and Buddhist groups, influencing funeral rituals and reporting, especially of infant deaths. Participants regarded elderly deaths as "natural" and "deserved," while young deaths were seen as either "good deaths" or "bad deaths." "Bad deaths" were defined as deaths of "dishonourable" persons who had led a "bad life" involving activities such as gambling, drinking or stealing. The causes of "bad deaths" and deaths due to stigmatized diseases (e.g., HIV/AIDS, tuberculosis and leprosy) were often concealed by the family. The study suggests that the risk of under-reporting deaths seems to be largest for deaths of infants and "bad deaths." Little awareness of regulations and lack of incentives for reporting or lack of sanctions for not reporting deaths also result in under-reporting of deaths. Therefore, education programs and enforcement of legal regulations on death notification should be emphasized. The risk of misreporting the real causes of "bad deaths" and deaths due to stigmatized diseases should be considered in verbal autopsy interviews. Using different sources of information (triangulation) is useful in order to minimize both under-registration and misreporting causes of death.

Deaths from pesticide poisoning in England and Wales: 1945-1989.

PubMed

Casey, P; Vale, J A

1994-02-01

1. Data on deaths from pesticide poisoning occurring in England and Wales between 1945 and 1989 (no data are available for 1954) have been collated; pesticides were responsible for only 1012 (1.1%) of the 87,385 deaths from poisoning (excluding those due to carbon monoxide) occurring over this 44 year period. At least 73% of all pesticide fatalities were due to suicide and overall there was a predominance of males (male:female ratio 2.4:1). No deaths from pesticide poisoning in children under 10 years have been reported since 1974 although almost 50% of suspected pesticide poisoning incidents involve this age group. 2. Herbicides were responsible for 787 (78%) fatal poisonings, 110 (11%) were caused by insecticides, 69 (6.8%) by rodenticides, 30 (3.0%) by wood preservatives and 16 (1.6%) by other pesticides. 3. The herbicide, paraquat, was responsible for 570 of 1012 (56%) deaths and, although there has been a progressive decline in the annual number of deaths from paraquat poisoning since 1982, paraquat remains the most common cause of fatal pesticide poisoning in England and Wales. 4. Sodium chlorate caused 113 (11.2%) deaths, most of these fatalities occurring between 1965 and 1983; only one death has been recorded since 1984. The phenoxyacetate herbicides resulted in 50 deaths; 2,4-D was implicated most commonly. Sixty-eight deaths were due to organophosphorus insecticides; demeton-S-methyl, malathion and mevinphos were involved most frequently. Only eight deaths resulted from organochlorine insecticides and two of these also involved an organophosphorus insecticide.(ABSTRACT TRUNCATED AT 250 WORDS)

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

PubMed

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

2017-05-01

The principal causes of death among 45,708 patients with diabetes (29,801 men and 15,907 women) who died in 241 hospitals throughout Japan during 2001-2010 were determined based on a survey of the hospital records. Autopsy had been conducted in 978 of the 45,708 cases. The most frequent cause of death was malignant neoplasia (38.3%), followed by, in order of descending frequency: infections (17.0%); and then vascular diseases (14.9%), including renal failure (3.5%), ischemic heart diseases (4.8%) and cerebrovascular diseases (6.6%). Diabetic coma associated with hyperglycemia with or without ketoacidosis accounted for only 0.6% of the deaths. In regard to the relationship between the age and cause of death in patients with diabetes, the incidence of death due to vascular diseases was higher in patients over the age of 30 or 40 years, and the 97.0% of the total death due to vascular diseases was observed in patients over the age of 50 years. The incidence of death due to infectious diseases, especially pneumonia, increased in an age-dependent fashion, and the 80.7% of the total death due to pneumonia was observed in patients over the age of 70 years. 'Poorer' glycemic control was associated with the reduced lifespan of patients with diabetes, especially of those with nephropathy. The average age at death in the survey population was 72.6 years. The lifespan was 1.6 years shorter in patients with 'poorer' glycemic control than in those with 'better' glycemic control. In patients with diabetes of less than 10 years' duration, the incidence of death due to macroangiopathy was higher than that due to nephropathy. Of the 45,708 patients with diabetes, 33.9% were on oral medication, 41.9% received insulin therapy and 18.8% were treated by diet alone. Among the patients in whom the cause of death was diabetic nephropathy, a high percentage, 53.7%, was on insulin therapy. The average age at death of the 45,708 patients with diabetes was 71.4 years in men and 75.1 years in women. However, the report of the Ministry of Health and Welfare of Japan in 2010 set the average lifespan of the Japanese at 79.6 years for men and 86.3 years for women. Thus, the average lifespan of patients with diabetes still appears to be shorter than that of the general population in Japan. However, the differences in lifespan between patients with diabetes and the general population were shorter than those in the former surveys. © 2017 Japan Diabetes Society (JDS). Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Mortality among Hispanic drug users in Puerto Rico.

PubMed

Robles, Rafaela R; Matos, Tomás D; Colón, Héctor M; Sahai, Hardeo; Reyes, Juan C; Marrero, C Amalia; Calderón, José M

2003-12-01

This paper assesses mortality rate for a cohort of drug users in Puerto Rico compared with that of the Island's general population, examining causes of death and estimating relative risk of death. Date and cause of death were obtained from death certificates during 1998. Vital status was confirmed through contact with subjects, family, and friends. HIV/AIDS was the major cause of death (47.7%), followed by homicide (14.6%), and accidental poisoning (6.3%). Females had higher relative risk of death than males in all age categories. Not living with a sex partner and not receiving drug treatment were related to higher mortality due to HIV/AIDS. Drug injection was the only variable explaining relative risk of death due to overdose. Puerto Rico needs to continue developing programs to prevent HIV/AIDS among drug users. Special attention should be given to young women, who appear to be in greatest need of programs to prevent early mortality.

Carbon monoxide-related deaths in a metropolitan county in the USA: an 11-year study.

PubMed

Homer, Cynthia D; Engelhart, David A; Lavins, Eric S; Jenkins, Amanda J

2005-05-10

Carbon monoxide (CO) poisoning as a cause of death is well documented in industrialized countries. The objective of this study was to compare demographic data in deaths due to accidents (in fires) and suicides in the same population between 1988 and 1998. Furthermore, the potential effect of a community wide education effort regarding safety in the home was assessed. Postmortem reports were reviewed for all deaths examined at the Office of the Cuyahoga County Coroner in Cleveland, OH, USA. During the study period, there were 209 accidental deaths due to fires in the home (6.5% of all accidents in the home) and 182 CO deaths by suicide (9.8% of all suicides). Demographic characteristics of the two groups differed: while males represented the majority of cases in both groups (55% of accidents, 70% suicides), race specific death rates were higher for whites than blacks (18/100,000 white, 3/100,000 black) in suicides compared with 29/100,000 deaths for blacks and 11/100,000 for whites in accidental cases. Fire deaths were prevalent in the young (0-9 years) and old (>60) whereas in the suicide group the age specific death rate was highest for those over 70 years. The majority of fire deaths occurred in the city of Cleveland but suicides were prevalent in the suburbs. More fire deaths occurred in December than any other month whereas more suicides occurred in April. In 1992, there was a community wide effort to provide free smoke detectors to residents in Cleveland. In 1992, there were 4.2/100,000 fire deaths in the city. This decreased to 0.6/100,000 in 1996, increased to 1.2/100,000 in 1997 followed by a decrease to 0.8/100,000 in 1998. This suggested that the program may have aided in decreasing these types of deaths. Deaths due to fires in the suburbs were <1/100,000 throughout the study period.

The impact of a national alcohol policy on deaths due to transport accidents in Russia.

PubMed

Pridemore, William Alex; Chamlin, Mitchell B; Kaylen, Maria T; Andreev, Evgeny

2013-12-01

To determine the impact of a suite of 2006 Russian alcohol control policies on deaths due to traffic accidents in the country. We used autoregressive integrated moving average (ARIMA) interrupted time-series techniques to model the impact of the intervention on the outcome series. The time-series began in January 2000 and ended in December 2010. The alcohol policy was implemented in January 2006, providing 132 monthly observations in the outcome series, with 72 months of pre-intervention data and 60 months of post-intervention data. The outcome variables were the monthly number of male- and female-specific deaths of those aged 15+ years due to transport accidents in Russia. The 2006 set of alcohol policies had no impact on female deaths due to traffic accidents (ω0  = -50.31, P = 0.27). However, the intervention model revealed an immediate and sustained monthly decrease of 203 deaths due to transport accidents for males (ω0  = -203.40, P = 0.04), representing an 11% reduction relative to pre-intervention levels. The implementation of the suite of 2006 Russian alcohol control policies is partially responsible for saving more than 2400 male lives annually that would otherwise have been lost to traffic accidents. © 2013 Society for the Study of Addiction.

Some epidemiological aspects and economic costs of injuries in Malaysia.

PubMed

Arokiasamy, J T; Krishnan, R

1994-01-01

Injuries are one of the leading causes of death in the world. In Malaysia, injuries form one of the three main causes of mortality. They are also an important cause of permanent and temporary disability and work absenteeism in the productive age group. Increasing affluence and industrialization coupled with growing population and transportation needs in rapidly developing countries like Malaysia have resulted in a surge of road and occupational injuries. Three quarters of fatalities due to road, occupational, drowning and home injuries occur in those below 45 years of age. A majority of injuries in these categories are attributed to "human" factors and therefore can be prevented by public education and enforced training of workers. The total annual economic loss due to all types of injuries is estimated to be 2 billion Malaysian Ringgit (US$1 = MR2.76 approximately). The government is currently in the process of setting up full-time departments for road safety and occupational health and safety.

Increasing RpoS expression causes cell death in Borrelia burgdorferi.

PubMed

Chen, Linxu; Xu, Qilong; Tu, Jiagang; Ge, Yihe; Liu, Jun; Liang, Fang Ting

2013-01-01

RpoS, one of the two alternative σ factors in Borrelia burgdorferi, is tightly controlled by multiple regulators and, in turn, determines expression of many critical virulence factors. Here we show that increasing RpoS expression causes cell death. The immediate effect of increasing RpoS expression was to promote bacterial division and as a consequence result in a rapid increase in cell number before causing bacterial death. No DNA fragmentation or degradation was observed during this induced cell death. Cryo-electron microscopy showed induced cells first formed blebs, which were eventually released from dying cells. Apparently blebbing initiated cell disintegration leading to cell death. These findings led us to hypothesize that increasing RpoS expression triggers intracellular programs and/or pathways that cause spirochete death. The potential biological significance of induced cell death may help B. burgdorferi regulate its population to maintain its life cycle in nature.

Yersinia pestis endowed with increased cytotoxicity is avirulent in a bubonic plague model and induces rapid protection against pneumonic plague.

PubMed

Zauberman, Ayelet; Tidhar, Avital; Levy, Yinon; Bar-Haim, Erez; Halperin, Gideon; Flashner, Yehuda; Cohen, Sara; Shafferman, Avigdor; Mamroud, Emanuelle

2009-06-16

An important virulence strategy evolved by bacterial pathogens to overcome host defenses is the modulation of host cell death. Previous observations have indicated that Yersinia pestis, the causative agent of plague disease, exhibits restricted capacity to induce cell death in macrophages due to ineffective translocation of the type III secretion effector YopJ, as opposed to the readily translocated YopP, the YopJ homologue of the enteropathogen Yersinia enterocolitica Oratio8. This led us to suggest that reduced cytotoxic potency may allow pathogen propagation within a shielded niche, leading to increased virulence. To test the relationship between cytotoxic potential and virulence, we replaced Y. pestis YopJ with YopP. The YopP-expressing Y. pestis strain exhibited high cytotoxic activity against macrophages in vitro. Following subcutaneous infection, this strain had reduced ability to colonize internal organs, was unable to induce septicemia and exhibited at least a 10(7)-fold reduction in virulence. Yet, upon intravenous or intranasal infection, it was still as virulent as the wild-type strain. The subcutaneous administration of the cytotoxic Y. pestis strain appears to activate a rapid and potent systemic, CTL-independent, immunoprotective response, allowing the organism to overcome simultaneous coinfection with 10,000 LD(50) of virulent Y. pestis. Moreover, three days after subcutaneous administration of this strain, animals were also protected against septicemic or primary pneumonic plague. Our findings indicate that an inverse relationship exists between the cytotoxic potential of Y. pestis and its virulence following subcutaneous infection. This appears to be associated with the ability of the engineered cytotoxic Y. pestis strain to induce very rapid, effective and long-lasting protection against bubonic and pneumonic plague. These observations have novel implications for the development of vaccines/therapies against Y. pestis and shed new light on the virulence strategies of Y. pestis in nature.

Murder-suicide by carbon dioxide (CO2) poisoning: a family case from Berlin, Germany.

PubMed

Sautter, Julia; Gapert, René; Tsokos, Michael; Oesterhelweg, Lars

2014-03-01

This report demonstrates how carbon dioxide (CO(2)) may be a potent weapon in murder-suicide, where the death scene offers virtually no clues as to the lethal modality and the autopsy findings are nonspecific. Four bodies were discovered in an apartment in midsummer 2012 in Berlin, Germany. The bodies were those of a father (a 69-year-old business consultant), his wife (aged 26-years), and two sons (aged 3 and 6 years, respectively). The police found the wife and two sons lying in their beds and the husband in a supine position on the floor with a plastic bag over his head tied loosely around his neck with a rope. A 500 g single-use CO(2) cylinder was standing on the floor. The container was almost empty and according to the label had been sold as a CO(2)-fertilizer for aquarium plants. Two synthetic inhalation face masks and tubing were also found, which tested positive for the DNA of all four deceased family members. It is hypothesized that the husband placed an inhalation mask over the mouths and noses of his wife and children while they were sleeping. Inhalation of pure CO(2) ensured their rapid unconsciousness due to hypercapnia and severe anoxia. The rapid increase in CO(2) concentration would render a victim helpless, with no time to wake and defend themselves, or others. The proximate cause of death in all cases was attributed to CO(2) intoxication, based on the scene findings, the reconstructed sequence of events, the autopsy, and results of toxicological studies.

Scaling up antiretroviral therapy in South Africa: the impact of speed on survival.

PubMed

Walensky, Rochelle P; Wood, Robin; Weinstein, Milton C; Martinson, Neil A; Losina, Elena; Fofana, Mariam O; Goldie, Sue J; Divi, Nomita; Yazdanpanah, Yazdan; Wang, Bingxia; Paltiel, A David; Freedberg, Kenneth A

2008-05-01

Only 33% of eligible human immunodeficiency virus (HIV)-infected patients in South Africa receive antiretroviral therapy (ART). We sought to estimate the impact of alternative ART scale-up scenarios on patient outcomes from 2007-2012. Using a simulation model of HIV infection with South African data, we projected HIV-associated mortality with and without effective ART for an adult cohort in need of therapy (2007) and for adults who became eligible for treatment (2008-2012). We compared 5 scale-up scenarios: (1) zero growth, with a total of 100,000 new treatment slots; (2) constant growth, with 600,000; (3) moderate growth, with 2.1 million; (4) rapid growth, with 2.4 million); and (5) full capacity, with 3.2 million. Our projections showed that by 2011, the rapid growth scenario fully met the South African need for ART; by 2012, the moderate scenario met 97% of the need, but the zero and constant growth scenarios met only 28% and 52% of the need, respectively. The latter scenarios resulted in 364,000 and 831,000 people alive and on ART in 2012. From 2007 to 2012, cumulative deaths in South Africa ranged from 2.5 million under the zero growth scenario to 1.2 million under the rapid growth scenario. Alternative ART scale-up scenarios in South Africa will lead to differences in the death rate that amount to more than 1.2 million deaths by 2012. More rapid scale-up remains critically important.

Postmortem ICD interrogation in mode of death classification.

PubMed

Nikolaidou, Theodora; Johnson, Miriam J; Ghosh, Justin M; Marincowitz, Carl; Shah, Saumil; Lammiman, Michael J; Schilling, Richard J; Clark, Andrew L

2018-04-01

The definition of sudden death due to arrhythmia relies on the time interval between onset of symptoms and death. However, not all sudden deaths are due to arrhythmia. In patients with an implantable cardioverter defibrillator (ICD), postmortem device interrogation may help better distinguish the mode of death compared to a time-based definition alone. This study aims to assess the proportion of "sudden" cardiac deaths in patients with an ICD that have confirmed arrhythmia. We conducted a literature search for studies using postmortem ICD interrogation and a time-based classification of the mode of death. A modified QUADAS-2 checklist was used to assess risk of bias in individual studies. Outcome data were pooled where sufficient data were available. Our search identified 22 studies undertaken between 1982 and 2015 with 23,600 participants. The pooled results (excluding studies with high risk of bias) suggest that ventricular arrhythmias are present at the time of death in 76% of "sudden" deaths (95% confidence interval [CI] 67-85; range 42-88). Postmortem ICD interrogation identifies 24% of "sudden" deaths to be nonarrhythmic. Postmortem device interrogation should be considered in all cases of unexplained sudden cardiac death. © 2018 Wiley Periodicals, Inc.

Community-Based Surveillance to Monitor Mortality in a Malaria-Endemic and Ebola-Epidemic Setting in Rural Guinea.

PubMed

Tiffany, Amanda; Moundekeno, Faya Pascal; Traoré, Alexis; Haile, Melat; Sterk, Esther; Guilavogui, Timothé; Serafini, Micaela; Genton, Blaise; Grais, Rebecca F

2016-12-07

Multiple community-based approaches can aid in quantifying mortality in the absence of reliable health facility data. Community-based sentinel site surveillance that was used to document mortality and the systems utility for outbreak detection was evaluated. We retrospectively analyzed data from 46 sentinel sites in three sous-préfectures with a reinforced malaria control program and one sous-préfecture without (Koundou) in Guinea. Deaths were recorded by key informants and classified as due to malaria or another cause. Malaria deaths were those reported as due to malaria or fever in the 3 days before death with no other known cause. Suspect Ebola virus disease (sEVD) deaths were those due to select symptoms in the EVD case definition. Deaths were aggregated by sous-préfecture and analyzed by a 6-month period. A total of 43,000 individuals were monitored by the surveillance system; 1,242 deaths were reported from July 2011-June 2014, of which 55.2% (N = 686) were reported as due to malaria. Malaria-attributable proportional mortality decreased by 26.5% (95% confidence interval [CI] = 13.9-33.1, P < 0.001) in the program area and by 6.6% (95% CI = -17.3-30.5, P = 0.589) in Koundou. Sixty-eight deaths were classified as sEVD and increased by 6.1% (95% CI = 1.3-10.8, P = 0.021). Seventeen sEVD deaths were reported from November 2013 to March 2014 including the first two laboratory-confirmed EVD deaths. Community surveillance can capture information on mortality in areas where data collection is weak, but determining causes of death remains challenging. It can also be useful for outbreak detection if timeliness of data collection and reporting facilitate real-time data analysis. © The American Society of Tropical Medicine and Hygiene.

Child Deaths Due to Injury in the Four UK Countries: A Time Trends Study from 1980 to 2010

PubMed Central

Hardelid, Pia; Davey, Jonathan; Dattani, Nirupa; Gilbert, Ruth

2013-01-01

Background Injuries are an increasingly important cause of death in children worldwide, yet injury mortality is highly preventable. Determining patterns and trends in child injury mortality can identify groups at particularly high risk. We compare trends in child deaths due to injury in four UK countries, between 1980 and 2010. Methods We obtained information from death certificates on all deaths occurring between 1980 and 2010 in children aged 28 days to 18 years and resident in England, Scotland, Wales or Northern Ireland. Injury deaths were defined by an external cause code recorded as the underlying cause of death. Injury mortality rates were analysed by type of injury, country of residence, age group, sex and time period. Results Child mortality due to injury has declined in all countries of the UK. England consistently experienced the lowest mortality rate throughout the study period. For children aged 10 to 18 years, differences between countries in mortality rates increased during the study period. Inter-country differences were largest for boys aged 10 to 18 years with mortality rate ratios of 1.38 (95% confidence interval 1.16, 1.64) for Wales, 1.68 (1.48, 1.91) for Scotland and 1.81 (1.50, 2.18) for Northern Ireland compared with England (the baseline) in 2006–10. The decline in mortality due to injury was accounted for by a decline in unintentional injuries. For older children, no declines were observed for deaths caused by self-harm, by assault or from undetermined intent in any UK country. Conclusion Whilst child deaths from injury have declined in all four UK countries, substantial differences in mortality rates remain between countries, particularly for older boys. This group stands to gain most from policy interventions to reduce deaths from injury in children. PMID:23874585

8 CFR 319.2 - Person whose United States citizen spouse is employed abroad.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (c) Loss of marital union due to death, divorce, or expatriation of the citizen spouse. A person is..., before or after the filing of the application, the marital union ceases to exist due to death or divorce...

Intoxication by cyanide in fires: a study in monkeys using polyacrylonitrile

DOE Office of Scientific and Technical Information (OSTI.GOV)

Purser, D.A.; Grimshaw, P.; Berrill, K.R.

It is suspected that hydrogen cyanide (HCN) may be an important factor in incapacitating fire victims, but the effects of sublethal exposures are not well characterized. Also, the incapacitating effects of fire atmospheres result from exposure to a mixture of toxic products so that the contribution from each component is difficult to determine. The mechanisms of incapacitation in monkeys exposed to the pyrolysis products of polyacrylonitrile (PAN) were compared to those resulting from low level HCN gas exposures. The physiological effects of the PAN atmospheres were almost identical to those of HCN gas alone. They consisted of hyperventilation, followed bymore » loss of consciousness after 1-5 min, bradycardia with arrhythmias and T-wave abnormalities, and were followed by a rapid recovery after exposure. Hydrogen cyanide is considered to be the major toxic product formed by the pyrolysis of PAN. It is suggested that HCN may produce rapid incapacitation at low blood levels of cyanide in fires, while death may occur later due to carbon monoxide poisoning or other factors.« less

Altruism in Terminal Cancer Patients and Rapid Tissue Donation Program: Does the Theory Apply?

PubMed Central

Murphy, Devin; Pratt, Christie; Muñoz-Antonia, Teresita; Guerra, Lucy; Schabath, Matthew B; Leon, Marino E; Haura, Eric

2013-01-01

Rapid Tissue Donation (RTD) is an advancing oncology research procedure for collecting tumors, metastases, and unaffected tissue 2 to 6 hours after death. Researchers can better determine rates of progression, response to treatment, and polymorphic differences among patients. Cancer patients may inquire about posthumous body donation for research to offer a personal contribution to research; however, there are barriers to recruiting for an RTD program. Physicians must reassure the patient that their treatment options and quality of care will not be compromised due to participating in RTD. In this commentary we discuss how theories of altruism may explain cancer patients’ desire to participate in an RTD program, the ethical concerns of health care professionals and patients and the use of altruism as a recruitment strategy. We offer recommendations for examining the cultural and ethical climate of the institution prior to initiating such a program such as examining the relationship of healthcare professionals and patients, identifying ethical concerns, and examining ways to promote acceptance and buy-in across professionals, patients, and families. PMID:23539332

Point-of-Care Diagnostics for Improving Maternal Health in South Africa

PubMed Central

Mashamba-Thompson, Tivani P.; Sartorius, Benn; Drain, Paul K.

2016-01-01

Improving maternal health is a global priority, particularly in high HIV-endemic, resource-limited settings. Failure to use health care facilities due to poor access is one of the main causes of maternal deaths in South Africa. “Point-of-care” (POC) diagnostics are an innovative healthcare approach to improve healthcare access and health outcomes in remote and resource-limited settings. In this review, POC testing is defined as a diagnostic test that is carried out near patients and leads to rapid clinical decisions. We review the current and emerging POC diagnostics for maternal health, with a specific focus on the World Health Organization (WHO) quality-ASSURED (Affordability, Sensitivity, Specificity, User friendly, Rapid and robust, Equipment free and Delivered) criteria for an ideal point-of-care test in resource-limited settings. The performance of POC diagnostics, barriers and challenges related to implementing POC diagnostics for maternal health in rural and resource-limited settings are reviewed. Innovative strategies for overcoming these barriers are recommended to achieve substantial progress on improving maternal health outcomes in these settings. PMID:27589808

Rapid brain death caused by a cerebellar abscess with Fusobacterium nucleatum in a young man with drug abuse: a case report.

PubMed

Hischebeth, Gunnar T R; Keil, Vera C; Gentil, Katrin; Boström, Azize; Kuchelmeister, Klaus; Bekeredjian-Ding, Isabelle

2014-06-10

Fusobacterium nucleatum is a strict anaerobic microorganism that causes disease entities such as periodontal and soft tissue abscesses, pulmonary and intraabdominal infections and very rarely intracerebral infections. Here, we report the rare case of a previously healthy 25-year-old German man with a cerebellar abscess caused by Fusobacterium nucleatum that resulted in rapid brain death. Toxicological screening showed positivity for amphetamines and cannabis. The diagnosis was obtained by polymerase chain reaction amplification of bacterial deoxyribonucleic acid in cerebrospinal fluid. In drug users clinicians should think about rare causes of brain abscesses/meningitis. Early diagnosis is necessary and justifies the use of molecular techniques.

Rapid change in the defense of flightless young by a mourning dove parent

USGS Publications Warehouse

Berdeen, James; Otis, D.L.

2011-01-01

We report that an adult-sized Zenaida macroura (Mourning Dove), presumably a parent, rapidly decreased risk taken in defense of a juvenile as the likelihood of predation to the juvenile increased. We attribute this decrease in risk taken to (1) the parent's perception that the risk of predation had increased to the extent that a continuation of defensive behaviors would not prevent the death of the juvenile, and (2) its attempt to minimize its own risk of death. It may be that there is a threshold beyond which Mourning Dove parents will forgo the risk of additional defense of offspring in favor of making another reproductive attempt.

Usefulness of postmortem biochemistry in identification of ketosis: Diagnosis of ketoacidosis at the onset of autoimmune type 1 diabetes in an autopsy case with cold exposure and malnutrition.

PubMed

Tani, Naoto; Michiue, Tomomi; Chen, Jian-Hua; Oritani, Shigeki; Ishikawa, Takaki

2016-09-01

A severely malnourished, Japanese female in her twenties was found dead in her apartment. On autopsy, most of the findings from the internal examination were suggestive of hypothermia. Postmortem biochemistry, however, showed severely increased levels of glycated hemoglobin (HbA1c) and blood and urine glucose levels. Levels of acetone, 3-hydroxybutyric acid, and acetoacetate in various body fluids were also highly increased, indicating ketosis. The serum insulin and c-peptide levels were severely low, and subsequent testing was positive for anti-GAD antibodies. Immunohistochemical examination of the pancreatic islet cells revealed few insulin-positive cells but many glucagon-positive cells on staining. Furthermore, slight invasion of CD8-positive lymphocytes in the pancreatic islets of Langerhans was observed. Results of immunostaining of the pancreatic and bronchial epithelial tissues were partly positive for the Influenza A virus. We concluded that severe ketoacidosis associated with rapid-onset hyperglycemia due to autoimmune type 1 diabetes (AT1D) had occurred shortly before death. However, the ketosis was accompanied by hypothermia and malnutrition as well as diabetic ketoacidosis (DKA). Therefore, we retrospectively collected biochemical data on cases of hypothermia and malnutrition and compared them with the present case. Serum glucose, acetone, 3-hydroxybutyric acid, and acetoacetic acid can be used for screening and diagnosis to distinguish DKA from ketosis due to hypothermia and malnutrition. Therefore, in the present case, we diagnosed that the natural cause of death was due to AT1D. In conclusion, screening investigations for relevant biochemical markers can provide essential information for the diagnosis of metabolic disturbances, which fail to demonstrate characteristic autopsy findings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Diagnostic role of serum tryptase in anaphylactic deaths in forensic medicine: a systematic review and meta-analysis.

PubMed

Sun, Kai-Jian; He, Jie-Tao; Huang, Hong-Yan; Xue, Ye; Xie, Xiao-Li; Wang, Qi

2018-06-01

Postmortem diagnosis of sudden death due to anaphylaxis can be very difficult due to the non-specific pathological findings in forensic practice. Postmortem serum tryptase has been used as an indicator of possible ante-mortem anaphylaxis. Though many previous studies have been conducted to explore the diagnostic significance of serum tryptase for lethal anaphylaxis, inconsistent results were documented. In this study, we made a retrospective study and presented a systematic review and meta-analysis that aims to summarize the diagnostic significance of postmortem serum tryptase in the deceased with and without anaphylactic shock and to calculate a cutoff value for future reference in the identification of deaths due to anaphylactic shock. A complete literature search in the PubMed, Cochrane Library, CNKI and Embase databases (published prior to March 1st, 2017) was performed. The quality of the eligible literature was evaluated according to the Newcastle-Ottawa Quality Assessment Scale (NOS), and the relevant data was extracted. The procedure of meta-analysis was performed by RevMan 5.3 software. Subgroup analysis was performed according to different causes of death. A total of nine studies with 296 patients were identified. The NOS of each included study was equal to 7. The results indicated that high concentrations of tryptase were significantly associated with anaphylactic shock when compared to the other causes of death. The weighted mean difference (WMD) was 29.53 (95% CI = 7.58-51.47, p = 0.008). Similar results were detected in the subgroup analysis when compared to deaths due to cardiovascular disease (CVD). However, no obvious elevation of tryptase in decedents with CVD compared to the other cause of death was observed (WMD = 4.42, 95% CI = -0.94-9.79). We concluded that high serum tryptase is a promising diagnostic biomarker for deaths due to anaphylactic shock, especially when it is higher than 30.4 μg/L.

7 CFR 701.33 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Death, incompetency, or disappearance. 701.33 Section... RELATED PROGRAMS PREVIOUSLY ADMINISTERED UNDER THIS PART § 701.33 Death, incompetency, or disappearance. In case of death, incompetency, or disappearance of any participant, any cost-share payment due shall...

Sudden Infant Death Syndrome (SIDS) and Vaccines

MedlinePlus

... this? Submit What's this? Submit Button Sudden Infant Death Syndrome (SIDS) Recommend on Facebook Tweet Share Compartir ... an international network of vaccine safety experts. SIDS deaths declined due to recommendations to put infants on ...

Prospective register-based study of the impact of immigration on educational inequalities in mortality in Norway.

PubMed

Elstad, Jon Ivar; Øverbye, Einar; Dahl, Espen

2015-04-11

Differences in mortality with regard to socioeconomic status have widened in recent decades in many European countries, including Norway. A rapid upsurge of immigration to Norway has occurred since the 1990s. The article investigates the impact of immigration on educational mortality differences among adults in Norway. Two linked register-based data sets are analyzed; the first consists of all registered inhabitants aged 20-69 in Norway January 1, 1993 (2.6 millions), and the second of all registered inhabitants aged 20-69 as of January 1, 2008 (2.8 millions). Deaths 1993-1996 and 2008-2011, respectively, immigrant status, and other background information are available in the data. Mortality is examined by Cox regression analyses and by estimations of age-adjusted deaths per 100,000 personyears. Both relative and absolute educational inequality in mortality increased from the 1993-1996 period to 2008-2011, but overall mortality levels went down during these years. Immigrants in general, and almost all the analyzed immigrant subcategories, had lower mortality than the native majority. This was due to comparatively low mortality among lower educated immigrants, while mortality among higher educated immigrants was similar to the mortality level of highly educated natives. The widening of educational inequality in mortality during the 1990s and 2000s in Norway was not due to immigration. Immigration rather contributed to slightly lower overall mortality in the population and a less steep educational gradient in mortality.

The effects of sudden oak death on foliar moisture content and crown fire potential in tanoak

Treesearch

H. Kuljian; J.M. Varner

2010-01-01

The introduction of non-native pathogens can have profound effects on forest ecosystems resulting in loss of species, changes in species composition, and altered fuel structure. The introduction of Phytophthora ramorum, the pathogen recognized as causing Sudden Oak Death (SOD), leads to rapid decline and mortality of tanoak (Lithocarpus densiflorus) in forests of...

Mapping sudden oak death risk nationally using host, climate, and pathways data

Treesearch

Frank H. Koch; William D. Smith

2008-01-01

In 2002, a team of United States Department of Agriculture-Forest Service (USDA-FS) scientists developed a preliminary risk map to serve as the foundation for an efficient, cost effective sample design for the national sudden oak death detection survey. At the time, a need to initiate rapid detection in the face of limited information on Phytophthora ramorum...

Atrial fibrillation and sudden cardiac death: catheter-based sensor and mapping system of the heart

NASA Astrophysics Data System (ADS)

Ramasamy, Mouli; Kumar, Prashanth S.; Varadan, Vijay K.

2017-04-01

Ventricular arrhythmias in the heart and the rapid heartbeat of ventricular tachycardia can lead to sudden cardiac death. This is a major health issue worldwide. What is needed is to develop a catheter based sensor and mapping approach which will provide the mechanisms of ventricular arrhythmia, and effectively prevent and treat the same, potentially save life.

Aetiology of sudden cardiac death in sport: a histopathologist's perspective.

PubMed

Sheppard, Mary N

2012-11-01

In the UK, when a young person dies suddenly, the coroner is responsible for establishing the cause of death. They will ask a consultant pathologist to carry out an autopsy in order to ascertain when, where and how that person died. Once the cause of death is established and is due to natural causes, the coroner can issue a death certificate. Importantly, the coroner is not particularly interested in the cause of death as long as it is due to natural causes, which avoids the need for an inquest (a public hearing about the death). However, if no identifiable cause is established at the initial autopsy, the coroner can refer the heart to a cardiac pathologist, since the cause of death is usually due to heart disease in most cases. Consultant histopathologists are responsible for the analysis of human tissue from both living individuals and the dead in order to make a diagnosis of disease. With recent advancements in the management protocols for routine autopsy practice and assessment following the sudden death of a young individual, this review describes the role of the consultant histopathologist in the event of a sudden death of a young athletic individual, together with the older middle-aged 'weekend warrior' athlete. It provides concise mechanisms for the main causes of sudden cardiac death (including coronary artery disease, cardiomyopathies, valve abnormalities, major vessel ruptures and electrical conduction abnormalities) based on detailed autopsy data from our specialised cardiac pathology laboratory. Finally, the review will discuss the role of the histopathologist in the event of a 'negative' autopsy.

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

PubMed

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

2016-11-01

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

Omcg1 is critically required for mitosis in rapidly dividing mouse intestinal progenitors and embryonic stem cells.

PubMed

Léguillier, Teddy; Vandormael-Pournin, Sandrine; Artus, Jérôme; Houlard, Martin; Picard, Christel; Bernex, Florence; Robine, Sylvie; Cohen-Tannoudji, Michel

2012-07-15

Recent studies have shown that factors involved in transcription-coupled mRNA processing are important for the maintenance of genome integrity. How these processes are linked and regulated in vivo remains largely unknown. In this study, we addressed in the mouse model the function of Omcg1, which has been shown to participate in co-transcriptional processes, including splicing and transcription-coupled repair. Using inducible mouse models, we found that Omcg1 is most critically required in intestinal progenitors. In absence of OMCG1, proliferating intestinal epithelial cells underwent abnormal mitosis followed by apoptotic cell death. As a consequence, the crypt proliferative compartment of the small intestine was quickly and totally abrogated leading to the rapid death of the mice. Lack of OMCG1 in embryonic stem cells led to a similar cellular phenotype, with multiple mitotic defects and rapid cell death. We showed that mutant intestinal progenitors and embryonic stem cells exhibited a reduced cell cycle arrest following irradiation, suggesting that mitotic defects may be consecutive to M phase entry with unrepaired DNA damages. These findings unravel a crucial role for pre-mRNA processing in the homeostasis of the small intestine and point to a major role of OMCG1 in the maintenance of genome integrity.

38 CFR 21.5067 - Death of participant.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Death of participant. 21.... Chapter 32 Participation § 21.5067 Death of participant. (a) Disposition of unused contributions. If an.... Educational assistance remaining due and unpaid at the date of the veteran's death is payable under the...

20 CFR 410.471 - Conclusion by physician regarding miner's disability or death.

Code of Federal Regulations, 2011 CFR

2011-04-01

... disability or death. 410.471 Section 410.471 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.471 Conclusion by physician regarding miner's disability or death. The...

38 CFR 21.5067 - Death of participant.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Death of participant. 21.... Chapter 32 Participation § 21.5067 Death of participant. (a) Disposition of unused contributions. If an.... Educational assistance remaining due and unpaid at the date of the veteran's death is payable under the...

38 CFR 21.5067 - Death of participant.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Death of participant. 21.... Chapter 32 Participation § 21.5067 Death of participant. (a) Disposition of unused contributions. If an.... Educational assistance remaining due and unpaid at the date of the veteran's death is payable under the...

38 CFR 21.5067 - Death of participant.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Death of participant. 21.... Chapter 32 Participation § 21.5067 Death of participant. (a) Disposition of unused contributions. If an.... Educational assistance remaining due and unpaid at the date of the veteran's death is payable under the...

38 CFR 21.5067 - Death of participant.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Death of participant. 21.... Chapter 32 Participation § 21.5067 Death of participant. (a) Disposition of unused contributions. If an.... Educational assistance remaining due and unpaid at the date of the veteran's death is payable under the...

Causes of mortality due to rheumatic diseases in Jerez de los Caballeros (Badajoz) during the 19th century.

PubMed

Peral Pacheco, Diego; Suárez-Guzmán, Francisco Javier

2016-01-01

A total of 26,203 of the deaths in Jerez de los Caballeros (Badajoz) during the 19th century were collected and grouped according to the Bertillon's Classification, in order to study the causes of death from rheumatic diseases. An analysis was made using the Death Registers, those located in the Parish Archives, and files of the Municipal Archives. There were a total of 31 deaths due to rheumatic diseases, with the 65-74 years age group being most frequent. The lack of records may be due to the inaccuracy of the diagnoses. September was the month of increased mortality. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Modulation of low-latitude west wind on abnormal track and intensity of tropical cyclone Nargis (2008) in the Bay of Bengal

NASA Astrophysics Data System (ADS)

Li, Wei-Wei; Wang, Chunzai; Wang, Dongxiao; Yang, Lei; Deng, Yi

2012-03-01

Tropical cyclone (TC) Nargis (2008) made landfall in Myanmar on 02 May 2008, bringing a storm surge, major flooding, and resulting in a significant death toll. TC Nargis (2008) displayed abnormal features, including rare eastward motion in its late stage, rapid intensification before landing. Using reanalysis data and a numerical model, we investigated how a low-latitude westerly wind modulated TC Nargis' (2008) track and provided favorable atmospheric conditions for its rapid intensification. More importantly, we found a possible counterbalance effect of flows from the two hemispheres on the TC track in the Bay of Bengal. Our analysis indicates that a strong westerly wind burst across the Bay of Bengal, resulting in TC Nargis' (2008) eastward movement after its recurvature. This sudden enhancement of westerly wind was mainly due to the rapidly intensified mid-level cross-equatorial flow. Our results show that a high-pressure system in the Southern Hemisphere induced this strong, mid-level, cross-equatorial flow. During the rapid intensification period of TC Nargis (2008), this strong and broad westerly wind also transported a large amount of water vapor to TC Nargis (2008). Sufficient water vapor gave rise to continuously high and increased mid-level relative humidity, which was favorable to TC Nargis' (2008) intensification. Condensation of water vapor increased the energy supply, which eventuated the intensification of TC Nargis (2008) to a category 4 on the Saffir-Simpson scale.

Extracellular vesicle-mediated transfer of processed and functional RNY5 RNA

PubMed Central

Chakrabortty, Sudipto K.; Prakash, Ashwin; Nechooshtan, Gal; Hearn, Stephen; Gingeras, Thomas R.

2015-01-01

Extracellular vesicles (EVs) have been proposed as a means to promote intercellular communication. We show that when human primary cells are exposed to cancer cell EVs, rapid cell death of the primary cells is observed, while cancer cells treated with primary or cancer cell EVs do not display this response. The active agents that trigger cell death are 29- to 31-nucleotide (nt) or 22- to 23-nt processed fragments of an 83-nt primary transcript of the human RNY5 gene that are highly likely to be formed within the EVs. Primary cells treated with either cancer cell EVs, deproteinized total RNA from either primary or cancer cell EVs, or synthetic versions of 31- and 23-nt fragments trigger rapid cell death in a dose-dependent manner. The transfer of processed RNY5 fragments through EVs may reflect a novel strategy used by cancer cells toward the establishment of a favorable microenvironment for their proliferation and invasion. PMID:26392588

Changing epidemiology of maternal mortality in rural India: time to reset strategies for MDG-5.

PubMed

Shah, Pankaj; Shah, Shobha; Kutty, Raman V; Modi, Dhiren

2014-05-01

To understand changes in epidemiology of maternal mortality in rural India in the context of increasing institutional deliveries and implementation of community-based interventions that can inform policies to reach MDG-5. This study is a secondary analysis of prospectively collected community-based data of every pregnancy and its outcomes from 2002 to 2011 in a rural, tribal area of Gujarat, India as part of safe-motherhood programme implemented by voluntary organisation, SEWA Rural. The programme consisted of community-based interventions supported by a first referral unit, and promotion of institutional deliveries. For every maternal death, a verbal autopsy was conducted. The incidence rates for maternal mortality according to place, cause and timing of maternal deaths in relation to pregnancy were computed. Annual incidence rate ratios (IRR) and 95% confidence intervals, adjusted for caste and maternal education, were estimated using Poisson regression to test for linear trend in reduction in mortality during the study period. Thirty-two thousand eight hundred and ninety-three pregnancies, 29,817 live births and 80 maternal deaths were recorded. Maternal mortality ratio improved from 607 (19 deaths) in 2002-2003 to 161 (five deaths) in 2010-2011. The institutional delivery rate increased from 23% to 65%. The trend of falling maternal deaths was significant over time, with an annual reduction of 17% (adjusted IRR 0.83 CI 0.75-0.91, P-value <0.001). There were significant reductions in adjusted incidence rate of maternal deaths due to direct causes, during intrapartum and post-partum periods, and those which occurred at home. However, reductions in incidence of maternal deaths due to indirect causes, at hospital and during antepartum period were not statistically significant. Most maternal deaths are now occurring at hospitals and due to indirect causes. Gains in institutional deliveries and community-based interventions resulting in fewer maternal deaths due to direct causes should be maintained. However, it would be essential to now prioritize management of indirect causes of maternal mortality during pregnancy at community and hospitals for further reduction in maternal deaths to achieve MDG-5. © 2014 John Wiley & Sons Ltd.

20 CFR 410.240 - Evidence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... evidence may be submitted as part of a prescribed application form if the form provides for its inclusion... disability or death due to pneumoconiosis. For evidence requirements to support allegations of total disability or death due to pneumoconiosis; for the effect of the failure or refusal of an individual to...

Environmental pollution and deaths due to stroke in a city with low levels of air pollution: ecological time series study.

PubMed

Amancio, Camila Trolez; Nascimento, Luiz Fernando

2014-12-01

Little has been discussed about the increased risk of stroke after exposure to air pollutants, particularly in Brazil. The mechanisms through which air pollution can influence occurrences of vascular events such as stroke are still poorly understood. The aim of this study was to estimate the association between exposure to some air pollutants and risk of death due to stroke. Ecological time series study with data from São José dos Campos, Brazil. Data on deaths due to stroke among individuals of all ages living in São José dos Campos and on particulate matter, sulfur dioxide and ozone were used. Statistical analysis was performed using a generalized additive model of Poisson regression with the Statistica software, in unipollutant and multipollutant models. The percentage increase in the risk of increased interquartile difference was calculated. There were 1,032 deaths due to stroke, ranging from 0 to 5 per day. The statistical significance of the exposure to particulate matter was ascertained in the unipollutant model and the importance of particulate matter and sulfur dioxide, in the multipollutant model. The increases in risk were 10% and 7%, for particulate matter and sulfur dioxide, respectively. It was possible to identify exposure to air pollutants as a risk factor for death due to stroke, even in a city with low levels of air pollution.

Cholinergic aspects of cyanide intoxication

DOE Office of Scientific and Technical Information (OSTI.GOV)

Von Bredow, J.D.; Vick, J.A.

1993-05-13

The acute exposure of pentobarbital anesthetized dogs to cyanide leads to a rapid increase and sudden halt in respiration accompanied by cardiovascular irregularities and extreme bradycardia which ultimately lead to cardiac arrest and death. Cardiac irregularities and cardiac arrest in the presence of cyanide induced respiratory arrest are assumed to be due to anoxia and therefore unresponsive to cardiotonic agents. Pretreatment or treatment with atropine sulfate or methyl atropine nitrate provides a marked reduction in the cardiovascular irregularities, bradycardia and hypotension. The cyanide induced cardiovascular effect can also be prevented by bilateral vagotomy. An intramuscularly injected combination of 20 mg/kgmore » sodium nitrite and 1 mg/kg of atropine sulfate ensured recovery of pentobarbital anesthetized dogs exposed to lethal concentrations (2.5 mg/kg i.v.) of sodium cyanide.« less

Missile injuries of the abdomen in Zimbabwe-Rhodesia.

PubMed

Dent, R I; Jena, G P

1980-05-01

One hundred and thirteen patients with missile injuries of the abdomen were seen over a 3-year period at one hospital in Zimbabwe-Rhodesia. The details of these injuries and the results of their treatment are presented. Twenty-four patients died (21 per cent). Twenty of these patients had sustained high velocity missile injuries, 18 had damaged colons and 3 died from major vascular injuries before surgery. Excluding these last 3 patients, the mortality rate for high velocity wounds of the colon was 52 per cent and that for all other patients was 6 per cent (P less than 0.01). More than half the postoperative deaths were due to septicaemia. The importance is stressed is stressed of early and effective resuscitation, including appropriate antibiotic therapy and rapid evacuation to facilities for major surgery.

Septic shock sera containing circulating histones induce dendritic cell-regulated necrosis in fatal septic shock patients.

PubMed

Raffray, Loic; Douchet, Isabelle; Augusto, Jean-Francois; Youssef, Jihad; Contin-Bordes, Cecile; Richez, Christophe; Duffau, Pierre; Truchetet, Marie-Elise; Moreau, Jean-Francois; Cazanave, Charles; Leroux, Lionel; Mourrissoux, Gaelle; Camou, Fabrice; Clouzeau, Benjamin; Jeannin, Pascale; Delneste, Yves; Gabinski, Claude; Guisset, Olivier; Lazaro, Estibaliz; Blanco, Patrick

2015-04-01

Innate immune system alterations, including dendritic cell loss, have been reproducibly observed in patients with septic shock and correlated to adverse outcomes or nosocomial infections. The goal of this study is to better understand the mechanisms behind this observation in order to better assess septic shock pathogenesis. Prospective, controlled experimental study. Research laboratory at an academic medical center. The study enrolled 71 patients, 49 with septic shock and 22 with cardiogenic shock. Seventeen healthy controls served as reference. In vitro monocyte-derived dendritic cells were generated from healthy volunteers. Sera were assessed for their ability to promote in vitro dendritic cell death through flow cytometry detection in each group of patients. The percentage of apoptotic or necrotic dendritic cells was evaluated by annexin-V and propidium iodide staining. We observed that only patients with septic shock and not patients with pure cardiogenic shock were characterized by a rapid and profound loss of circulating dendritic cells. In vitro analysis revealed that sera from patients with septic shock induced higher dendritic cell death compared to normal sera or cardiogenic shock (p<0.005). Sera from surviving patients induced dendritic cell death through a caspase-dependent apoptotic pathway, whereas sera from nonsurviving patients induced dendritic cell-regulated necrosis. Dendritic cell necrosis was not due to necroptosis but was dependent of the presence of circulating histone. The toxicity of histones toward dendritic cell could be prevented by recombinant human activated protein C. Finally, we observed a direct correlation between the levels of circulating histones in patients and the ability of the sera to promote dendritic cell-regulated necrosis. The study demonstrates a differential mechanism of dendritic cell death in patients with septic shock that is dependent on the severity of the disease.

Contribution of the ethics committee of the French society of intensive care medicine to a scenario for the implementation of organ donation after Maastricht III-type cardiac death in France.

PubMed

Graftieaux, J-P; Bollaert, P-E; Haddad, L; Kentish-Barnes, N; Nitenberg, G; Robert, R; Villers, D; Dreyfuss, D

2014-02-01

French law allows organ donation after death due to cardiocirculatory arrest. In the Maastricht classification, type III non-heart-beating donors are those who experience cardiocirculatory arrest after the withdrawal of life-sustaining treatments. French authorities in charge of regulating organ donation (Agence de la Biomédecine, ABM) are considering organ collection from Maastricht type III donors. We describe a scenario for Maastricht type III organ donation that fully complies with the ethical norms governing care to dying patients. That organ donation may occur after death should have no impact on the care given to the patient and family. The dead-donor rule must be followed scrupulously: the organ retrieval procedure must neither cause nor hasten death. The decision to withdraw life-sustaining treatments, withdrawal modalities, and care provided to the patient and family must adhere strictly to the requirements set forth in patient-rights legislation (the 2005 Léonetti law in France) and should not be influenced in any way by the possibility of organ donation. A major ethical issue regarding the family is how best to transition from discussing treatment-withdrawal decisions to discussing possible organ retrieval for donation should the patient die rapidly after treatment withdrawal. Close cooperation between the healthcare team and the organ retrieval team is crucial to minimize the distress of family members during this transition. Modalities for implementing Maastricht type III organ donation are discussed here, including the best location for withdrawing life-sustaining treatments (operating room or intensive care unit). Copyright © 2014. Published by Elsevier SAS.

Toxicology and pharmacology of some ruthenium compounds: Vascular smooth muscle relaxation by nitrosyl derivatives of ruthenium and iridium.

PubMed

Kruszyna, H; Kruszyna, R; Hurst, J; Smith, R P

1980-07-01

A series of compounds were synthesized from ruthenium trichloride, and their ip LD50s were determined in mice: pentamminenitrosylruthenium(II) chloride, 8.9; chloronitrobis(2,2'-dipyridyl)ruthenium(II), 55;dichlorobis(2,2'-dipyridyl)ruthenium(II), 63; ruthenium trichloride, 108; and potassium pentachloronitrosylruthenate(II), 127 mg/kg. The two bis-bipyridyl complexes produced death in convulsions within minutes, whereas the remaining compounds resulted in long, debilitating courses with death occurring in 4-7d. When given in massive overdoses, however, the compounds with inorganic ligands also produced rapid convulsive death in mice, and when given iv to anesthetized cats, they produced respiratory arrest. The major toxic effects of all the complexes appeared to be due to the metal and not to its associated ligands. Only complexes having nitrosyl ligand specifically relaxed vascular smooth muscle. Potassium pentabromoiridate(III) also relaxed rabbit aortic strips that had been contracted by adrenergic agonists, but potassium pentachloroiridate(III) did not. None of the complexes was as active as nitroprusside in relaxing aortic strips or in decreasing arterial blood pressure in cats. No compound tested was as potent as cisplatin in antitumor activity. The pentamminenitrosylruthenium(II) complex also relaxed guinea pig ileum and frog rectus abdominus when these isolated muscles had been contracted by acetylcho line. It appears that these organoruthenium compounds may produce death in central respiratory arrest, as do the inorganic complexes when given iv or ip in massive overdoses. In minimally lethal doses, the complexes with inorganic ligands may affect a variety of contractile tissues, perhaps by a general mechanism involving Ca. These complexes are apt to be generally cytotoxic as well.

Necrotizing fasciitis: case series and review of the literature on clinical and medico-legal diagnostic challenges.

PubMed

Fais, Paolo; Viero, Alessia; Viel, Guido; Giordano, Renzo; Raniero, Dario; Kusstatscher, Stefano; Giraudo, Chiara; Cecchetto, Giovanni; Montisci, Massimo

2018-04-07

Necrotizing fasciitis (NF) is a life-threatening infection of soft tissues spreading along the fasciae to the surrounding musculature, subcutaneous fat and overlying skin areas that can rapidly lead to septic shock and death. Due to the pandemic increase of medical malpractice lawsuits, above all in Western countries, the forensic pathologist is frequently asked to investigate post-mortem cases of NF in order to determine the cause of death and to identify any related negligence and/or medical error. Herein, we review the medical literature dealing with cases of NF in a post-mortem setting, present a case series of seven NF fatalities and discuss the main ante-mortem and post-mortem diagnostic challenges of both clinical and forensic interests. In particular, we address the following issues: (1) origin of soft tissue infections, (2) micro-organisms involved, (3) time of progression of the infection to NF, (4) clinical and histological staging of NF and (5) pros and cons of clinical and laboratory scores, specific forensic issues related to the reconstruction of the ideal medical conduct and the evaluation of the causal value/link of any eventual medical error.

Computer-aided diagnosis (CAD) for colonoscopy

NASA Astrophysics Data System (ADS)

Gu, Jia; Poirson, Allen

2007-03-01

Colorectal cancer is the second leading cause of cancer deaths, and ranks third for new cancer cases and cancer mortality for both men and women. However, its death rate can be dramatically reduced by appropriate treatment when early detection is available. The purpose of colonoscopy is to identify and assess the severity of lesions, which may be flat or protruding. Due to the subjective nature of the examination, colonoscopic proficiency is highly variable and dependent upon the colonoscopist's knowledge and experience. An automated image processing system providing an objective, rapid, and inexpensive analysis of video from a standard colonoscope could provide a valuable tool for screening and diagnosis. In this paper, we present the design, functionality and preliminary results of its Computer-Aided-Diagnosis (CAD) system for colonoscopy - ColonoCAD TM. ColonoCAD is a complex multi-sensor, multi-data and multi-algorithm image processing system, incorporating data management and visualization, video quality assessment and enhancement, calibration, multiple view based reconstruction, feature extraction and classification. As this is a new field in medical image processing, our hope is that this paper will provide the framework to encourage and facilitate collaboration and discussion between industry, academia, and medical practitioners.

Rapid degeneration of rod photoreceptors expressing self-association-deficient arrestin-1 mutant

PubMed Central

Song, Xiufeng; Seo, Jungwon; Baameur, Faiza; Vishnivetskiy, Sergey A.; Chen, Qiuyan; Kook, Seunghyi; Kim, Miyeon; Brooks, Evan K.; Altenbach, Christian; Hong, Yuan; Hanson, Susan M.; Palazzo, Maria C.; Chen, Jeannie; Hubbell, Wayne L.; Gurevich, Eugenia V.; Gurevich, Vsevolod V.

2013-01-01

Arrestin-1 binds light-activated phosphorhodopsin and ensures timely signal shutoff. We show that high transgenic expression of an arrestin-1 mutant with enhanced rhodopsin binding and impaired oligomerization causes apoptotic rod death in mice. Dark rearing does not prevent mutant-induced cell death, ruling out the role of arrestin complexes with light-activated rhodopsin. Similar expression of WT arrestin-1 that robustly oligomerizes, which leads to only modest increase in the monomer concentration, does not affect rod survival. Moreover, WT arrestin-1 co-expressed with the mutant delays retinal degeneration. Thus, arrestin-1 mutant directly affects cell survival via binding partner(s) other than light-activated rhodopsin. Due to impaired self-association of the mutant its high expression dramatically increases the concentration of the monomer. The data suggest that monomeric arrestin-1 is cytotoxic and WT arrestin-1 protects rods by forming mixed oligomers with the mutant and/or competing with it for the binding to non-receptor partners. Thus, arrestin-1 self-association likely serves to keep low concentration of the toxic monomer. The reduction of the concentration of harmful monomer is an earlier unappreciated biological function of protein oligomerization. PMID:24012956

Rapid degeneration of rod photoreceptors expressing self-association-deficient arrestin-1 mutant.

PubMed

Song, Xiufeng; Seo, Jungwon; Baameur, Faiza; Vishnivetskiy, Sergey A; Chen, Qiuyan; Kook, Seunghyi; Kim, Miyeon; Brooks, Evan K; Altenbach, Christian; Hong, Yuan; Hanson, Susan M; Palazzo, Maria C; Chen, Jeannie; Hubbell, Wayne L; Gurevich, Eugenia V; Gurevich, Vsevolod V

2013-12-01

Arrestin-1 binds light-activated phosphorhodopsin and ensures timely signal shutoff. We show that high transgenic expression of an arrestin-1 mutant with enhanced rhodopsin binding and impaired oligomerization causes apoptotic rod death in mice. Dark rearing does not prevent mutant-induced cell death, ruling out the role of arrestin complexes with light-activated rhodopsin. Similar expression of WT arrestin-1 that robustly oligomerizes, which leads to only modest increase in the monomer concentration, does not affect rod survival. Moreover, WT arrestin-1 co-expressed with the mutant delays retinal degeneration. Thus, arrestin-1 mutant directly affects cell survival via binding partner(s) other than light-activated rhodopsin. Due to impaired self-association of the mutant its high expression dramatically increases the concentration of the monomer. The data suggest that monomeric arrestin-1 is cytotoxic and WT arrestin-1 protects rods by forming mixed oligomers with the mutant and/or competing with it for the binding to non-receptor partners. Thus, arrestin-1 self-association likely serves to keep low concentration of the toxic monomer. The reduction of the concentration of harmful monomer is an earlier unappreciated biological function of protein oligomerization. © 2013.

Wolff-Parkinson-White syndrome: lessons learnt and lessons remaining.

PubMed

Benson, D Woodrow; Cohen, Mitchell I

2017-01-01

The Wolff-Parkinson-White pattern refers to the electrocardiographic appearance in sinus rhythm, wherein an accessory atrioventricular pathway abbreviates the P-R interval and causes a slurring of the QRS upslope - the "delta wave". It may be asymptomatic or it may be associated with orthodromic reciprocating tachycardia; however, rarely, even in children, it is associated with sudden death due to ventricular fibrillation resulting from a rapid response by the accessory pathway to atrial fibrillation, which itself seems to result from orthodromic reciprocating tachycardia. Historically, patients at risk for sudden death were characterised by the presence of symptoms and a shortest pre- excited R-R interval during induced atrial fibrillation <250 ms. Owing to the relatively high prevalence of asymptomatic Wolff-Parkinson-White pattern and availability of catheter ablation, there has been a need to identify risk among asymptomatic patients. Recent guidelines recommend invasive evaluation for such patients where pre-excitation clearly does not disappear during exercise testing. This strategy has a high negative predictive value only. The accuracy of this approach is under continued investigation, especially in light of other considerations: Patients having intermittent pre-excitation, once thought to be at minimal risk may not be, and the role of isoproterenol in risk assessment.

The public health context of violence in Colombia.

PubMed

Garfield, Richard; Llanten Morales, Claudia Patricia

2004-10-01

Among the countries of the Americas, Colombia has the highest level of deaths due to homicides and armed conflict. The objective of this research was to combine and contrast information from various sources on deaths due to violence in Colombia in order to identify major trends in violence in the country and to compare those trends with those in other nations of the Americas. We drew together information from a wide array of sources, including the Government of Colombia, Colombian forensic institutions, nongovernmental organizations, and international research centers. We considered the impact of the violence on mortality as well as in such areas as nonfatal injuries, displacement of persons, and kidnappings. While there have been many deaths in Colombia directly related to military conflict, there have been many more deaths and injuries as an indirect result of war. The highest levels of deaths directly related to violence occurred during the 1990-1995 period. Although deaths due directly to armed conflict declined in the late 1990s, the related events of kidnappings and displacement did not. Efforts to reduce the violence-related suffering in Colombia must consider both direct and indirect causes of mortality as well as nonfatal outcomes such as kidnappings and displacement.

Trends in external causes of child and adolescent mortality in Poland, 1999-2012.

PubMed

Grajda, Aneta; Kułaga, Zbigniew; Gurzkowska, Beata; Góźdź, Magdalena; Wojtyło, Małgorzata; Litwin, Mieczysław

2017-01-01

To examine the pattern and trend of deaths due to external causes among Polish children and adolescents in 1999-2012, and to compare trends in Poland's neighboring countries. Death records were obtained from the Central Statistical Office of Poland. External causes mortality rates (MR) with 95 % confidence interval were calculated. The annual percentage change of MR was examined using linear regression. To compare MR with Belarus, Ukraine, Czech Republic and Germany, data from the European Mortality Database were used. MR were the highest in the age 15-19 years (33.7/100,000) and among boys (22.7/100,000). Unintentional injuries including transport accidents, drowning, and suicides (especially in children over 10 years old), were the main cause of death in the analyzed groups. Between 1999 and 2012 annual MR for unintentional injuries declined substantially. MR due to injuries and poisoning in Poland were higher compared with Czech Republic and Germany and lower in comparison with Belarus and Ukraine. Deaths due to unintentional injuries are still the leading cause of death among Polish children and adolescents. There are differences in death rates between Poland and neighboring countries.

Road traffic accidents: Global Burden of Disease study, Brazil and federated units, 1990 and 2015.

PubMed

Ladeira, Roberto Marini; Malta, Deborah Carvalho; Morais, Otaliba Libânio de; Montenegro, Marli de Mesquita Silva; Soares, Adauto Martins; Vasconcelos, Cíntia Honório; Mooney, Meghan; Naghavi, Mohsen

2017-05-01

To describe the global burden of disease due to road traffic accidents in Brazil and federated units in 1990 and 2015. This is an analysis of secondary data from the 2015 Global Burden of Disease study estimates. The following estimates were used: standardized mortality rates and years of life lost by death or disability, potential years of life lost due to premature death, and years of unhealthy living conditions. The Mortality Information System was the main source of death data. Underreporting and redistribution of ill-defined causes and nonspecific codes were corrected. Around 52,326 deaths due to road traffic accidents were estimated in Brazil in 2015. From 1990 to 2015, mortality rates decreased from 36.9 to 24.8/100 thousand people, a reduction of 32.8%. Tocantins and Piauí have the highest mortality risks among the federated units (FU), with 41.7/100 and 33.1/100 thousand people, respectively. They both present the highest rates of potential years of life lost due to premature deaths. Road traffic accidents are a public health problem. Using death- or disability-adjusted life years in studies of these causes is important because there are still no sources to know the magnitude of sequelae, as well as the weight of early deaths. Since its data are updated every year, the Global Burden of Disease study may provide evidence to formulate traffic security and health attention policies, which are guided to the needs of the federated units and of different groups of traffic users.

Sudden unexpected death from oligodendroglioma: a case report and review of the literature.

PubMed

Manousaki, Maria; Papadaki, Helen; Papavdi, Asteria; Kranioti, Elena F; Mylonakis, Panagiotis; Varakis, John; Michalodimitrakis, Manolis

2011-12-01

Sudden and unexpected deaths due to asymptomatic 5 primary brain tumors are extremely rare, with an incidence that ranges from 0.16 to 3.2%. Usually, such tumors are glioblastomas or, less commonly, astrocytomas. Asymptomatic oligodendrogliomas causing sudden death are hardly ever reported among medico-legal investigated cases.We report a rare case of sudden and unexpected death from a previously asymptomatic and undiagnosed, well-differentiated, grade II oligodendrogloioma (WHO classification). According to the autopsy and the microscopic findings brain edema as a result of obstruction of the cerebrospinal fluid flow due to hemorrhagic leakage of the oligodendroglioma is incriminated as the most probable physiopathological mechanism for the sudden death. Diagnosis is mainly based on the special microscopic features of the tumor cells (typical "fried-egg" appearance), interrupted by a dense network of branching capillaries. We discuss further the pathophysiological mechanisms of death and present a short review of literature.

Risk and Protective Factors for Cause-Specific Mortality After Spinal Cord Injury.

PubMed

Krause, James S; Cao, Yue; DeVivo, Michael J; DiPiro, Nicole D

2016-10-01

To investigate the association of multiple sets of risk and protective factors (biographic and injury, socioeconomic, health) with cause-specific mortality after spinal cord injury (SCI). Retrospective analysis of a prospectively created cohort. Spinal Cord Injury Model Systems facilities. Adults (N=8157) with traumatic SCI who were enrolled in a model systems facility after 1973 and received follow-up evaluation that included all study covariates (between November 1, 1995 and October 31, 2006). Not applicable. All-cause mortality was determined using the Social Security Death Index as of January 1, 2014. Causes of death were obtained from the National Death Index and classified as infective and parasitic diseases, neoplasms, respiratory system diseases, heart and blood vessel diseases, external causes, and other causes. Competing risk analysis, with time-dependent covariates, was performed with hazard ratios (HRs) for each cause of death. The HRs for injury severity indicators were highest for deaths due to respiratory system diseases (highest HR for injury level C1-4, 4.84) and infective and parasitic diseases (highest HR for American Spinal Injury Association Impairment Scale grade A, 5.70). In contrast, injury level and American Spinal Injury Association Impairment Scale grade were relatively unrelated to death due to neoplasms and external causes. Of the socioeconomic indicators, education and income were significantly predictive of a number of causes of death. Pressure ulcers were the only 1 of 4 secondary health condition indicators consistently related to cause of death. Injury severity was related to mortality due to infective disease and respiratory complications, suggesting that those with the most severe SCI should be targeted for prevention of these causes. Socioeconomic and health factors were more broadly related to a number of causes of death. Intervention strategies that enhance socioeconomic status and health may also result in reduced mortality due to multiple causes. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

20 CFR 718.303 - Death from a respirable disease.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Death from a respirable disease. 718.303... DISABILITY OR DEATH DUE TO PNEUMOCONIOSIS Presumptions Applicable to Eligibility Determinations § 718.303 Death from a respirable disease. (a)(1) If a deceased miner was employed for ten or more years in one or...

20 CFR 718.303 - Death from a respirable disease.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Death from a respirable disease. 718.303... DISABILITY OR DEATH DUE TO PNEUMOCONIOSIS Presumptions Applicable to Eligibility Determinations § 718.303 Death from a respirable disease. (a)(1) If a deceased miner was employed for ten or more years in one or...

A country divided? Regional variation in mortality in Ukraine.

PubMed

Murphy, Adrianna; Levchuk, Nataliia; Stickley, Andrew; Roberts, Bayard; McKee, Martin

2013-12-01

We set out to identify the contribution of various causes of death to regional differences in life expectancy in Ukraine. Mortality data by oblast (province) were obtained from the State Statistical Committee of Ukraine. The contribution of various causes of death to differences in life expectancy between East, West and South Ukraine was estimated using decomposition. In 2008, life expectancy for men in South (61.8 years) and East Ukraine (61.2 years) was lower than for men in West Ukraine (64.0 years). A similar pattern was observed among women. This was mostly due to deaths from infectious disease and external causes among young adults, and cardio- and cerebro-vascular deaths among older adults. Deaths from TB among young adults contribute most to differences in life expectancy. Deaths due to infectious disease, especially TB, play an important role in the gap in life expectancy between regions in Ukraine. These deaths are entirely preventable--further research is needed to identify what has 'protected' individuals in Western Ukraine from the burden of deaths experienced by their Southern and Eastern counterparts.

Cell signaling pathways in the mechanisms of neuroprotection afforded by bergamot essential oil against NMDA-induced cell death in vitro.

PubMed

Corasaniti, M T; Maiuolo, J; Maida, S; Fratto, V; Navarra, M; Russo, R; Amantea, D; Morrone, L A; Bagetta, G

2007-06-01

The effects of bergamot essential oil (BEO; Citrus bergamia, Risso) on excitotoxic neuronal damage was investigated in vitro. The study was performed in human SH-SY5Y neuroblastoma cells exposed to N-methyl-D-aspartate (NMDA). Cell viability was measured by dye exclusion. Reactive oxygen species (ROS) and caspase-3 activity were measured fluorimetrically. Calpain I activity and the activation (phosphorylation) of Akt and glycogen synthase kinase-3beta (GSK-3beta) were assayed by Western blotting. NMDA induced concentration-dependent, receptor-mediated, death of SH-SY5Y cells, ranging from 11 to 25% (0.25-5 mM). Cell death induced by 1 mM NMDA (21%) was preceded by a significant accumulation of intracellular ROS and by a rapid activation of the calcium-activated protease calpain I. In addition, NMDA caused a rapid deactivation of Akt kinase and this preceded the detrimental activation of the downstream kinase, GSK-3beta. BEO (0.0005-0.01%) concentration dependently reduced death of SH-SY5Y cells caused by 1 mM NMDA. In addition to preventing ROS accumulation and activation of calpain, BEO (0.01%) counteracted the deactivation of Akt and the consequent activation of GSK-3beta, induced by NMDA. Results obtained by using specific fractions of BEO, suggested that monoterpene hydrocarbons were responsible for neuroprotection afforded by BEO against NMDA-induced cell death. Our data demonstrate that BEO reduces neuronal damage caused in vitro by excitotoxic stimuli and that this neuroprotection was associated with prevention of injury-induced engagement of critical death pathways.

Marvelous but Morbid: Infective endocarditis due to Serratia marcescens.

PubMed

Phadke, Varun K; Jacob, Jesse T

2016-05-01

A 46-year-old man with HIV infection and active intravenous drug use presented with approximately two weeks of fevers and body aches. On physical examination he was somnolent, had a new systolic murmur, bilateral conjunctival hemorrhages, diffuse petechiae, and left-sided arm weakness. Echocardiography revealed a large mitral valve vegetation and brain imaging demonstrated numerous embolic infarctions. Blood cultures grew Serratia marcescens . Despite aggressive treatment with meropenem the patient died due to intracranial hemorrhage complicated by herniation. Serratia marcescens is an uncommon cause of infective endocarditis. While this disease has historically been associated with intravenous drug use, more recent reports suggest that it is now largely a consequence of opportunistic infections of the chronically ill. Our case highlights several characteristic features of this infection, including isolation of a non-pigmented strain of the organism, an antibiotic susceptibility profile suggestive of AmpC β-lactamase production, and rapid clinical deterioration with multiple embolic complications resulting in death. In this review we discuss the history, epidemiology, and management of endovascular infections due to Serratia spp., emphasizing the continued importance of considering this organism in the differential diagnosis of endocarditis among intravenous drug users and as a potential indication for surgical therapy.

Marvelous but Morbid: Infective endocarditis due to Serratia marcescens

PubMed Central

Phadke, Varun K.; Jacob, Jesse T.

2016-01-01

A 46-year-old man with HIV infection and active intravenous drug use presented with approximately two weeks of fevers and body aches. On physical examination he was somnolent, had a new systolic murmur, bilateral conjunctival hemorrhages, diffuse petechiae, and left-sided arm weakness. Echocardiography revealed a large mitral valve vegetation and brain imaging demonstrated numerous embolic infarctions. Blood cultures grew Serratia marcescens. Despite aggressive treatment with meropenem the patient died due to intracranial hemorrhage complicated by herniation. Serratia marcescens is an uncommon cause of infective endocarditis. While this disease has historically been associated with intravenous drug use, more recent reports suggest that it is now largely a consequence of opportunistic infections of the chronically ill. Our case highlights several characteristic features of this infection, including isolation of a non-pigmented strain of the organism, an antibiotic susceptibility profile suggestive of AmpC β-lactamase production, and rapid clinical deterioration with multiple embolic complications resulting in death. In this review we discuss the history, epidemiology, and management of endovascular infections due to Serratia spp., emphasizing the continued importance of considering this organism in the differential diagnosis of endocarditis among intravenous drug users and as a potential indication for surgical therapy. PMID:27346925

Rapid brain death caused by a cerebellar abscess with Fusobacterium nucleatum in a young man with drug abuse: a case report

PubMed Central

2014-01-01

Background Fusobacterium nucleatum is a strict anaerobic microorganism that causes disease entities such as periodontal and soft tissue abscesses, pulmonary and intraabdominal infections and very rarely intracerebral infections. Case presentation Here, we report the rare case of a previously healthy 25-year-old German man with a cerebellar abscess caused by Fusobacterium nucleatum that resulted in rapid brain death. Toxicological screening showed positivity for amphetamines and cannabis. The diagnosis was obtained by polymerase chain reaction amplification of bacterial deoxyribonucleic acid in cerebrospinal fluid. Conclusions In drug users clinicians should think about rare causes of brain abscesses/meningitis. Early diagnosis is necessary and justifies the use of molecular techniques. PMID:24915846

Hyperleucocytosis in paediatric acute myeloid leukaemia - the challenge of white blood cell counts above 200 × 109 /l. The NOPHO experience 1984-2014.

PubMed

Zeller, Bernward; Glosli, Heidi; Forestier, Erik; Ha, Shau-Yin; Jahnukainen, Kirsi; Jónsson, Ólafur G; Lausen, Birgitte; Palle, Josefine; Hasle, Henrik; Abrahamsson, Jonas

2017-08-01

Hyperleucocytosis in paediatric acute myeloid leukaemia (AML) is associated with increased morbidity and mortality. We studied hyperleucocytosis in 890 patients with AML aged 0-18 years registered in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) registry, with special focus on very high white blood cell counts (WBC >200 × 10/l). Eighty-six patients (10%) had WBC 100-199 × 10 9 /l and 57 (6%) had WBC ≥200 × 10 9 /l. Patients with WBC ≥200 × 10 9 /l had a high frequency of t(9;11) and a paucity of trisomy 8. Due to the high frequency of deaths within the first 2 weeks (30% vs. 1% for all others), overall survival in this group was inferior to patients with WBC <200 × 10 9 /l (39% vs. 61%). Main cause of early death was intracranial haemorrhage and leucostasis. Twenty-six per cent of these patients never started antileukaemic protocol therapy. Leukapheresis or exchange transfusion was used in 24% of patients with hyperleucocytosis without impact on survival. Patients with hyperleucocytosis surviving the first week had identical survival as patients with lower WBC. We conclude that death within the first days after diagnosis is the major challenge in patients with high WBC and advocate rapid initiation of intensive chemotherapy. © 2017 John Wiley & Sons Ltd.

Intrapartum anti-disseminated intravascular coagulation therapy leading to successful vaginal delivery following intrauterine fetal death caused by placental abruption: a case report.

PubMed

Honda, Michiko; Matsunaga, Shigetaka; Era, Sumiko; Takai, Yasushi; Baba, Kazunori; Seki, Hiroyuki

2014-12-23

Disseminated intravascular coagulation due to placental abruption with intrauterine fetal death is not uncommon. It can result in increased maternal mortality rates and the need for hysterectomy or greater transfusion volumes if the delivery is not completed within six to eight hours. However, consensus is lacking regarding the delivery approach for cases in which delivery is prolonged. A 37-year-old Japanese woman was transported to our tertiary center two and a half hours after the onset of labor because of a diagnosis of placental abruption with intrauterine fetal death at 40 weeks and three days' gestation. On arrival, although severe hypofibrinogenemia was observed, there was no external hemorrhage. Because her cervical canal dilation was good (Bishop score, 7), labor was induced using oxytocin. Anti-disseminated intravascular coagulation therapy was simultaneously started via transfusion. After her hypofibrinogenemia resolved, delivery progressed rapidly, and the fetus was delivered approximately 10 hours after the onset. To reduce postpartum hemorrhage, 6g of fibrinogen concentrate and tranexamic acid, an antifibrinolytic agent, were administered immediately before extraction of the dead fetus and placenta. Although the amount of intrapartum hemorrhage was 1824g, there was no abnormal bleeding after delivery, and our patient was discharged three days later. In cases of placental abruption complicated with disseminated intravascular coagulation, intrapartum administration of coagulation factors can simultaneously promote effective labor and correct hypofibrinogenemia, enabling minimally invasive vaginal delivery.

An overview of research advances in road traffic trauma in China.

PubMed

Wang, Zhengguo; Jiang, Jianxin

2003-03-01

With rapid development of social economies, road traffic accidents (RTAs) have continued to increase, and have become the "primary public hazard" to humans. Road traffic trauma (RTT) is a major cause of death in young people of all motorized countries. This article reviews the current advances in RTT research, in order to find some approaches to improving traffic administration and reducing RTAs and RTT. All available data were collected from government, literature, our own research, and conference proceedings. Statistical analysis from every country showed that human factors were still the main cause of RTAs, accounting for more than 90%. Vehicle and road factors caused 3-5% and less than 2% of the total RTAs, respectively. Approximately 85% of RTAs were caused by 21 to 45-year-olds. About 50% of deaths due to RTAs in the United States were related to drinking. In China, RTAs due to driver drinking accounted for 0.29-1.48%. About 6-8% of drivers were prone to RTA, causing 30-40% of RTAs. Seat belts are an effective way to prevent casualties, reducing mortality and morbidity by 13-50%. In China, about 70% of RTAs were related to bicycles. Prehospital emergency treatment is very important. About 35% of deaths may be avoided if the injured receive early and effective treatment. From 1983 to 1992 the mortality of RTT increased by 13% in 18 developing countries, while it decreased by 18% in 13 developed countries, indicating the importance of comprehensive treatment of traffic administration. In addition many advances have been made in basic scientific research of RTT, such as development of serial bioimpact machines and investigation of biomechanical and biochemical mechanisms of impact injuries. In this century, RTAs and RTT are predicted to continue to increase in many countries, especially in developing ones. Full cooperation and comprehensive treatment should be performed in order to improve traffic safety.

Standard expected years of life lost due to tuberculosis in Poland.

PubMed

Bryła, M; Dziankowska-Zaborszczyk, E; Maniecka-Bryła, I

2017-02-01

Central European countries such as Poland have higher tuberculosis (TB) morbidity and mortality than Western European Union countries. To evaluate changes in mortality due to TB during the period 1999-2012 in Poland and years of life lost due to the disease. Information obtained from 5 219 205 death certificates in Poland during the period 1999-2012 was used for the study. Crude (CDRs) and standardised (SDRs) death rates due to TB were analysed. Standard expected years of life lost per living person (SEYLLp) was also calculated. In Poland, TB and related complications contributed 0.23% of total deaths from 1999 to 2012. The SEYLLp was 3.46 per 10 000 population in 1999 and 1.88 in 2012. It was respectively 5.75 and 3.12 for males, and 1.31 and 0.72 for females. The SEYLLp index decreased over the period (annual per cent change [APC] -4.27%, P < 0.05); the decrease was greater in females than in males (APC -4.75%, P < 0.05 vs. APC -4.15%, P < 0.05). Despite an improvement in the epidemiological situation, TB remains the most common single cause of death due to an infectious agent in Poland.

Risk factors for mortality in landslide- and flood-affected populations in Uganda.

PubMed

Agrawal, Shreya; Gorokhovich, Yuri; Doocy, Shannon

2013-01-01

Assess mortality risk factors including age, sex, and disaster type, in the March 2010 floods and landslides in Eastern Uganda and to compare time period, cause, location, and receipt of medical care among landslide and flood fatalities. A stratified cluster survey was conducted of 802 affected households in community and camp locations. Flood and landslide affected populations in the East Uganda the districts of Baduda and Butaleja. Adult household members in 802 households were surveyed regarding household member deaths in the floods and landslides areas. The primary outcome measure was the odds of death associated with age, sex, and disaster type (flood or landslide). The secondary outcome measure was the odds of event (landslide or flood) among fatalities associated with sex, age, time period of death, and cause of death. The odds of death were significantly higher in landslide affected populations than in flood affected populations (OR 3.06, 95% CI 2.20-4.25, p < 0.001). Time period of death (p = 0.016), type of death (p < 0.001), death after seeking medical care (p = 0.033), month of death (p < 0.001), and cause of death (p < 0.001) were significantly associated with increased odds of death due to landslides as compared to floods. More deaths occurred due to landslides than floods, and landslide deaths were more immediate, with a majority occurring on the day of the event. Females and younger age groups faced a greater risk of death from the landslide than the flood.

Toddler run-overs--a persistent problem.

PubMed

Byard, Roger W; Jensen, Lisbeth L

2009-05-01

Trauma accounts for a high percentage of unexpected deaths in toddlers and young children, mostly due to vehicle accidents, drowning and fires. Given recent efforts to publicise the dangers of toddler run-overs a study was undertaken to determine how significant this problem remains in South Australia. Review of coronial files over 7 years from 2000 to 2006 revealed 50 cases of sudden and unexpected death in children aged between 1 and 3 years of which 12 of 28 accidents involved motor vehicles (6 run-overs and 6 passengers). The 6 children who were killed by vehicle run-overs were aged from 12 months to 22 months (ave=16.8 months) with a male to female ratio of 1:1. Four deaths occurred with reversing vehicles in home driveways and one at a community centre. The remaining death involved a child being run over at the beach by a forward moving vehicle. Vehicles included sedans in four cases and a four-wheel drive in one case (one vehicle was not described), and were driven by the victim's parent in four cases, a friend of the family in one, and an unrelated person in the final case. Deaths were all due to blunt cranial trauma. Despite initiatives to prevent these deaths, toddler run-overs in South Australia approximate the number of sudden deaths due to homicides, drownings and natural diseases, respectively, for the same age group; deaths are also occurring in places other than home driveways, and sedans were more often involved than four-wheel drive vehicles.

Population-based estimate of trauma-related deaths for law enforcement personnel: Risks for death are higher and increasing over time.

PubMed

Eastman, Alexander L; Cripps, Michael W; Abdelfattah, Kareem R; Inaba, Kenji; Weiser, Thomas G; Spain, David A; Staudenmayer, Kristan L

2017-08-01

Trauma-related deaths remain an important public health problem. One group susceptible to death due to traumatic mechanisms is US law enforcement (LE). We hypothesized that LE officers experienced a higher chance of violent death compared with the general US population and that risks have increased over time. The National Institute on Occupational Safety and Health National Occupational Mortality Surveillance is a population-based survey of occupational deaths. It includes data for workers who died during 1985 to 1998 in one of 30 US states (EARLY period). Additional deaths were added from 23 US states in 1999, 2003 to 2004, 2007 to 2010 (LATE period). Mortality rates are estimated by calculating proportionate mortality ratios (PMR). A PMR above 100 is considered to exceed the average background risk for all occupations. All adults older than 18 years whose primary occupation was listed as "law enforcement worker" were included in the analysis. Law enforcement personnel were more likely to die from an injury compared with the general population (Fig. 1). The overall PMR for injury in EARLY was 111 (95% confidence interval [CI], 108-114; p < 0.01), and for LATE was 118 (95% CI, 110-127; p < 0.01). Four mechanisms of death reached statistical significance: motor vehicle traffic (MVT)-driver, MVT-other, intentional self-harm, and assault/homicide. The highest PMR in EARLY was associated with firearms (PMR, 272; 95% CI, 207-350; p < 0.01). The highest PMR in LATE was associated with death due to being a driver in an MVT (PMR, 194; 95% CI, 169-222; p < 0.01). There were differences in risk of death by race and sex. White females had the highest PMR due to assault and homicide (PMR, 317; 95% CI, 164-554; p < 0.01). All groups had similar risks of death due to intentional self-harm (PMR, 130-171). The risk of death for US LE officers is high and increasing over time, suggesting an at-risk population that requires further interventions. Targeted efforts based on risk factors, such as sex and race, may assist with the development of prevention programs for this population. Epidemiologic study, level II.

Trends in Causes of Adult Deaths among the Urban Poor: Evidence from Nairobi Urban Health and Demographic Surveillance System, 2003-2012.

PubMed

Mberu, Blessing; Wamukoya, Marylene; Oti, Samuel; Kyobutungi, Catherine

2015-06-01

What kills people around the world and how it varies from place to place and over time is critical in mapping the global burden of disease and therefore, a relevant public health question, especially in developing countries. While more than two thirds of deaths worldwide are in developing countries, little is known about the causes of death in these nations. In many instances, vital registration systems are nonexistent or at best rudimentary, and even when deaths are registered, data on the cause of death in particular local contexts, which is an important step toward improving context-specific public health, are lacking. In this paper, we examine the trends in the causes of death among the urban poor in two informal settlements in Nairobi by applying the InterVA-4 software to verbal autopsy data. We examine cause of death data from 2646 verbal autopsies of deaths that occurred in the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) between 1 January 2003 and 31 December 2012 among residents aged 15 years and above. The data is entered into the InterVA-4 computer program, which assigns cause of death using probabilistic modeling. The results are presented as annualized trends from 2003 to 2012 and disaggregated by gender and age. Over the 10-year period, the three major causes of death are tuberculosis (TB), injuries, and HIV/AIDS, accounting for 26.9, 20.9, and 17.3% of all deaths, respectively. In 2003, HIV/AIDS was the highest cause of death followed by TB and then injuries. However, by 2012, TB and injuries had overtaken HIV/AIDS as the major causes of death. When this is examined by gender, HIV/AIDS was consistently higher for women than men across all the years generally by a ratio of 2 to 1. In terms of TB, it was more evenly distributed across the years for both males and females. We find that there is significant gender variation in deaths linked to injuries, with male deaths being higher than female deaths by a ratio of about 4 to 1. We also find a fifteen percentage point increase in the incidences of male deaths due to injuries between 2003 and 2012. For women, the corresponding deaths due to injuries remain fairly stable throughout the period. We find cardiovascular diseases as a significant cause of death over the period, with overall mortality increasing steadily from 1.6% in 2003 to 8.1% in 2012, and peaking at 13.7% in 2005 and at 12.0% in 2009. These deaths were consistently higher among women. We identified substantial variations in causes of death by age, with TB, HIV/AIDS, and CVD deaths lowest among younger residents and increasing with age, while injury-related deaths are highest among the youngest adults 15-19 and steadily declined with age. Also, deaths related to neoplasms and respiratory tract infections (RTIs) were prominent among older adults 50 years and above, especially since 2005. Emerging at this stage is evidence that HIV/AIDS, TB, injuries, and cardiovascular disease are linked to approximately 73% of all adult deaths among the urban poor in Nairobi slums of Korogocho and Viwandani in the last 10 years. While mortality related to HIV/AIDS is generally declining, we see an increasing proportion of deaths due to TB, injuries, and cardiovascular diseases. In sum, substantial epidemiological transition is ongoing in this local context, with deaths linked to communicable diseases declining from 66% in 2003 to 53% in 2012, while deaths due to noncommunicable causes experienced a four-fold increase from 5% in 2003 to 21.3% in 2012, together with another two-fold increase in deaths due to external causes (injuries) from 11% in 2003 to 22% in 2012. It is important to also underscore the gender dimensions of the epidemiological transition clearly visible in the mix. Finally, the elevated levels of disadvantage of slum dwellers in our analysis relative to other population subgroups in Kenya continue to demonstrate appreciable deterioration of key urban health and social indicators, highlighting the need for a deliberate strategic focus on the health needs of the urban poor in policy and program efforts toward achieving international goals and national health and development targets.

Mechanism of eliciting host immunity against cancer cells treated with silica-phthalocyanine-based near infrared photoimmunotherapy (Conference Presentation)

NASA Astrophysics Data System (ADS)

Kobayashi, Hisataka

2016-03-01

Near infrared (NIR) photoimmunotherapy (PIT) is a new type of molecularly-targeted cancer photo-therapy based on conjugating a near infrared silica-phthalocyanine dye, IR700, to a monoclonal antibody (MAb) targeting cancer-specific cell-surface molecules. When exposed to NIR light, the conjugate induces a highly-selective necrotic/ immunogenic cell death (ICD) only in receptor-positive, MAb-IR700-bound cancer cells. This cell death occurs as early as 1 minute after exposure to NIR light. Meanwhile, immediately adjacent receptor-negative cells including immune cells are unharmed. Therefore, we hypothesized that NIR-PIT could efficiently elicit host immunity against treated cancer cells. Three-dimensional dynamic quantitative phase contrast microscopy and selective plane illumination microscopy of tumor cells undergoing PIT showed rapid swelling in treated cells immediately after light exposure suggesting rapid water influx into cells, followed by irreversible morphologic changes such as bleb formation, and rupture of vesicles. Furthermore, biological markers of ICD including relocation of HSP70/90 and calreticulin, and release of ATP and High Mobility Group Box 1 (HMGB1), were clearly detected immediately after NIR-PIT. When NIR-PIT was performed in a mixture of cancer cells and immature dendritic cells, maturation of immature dendritic cells was strongly induced rapidly after NIR-PIT. In summary, NIR-PIT can induce necrotic/ immunogenic cell death that promotes rapid maturation of immature dendritic cells adjacent to dying cancer cells. Therefore, NIR-PIT could efficiently initiate host immune response against NIR-PIT treated cancer cells growing in patients.

Investigation of fatalities due to acute gasoline poisoning.

PubMed

Martínez, María A; Ballesteros, Salomé

2005-10-01

This paper presents a simple, rapid, reliable, and validated method suited for forensic examination of gasoline in biological samples. The proposed methodology has been applied to the investigation of four fatal cases due to gasoline poisoning that occurred in Spain in 2003 and 2004. Case histories and pathological and toxicological findings are described in order to illustrate the danger of gasoline exposure under several circumstances. Gasoline's tissular distribution, its quantitative toxicological significance, and the possible mechanisms leading to death are also discussed. The toxicological screening and quantitation of gasoline was performed by means of gas chromatography (GC) with flame-ionization detection, and confirmation was performed using GC-mass spectrometry in total ion chromatogram mode. m,p-Xylene peak was selected to estimate gasoline in all biological samples. Gasoline analytical methodology was validated at five concentration levels from 1 to 100 mg/L. The method provided extraction recoveries between 77.6% and 98.3%. The limit of detection was 0.3 mg/L, and the limit of quantitation was 1.0 mg/L. The linearity of the blood calibration curves was excellent with r2 values of > 0.997. Intraday and interday precisions had a coefficient of variation < or = 5.4% in all cases. Cases 1 and 2 consist of the accidental inhalation of gasoline vapor inside a small enclosed space. Case 3 is a death by recreational gasoline inhalation in a male adolescent. Heart blood concentrations were 28.4, 18.0, and 38.3 mg/L, respectively; liver concentrations were 41.4, 52.9, and 124.2 mg/kg, respectively; and lung concentrations were 5.6, 8.4, and 39.3 mg/kg, respectively. Case 4 was an accidental death due to gasoline ingestion of a woman with senile dementia. Peripheral blood concentration was 122.4 mg/L, the highest in our experience. Because pathological findings were consistent with other reports of gasoline intoxication and constituents of gasoline were found in the body, cause of death was attributed to acute gasoline intoxication. As a rule, this kind of poisoning offers little difficulty in diagnosis because there is a history of exposure, and the odor usually clings to the clothes, skin, or gastric contents. However, anatomic autopsy findings will be nonspecific and therefore toxicological analysis is necessary. There is a paucity of recent references regarding analytical and toxicological data, and this article provides evidence about toxic concentrations and is a useful adjunct to the postmortem toxicological interpretation of fatalities if the decedent has been involved in gasoline use.

[Time trend study of firearm mortality in Argentina, 1980-2012].

PubMed

Spinelli, Hugo; Santoro, Adrián; Guevel, Carlos; Alazraqui, Marcio

2015-06-01

This work analyzes the impact of firearm mortality between 1980 and 2012 in Argentina. For this purpose a descriptive epidemiological time trend study was carried out including the following variables: sex, age group, intentionality and jurisdiction. Data was obtained from the Office of Health Statistics and Information of the Argentine Ministry of Health. A total of 87,671 deaths due to firearms were discovered, of which 85.7% occurred in men. The highest mortality rate due to firearms corresponded to the year 2002, reaching 21.2 deaths per 100,000 inhabitants. The age group concentrating the largest number of deaths due to firearms was that of 20-29 years, accounting for 25.6% of all deaths. The highest adjusted rates corresponded to the years 2000-2002, with values of 10.0 to 11.6 deaths per 100,000 inhabitants. This time period coincides with the institutional-economic crisis the country experienced. The province of Buenos Aires was the place of residence of 49.1% of the deceased. In the discussion, political-economic and ideological-cultural dimensions of the relations among firearms, violence, science and society are considered.

Associations between HIV, highly active anti-retroviral therapy, and hypertensive disorders of pregnancy among maternal deaths in South Africa 2011-2013.

PubMed

Sebitloane, Hannah M; Moodley, Jagidesa; Sartorius, Benn

2017-02-01

To explore potential relationships between HIV and highly active anti-retroviral therapy (HAART), and hypertensive disorders of pregnancy (HDP). A retrospective secondary analysis of maternal-deaths data from the 2011-2013 Saving Mothers Report from South Africa. The incidence of HIV infection amongst individuals who died owing to HDP was determined and comparisons were made based on HIV status and the use of HAART. Among 4452 maternal deaths recorded in the Saving Mothers report, a lower risk of a maternal deaths being due to HDP was observed among women who had HIV infections compared with women who did not have HIV (relative risk [RR] 0.57, 95% confidence interval [CI] 0.51-0.64). Further, reduced odds of death being due to HDP were recorded among women with AIDS not undergoing HAART compared with women with HIV who did not require treatment (RR 0.42, 95% CI 0.3-0.58). Notably, among all women with AIDS, a greater risk of death due to HDP was demonstrated among those who received HAART compared with those who did not (RR 1.15, 95% CI 1.02-1.29). HIV and AIDS were associated with a decreased risk of HDP being the primary cause of death; the use of HAART increased this risk. © 2016 International Federation of Gynecology and Obstetrics.

[Real-time PCR in rapid diagnosis of Aeromonas hydrophila necrotizing soft tissue infections].

PubMed

Kohayagawa, Yoshitaka; Izumi, Yoko; Ushita, Misuzu; Niinou, Norio; Koshizaki, Masayuki; Yamamori, Yuji; Kaneko, Sakae; Fukushima, Hiroshi

2009-11-01

We report a case of rapidly progressive necrotizing soft tissue infection and sepsis followed by a patient's death. We suspected Vibrio vulnificus infection because the patient's underlying disease was cirrhosis and the course extremely rapid. No microbe had been detected at death. We extracted DNA from a blood culture bottle. SYBR green I real-time PCR was conducted but could not detect V. vulnificus vvh in the DNA sample. Aeromonas hydrophila was cultured and identified in blood and necrotized tissue samples. Real-time PCR was conducted to detect A. hydrophila ahh1, AHCYTOEN and aerA in the DNA sample extracted from the blood culture bottle and an isolated necrotized tissue strain, but only ahh1 was positive. High-mortality in necrotizing soft tissue infections makes it is crucial to quickly detect V. vulnificus and A. hydrophila. We found real-time PCR for vvh, ahh1, AHCYTOEN, and aerA useful in detecting V. vulnificus and A. hydrophila in necrotizing soft tissue infections.

Missed Opportunities in Neonatal Deaths in Rwanda: Applying the Three Delays Model in a Cross-Sectional Analysis of Neonatal Death.

PubMed

Wilmot, Efua; Yotebieng, Marcel; Norris, Alison; Ngabo, Fidele

2017-05-01

Objective Administered in a timely manner, current evidence-based interventions could reduce neonatal deaths from infections, intrapartum injuries and complications due to prematurity. The three delays model (delay in seeking care, in arriving at a health facility, and in receiving adequate care), which has been applied to understanding maternal deaths, may be useful for understanding neonatal deaths. We assess the main causes of neonatal deaths in Rwanda and their associated delays. Methods Using a cross-sectional study design, we evaluated data from 2012 from 40 facilities in which babies were delivered. Audit committees in each facility reviewed each neonatal death in the facility and reported finding to the Ministry of Health using structured questionnaires. Information from questionnaires were centralized in an electronic database. At the end of 2012, records from 40 health facilities across Rwanda's five provinces (mainly district hospitals) were available in the database and were used for this analysis. Results Of the 1324 neonates, the major causes of death were: asphyxia and its complications (36.7%), lower respiratory tract infections (LRTI) (22.5%), and prematurity (22.4%). At least one delay was experienced by nearly three-quarters of neonates: Maternal Delay in Seeking Care 22.1%, Maternal Delay in Arrival to Care 11.2%, Maternal Delay in Adequate Care 14.2%, Neonatal Delay in Seeking Care 8.1%, Neonatal Delay in Arrival to Care 9.3%, and Neonatal Delay in Adequate Care 29.1%. Neonates with each of the main causes of death had statistically significantly increased odds of experiencing Maternal Delay in Seeking Care. Asphyxia deaths had increased odds of experiencing all three Maternal Delays. LRTI deaths had increased odds of all three Neonatal Delays. Conclusion Delays for women in seeking obstetrical care is a critical factor associated with the main causes of neonatal death in Rwanda. Improving obstetrical care quality could reduce neonatal deaths due to asphyxia. Likewise, reducing all three delays could reduce neonatal deaths due to LRTI.

Epidemiological transition in a rural community of northern India: 18-year mortality surveillance using verbal autopsy.

PubMed

Kumar, Rajesh; Kumar, Dinesh; Jagnoor, J; Aggarwal, Arun K; Lakshmi, P V M

2012-10-01

Information on causes of death is vital for planning of health services. However, vital events registration systems are weak in developing countries. Therefore, verbal autopsy (VA) tools were incorporated in a community-based surveillance system to track causes of death. Trained fieldworker identified all deaths and interviewed a living relative of those who had died during 1992-2009, using VA, in eight villages of Haryana (11,864 populations). These field reports detailing events preceding death were reviewed by two trained physicians, who independently assigned an International Classification of Disease-10 code to each death. Discrepancies were resolved through reconciliation and, if necessary, adjudication. Non-communicable conditions were the leading causes of death (47.6%) followed by communicable diseases including maternal, perinatal and nutritional conditions (34.0%), and injuries (11.4%). Cause of death could not be determined in 6.9% cases. Deaths due to cardiovascular diseases showed a significant rise, whereas deaths due to diarrhoeal diseases have declined (p<0.01). Majority (90.0%) of the deceased had contacted a healthcare provider during illness but only 11.5% were admitted in hospital before death. Rising trend of cardiovascular diseases observed in a rural community of Haryana in India calls for reorientation of rural healthcare delivery system for prevention and control of chronic diseases.

Bacterial Associates Modify Growth Dynamics of the Dinoflagellate Gymnodinium catenatum

PubMed Central

Bolch, Christopher J. S.; Bejoy, Thaila A.; Green, David H.

2017-01-01

Marine phytoplankton cells grow in close association with a complex microbial associate community known to affect the growth, behavior, and physiology of the algal host. The relative scale and importance these effects compared to other major factors governing algal cell growth remain unclear. Using algal-bacteria co-culture models based on the toxic dinoflagellate Gymnodinium catenatum, we tested the hypothesis that associate bacteria exert an independent effect on host algal cell growth. Batch co-cultures of G. catenatum were grown under identical environmental conditions with simplified bacterial communities composed of one-, two-, or three-bacterial associates. Modification of the associate community membership and complexity induced up to four-fold changes in dinoflagellate growth rate, equivalent to the effect of a 5°C change in temperature or an almost six-fold change in light intensity (20–115 moles photons PAR m-2 s-1). Almost three-fold changes in both stationary phase cell concentration and death rate were also observed. Co-culture with Roseobacter sp. DG874 reduced dinoflagellate exponential growth rate and led to a more rapid death rate compared with mixed associate community controls or co-culture with either Marinobacter sp. DG879, Alcanivorax sp. DG881. In contrast, associate bacteria concentration was positively correlated with dinoflagellate cell concentration during the exponential growth phase, indicating growth was limited by supply of dinoflagellate-derived carbon. Bacterial growth increased rapidly at the onset of declining and stationary phases due to either increasing availability of algal-derived carbon induced by nutrient stress and autolysis, or at mid-log phase in Roseobacter co-cultures potentially due to the onset of bacterial-mediated cell lysis. Co-cultures with the three bacterial associates resulted in dinoflagellate and bacterial growth dynamics very similar to more complex mixed bacterial community controls, suggesting that three-way co-cultures are sufficient to model interaction and growth dynamics of more complex communities. This study demonstrates that algal associate bacteria independently modify the growth of the host cell under non-limiting growth conditions and supports the concept that algal–bacterial interactions are an important structuring mechanism in phytoplankton communities. PMID:28469613

When the Simulator Dies: Experiential Education about Death Designed for Undergraduate Nursing Students

ERIC Educational Resources Information Center

Foltz-Ramos, Kelly

2017-01-01

Background and Objectives: Graduates from undergraduate nursing programs report inadequate death education. Most death education is focused on end-of-life care and taught by lecture. Students are not provided opportunities to reflect on their own feelings about death. Due to lack of clinical nursing faculty and shortage of clinical sites, students…

20 CFR 335.5 - Death of employee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Death of employee. 335.5 Section 335.5... SICKNESS BENEFITS § 335.5 Death of employee. If an employee dies before filing one or more of the required... due but unpaid as of the date of an employee's death is the same as the order of distribution for...

Spontaneous apoptotic DNA fragmentation in cultured guinea pig gastric mucosal cells.

PubMed

Tsutsumi, S; Rokutan, K; Tsuchiya, T; Mizushima, T

2000-02-01

The purpose of this study was to elucidate the mechanism of spontaneous and rapid cell death of cultured gastric pit cells. Gastric pit cells have a rapid cell turnover rate in vivo. We here show that guinea pig gastric pit cells in culture undergo spontaneous and rapid apoptotic DNA fragmentation, which may represent the rapid cell turnover cycle of gastric pit cells in vivo. This spontaneous apoptotic DNA fragmentation required the presence of fetal calf serum in the culture media. Furthermore, the spontaneous apoptotic DNA fragmentation was prevented by protein synthesis and caspase inhibitors.

Declining death rates from hyperglycemic crisis among adults with diabetes, U.S., 1985-2002.

PubMed

Wang, Jing; Williams, Desmond E; Narayan, K M Venkat; Geiss, Linda S

2006-09-01

To examine trends in death rates for hyperglycemic crisis (diabetic ketoacidosis or hyperglycemic hyperosmolar state) among adults with diabetes in the U.S. from 1985 to 2002. Deaths with hyperglycemic crisis as the underlying cause were identified from national mortality data. Death rates were calculated using estimates of adults with diabetes from the National Health Interview Survey as the denominator and age adjusted to the 2000 U.S. population. The trends from 1985 to 2002 were tested using joinpoint regression analysis. Deaths due to hyperglycemic crisis dropped from 2,989 in 1985 to 2,459 in 2002. During the time period, age-adjusted death rates decreased from 42.4 to 23.8 per 100,000 adults with diabetes (4.4% decrease per year, P for trend <0.01). Death rates declined in all age-groups, with the greatest decrease occurring among individuals aged > or =65 years. Age-adjusted death rates fell for all race-sex subgroups, with black men experiencing the smallest decline. About one-fifth of deaths occurred at home or on arrival at the hospital, and the death rates for hyperglycemic crisis occurring at these places declined only modestly over time (2.1% decrease per year, P for trend = 0.049). Overall death rates due to hyperglycemic crisis among adults with diabetes have declined in the U.S. However, scope for further improvement remains, especially to further reduce death rates among black men and to prevent deaths occurring at home.

Medico legal investigations into sudden sniffing deaths linked with trichloroethylene.

PubMed

Da Broi, Ugo; Colatutto, Antonio; Sala, Pierguido; Desinan, Lorenzo

2015-08-01

Sudden deaths attributed to sniffing trichloroethylene are caused by the abuse of this solvent which produces pleasant inebriating effects with rapid dissipation. In the event of repeated cycles of inhalation, a dangerous and uncontrolled systemic accumulation of trichloroethylene may occur, followed by central nervous system depression, coma and lethal cardiorespiratory arrest. Sometimes death occurs outside the hospital environment, without medical intervention or witnesses and without specific necroscopic signs. Medico legal investigations into sudden sniffing deaths associated with trichloroethylene demand careful analysis of the death scene and related circumstances, a detailed understanding of the deceased's medical history and background of substance abuse and an accurate evaluation of all autopsy and laboratory data, with close cooperation between the judiciary, coroners and toxicologists. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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

PubMed

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

2018-01-01

Since March, 2011, the Syrian civil war has lowered life expectancy by as much as 20 years. We describe demographic, spatial, and temporal patterns of direct deaths of civilians and opposition combatants from conflict-related violence in 6 years of war. We analysed conflict-related violent deaths with complete information on date, place, and cause of death and demographic group occurring from March 18, 2011, to Dec 31, 2016, recorded by the Violation Documentation Center (VDC). We included civilian and combatant deaths in all Syrian governorates, excluding government-controlled areas. We did not include detainees and missing persons, nor deaths from siege conditions or insufficient medical care. We categorised deaths based on VDC weapon type. We used χ 2 testing to compare deaths from different weapons in civilian men, women, boys, and girls and adult and child combatants. We analysed deaths by governorate and over time. The VDC recorded 143 630 conflict-related violent deaths with complete information between March 18, 2011, and Dec 31, 2016. Syrian civilians constituted 101 453 (70·6%) of the deaths compared with 42 177 (29·4%) opposition combatants. Direct deaths were caused by wide-area weapons of shelling and air bombardments in 58 099 (57·3%) civilians, including 8285 (74·6%) civilian women and 13 810 (79·4%) civilian children, and in 4058 (9·6%) opposition combatants. Proportions of children among civilian deaths increased from 8·9% (388 of 4254 civilian deaths) in 2011 to 19·0% (4927 of 25 972) in 2013 and to 23·3% (2662 of 11 444) in 2016. Of 7566 deaths from barrel bombs, 7351 (97·2%) were civilians, of whom 2007 (27·3%) were children. Of 20 281 deaths by execution, 18 747 (92·4%) were civilians and 1534 (7·6%) were opposition combatants. Compared with opposition child soldiers who were male (n=333), deaths of civilian male children (n=11 730) were caused more often by air bombardments (39·2% vs 5·4%, p<0·0001) and shelling (37·3% vs 13·2%, p<0·0001) and less often by shooting (12·5% vs 76·0%, p<0·0001). Aerial bombing and shelling rapidly became primary causes of direct deaths of women and children and had disproportionate lethal effects on civilians, calling into question the use of wide-area explosive weapons in urban areas. Increased reliance on aerial bombing by the Syrian Government and international partners is likely to have contributed to findings that children were killed in increasing proportions over time, ultimately comprising a quarter of civilian deaths in 2016. The inordinate proportion of civilians among the executed is consistent with deliberate tactics to terrorise civilians. Deaths from barrel bombs were overwhelmingly civilian rather than opposition combatants, suggesting indiscriminate or targeted warfare contrary to international humanitarian law and possibly constituting a war crime. None. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Acetaminophen overdose

MedlinePlus

... overdose, there is a very good chance of recovery. However, without rapid treatment, a very large overdose of acetaminophen can lead to liver failure and death in a few days. Alternative Names ...

[Motor vehicle crash fatalities at 30 days in Spain].

PubMed

Pérez, Katherine; Pérez, Catherine; Cirera, Eva; Borrell, Carme; Plasencia, Antoni

2006-01-01

To assess level of fulfillment and utility of the hospital discharge register (HDR) as a complementary source of information for estimating the number of deaths at 30 days due to motor vehicle crashes in Spain. It is a cross-sectional study were we compared the number of people injured due to motor vehicle crashes hospitalised in a public hospital (HDR), in Spain during 2001, with the number of people severely injured or killed due to motor vehicle crashes reported by the police database (Dirección General de Tráfico, DGT) for the same year. A descriptive analysis was carried out by age, sex and region (Autonomous Community), as well as an estimation of the percentage of under-reporting of deaths by the DGT based on two assumptions. Police reported 27,272 severe injuries and 4,811 deaths during first 24 hours after the crash and after applying a fatality adjustment factor estimated 706 more deaths up to 30 days after the crash. The HDR reported 40,174 urgent hospitalisations. Of these, 1,099 died during the day of hospitalisation or within the following 30 days. The police only notified 68% of all cases that required hospitalisation. According to the number of deaths reported by police and contrasted with hospital register, estimations of the number of deaths at 30 days made by police could represent a level of under-reporting of between 3% and 6.6%, depending on the assumption considered. This study showed that the HDR is an information source that complements police statistics and is useful to estimate the number of deaths and non-fatal injuries due to motor vehicle crashes in Spain.

Duplex DNA-Invading γ-Modified Peptide Nucleic Acids Enable Rapid Identification of Bloodstream Infections in Whole Blood.

PubMed

Nölling, Jörk; Rapireddy, Srinivas; Amburg, Joel I; Crawford, Elizabeth M; Prakash, Ranjit A; Rabson, Arthur R; Tang, Yi-Wei; Singer, Alon

2016-04-19

Bloodstream infections are a leading cause of morbidity and mortality. Early and targeted antimicrobial intervention is lifesaving, yet current diagnostic approaches fail to provide actionable information within a clinically viable time frame due to their reliance on blood culturing. Here, we present a novel pathogen identification (PID) platform that features the use of duplex DNA-invading γ-modified peptide nucleic acids (γPNAs) for the rapid identification of bacterial and fungal pathogens directly from blood, without culturing. The PID platform provides species-level information in under 2.5 hours while reaching single-CFU-per-milliliter sensitivity across the entire 21-pathogen panel. The clinical utility of the PID platform was demonstrated through assessment of 61 clinical specimens, which showed >95% sensitivity and >90% overall correlation to blood culture findings. This rapid γPNA-based platform promises to improve patient care by enabling the administration of a targeted first-line antimicrobial intervention. Bloodstream infections continue to be a major cause of death for hospitalized patients, despite significant improvements in both the availability of treatment options as well their application. Since early and targeted antimicrobial intervention is one of the prime determinants of patient outcome, the rapid identification of the pathogen can be lifesaving. Unfortunately, current diagnostic approaches for identifying these infections all rely on time-consuming blood culture, which precludes immediate intervention with a targeted antimicrobial. To address this, we have developed and characterized a new and comprehensive methodology, from patient specimen to result, for the rapid identification of both bacterial and fungal pathogens without the need for culturing. We anticipate broad interest in our work, given the novelty of our technical approach combined with an immense unmet need. Copyright © 2016 Nölling et al.

Testing survey-based methods for rapid monitoring of child mortality, with implications for summary birth history data.

PubMed

Brady, Eoghan; Hill, Kenneth

2017-01-01

Under-five mortality estimates are increasingly used in low and middle income countries to target interventions and measure performance against global development goals. Two new methods to rapidly estimate under-5 mortality based on Summary Birth Histories (SBH) were described in a previous paper and tested with data available. This analysis tests the methods using data appropriate to each method from 5 countries that lack vital registration systems. SBH data are collected across many countries through censuses and surveys, and indirect methods often rely upon their quality to estimate mortality rates. The Birth History Imputation method imputes data from a recent Full Birth History (FBH) onto the birth, death and age distribution of the SBH to produce estimates based on the resulting distribution of child mortality. DHS FBHs and MICS SBHs are used for all five countries. In the implementation, 43 of 70 estimates are within 20% of validation estimates (61%). Mean Absolute Relative Error is 17.7.%. 1 of 7 countries produces acceptable estimates. The Cohort Change method considers the differences in births and deaths between repeated Summary Birth Histories at 1 or 2-year intervals to estimate the mortality rate in that period. SBHs are taken from Brazil's PNAD Surveys 2004-2011 and validated against IGME estimates. 2 of 10 estimates are within 10% of validation estimates. Mean absolute relative error is greater than 100%. Appropriate testing of these new methods demonstrates that they do not produce sufficiently good estimates based on the data available. We conclude this is due to the poor quality of most SBH data included in the study. This has wider implications for the next round of censuses and future household surveys across many low- and middle- income countries.

A Large-Scale Internet/Computer-Based, Training Module: Dissemination of Evidence-Based Management of Postpartum Hemorrhage to Front-Line Health Care Workers

ERIC Educational Resources Information Center

Abawi, Karim; Gertiser, Lynn; Idris, Raqibat; Villar, José; Langer, Ana; Chatfield, Alison; Campana, Aldo

2017-01-01

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in most developing and low-income countries and the cause of one-quarter of maternal deaths worldwide. With appropriate and prompt care, these deaths can be prevented. With the current and rapidly developing research and worldwide access to information, a lack of knowledge of…

Induction of the unfolded protein response by constitutive G-protein signaling in rod photoreceptor cells.

PubMed

Wang, Tian; Chen, Jeannie

2014-10-17

Phototransduction is a G-protein signal transduction cascade that converts photon absorption to a change in current at the plasma membrane. Certain genetic mutations affecting the proteins in the phototransduction cascade cause blinding disorders in humans. Some of these mutations serve as a genetic source of "equivalent light" that activates the cascade, whereas other mutations lead to amplification of the light response. How constitutive phototransduction causes photoreceptor cell death is poorly understood. We showed that persistent G-protein signaling, which occurs in rod arrestin and rhodopsin kinase knock-out mice, caused a rapid and specific induction of the PERK pathway of the unfolded protein response. These changes were not observed in the cGMP-gated channel knock-out rods, an equivalent light condition that mimics light-stimulated channel closure. Thus transducin signaling, but not channel closure, triggers rapid cell death in light damage caused by constitutive phototransduction. Additionally, we show that in the albino light damage model cell death was not associated with increase in global protein ubiquitination or unfolded protein response induction. Taken together, these observations provide novel mechanistic insights into the cell death pathway caused by constitutive phototransduction and identify the unfolded protein response as a potential target for therapeutic intervention. © 2014 by The American Society for Biochemistry and Molecular Biology, Inc.

Comparison between the Coastal Impacts of Cyclone Nargis and the Indian Ocean Tsunami

NASA Astrophysics Data System (ADS)

Fritz, H. M.; Blount, C.

2009-12-01

On 26 December 2004 a great earthquake with a moment magnitude of 9.3 occurred off the North tip of Sumatra, Indonesia. The Indian Ocean tsunami claimed 230,000 lives making it the deadliest in recorded history. Less than 4 years later tropical cyclone Nargis (Cat. 4) made landfall in Myanmar’s Ayeyarwady delta on 2 May 2008 causing the worst natural disaster in Myanmar’s recorded history. Official death toll estimates exceed 138,000 fatalities making it the 7th deadliest cyclone ever recorded worldwide. The Bay of Bengal counts seven tropical cyclones with death tolls in excess of 100,000 striking India and Bangladesh in the past 425 years, which highlights the difference in return periods between extreme cyclones and tsunamis. Damage estimates at over $10 billion made Nargis the most damaging cyclone ever recorded in the Indian Ocean. Although the two natural disasters are completely different in their generation mechanisms they both share massive coastal inundations as primary damage and death cause. While the damage patterns exhibit similarities the forcing differs. The primary tsunami impact is dominated by the runup of a few main waves washing rapidly ashore and inducing high lateral forces. On the contrary the tropical cyclone storm surge damage is the result of numerous storm waves continuously hitting the flooded structures on the elevated storm tide level. While coastal vegetation such as mangroves may be effective at reducing superimposed storm waves they are limited at reducing storm surge. Unfortunately, mangroves have been significantly cut for charcoal and land use as rice paddies in Myanmar due to rapid population growth and economic reasons, thereby increasing coastal vulnerability and land loss due to erosion (Figure 1). The period of a storm surge is typically an order of magnitude longer than the period of a tsunami resulting in significantly larger inundation distances along coastal plains and river deltas. The storm surge of cyclone Nargis penetrated more than 50 km inland along the Ayeyarwady delta while the maximum inundation of the Indian Ocean tsunami was 7 km at Banda Aceh. The extent of affected coast lines differs with 2 m storm surge thresholds of cyclone Nargis spanning 200 km of coastline, whereas East Africa was severely affected by the Indian Ocean tsunami at 5000 km from the epicenter. The available time window for dissemination of warnings and evacuations are significantly shorter for tsunamis than cyclones. Coastal protection in the Indian Ocean must be approached with community-based planning, education and awareness programs suited for a multi-hazard perspective. Ayeyarwady delta in Myanmar after cyclone Nargis: (a) Deforestation of mangroves for use as charcoal and land use as rice paddies; (b) Drinking water wells scoured in surf zone at Aya highlighting more than 100 m land loss due to coastal erosion.

Rapid dimerization of quercetin through an oxidative mechanism in the presence of serum albumin decreases its ability to induce cytotoxicity in MDA-MB-231 cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pham, Anh; Bortolazzo, Anthony; White, J. Brandon, E-mail: Brandon.White@sjsu.edu

Highlights: Black-Right-Pointing-Pointer Quercetin cannot be detected intracellularly despite killing MDA-MB-231 cells. Black-Right-Pointing-Pointer Quercetin forms a heterodimer through oxidation in media with serum. Black-Right-Pointing-Pointer The quercetin heterodimer does not kill MDA-MB-231 cells. Black-Right-Pointing-Pointer Ascorbic acid stabilizes quercetin increasing cell death in quercetin treated cells. Black-Right-Pointing-Pointer Quercetin, and not a modified form, is responsible for apoptosis and cell death. -- Abstract: Quercetin is a member of the flavonoid family and has been previously shown to have a variety of anti-cancer activities. We and others have reported anti-proliferation, cell cycle arrest, and induction of apoptosis of cancer cells after treatment with quercetin. Quercetinmore » has also been shown to undergo oxidation. However, it is unclear if quercetin or one of its oxidized forms is responsible for cell death. Here we report that quercetin rapidly oxidized in cell culture media to form a dimer. The quercetin dimer is identical to a dimer that is naturally produced by onions. The quercetin dimer and quercetin-3-O-glucopyranoside are unable to cross the cell membrane and do not kill MDA-MB-231 cells. Finally, supplementing the media with ascorbic acid increases quercetin's ability to induce cell death probably by reduction oxidative dimerization. Our results suggest that an unmodified quercetin is the compound that elicits cell death.« less

A Unifying Mechanism for Cancer Cell Death through Ion Channel Activation by HAMLET

PubMed Central

Storm, Petter; Kjaer Klausen, Thomas; Trulsson, Maria; Ho CS, James; Dosnon, Marion; Westergren, Tomas; Chao, Yinxia; Rydström, Anna; Yang, Henry; Pedersen, Stine Falsig; Svanborg, Catharina

2013-01-01

Ion channels and ion fluxes control many aspects of tissue homeostasis. During oncogenic transformation, critical ion channel functions may be perturbed but conserved tumor specific ion fluxes remain to be defined. Here we used the tumoricidal protein-lipid complex HAMLET as a probe to identify ion fluxes involved in tumor cell death. We show that HAMLET activates a non-selective cation current, which reached a magnitude of 2.74±0.88 nA within 1.43±0.13 min from HAMLET application. Rapid ion fluxes were essential for HAMLET-induced carcinoma cell death as inhibitors (amiloride, BaCl2), preventing the changes in free cellular Na+ and K+ concentrations also prevented essential steps accompanying carcinoma cell death, including changes in morphology, uptake, global transcription, and MAP kinase activation. Through global transcriptional analysis and phosphorylation arrays, a strong ion flux dependent p38 MAPK response was detected and inhibition of p38 signaling delayed HAMLET-induced death. Healthy, differentiated cells were resistant to HAMLET challenge, which was accompanied by innate immunity rather than p38-activation. The results suggest, for the first time, a unifying mechanism for the initiation of HAMLET’s broad and rapid lethal effect on tumor cells. These findings are particularly significant in view of HAMLET’s documented therapeutic efficacy in human studies and animal models. The results also suggest that HAMLET offers a two-tiered therapeutic approach, killing cancer cells while stimulating an innate immune response in surrounding healthy tissues. PMID:23505537

A unifying mechanism for cancer cell death through ion channel activation by HAMLET.

PubMed

Storm, Petter; Klausen, Thomas Kjaer; Trulsson, Maria; Ho C S, James; Dosnon, Marion; Westergren, Tomas; Chao, Yinxia; Rydström, Anna; Yang, Henry; Pedersen, Stine Falsig; Svanborg, Catharina

2013-01-01

Ion channels and ion fluxes control many aspects of tissue homeostasis. During oncogenic transformation, critical ion channel functions may be perturbed but conserved tumor specific ion fluxes remain to be defined. Here we used the tumoricidal protein-lipid complex HAMLET as a probe to identify ion fluxes involved in tumor cell death. We show that HAMLET activates a non-selective cation current, which reached a magnitude of 2.74±0.88 nA within 1.43±0.13 min from HAMLET application. Rapid ion fluxes were essential for HAMLET-induced carcinoma cell death as inhibitors (amiloride, BaCl2), preventing the changes in free cellular Na(+) and K(+) concentrations also prevented essential steps accompanying carcinoma cell death, including changes in morphology, uptake, global transcription, and MAP kinase activation. Through global transcriptional analysis and phosphorylation arrays, a strong ion flux dependent p38 MAPK response was detected and inhibition of p38 signaling delayed HAMLET-induced death. Healthy, differentiated cells were resistant to HAMLET challenge, which was accompanied by innate immunity rather than p38-activation. The results suggest, for the first time, a unifying mechanism for the initiation of HAMLET's broad and rapid lethal effect on tumor cells. These findings are particularly significant in view of HAMLET's documented therapeutic efficacy in human studies and animal models. The results also suggest that HAMLET offers a two-tiered therapeutic approach, killing cancer cells while stimulating an innate immune response in surrounding healthy tissues.

Mortality and morbidity due to gastric dilatation-volvulus syndrome in pedigree dogs in the UK.

PubMed

Evans, Katy M; Adams, Vicki J

2010-07-01

To estimate breed-specific risk of death due to, and prevalence of, gastric dilatation-volvulus (GDV) in UK pedigree dogs. Data were available on the reported cause of and age at death and occurrence of and age at diagnosis of disease from the 2004 purebred dog health survey. A total of 15,881 dogs of 165 breeds had died in the previous 10 years; GDV was the cause of death in 65 breeds. There were 36,006 live dogs of 169 breeds of which 48 breeds had experienced > or =1 episodes of GDV. Prevalence ratios were used to estimate breed-specific GDV mortality and morbidity risks. Gastric dilatation-volvulus was the cause of death for 389 dogs, representing 2.5% (95% CI: 2.2-2.7) of all deaths reported and the median age at death was 7.92 years. There were 253 episodes in 238 live dogs. The median age at first diagnosis was five years. Breeds at greatest risk of GDV mortality were the bloodhound, Grand Bleu de Gascogne, German longhaired pointer and Neapolitan mastiff. Breeds at greatest risk of GDV morbidity were the Grand Bleu de Gascogne, bloodhound, otterhound, Irish setter and Weimaraner. These results suggest that 16 breeds, mainly large/giant, are at increased risk of morbidity/mortality due to GDV.

Toluidine blue: rapid and simple malaria parasite screening and species identification.

PubMed

Awale, Rupali; Maji, Ratnaprabha; Patil, Parag; Lingiah, Raghavendra; Mukhopadhyay, Ashok Kumar; Sharma, Subhadra

2017-01-01

Malaria, a febrile illness mostly confined to the tropical countries is transmitted by bite of infected female Anopheles mosquito. In 2015 alone, 88% of the malaria burden and 90% deaths due to malaria were confined to the African and Asian countries. Although number of tests are available for rapid diagnosis and screening for malaria, peripheral blood smear examination remains the gold standard. Leishman stain is recommended by WHO however herein we evaluate one of the alternative methods of staining which is simple and rapid. Fifty patients attending the various outpatient departments of the tertiary care hospital with fever and suspected to have malaria were selected. Two thin-air dried smears prepared from the peripheral venous blood from these subjects were stained by Leishman and Toluidine blue method. The findings of the slides by two independent qualified professionals were noted and the results were analyzed. A total of 14% (7/50) cases were diagnosed to have malaria. All the malaria cases which were positive in Leishman stain were also detected in Toluidine blue stain. Malarial parasites were clearly visible against the homogenously light green background in Toluidine blue. The detection of malarial parasite by Toluidine blue was quick, easy and confirmative. Toluidine blue stained peripheral blood smear allows for easy identification and speciation of malarial parasite at low magnification and in shorter period of time.

A DNA Barcode-Based RPA Assay (BAR-RPA) for Rapid Identification of the Dry Root of Ficus hirta (Wuzhimaotao).

PubMed

Tian, Enwei; Liu, Qianqian; Ye, Haoting; Li, Fang; Chao, Zhi

2017-12-18

Background: Wuzhimaotao (the dry root of Ficus hirta ) is used as both medicine and food ingredient by the locals in areas around Nanling Mountains of China. Due to its very similar external morphologies with Duanchangcao (the root of Gelsemium elegans , which contains gelsemine that is extremely neurotoxic) and the associated growth of these two plants, incidents of food poisoning and even death frequently occur, resulting from the misuse of Duanchangcao as Wuzhimaotao. The aim of this study is to develop a fast, even, on-spot approach to identification of Wuzhimaotao. Methods: We used DNA barcode-based recombinase polymerase amplification (BAR-RPA) with species-specific primers targeting the internal transcribed spacer (ITS) region of the rDNA of F. hirta. BAR-RPA reaction time and temperature were optimized and the specificity and sensitivity of BAR-RPA species-specific primers were assessed. Results: This technique showed a high specificity and sensitivity to amplify the genomic DNA of F. hirta and allowed for rapid amplification (within 15 min) of the ITS region under a constant and mild temperature range of 37-42 °C without using thermocyclers. Conclusions: The BAR-RPA assay with a fast DNA extraction protocol provides a simple, energy-saving, and rapid method for identification of Wuzhimaotao in both laboratory and field settings.

Causes of death among commercially insured multiple sclerosis patients in the United States.

PubMed

Goodin, Douglas S; Corwin, Michael; Kaufman, David; Golub, Howard; Reshef, Shoshana; Rametta, Mark J; Knappertz, Volker; Cutter, Gary; Pleimes, Dirk

2014-01-01

Information on causes of death (CODs) for patients with multiple sclerosis (MS) in the United States is sparse and limited by standard categorizations of underlying and immediate CODs on death certificates. Prior research indicated that excess mortality among MS patients was largely due to greater mortality from infectious, cardiovascular, or pulmonary causes. To analyze disease categories in order to gain insight to pathways, which lead directly to death in MS patients. Commercially insured MS patients enrolled in the OptumInsight Research database between 1996 and 2009 were matched to non-MS comparators on age/residence at index year and sex. The cause most-directly leading to death from the death certificate, referred to as the "principal" COD, was determined using an algorithm to minimize the selection of either MS or cardiac/pulmonary arrest as the COD. Principal CODs were categorized into MS, cancer, cardiovascular, infectious, suicide, accidental, pulmonary, other, or unknown. Infectious, cardiovascular, and pulmonary CODs were further subcategorized. 30,402 MS patients were matched to 89,818 controls, with mortality rates of 899 and 446 deaths/100,000 person-years, respectively. Excluding MS, differences in mortality rate between MS patients and non-MS comparators were largely attributable to infections, cardiovascular causes, and pulmonary problems. Of the 95 excessive deaths (per 100,000 person-years) related to infectious causes, 41 (43.2%) were due to pulmonary infections and 45 (47.4%) were attributed to sepsis. Of the 46 excessive deaths (per 100,000 person-years) related to pulmonary causes, 27 (58.7%) were due to aspiration. No single diagnostic entity predominated for the 60 excessive deaths (per 100,000 person-years) attributable to cardiac CODs. The principal COD algorithm improved on other methods of determining COD in MS patients from death certificates. A greater awareness of the common CODs in MS patients will allow physicians to anticipate potential problems and, thereby, improve the care that they provide.

A study on the mortality patterns of missing and deceased persons with dementia who died due to wandering.

PubMed

Kikuchi, Kazunori; Ijuin, Mutsuo; Awata, Shuichi; Suzuki, Takao

2016-01-01

To clarify the mortality patterns derived from differences in the causes of death and to subsequently promote search activity and prevent the death of missing persons. The Ministry of Health, Labour and Welfare (MHLW) performed a mail survey using a self-administered questionnaire. The families of all 388 deceased dementia patients from among all of the missing persons reports involving dementia patients that were submitted to the police in 2013, and the 10,322 missing persons with dementia (or suspected cases) were the subjects of this survey. The survey was conducted from January 5 to February 2 in 2015. We analyzed the data provided by the MHLW on 61 cases in which the cause of death was recorded; the factors that were related to the differences in the causes of death were examined using a chi-squared test (Fisher's direct method) and a residual analysis. Based on previous studies, we classified the causes of death into three categories: "drowning," "hypothermia," and "others (e.g., traumatic injury, disease progression)." When the cause of death was hypothermia, death often occurred between three to four days from the time that the deceased individual went missing. A significantly higher number of patients who died of other causes were found to have died on the day that they went missing. More than 40% of the drowning cases occurred on the day that the deceased individual went missing. We identified 3 patterns of mortality: (1) death on the day that the deceased individual went missing due to traumatic injury, disease progression, drowning, and other causes; (2) death due to hypothermia within a few days after the deceased individual went missing; and (3) patterns other than (1) and (2).

Global earthquake casualties due to secondary effects: A quantitative analysis for improving PAGER losses

USGS Publications Warehouse

Wald, David J.

2010-01-01

This study presents a quantitative and geospatial description of global losses due to earthquake-induced secondary effects, including landslide, liquefaction, tsunami, and fire for events during the past 40 years. These processes are of great importance to the US Geological Survey’s (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system, which is currently being developed to deliver rapid earthquake impact and loss assessments following large/significant global earthquakes. An important question is how dominant are losses due to secondary effects (and under what conditions, and in which regions)? Thus, which of these effects should receive higher priority research efforts in order to enhance PAGER’s overall assessment of earthquakes losses and alerting for the likelihood of secondary impacts? We find that while 21.5% of fatal earthquakes have deaths due to secondary (non-shaking) causes, only rarely are secondary effects the main cause of fatalities. The recent 2004 Great Sumatra–Andaman Islands earthquake is a notable exception, with extraordinary losses due to tsunami. The potential for secondary hazards varies greatly, and systematically, due to regional geologic and geomorphic conditions. Based on our findings, we have built country-specific disclaimers for PAGER that address potential for each hazard (Earle et al., Proceedings of the 14th World Conference of the Earthquake Engineering, Beijing, China, 2008). We will now focus on ways to model casualties from secondary effects based on their relative importance as well as their general predictability.

The effects of the 2006 Russian alcohol policy on alcohol-related mortality: an interrupted time series analysis.

PubMed

Pridemore, William Alex; Chamlin, Mitchell B; Kaylen, Maria T; Andreev, Evgeny

2014-01-01

The aim of this study was to determine the impact of a set of 2006 Russian alcohol policies on alcohol-related mortality in the country. We used autoregressive integrated moving average interrupted time series techniques to model the impact of the policy on the number of sex-specific monthly deaths of those aged 15+ years due to alcohol poisoning, alcoholic cardiomyopathy, alcoholic liver cirrhosis, and alcohol-related mental and behavioral disorders. The time series began in January 2000 and ended in December 2010. The alcohol policy was implemented in January 2006. The alcohol policy resulted in a significant gradual and sustained decline in male deaths due to alcohol poisoning (ωo = -92.631, p < 0.008, δ1 = 0.883, p < 0.001) and in significant immediate and sustained declines in male (ω0 = -63.20, p < 0.05) and female (ω0 = -64.28, p < 0.005) deaths due to alcoholic liver cirrhosis. The 2006 suite of alcohol policies in Russia was responsible for an annual decline of about 6,700 male alcohol poisoning deaths and about 760 male and about 770 female alcoholic liver cirrhosis deaths. Without the alcohol policy, male alcohol poisoning deaths would have been 35% higher and male and female alcoholic liver cirrhosis deaths would have been 9 and 15% higher, respectively. We contextualize our findings in relation to declining mortality in Russia and to results from recent studies of the impact of this law on other causes of death. Copyright © 2013 by the Research Society on Alcoholism.

When the Mannequin Dies, Creation and Exploration of a Theoretical Framework Using a Mixed Methods Approach.

PubMed

Tripathy, Shreepada; Miller, Karen H; Berkenbosch, John W; McKinley, Tara F; Boland, Kimberly A; Brown, Seth A; Calhoun, Aaron W

2016-06-01

Controversy exists in the simulation community as to the emotional and educational ramifications of mannequin death due to learner action or inaction. No theoretical framework to guide future investigations of learner actions currently exists. The purpose of our study was to generate a model of the learner experience of mannequin death using a mixed methods approach. The study consisted of an initial focus group phase composed of 11 learners who had previously experienced mannequin death due to action or inaction on the part of learners as defined by Leighton (Clin Simul Nurs. 2009;5(2):e59-e62). Transcripts were analyzed using grounded theory to generate a list of relevant themes that were further organized into a theoretical framework. With the use of this framework, a survey was generated and distributed to additional learners who had experienced mannequin death due to action or inaction. Results were analyzed using a mixed methods approach. Forty-one clinicians completed the survey. A correlation was found between the emotional experience of mannequin death and degree of presession anxiety (P < 0.001). Debriefing was found to significantly reduce negative emotion and enhance satisfaction. Sixty-nine percent of respondents indicated that mannequin death enhanced learning. These results were used to modify our framework. Using the previous approach, we created a model of the effect of mannequin death on the educational and psychological state of learners. We offer the final model as a guide to future research regarding the learner experience of mannequin death.

20 CFR 410.470 - Determination by nongovernmental organization or other governmental agency.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.470 Determination by nongovernmental organization or other... death was or was not due to a particular cause, shall not be determinative of the question of whether or...

20 CFR 410.470 - Determination by nongovernmental organization or other governmental agency.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.470 Determination by nongovernmental organization or other... death was or was not due to a particular cause, shall not be determinative of the question of whether or...

20 CFR 410.414 - Determining the existence of pneumoconiosis, including statutory presumption.

Code of Federal Regulations, 2011 CFR

2011-04-01

... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.414 Determining the existence of pneumoconiosis, including statutory... disabled due to pneumoconiosis at the time of his death. (2) This presumption may be rebutted only if it is...

Impact of nutrient imbalance on wine alcoholic fermentations: nitrogen excess enhances yeast cell death in lipid-limited must.

PubMed

Tesnière, Catherine; Delobel, Pierre; Pradal, Martine; Blondin, Bruno

2013-01-01

We evaluated the consequences of nutritional imbalances, particularly lipid/nitrogen imbalances, on wine yeast survival during alcoholic fermentation. We report that lipid limitation (ergosterol limitation in our model) led to a rapid loss of viability during the stationary phase of fermentation and that the cell death rate is strongly modulated by nitrogen availability and nature. Yeast survival was reduced in the presence of excess nitrogen in lipid-limited fermentations. The rapidly dying yeast cells in fermentations in high nitrogen and lipid-limited conditions displayed a lower storage of the carbohydrates trehalose and glycogen than observed in nitrogen-limited cells. We studied the cell stress response using HSP12 promoter-driven GFP expression as a marker, and found that lipid limitation triggered a weaker stress response than nitrogen limitation. We used a SCH9-deleted strain to assess the involvement of nitrogen signalling pathways in the triggering of cell death. Deletion of SCH9 increased yeast viability in the presence of excess nitrogen, indicating that a signalling pathway acting through Sch9p is involved in this nitrogen-triggered cell death. We also show that various nitrogen sources, but not histidine or proline, provoked cell death. Our various findings indicate that lipid limitation does not elicit a transcriptional programme that leads to a stress response protecting yeast cells and that nitrogen excess triggers cell death by modulating this stress response, but not through HSP12. These results reveal a possibly negative role of nitrogen in fermentation, with reported effects referring to ergosterol limitation conditions. These effects should be taken into account in the management of alcoholic fermentations.

Cell signaling pathways in the mechanisms of neuroprotection afforded by bergamot essential oil against NMDA-induced cell death in vitro

PubMed Central

Corasaniti, M T; Maiuolo, J; Maida, S; Fratto, V; Navarra, M; Russo, R; Amantea, D; Morrone, L A; Bagetta, G

2007-01-01

Background and purpose: The effects of bergamot essential oil (BEO; Citrus bergamia, Risso) on excitotoxic neuronal damage was investigated in vitro. Experimental approach: The study was performed in human SH-SY5Y neuroblastoma cells exposed to N-methyl-D-aspartate (NMDA). Cell viability was measured by dye exclusion. Reactive oxygen species (ROS) and caspase-3 activity were measured fluorimetrically. Calpain I activity and the activation (phosphorylation) of Akt and glycogen synthase kinase-3β (GSK-3β) were assayed by Western blotting. Key results: NMDA induced concentration-dependent, receptor-mediated, death of SH-SY5Y cells, ranging from 11 to 25% (0.25–5 mM). Cell death induced by 1 mM NMDA (21%) was preceded by a significant accumulation of intracellular ROS and by a rapid activation of the calcium-activated protease calpain I. In addition, NMDA caused a rapid deactivation of Akt kinase and this preceded the detrimental activation of the downstream kinase, GSK-3β. BEO (0.0005–0.01%) concentration dependently reduced death of SH-SY5Y cells caused by 1 mM NMDA. In addition to preventing ROS accumulation and activation of calpain, BEO (0.01%) counteracted the deactivation of Akt and the consequent activation of GSK-3β, induced by NMDA. Results obtained by using specific fractions of BEO, suggested that monoterpene hydrocarbons were responsible for neuroprotection afforded by BEO against NMDA-induced cell death. Conclusions and Implications: Our data demonstrate that BEO reduces neuronal damage caused in vitro by excitotoxic stimuli and that this neuroprotection was associated with prevention of injury-induced engagement of critical death pathways. PMID:17401440

Impact of Nutrient Imbalance on Wine Alcoholic Fermentations: Nitrogen Excess Enhances Yeast Cell Death in Lipid-Limited Must

PubMed Central

Tesnière, Catherine; Delobel, Pierre; Pradal, Martine; Blondin, Bruno

2013-01-01

We evaluated the consequences of nutritional imbalances, particularly lipid/nitrogen imbalances, on wine yeast survival during alcoholic fermentation. We report that lipid limitation (ergosterol limitation in our model) led to a rapid loss of viability during the stationary phase of fermentation and that the cell death rate is strongly modulated by nitrogen availability and nature. Yeast survival was reduced in the presence of excess nitrogen in lipid-limited fermentations. The rapidly dying yeast cells in fermentations in high nitrogen and lipid-limited conditions displayed a lower storage of the carbohydrates trehalose and glycogen than observed in nitrogen-limited cells. We studied the cell stress response using HSP12 promoter-driven GFP expression as a marker, and found that lipid limitation triggered a weaker stress response than nitrogen limitation. We used a SCH9-deleted strain to assess the involvement of nitrogen signalling pathways in the triggering of cell death. Deletion of SCH9 increased yeast viability in the presence of excess nitrogen, indicating that a signalling pathway acting through Sch9p is involved in this nitrogen-triggered cell death. We also show that various nitrogen sources, but not histidine or proline, provoked cell death. Our various findings indicate that lipid limitation does not elicit a transcriptional programme that leads to a stress response protecting yeast cells and that nitrogen excess triggers cell death by modulating this stress response, but not through HSP12. These results reveal a possibly negative role of nitrogen in fermentation, with reported effects referring to ergosterol limitation conditions. These effects should be taken into account in the management of alcoholic fermentations. PMID:23658613

Cardiovascular causes of maternal sudden death. Sudden arrhythmic death syndrome is leading cause in UK.

PubMed

Krexi, Dimitra; Sheppard, Mary N

2017-05-01

This study aims to determine the causes of sudden cardiac death during pregnancy and in the postpartum period and patients' characteristics. There are few studies in the literature. Eighty cases of sudden unexpected death due to cardiac causes in relation to pregnancy and postpartum period in a database of 4678 patients were found and examined macroscopically and microscopically. The mean age was 30±7 years with a range from 16 to 43 years. About 30% were 35 years old or older; 50% of deaths occurred during pregnancy and 50% during the postpartum period. About 59.18% were obese or overweight where body mass index data were available. The leading causes of death were sudden arrhythmic death syndrome (SADS) (53.75%) and cardiomyopathies (13.80%). Other causes include dissection of aorta or its branches (8.75%), congenital heart disease (2.50%) and valvular disease (3.75%). This study highlights sudden cardiac death in pregnancy or in the postpartum period, which is mainly due to SADS with underlying channelopathies and cardiomyopathy. We wish to raise awareness of these frequently under-recognised entities in maternal deaths and the need of cardiological screening of the family as a result of the diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

Cardiovascular causes of maternal sudden death. Sudden Arrhythmic Death Syndrome is leading cause in UK.

PubMed

Krexi, Dimitra; Sheppard, Mary N

2017-09-01

This study aims to determine the causes of sudden cardiac death during pregnancy and in the postpartum period and patients' characteristics. There are few studies in the literature. Eighty cases of sudden unexpected death due to cardiac causes in relation to pregnancy and postpartum period in a database of 4678 patients were found and examined macroscopically and microscopically. The mean age was 30±7years with a range from 16 to 43 years. About 30% were 35 years old or older; 50% of deaths occurred during pregnancy and 50% during the postpartum period. About 59.18% were obese or overweight where body mass index data were available. The leading causes of death were sudden arrhythmic death syndrome (SADS) (53.75%) and cardiomyopathies (13.80%). Other causes include dissection of aorta or its branches (8.75%), congenital heart disease (2.50%) and valvular disease (3.75%). This study highlights sudden cardiac death in pregnancy or in the postpartum period, which is mainly due to SADS with underlying channelopathies and cardiomyopathy. We wish to raise awareness of these frequently under-recognised entities in maternal deaths and the need of cardiological screening of the family as a result of the diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

Quantification of alcohol-related mortality in Sweden.

PubMed

Sjögren, H; Eriksson, A; Broström, G; Ahlm, K

2000-01-01

The main aim of the present study was to estimate total alcohol-related mortality in Sweden. For natural deaths, a meta-analysis carried out in Australia was updated to the end of March 1998, and pooled estimates of the relative risks were calculated for different diseases based on data from scientific studies that have been published in the international literature. The proportion of current alcohol drinkers from recent Swedish surveys, and the pooled relative risk estimates were used to estimate disease-specific alcohol-attributable fractions. Natural deaths 'caused' or 'prevented' by alcohol were estimated for the period 1992-1996. For unnatural deaths, all cases from 1992 through 1996 in Sweden were analysed (n = 23 132). Alcohol was regarded to attribute to the death: if the deceased was a 'known alcoholic'; if the underlying or contributing cause of death was alcohol-related; if the deceased had an alcohol-related in-patient diagnosis during a 3-year period prior to death; if the case tested positive for blood alcohol. Person years of life lost/gained (<70 years) due to alcohol were also assessed. The assumptions underlying the attributable risk methods used to analyse alcohol-related mortality due to natural causes need to be borne in mind when interpreting the results on natural deaths. Moreover, the preventive effect of alcohol on coronary heart disease and stroke is still controversial. The findings of alcohol-related mortality due to unnatural causes were much more reliable. About 3.5% of deaths were attributed to alcohol; alcohol involvement was more than twice as common in deaths of males (4.8%) than in those of females (2.0%). About one-quarter of the deaths in those aged below 50 years were attributed to alcohol. In those (

Infrared imaging of the crime scene: possibilities and pitfalls.

PubMed

Edelman, Gerda J; Hoveling, Richelle J M; Roos, Martin; van Leeuwen, Ton G; Aalders, Maurice C G

2013-09-01

All objects radiate infrared energy invisible to the human eye, which can be imaged by infrared cameras, visualizing differences in temperature and/or emissivity of objects. Infrared imaging is an emerging technique for forensic investigators. The rapid, nondestructive, and noncontact features of infrared imaging indicate its suitability for many forensic applications, ranging from the estimation of time of death to the detection of blood stains on dark backgrounds. This paper provides an overview of the principles and instrumentation involved in infrared imaging. Difficulties concerning the image interpretation due to different radiation sources and different emissivity values within a scene are addressed. Finally, reported forensic applications are reviewed and supported by practical illustrations. When introduced in forensic casework, infrared imaging can help investigators to detect, to visualize, and to identify useful evidence nondestructively. © 2013 American Academy of Forensic Sciences.

Synergistic antimicrobial therapy using nanoparticles and antibiotics for the treatment of multidrug-resistant bacterial infection

NASA Astrophysics Data System (ADS)

Gupta, Akash; Saleh, Neveen M.; Das, Riddha; Landis, Ryan F.; Bigdeli, Arafeh; Motamedchaboki, Khatereh; Rosa Campos, Alexandre; Pomeroy, Kenneth; Mahmoudi, Morteza; Rotello, Vincent M.

2017-06-01

Infections caused by multidrug-resistant (MDR) bacteria pose a serious global burden of mortality, causing thousands of deaths each year. Antibiotic treatment of resistant infections further contributes to the rapidly increasing number of antibiotic-resistant species and strains. Synthetic macromolecules such as nanoparticles (NPs) exhibit broad-spectrum activity against MDR species, however lack of specificity towards bacteria relative to their mammalian hosts limits their widespread therapeutic application. Here, we demonstrate synergistic antimicrobial therapy using hydrophobically functionalized NPs and fluoroquinolone antibiotics for treatment of MDR bacterial strains. An 8-16-fold decrease in antibiotic dosage is achieved in presence of engineered NPs to combat MDR strains. This strategy demonstrates the potential of using NPs to ‘revive’ antibiotics that have been rendered ineffective due to the development of resistance by pathogenic bacteria.

Near Real-Time Flood Monitoring and Impact Assessment Systems. Chapter 6; [Case Study: 2011 Flooding in Southeast Asia

NASA Technical Reports Server (NTRS)

Ahamed, Aakash; Bolten, John; Doyle, C.; Fayne, Jessica

2016-01-01

Floods are the costliest natural disaster (United Nations 2004), causing approximately6.8 million deaths in the twentieth century alone (Doocy et al. 2013).Worldwide economic flood damage estimates in 2012 exceed $19 Billion USD(Munich Re 2013). Extended duration floods also pose longer term threats to food security, water, sanitation, hygiene, and community livelihoods, particularly in developing countries (Davies et al. 2014).Projections by the Intergovernmental Panel on Climate Change (IPCC) suggest that precipitation extremes, rainfall intensity, storm intensity, and variability are increasing due to climate change (IPCC 2007). Increasing hydrologic uncertainty will likely lead to unprecedented extreme flood events. As such, there is a vital need to enhance and further develop traditional techniques used to rapidly assessflooding and extend analytical methods to estimate impacted population and infrastructure.

A Fatal Spontaneous Gas Gangrene due to Clostridium perfringens during Neutropenia of Allogeneic Stem Cell Transplantation: Case Report and Literature Review.

PubMed

Lee, Hae-Lim; Cho, Sung-Yeon; Lee, Dong-Gun; Ko, Yumi; Hyun, Ji In; Kim, Bo Kyoung; Seo, Jae Hyun; Lee, Jung Woo; Lee, Seok

2014-09-01

Most cases of gas gangrene caused by Clostridium species begin with trauma-related injuries but in rare cases, spontaneous gas gangrene (SGG) can occur when patients have conditions such as advanced malignancy, diabetes, or immunosuppression. Clostridium perfringens, a rare cause of SGG, exists as normal flora of skin and intestines of human. Adequate antibiotics with surgical debridement of infected tissue is the only curative therapeutic management. Mortality rate among adults is reported range of 67-100% and majority of deaths are occurred within 24 hours of onset. We experienced a case of SGG on the trunk, buttock and thigh in a neutropenic patient with acute lymphoblastic leukemia. His clinical course was rapid and fatal during pre-engraftment neutropenic period of allogeneic stem cell transplantation.

Radionuclide Imaging of Neurohormonal System of the Heart

PubMed Central

Chen, Xinyu; Werner, Rudolf A.; Javadi, Mehrbod S.; Maya, Yoshifumi; Decker, Michael; Lapa, Constantin; Herrmann, Ken; Higuchi, Takahiro

2015-01-01

Heart failure is one of the growing causes of death especially in developed countries due to longer life expectancy. Although many pharmacological and instrumental therapeutic approaches have been introduced for prevention and treatment of heart failure, there are still limitations and challenges. Nuclear cardiology has experienced rapid growth in the last few decades, in particular the application of single photon emission computed tomography (SPECT) and positron emission tomography (PET), which allow non-invasive functional assessment of cardiac condition including neurohormonal systems involved in heart failure; its application has dramatically improved the capacity for fundamental research and clinical diagnosis. In this article, we review the current status of applying radionuclide technology in non-invasive imaging of neurohormonal system in the heart, especially focusing on the tracers that are currently available. A short discussion about disadvantages and perspectives is also included. PMID:25825596

Measles vaccination response during Kosi floods, Bihar, India 2008.

PubMed

Varkey, Sherin; Krishna, Gopal; Pradhan, Narottam; Gupta, Satish Kumar; Caravotta, Jorge; Hombergh, Henri Vanden; Hoekstra, Edward; Askari, Sufia; Kansal, O P

2009-11-01

The Kosi floods of Bihar in 2008 led to initial rapid displacement followed by rehabilitation of the affected population. Strategically planned phase-wise activity of supplementary as well as primary measles vaccination combined with a variety of other interventions proved to be successful in preventing outbreaks and deaths due to measles. While 70% supplementary measles vaccination coverage was achieved in relief camps, the coverage of primary measles doses in the latter phases was dependant on accessibility of villages and previous vaccination status of eligible beneficiaries. The integrated diseases surveillance system, which became operational during the floods, also complemented the vaccination efforts by providing daily figures of cases with fever and rash. The overall response was not only successful in terms of preventing measles mortality, but also provided vital lessons that may be useful for planning future vaccination responses in emergency settings.

Current management of symptomatic intracranial stenosis.

PubMed

Taylor, Robert A; Weigele, John B; Kasner, Scott E

2011-08-01

Intracranial arterial stenosis (IAS) is the cause of about 10% of all ischemic strokes in the United States, but may account for about 40% of strokes in some populations. After a stroke or transient ischemic attack due to IAS, patients face a 12% annual risk of recurrent stroke on medical therapy, with most strokes occurring in the first year. Warfarin is no better than aspirin in preventing recurrent strokes but poses a higher risk of serious bleeding and death. Groups with the highest risk of recurrent stroke are those with high-grade (≥ 70%) stenosis, those with recent symptom onset, those with symptoms precipitated by hemodynamic maneuvers, and women. Endovascular treatment of IAS is a rapidly evolving therapeutic option. Antiplatelet agents are currently recommended as the primary treatment for symptomatic IAS, with endovascular therapy reserved for appropriate high-risk cases refractory to medical therapy.

A Fatal Spontaneous Gas Gangrene due to Clostridium perfringens during Neutropenia of Allogeneic Stem Cell Transplantation: Case Report and Literature Review

PubMed Central

Lee, Hae-Lim; Cho, Sung-Yeon; Ko, Yumi; Hyun, Ji In; Kim, Bo Kyoung; Seo, Jae Hyun; Lee, Jung Woo; Lee, Seok

2014-01-01

Most cases of gas gangrene caused by Clostridium species begin with trauma-related injuries but in rare cases, spontaneous gas gangrene (SGG) can occur when patients have conditions such as advanced malignancy, diabetes, or immunosuppression. Clostridium perfringens, a rare cause of SGG, exists as normal flora of skin and intestines of human. Adequate antibiotics with surgical debridement of infected tissue is the only curative therapeutic management. Mortality rate among adults is reported range of 67-100% and majority of deaths are occurred within 24 hours of onset. We experienced a case of SGG on the trunk, buttock and thigh in a neutropenic patient with acute lymphoblastic leukemia. His clinical course was rapid and fatal during pre-engraftment neutropenic period of allogeneic stem cell transplantation. PMID:25298910

Educational gains in cause-specific mortality: Accounting for cognitive ability and family-level confounders using propensity score weighting.

PubMed

Bijwaard, Govert E; Myrskylä, Mikko; Tynelius, Per; Rasmussen, Finn

2017-07-01

A negative educational gradient has been found for many causes of death. This association may be partly explained by confounding factors that affect both educational attainment and mortality. We correct the cause-specific educational gradient for observed individual background and unobserved family factors using an innovative method based on months lost due to a specific cause of death re-weighted by the probability of attaining a higher educational level. We use data on men with brothers from the Swedish Military Conscription Registry (1951-1983), linked to administrative registers. This dataset of some 700,000 men allows us to distinguish between five education levels and many causes of death. The empirical results reveal that raising the educational level from primary to tertiary would result in an additional 20 months of survival between ages 18 and 63. This improvement in mortality is mainly attributable to fewer deaths from external causes. The highly educated gain more than nine months due to the reduction in deaths from external causes, but gain only two months due to the reduction in cancer mortality and four months due to the reduction in cardiovascular mortality. Ignoring confounding would lead to an underestimation of the gains by educational attainment, especially for the less educated. Our results imply that if the education distribution of 50,000 Swedish men from the 1951 cohort were replaced with that of the corresponding 1983 cohort, 22% of the person-years that were lost to death between ages 18 and 63 would have been saved for this cohort. Copyright © 2017 Elsevier Ltd. All rights reserved.

Death certificate data and causes of death in patients with parkinsonism.

PubMed

Moscovich, Mariana; Boschetti, Gabriela; Moro, Adriana; Teive, Helio A G; Hassan, Anhar; Munhoz, Renato P

2017-08-01

Assessment of variables related to mortality in Parkinson disease (PD) and other parkinsonian syndromes relies, among other sources, on accurate death certificate (DC) documentation. We assessed the documentation of the degenerative disorder on DCs and evaluated comorbidities and causes of death among parkinsonian patients. Demographic and clinical data were systematically and prospectively collected on deceased patients followed at a tertiary movement disorder clinic. DCs data included the documentation of parkinsonism, causes, and place of death. Among 138 cases, 84 (60.9%) male, mean age 77.9 years, mean age of onset 66.7, and mean disease duration 10.9 years. Clinical diagnoses included PD (73.9%), progressive supranuclear palsy (10.9%), multiple system atrophy (7.2%), Lewy body dementia (7.2%) and corticobasal degeneration (0.7%). Psychosis occurred in 60.1% cases, dementia in 48.5%. Most PD patients died due to heterogeneous causes before reaching advanced stages. Non-PD parkinsonian patients died earlier due to causes linked to the advanced neurodegenerative process. PD was documented in 38.4% of DCs with different forms of inconsistencies. That improved, but remained significant when it was signed by a specialist. More than half of PD cases died while still ambulatory and independent, after a longer disease course and due to causes commonly seen in that age group. Deaths among advanced PD patients occurred due to causes similar to what we found in non-PD cases. These findings can be useful for clinical, prognostic and counseling purposes. Underlying parkinsonian disorders are poorly documented in DCs, undermining its' use as sources of data collection. Copyright © 2017 Elsevier Ltd. All rights reserved.

Lost life years due to premature mortality caused by diseases of the respiratory system.

PubMed

Maniecka-Bryła, Irena; Paciej-Gołębiowska, Paulina; Dziankowska-Zaborszczyk, Elżbieta; Bryła, Marek

2018-06-04

In Poland, as in most other European countries, diseases of the respiratory system are the 4th leading cause of mortality; they are responsible for about 8% of all deaths in the European Union (EU) annually. To assess the socio-economic aspects of mortality, it has become increasingly common to apply potential measures rather than conventionally used ratios. The aim of this study was to analyze years of life lost due to premature deaths caused by diseases of the respiratory system in Poland from 1999 to 2013. The study was based on a dataset of 5,606,516 records, obtained from the death certificates of Polish residents who died between 1999 and 2013. The information on deaths caused by diseases of the respiratory system, i.e., coded as J00-J99 according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), was analyzed. The Standard Expected Years of Life Lost (SEYLL) indicator was used in the study. In the years 1999-2013, the Polish population suffered 280,519 deaths caused by diseases of the respiratory system (4.69% of all deaths). In the period analyzed, a gradual decrease in the standardized death rate was observed - from 46.31 per 100,000 inhabitants in 1999 to 41.02 in 2013. The dominant causes of death were influenza and pneumonia (J09-J18) and chronic lower respiratory diseases (J40-J47). Diseases of the respiratory system were the cause of 4,474,548.92 lost life years. The Standard Expected Years of Life Lost per person (SEYLLp) was 104.72 per 10,000 males and 52.85 per 10,000 females. The Standard Expected Years of Life Lost per death (SEYLLd) for people who died due to diseases of the respiratory system was 17.54 years of life on average for men and 13.65 years on average for women. The use of the SEYLL indicator provided significant information on premature mortality due to diseases of the respiratory system, indicating the fact that they play a large role in the health status of the Polish population.

Laboratory Diagnosis of Human Rabies: Recent Advances

PubMed Central

Mani, Reeta Subramaniam; Madhusudana, Shampur Narayan

2013-01-01

Rabies, an acute progressive, fatal encephalomyelitis, transmitted most commonly through the bite of a rabid animal, is responsible for an estimated 61,000 human deaths worldwide. The true disease burden and public health impact due to rabies remain underestimated due to lack of sensitive laboratory diagnostic methods. Rapid diagnosis of rabies can help initiate prompt infection control and public health measures, obviate the need for unnecessary treatment/medical tests, and assist in timely administration of pre- or postexposure prophylactic vaccination to family members and medical staff. Antemortem diagnosis of human rabies provides an impetus for clinicians to attempt experimental therapeutic approaches in some patients, especially after the reported survival of a few cases of human rabies. Traditional methods for antemortem and postmortem rabies diagnosis have several limitations. Recent advances in technology have led to the improvement or development of several diagnostic assays which include methods for rabies viral antigen and antibody detection and assays for viral nucleic acid detection and identification of specific biomarkers. These assays which complement traditional methods have the potential to revolutionize rabies diagnosis in future. PMID:24348170

Delayed-onset and recurrent limb weakness associated with West Nile virus infection.

PubMed

Sejvar, James J; Davis, Larry E; Szabados, Erica; Jackson, Alan C

2010-02-01

Human neurologic illness following infection with West Nile virus (WNV) may include meningitis, encephalitis, and acute flaccid paralysis (AFP). Most WNV-associated AFP is due to involvement of the spinal motor neurons producing an anterior (polio)myelitis. WNV poliomyelitis is typically characterized by acute and rapidly progressing limb weakness occurring early in the course of illness, which is followed by death or clinical plateauing with subsequent improvement to varying degrees. We describe four cases of WNV poliomyelitis in which the limb weakness was characterized by an atypical temporal pattern, including one case with onset several weeks after illness onset, and three cases developing relapsing or recurrent limb weakness following a period of clinical plateauing or improvement. Delayed onset or recurrent features may be due to persistence of viral infection or delayed neuroinvasion with delayed injury by excitotoxic or other mechanisms, by immune-mediated mechanisms, or a combination thereof. Further clinical and pathogenesis studies are needed to better understand the mechanisms for these phenomena. Clinicians should be aware of these clinical patterns in patients with WNV poliomyelitis.

Diabetes hospitalizations and deaths in a cohort of treatment-seeking illicit drug users

PubMed Central

Aregbesola, Alex; Olubamwo, Olubunmi; Ronkainen, Kimmo; Tiihonen, Jari; Föhr, Jaana; Kauhanen, Jussi

2018-01-01

Background: Studies on diabetes among illicit drug users are scarce in Finland. This study aimed to describe hospitalization and death due to diabetes among treatment-seeking illicit drug users. Methods: Information of 4817 treatment-seeking drug users (3365 men and 1452 women) aged 11–65 years (mean 24.5 years) was linked to the Finnish national hospital discharge register and the national death registry to identify those clients who were hospitalized or died from diabetes mellitus during 1997–2013. Results: Fifty-three persons (42 men and 11 women) had primary diagnoses of diabetes, with a total of 146 hospitalizations (121 among men and 25 among women). The total length of stay among men (1183 days) far exceeded those of women (138 days). Overall, type 1 diabetes was the main contributor to hospitalizations (67%, n = 98/146). The proportion of Type 1 diabetes with complications was 31% in men (n = 37/121) and 44% in women (n = 11/25). All cases of deaths due to diabetes (n = 7) occurred in men. Conclusion: Diabetes hospitalizations were mainly due to Type 1 diabetes. Longer length of hospital stay was observed in men, and all diabetes deaths occurred among men. Male drug users and drug users in general would require more support to reduce morbidity and mortality due to diabetes.

[Factors associated to mortality by non-communicable diseases in Colombia, 2008-2012].

PubMed

Martínez, Julio Cesar

2016-12-01

Non-communicable diseases are the leading cause of premature mortality and disability in the world. To describe the trend pattern and to explore which risk factors were associated with mortality rates in Colombia from 2008 to 2012. A descriptive study was conducted to analyze mortality rate trends from the official vital statistics (death certificates) from 2008 to 2012. Between 2008 and 2012 there were 727,146 deaths due to non-communicable diseases, and 58.5% of them occurred among men aged less than 75 years. The mortality rate during the study period was 319.5 deaths per 100,000 people. The trend showed a statistically significant decline in mortality rates (-3%) across the country. For each woman who died due to external causes (i.e., not related to illness or old age), five men died under the same circumstances (OR=5,295; IC 95%: 5,143-5,454). The five most important causes of mortality were heart diseases, injuries due to aggressions, malignant tumors, chronic lower respiratory diseases and road traffic accidents. The cause of death differed significantly by sex and age. The main causes of death in Colombia were heart diseases and injuries (homicide). Mortality was higher among men of all ages than among women, but 15 to 45 year-old males were more likely to die due to external causes.

Racial Differences in Accidental and Violent Deaths Among U.S. Navy Personnel

DTIC Science & Technology

1984-10-01

for accidental injuries than whites; i O bjective The objective of this study was to examine the death rates of black and white enlisted personnel...pre-servIce soclo- cultural factors may play a role in accounting for the high death rates among older black .males. It is suggested, however, that...all deaths of personnel diagnosed as having injuries due to accidents, poisonings and violence (ICDA-8 codes 800.0 -. 999.9). Death rates were

A quasi-experimental controlled evaluation of the impact of a hospice rapid response community service for end-of-life care on achievement of preferred place of death.

PubMed

Holdsworth, Laura M; Gage, Heather; Coulton, Simon; King, Annette; Butler, Claire

2015-10-01

Rapid response services operating 24 h a day have been advocated in UK health policy to support dying patients at home, though there is limited evidence of their effectiveness. To assess the impact of a rapid response hospice at home service (intervention) on people dying in their preferred place, and carer quality of life, compared to usual care (control). Quasi-experimental multi-centred controlled evaluation. Patient data were collected from hospice records; carers completed postal questionnaires to report quality of life, anxiety and depression. Community served by one hospice (three contiguous sites) in South East England; 953 patients who died with a preferred place of death recorded and 64 carers who completed questionnaires. There was no significant difference between control and intervention groups in proportions achieving preferred place of death (61.9% vs 63.0% (odds ratio: 0.949; 95% confidence interval: 0.788-1.142)). People living at home alone were less likely to die where they wanted (0.541; 95% confidence interval: 0.438-0.667). Carers in the intervention group reported worse mental health component summary scores (short form-12, p = 0.03) than those in the control group; there were no differences in other carer outcomes. The addition of a rapid response hospice at home service did not have a significant impact on helping patients to die where they wanted in an area already well served by community palliative care. Recording preferences, and changes over time, is difficult and presented challenges for this study. © The Author(s) 2015.

Yellow Fever outbreaks in unvaccinated populations, Brazil, 2008-2009.

PubMed

Romano, Alessandro Pecego Martins; Costa, Zouraide Guerra Antunes; Ramos, Daniel Garkauskas; Andrade, Maria Auxiliadora; Jayme, Valéria de Sá; Almeida, Marco Antônio Barreto de; Vettorello, Kátia Campomar; Mascheretti, Melissa; Flannery, Brendan

2014-03-01

Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever.

Yellow Fever Outbreaks in Unvaccinated Populations, Brazil, 2008–2009

PubMed Central

Romano, Alessandro Pecego Martins; Costa, Zouraide Guerra Antunes; Ramos, Daniel Garkauskas; Andrade, Maria Auxiliadora; Jayme, Valéria de Sá; de Almeida, Marco Antônio Barreto; Vettorello, Kátia Campomar; Mascheretti, Melissa; Flannery, Brendan

2014-01-01

Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever. PMID:24625634

Fatal head injury: a sequelae to electric shock - a case report.

PubMed

Jayanth, S H; Hugar, Basappa S; Chandra, Y P Girish; Krishnan, A Gokula

2015-03-01

Deaths due to electric shock are increasing despite stringent laws and preventive measures. These shocks are a leading cause of death amongst construction workers. In about 20% of the cases, no visible injury due to electricity can be seen. In some cases, non-electrical injuries are present and at times there are no eyewitnesses to provide a detailed account of events. In such circumstances, examination of scene of death, autopsy and accident reconstruction with the help of an electrical expert are all necessary to determine the cause of death. Here, we report one such case where a mason working on the second floor of a building under construction sustained an electrical injury, following which he was thrown to the ground sustaining a fatal traumatic injury. After careful consideration, his death was attributed to the head injury. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Gas gangrene (image)

MedlinePlus

Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. It generally ... causing painful swelling and destruction of involved tissue. Gas gangrene is rapidly progressive and often fatal.

Improving donation outcomes: hospital development and the Rapid Assessment of Hospital Procurement Barriers in Donation.

PubMed

Siminoff, Laura A; Traino, Heather M

2009-06-01

Deficiencies in the donation process continue to contribute to the shortage of organs available for transplant. Continuous quality improvement of hospitals' donation processes is needed to identify and correct the problems. To test the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD), a direct observation technique with a focused ethnographic strategy, for assessing hospitals' donation processes and identifying areas in need of continuous quality improvement interventions. A pre-post assessment of hospitals' barriers to patient identification and referral, and family consent to donation. Seventeen hospitals within the catchment area of a Northeastern organ procurement organization were assessed by using the RAPiD method. Hospital administrators, health care providers, and staff (N = 537) were interviewed as part of the assessments. Interventions, including on-site training and education, and the use of in-house coordinators, were specifically tailored to each hospital's unique set of barriers to donation. The interventions were delivered to the hospitals in the form of recommendations. The participating organ procurement organization was responsible for implementation of the interventions. The RAPiD hospital evaluations revealed gaps in respondents' knowledge of organ donation, brain death, and referral criteria; a reluctance to declare brain death; and a rocky relationship between the hospitals and the organ procurement organization. As a result of the interventions, 9 hospitals' environments for organ donation improved, 7 showed no change, and 1 was worse.

FAST: Rapid determinations of antibiotic susceptibility phenotypes using label-free cytometry.

PubMed

Huang, Tzu-Hsueh; Tzeng, Yih-Ling; Dickson, Robert M

2018-05-07

Sepsis, a life-threatening immune response to blood infections (bacteremia), has a ∼30% mortality rate and is the 10th leading cause of US hospital deaths. The typical bacterial loads in adult septic patients are ≤100 bacterial cells (colony forming units, CFU) per ml blood, while pediatric patients exhibit only ∼1000 CFU/ml. Due to the low numbers, bacteria must be propagated through ∼24-hours blood cultures to generate sufficient CFUs for diagnosis and further analyses. Herein, we demonstrate that, unlike other rapid post-blood culture antibiotic susceptibility tests (ASTs), our phenotypic approach can drastically accelerate ASTs for the most common sepsis-causing gram-negative pathogens by circumventing long blood culture-based amplification. For all blood isolates of multi-drug resistant pathogens investigated (Escherichia coli, Klebsiella pneumoniae, and Acinetobacter nosocomialis), effective antibiotic(s) were readily identified within the equivalent of 8 hours from initial blood draw using <0.5 mL of adult blood per antibiotic. These methods should drastically improve patient outcomes by significantly reducing time to actionable treatment information and reduce the incidence of antibiotic resistance. © 2018 International Society for Advancement of Cytometry. © 2018 International Society for Advancement of Cytometry.

Explaining the Rapid Increase in Nigeria's Sex Ratio at Birth: Factors and Implications.

PubMed

Kaba, Amadu J

2015-06-01

This paper examines the rapid increase in Nigeria's sex ratio at birth from 1.03 boys born for every 1 girl born in each year from 1996-2008 to 1.06 in each year from 2009-2014, second only to Tunisia in Africa at 1.07. The average sex ratio at birth in the world in 2014 was 1.07. In most Black African nations or Black majority nations, it is 1.03 or less. Among the factors presented for this development are: historical fluctuations of sex ratio at birth; geography and ethnicity; male preference/chasing a son; Age of parents; high death rates of male infants and males in general; and wealth/socioeconomic status. Among the potential implications are: young and poor men in Nigeria may not be able to find brides and form families due to a potential shortage of females; emigration of young and poor Nigerian men to West (Africa) and elsewhere to seek brides and form families; immigration of marriage age women from West (Africa) and around the world to Nigeria to seek husbands; and low contraceptive use and high fertility rates in Nigeria.

Endoplasmic reticulum-resident E3 ubiquitin ligase Hrd1 controls B-cell immunity through degradation of the death receptor CD95/Fas

PubMed Central

Kong, Sinyi; Yang, Yi; Xu, Yuanming; Wang, Yajun; Zhang, Yusi; Melo-Cardenas, Johanna; Xu, Xiangping; Gao, Beixue; Thorp, Edward B.; Zhang, Donna D.; Zhang, Bin; Song, Jianxun; Zhang, Kezhong; Zhang, Jianning; Zhang, Jinping; Li, Huabin; Fang, Deyu

2016-01-01

Humoral immunity involves multiple checkpoints during B-cell development, maturation, and activation. The cell death receptor CD95/Fas-mediated apoptosis plays a critical role in eliminating the unwanted activation of B cells by self-reactive antigens and in maintaining B-cell homeostasis through activation-induced B-cell death (AICD). The molecular mechanisms controlling AICD remain largely undefined. Herein, we show that the E3 ubiquitin ligase Hrd1 protected B cells from activation-induced cell death by degrading the death receptor Fas. Hrd1-null B cells exhibited high Fas expression during activation and rapidly underwent Fas-mediated apoptosis, which could be largely inhibited by FasL neutralization. Fas mutation in Hrd1 KO mice abrogated the increase in B-cell AICD. We identified Hrd1 as the first E3 ubiquitin ligase of the death receptor Fas and Hrd1-mediated Fas destruction as a molecular mechanism in regulating B-cell immunity. PMID:27573825

Endoplasmic reticulum-resident E3 ubiquitin ligase Hrd1 controls B-cell immunity through degradation of the death receptor CD95/Fas.

PubMed

Kong, Sinyi; Yang, Yi; Xu, Yuanming; Wang, Yajun; Zhang, Yusi; Melo-Cardenas, Johanna; Xu, Xiangping; Gao, Beixue; Thorp, Edward B; Zhang, Donna D; Zhang, Bin; Song, Jianxun; Zhang, Kezhong; Zhang, Jianning; Zhang, Jinping; Li, Huabin; Fang, Deyu

2016-09-13

Humoral immunity involves multiple checkpoints during B-cell development, maturation, and activation. The cell death receptor CD95/Fas-mediated apoptosis plays a critical role in eliminating the unwanted activation of B cells by self-reactive antigens and in maintaining B-cell homeostasis through activation-induced B-cell death (AICD). The molecular mechanisms controlling AICD remain largely undefined. Herein, we show that the E3 ubiquitin ligase Hrd1 protected B cells from activation-induced cell death by degrading the death receptor Fas. Hrd1-null B cells exhibited high Fas expression during activation and rapidly underwent Fas-mediated apoptosis, which could be largely inhibited by FasL neutralization. Fas mutation in Hrd1 KO mice abrogated the increase in B-cell AICD. We identified Hrd1 as the first E3 ubiquitin ligase of the death receptor Fas and Hrd1-mediated Fas destruction as a molecular mechanism in regulating B-cell immunity.

Sudden unexpected death due to Graves' disease during physical altercation.

PubMed

Wei, Dengming; Yuan, Xiaogang; Yang, Tiantong; Chang, Lin; Zhang, Xiang; Burke, Allen; Fowler, David; Li, Ling

2013-09-01

We report a case of a 30-year-old woman who suddenly collapsed after having a physical altercation with her husband. Despite immediate resuscitation, she died on arrival at the hospital. The victim's parents requested an autopsy because they believed that their daughter was killed by her husband. Postmortem examination revealed that the victim had a diffusely enlarged thyroid gland and cardiomegaly with left ventricular hypertrophy. There was no evidence of significant trauma on the body. Further postmortem thyroid function tests and review of her medical history indicated that her death was due to Graves' disease. To the best of our knowledge, this is the first case reported of sudden death due to cardiac arrhythmia from Graves' disease induced by physical and emotional stress associated with the criminal activity of another person. The autopsy findings are described. In addition, the literature is reviewed and the significance of postmortem evaluation of thyroid hormones in the cases of sudden death is discussed. © 2013 American Academy of Forensic Sciences.

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

PubMed

Raczkowska, Zuzanna; Samojłowicz, Dorota

2013-01-01

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

[Occupational mortality in Italy during 1992, assessed through record-linkage between pension records and death certificates].

PubMed

d'Errico, A; Filippi, M; Demaria, M; Picanza, Grazia; Crialesi, Roberta; Costa, G; Campo, G; Passerini, M

2005-01-01

The creation of a surveillance system of occupational mortality in Italy is limited by the low quality of information on occupation in death certificates, since the information is often incomplete or lacking and because only the occupation at the time of death is registered. To evaluate the possible use of INPS (National Institute of Social Security) records for the purpose of surveillance of occupational mortality, in terms of feasibility of setting up a system and of validity of the results obtained. Death records of 218,510 subjects aged 18-74, deceased in the 12 months following the 1991 census, were obtained from ISTAT (Central Statistics Institute). These were combined through record-linkage with the INPS social security archives, which contain the employment records by economic sector going back to 1974, in order to assign these deaths the sector in which they had worked the longest. Mortality by specific causes was evaluated by industry by means of a proportional mortality analysis stratified by sex and occupational status, and adjusted for age, education, marital status, geographical area of birth, drawing a disability pension, employment status at the time of death and work instability. Record-linkage allowed attribution of the longest held job to 70% of the deaths recorded. Results are presented and discussed only on mortality in men due to asbestosis and silicosis, and causes of death with a substantial proportion attributable to occupation: chronic obstructive pulmonary disease (COPD); cancers of the bladder, nasal cavity, larynx, lung and pleura; leukaemia and lymphoma; accidental causes. Among the economic sectors with a significant excess mortality, the following are well documented in the literature: mortality due to COPD in the coal and peat-bog sectors; due to leukaemia among farmers; due to sino-nasal tumours in wood-working and furniture production; due to cancer of the larynx, lung, and pleura in occupations where there was probable exposure to asbestos (fishing and maritime transport, non-metal mining, building industry, and naval, train and aircraft construction); due to silicosis in industries with potential exposure to crystalline silica; due to accidental causes in the building industry and farming. Other mortality excesses and deficits, especially those due to bladder and lympho-haemopoietic cancers, appear to be only partly consistent with those described by other authors. The feasibility of developing a surveillance system of occupational mortality based on the INPS source was found to be good, and, at least among males, for 75% of the deceased subjects historical information existed concerning the economic sectors registered in the INPS records. The results obtained would appear to indicate that the system is capable of highlighting risk excesses due to widespread exposure in the industries examined, regarding diseases for which there is a strong association with exposure. On the other hand, due to the inherent limits of the study's design (lack of a complete work history and of precise information on the jobs held) its use is not recommended in the surveillance of diseases with a low proportion attributable to a risk factor, or with wide exposure variability in a given sector among the various jobs.

An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides: Mortality Update - 1986.

DTIC Science & Technology

1986-12-26

the counts of new deaths in the populations since the last report. Table 3 contains summary counts and death rates by occupation, race and group. All...the last report, due to 2 Ranch Hand ground deaths during 1985. Although the overall Ranch Hand and Comparison death rates of 4.7 and 5.1 percent, shown

Contending With Preplanned Death: Questions for Clinicians.

PubMed

Yager, Joel

2017-09-01

The goal of this column is to assist readers in reflecting on their attitudes and responses toward clinical and nonclinical situations involving preplanned deaths by decisionally capable individuals. Such circumstances range from encountering individuals in one's personal and professional lives who desire and intend to end their lives under their own terms, to having such individuals request assistance with predeath and postdeath arrangements. Attending to pertinent literature, this essay uses Socratic inquiry to question conventional assumptions and attitudes, push readers' thoughts beyond typical comfort zones, and consider alternative modes of responding to challenges posed by preplanned death. Studies indicate that, for their own end-of-life circumstances, physicians would prefer a briefer, higher quality life to prolonged low-quality life, dignity in infirmity and death, and avoidance of terminal suffering. Lay people generally endorse similar preferences. Although contemporary society generally shuns contemplating preplanned death, cultural attitudes regarding preplanned death are rapidly evolving, and variations of "Death with Dignity" legislation have gained traction in increasing numbers of US states as well as internationally. As yet, no broad consensus exists as to how clinicians should manage circumstances involving preplanned death. Considerations regarding preplanned deaths merit greater professional and public discussion. Many options exist for improving how professionals address the quality of human experiences surrounding death.

Hypoglycaemia, chronic kidney disease and death in type 2 diabetes: the Hong Kong diabetes registry

PubMed Central

2014-01-01

Background In patients with type 2 diabetes, chronic kidney disease (CKD) is associated with increased risk of hypoglycaemia and death. Yet, it remains uncertain whether hypoglycaemia-associated mortality is modified by CKD. Methods Type 2 diabetic patients, with or without CKD at enrolment were observed between 1995 and 2007, and followed up till 2009 at hospital medical clinics. We used additive interaction, estimated by relative excess risk due to interaction (RERI) and attributable proportion due to interaction (AP) to examine possible synergistic effects between CKD and severe hypoglycaemia (defined as hospitalisations due to hypoglycaemia in the 12 months prior to enrolment) on the risk of death. Results In this cohort of 8,767 type 2 diabetic patients [median age: 58 (interquartile range: 48 to 68) years; disease duration: 5 (1 to 11) years, men: 47.0%], 1,070 (12.2%) had died during a median follow-up period of 6.66 years (3.42-10.36) with 60,379 person-years.Upon enrolment, 209 patients had severe hypoglycaemia and 194 developed severe hypoglycaemia during follow-up (15 patients had both). In multivariable analysis and using patients without severe hypoglycaemia nor CKD as the referent group (683 deaths in 7,598 patients), severe hypoglycaemia alone (61 deaths in 272 patients) or CKD alone (267 death in 781 patients) were associated with increased risk of death [Hazard ratio, HR: 1.81(95%CI: 1.38 to 2.37) and 1.63 (1.38 to 1.93) respectively]. Having both risk factors (59 deaths in 116 patients) greatly enhanced the HR of death to 3.91 (2.93 to 5.21) with significant interaction (RERI: 1.46 and AP: 0.37, both p-values < 0.05). Conclusions Severe hypoglycaemia and CKD interact to increase risk of death in type 2 diabetes patients. PMID:24927961

Mouse embryonic stem cells undergo Charontosis, a novel programmed cell death pathway dependent upon cathepsins, p53, and EndoG, in response to etoposide treatment

PubMed Central

Tichy, Elisia D.; Stephan, Zachary A.; Osterburg, Andrew; Noel, Greg; Stambrook, Peter J.

2013-01-01

Embryonic stem cells (ESCs) are hypersensitive to many DNA damaging agents and can rapidly undergo cell death or cell differentiation following exposure. Treatment of mouse ESCs (mESCs) with etoposide (ETO), a topoisomerase II poison, followed by a recovery period resulted in massive cell death with characteristics of a programmed cell death pathway (PCD). While cell death was both caspase- and necroptosis-independent, it was partially dependent on the activity of lysosomal proteases. A role for autophagy in the cell death process was eliminated, suggesting that ETO induces a novel PCD pathway in mESCs. Inhibition of p53 either as a transcription factor by pifithrin α or in its mitochondrial role by pifithrin μ significantly reduced ESC death levels. Finally, EndoG was newly identified as a protease participating in the DNA fragmentation observed during ETO-induced PCD. We coined the term Charontosis after Charon, the ferryman of the dead in Greek mythology, to refer to the PCD signaling events induced by ETO in mESCs. PMID:23500643

Gas gangrene (image)

MedlinePlus

Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. Patients with ... vascular diseases are more prone to spontaneously develop gas gangrene, which is rapidly progressive and often fatal.

Health benefits of improving air quality in the rapidly aging Korean society.

PubMed

Bae, Hyun Joo; Park, Jeongim

2009-11-15

Korea is experiencing an extraordinarily rapid demographic transition. We investigated the short-term association between air pollution and mortality and assessed the impact of improved air quality on mortality in a rapidly aging city, Seoul, Korea. The generalized additive model (GAM) was used to estimate the relative risks (RR) of mortality associated with changes in air pollution. The time trends, seasonal variations, day of the week effects, and weather effects were controlled in the models. To estimate the health benefits, we used the US Environmental Protection Agency's BenMAP. For people 0-64 years of age, elderly people (65+ years), and all age groups, an increase of 10 microg/m(3) in PM(10) was associated with increases in daily death counts of 0.27% (95% CI: 0.04-0.50), 0.45% (95% CI: 0.27-0.64), and 0.37% (95% CI: 0.23-0.52), respectively. For ages 0-64 years, elderly people, and all age groups, a 10 ppb increase in 1-hour maximum ozone concentration resulted in an increased risk of daily death counts of 0.28% (95% CI: -0.19-0.74), 0.96% (95% CI: 0.46-1.47), and 0.81% (95% CI: 0.35-1.26), respectively. For elderly people, it was estimated that the health benefits of attaining the World Health Organization's (WHO) air quality guidelines (AQGs) for PM(10) (24-hour average 50 microg/m(3)) would suggest an annual reduction of 964 (95% CI: 564-1366) premature deaths, and 329 (95% CI: 159-500) premature deaths could be prevented annually in 2015 from attaining the WHO's guidelines for ozone (8-hour average 100 microg/m(3)). The rapid increase of the elderly population has major consequences and implications for society and public health. This study showed that elderly people are at higher risk for the acute mortality effects of air pollution. Therefore, cleaner air will substantially contribute to improved public health in Seoul, given the growing concern about the adverse effects of air pollution for elderly people.

Gender and age differences in suicide mortality in the context of violent death: findings from a multi-state population-based surveillance system.

PubMed

Bozzay, Melanie L; Liu, Richard T; Kleiman, Evan M

2014-07-01

Males are more likely than females to die by all forms of violent death, including suicide. The primary purpose of the present study was to explore whether the gender difference in suicide rates is largely accounted for by males' general greater tendency to experience violent deaths. The current study examined gender and age differences in suicides and other violent deaths, using data from a population-based surveillance system. Pearson's chi-square tests and logistic regression analyses were conducted with data for 32,107 decedents in the 2003-2005 National Violent Death Reporting System (NVDRS). Decedents were categorized by gender, age, and death by suicide versus other violent means. When suicides were examined in the greater context of violent death, the total proportion of violent deaths due to suicide did not differ across gender. When deaths were examined by age group, after controlling for ethnicity, marital status, and U.S. location in which the death occurred, males in early to mid childhood were significantly more likely than same-aged females to die by suicide relative to all other violent deaths. The portion of deaths due to suicide was for the most part equal across both genders in late childhood, young adulthood, and mid-adulthood. Older males were more likely than older females to die by suicide relative to other violent deaths. Our findings suggest that that the risk of dying by suicide relative to other violent deaths may be more pronounced at certain developmental stages for each gender. This knowledge may be valuable in tailoring prevention strategies. Copyright © 2014 Elsevier Inc. All rights reserved.

Sudden death victims <45 years: Agreement between cause of death established by the forensic physician and autopsy results.

PubMed

Ceelen, Manon; van der Werf, Christian; Hendrix, Anneke; Naujocks, Tatjana; Woonink, Frits; de Vries, Philip; van der Wal, Allard; Das, Kees

2015-08-01

The goal of this study was to ascertain accordance between cause of death established by the forensic physician and autopsy results in young sudden death victims in the Netherlands. Sudden death victims aged 1-45 years examined by forensic physicians operating in the participating regions which also underwent an autopsy between January 2006 and December 2011 were included (n = 70). Cause of death established by the forensic physician based on the external medicolegal examination was compared with autopsy findings using the ICD10-classification. Autopsy findings revealed that the majority of sudden death victims have died from a cardiac disease (n = 51, 73%). Most of the presumed heart disease related cases were confirmed by autopsy (n = 13, 87%). On the contrary, a large number of deaths caused by circulatory diseases were not recognised by the forensic physician (n = 38, 75%). In most of these cases, the forensic physician was forced to report an undetermined cause due to the lack of a solid explanation for death. Cause of death reported by the forensic physician appeared to be in agreement with the autopsy results in 12 cases (17%). Cause of death determination in young sudden death victims is a difficult task for forensic physicians due to the limited tools available during the medicolegal examination. An effort should be made to standardize extensive post-mortem investigation after sudden death in the young. Autopsy can provide valuable information regarding the cause of death, which is of great importance in view of the identification of inheritable diseases among decedents and their families. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial.

PubMed

Roberts, Ian; Shakur, Haleema; Afolabi, Adefemi; Brohi, Karim; Coats, Tim; Dewan, Yashbir; Gando, Satoshi; Guyatt, Gordon; Hunt, B J; Morales, Carlos; Perel, Pablo; Prieto-Merino, David; Woolley, Tom

2011-03-26

The aim of the CRASH-2 trial was to assess the effects of early administration of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage. Tranexamic acid significantly reduced all-cause mortality. Because tranexamic acid is thought to exert its effect through inhibition of fibrinolysis, we undertook exploratory analyses of its effect on death due to bleeding. The CRASH-2 trial was undertaken in 274 hospitals in 40 countries. 20,211 adult trauma patients with, or at risk of, significant bleeding were randomly assigned within 8 h of injury to either tranexamic acid (loading dose 1 g over 10 min followed by infusion of 1 g over 8 h) or placebo. Patients were randomly assigned by selection of the lowest numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Both participants and study staff (site investigators and trial coordinating centre staff ) were masked to treatment allocation. We examined the effect of tranexamic acid on death due to bleeding according to time to treatment, severity of haemorrhage as assessed by systolic blood pressure, Glasgow coma score (GCS), and type of injury. All analyses were by intention to treat. The trial is registered as ISRCTN86750102, ClinicalTrials.gov NCT00375258, and South African Clinical Trial Register/Department of Health DOH-27-0607-1919. 10,096 patients were allocated to tranexamic acid and 10,115 to placebo, of whom 10,060 and 10,067, respectively, were analysed. 1063 deaths (35%) were due to bleeding. We recorded strong evidence that the effect of tranexamic acid on death due to bleeding varied according to the time from injury to treatment (test for interaction p<0.0001). Early treatment (≤1 h from injury) significantly reduced the risk of death due to bleeding (198/3747 [5.3%] events in tranexamic acid group vs 286/3704 [7.7%] in placebo group; relative risk [RR] 0.68, 95% CI 0.57-0.82; p<0.0001). Treatment given between 1 and 3 h also reduced the risk of death due to bleeding (147/3037 [4.8%] vs 184/2996 [6.1%]; RR 0.79, 0.64-0.97; p=0.03). Treatment given after 3 h seemed to increase the risk of death due to bleeding (144/3272 [4.4%] vs 103/3362 [3.1%]; RR 1.44, 1.12-1.84; p=0.004). We recorded no evidence that the effect of tranexamic acid on death due to bleeding varied by systolic blood pressure, Glasgow coma score, or type of injury. Tranexamic acid should be given as early as possible to bleeding trauma patients. For trauma patients admitted late after injury, tranexamic acid is less effective and could be harmful. UK NIHR Health Technology Assessment programme, Pfizer, BUPA Foundation, and J P Moulton Charitable Foundation. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Mortality due to pesticide poisoning in Colombia, 1998-2011].

PubMed

Chaparro-Narváez, Pablo; Castañeda-Orjuela, Carlos

2015-08-01

Poisoning due to pesticides is an important public health problem worldwide due its morbidity and mortality. In Colombia, there are no exact data on mortality due to pesticide poisoning. To estimate the trend of mortality rate due to pesticide poisoning in Colombia between 1998 and 2011. We carried out a descriptive analysis with the database reports of death as unintentional poisoning, self-inflicted intentional poisoning, aggression with pesticides, and poisoning with non-identified intentionality, population projections between 1998 and 2011, and rurality indexes. Crude and age-adjusted mortality rates were estimated and trends and Spearman coefficients were evaluated. A total of 4,835 deaths were registered (age-adjusted mortality rate of 2.38 deaths per 100,000 people). Mortality rates were higher in rural areas, for self-inflicted intentional poisoning, in men and in age groups between 15 and 39 years old. The trend has been decreasing since 2002. Municipality mortality rates due to unintentional poisoning and aggression correlated significantly with the rurality index in less rural municipalities. Mortality rates due to pesticide poisoning presented a mild decrease between 1998 and 2011. It is necessary to adjust and reinforce the measures conducive to reducing pesticide exposure in order to avoid poisoning and reduce mortality.

Warm Fresh Whole Blood Is Independently Associated With Improved Survival for Patients With Combat-Related Traumatic Injuries

DTIC Science & Technology

2009-04-01

2 US Military reports estimate that 15% to 20% of traumatic deaths are preventable , and 66% to 80% of these deaths occur from hemorrhage.3,4 Rural...civilian data indicates that approximately 10% of deaths are preventable .5,6 If 10% to 20% of 150,000 US civilian traumatic deaths are preventable , and...66% to 80% of these preventable deaths are due to uncontrolled bleeding this translates to between 10,000 and 24,000 potentially preventable

Death as a result of violent asphyxia in autopsy reports.

PubMed

Trnka, J; Gesicki, M; Suslo, R; Siuta, J; Drobnik, J; Pirogowicz, I

2013-01-01

Violent asphyxia can be subdivided into various kinds according to the mechanism, so that the resuscitation techniques are different in each case. The purpose of the present article was to analyze the autopsy reports of the Department of Forensic Medicine of the Medical University in Wroclaw, Poland of 2010, in which the established cause of death was violent asphyxia. We found that among the 890 autopsies performed, there were 164 cases of death due to violent asphyxia caused by drowning, choking on food, gastric fluid, or blood, hanging, manual strangulations, immobilization of the chest (positional asphyxia), environmental asphyxia due to substitution of the oxygen-rich air for some other gas, and others. The most common cause of death in the group was hanging, mostly suicidal hangings of alcohol-intoxicated males. Despite an early medical treatment consisting of removing the noose from the neck and suction the fluids from the mouth and bronchial tree to safe the central nervous system from imminent hypoxia, there were negative outcomes in most cases due to the development of critical brain ischemia, with deaths followed after several days spent in the intensive care units. No connection to gender or age of the deceased was noted. We conclude that violent asphyxia remains to be a quite commonly cause of death in the practice of forensic pathologists - among all the autopsies performed in 2010 every sixth was of an asphyxia victim.

Maternal mortality in St. Petersburg, Russian Federation.

PubMed Central

Gurina, Natalia A.; Vangen, Siri; Forsén, Lisa; Sundby, Johanne

2006-01-01

OBJECTIVE: To study the levels and causes of maternal mortality in St. Petersburg, Russian Federation. METHODS: We collected data about all pregnancy-related deaths in St. Petersburg over the period 1992-2003 using several sources of information. An independent research group reviewed and classified all cases according to ICD-10 and the Confidential Enquiries into Maternal Deaths in the United Kingdom. We tested trends of overall and cause specific ratios (deaths per 100,000 births) for four 3-year intervals using the chi2 test. FINDINGS: The maternal mortality ratio for the study period was 43 per 100,000 live births. A sharp decline of direct obstetric deaths was observed from the first to fourth 3-year interval (49.8 for 1992-94 versus 18.5 for 2001-03). Sepsis and haemorrhage were the main causes of direct obstetric deaths. Among the total deaths from sepsis, 63.8% were due to abortion. Death ratios from sepsis declined significantly from the first to second study interval. In the last study interval (2001-03), 50% of deaths due to haemorrhage were secondary to ectopic pregnancies. The death ratio from thromboembolism remained low (2.9%) and stable throughout the study period. Among indirect obstetric deaths a non-significant decrease was observed for deaths from cardiac disease. Death ratios from infectious causes and suicides increased over the study period. CONCLUSIONS: Maternal mortality levels in St. Petersburg still exceed European levels by a factor of five. Improved management of abortion, emergency care for sepsis and haemorrhage, and better identification and control of infectious diseases in pregnancy, are needed. PMID:16628301

Burden of Violent Death on Years of Life Lost in Rhode Island, 2006-2013.

PubMed

Jiang, Yongwen; Ranney, Megan L; Perez, Beatriz; Viner-Brown, Samara

2016-11-01

Mortality from injuries, particularly violent injuries, is more common among the young. Although traditional epidemiologic measures describe burden of death using rate-related mortalities, this method may not accurately represent burden of premature death. Years of life lost (YLLs) incorporate time discounting and age weighting to more accurately estimate the burden of death. To the authors' knowledge, there has been no examination of YLLs using the Rhode Island Violent Death Reporting System data. This study's objective was to assess the burden of violent death in Rhode Island in terms of YLLs. This study used 2006-2013 Rhode Island Violent Death Reporting System data. YLLs as a result of premature violent deaths were assessed overall and by age, sex, race/ethnicity, and manner of death. Data were analyzed in 2015. Suicide made the largest contribution to the overall YLLs (61.3%), followed by homicide (24.0%), whereas undetermined intent deaths captured by the system accounted for 14.8% of YLLs. In Rhode Island, people aged 25-44 years had the highest YLLs due to suicide, and Hispanics had the highest YLLs due to homicide/legal intervention. By comparison, using crude mortality rate calculations, people aged 45-64 years had the highest suicide mortality rate and non-Hispanic blacks had the highest homicide mortality rate. YLL calculations provide a different picture than crude mortality-based assessments of the population at highest risk for violent death. This study demonstrates the strengths of using YLL to assess the burden of violent death at the state level. Published by Elsevier Inc.

Molecular mechanisms of neuroprotective action of immunosuppressants--facts and hypotheses.

PubMed

Kaminska, Bozena; Gaweda-Walerych, Katarzyna; Zawadzka, Malgorzata

2004-01-01

Cyclosporin A (CsA) and FK506 (Tacrolimus) are short polypeptides which block the activation of lymphocytes and other immune system cells. Immunosuppressants exert neuroprotective and neurotrophic action in traumatic brain injury, sciatic nerve injury, focal and global ischemia in animals. Their neuroprotective actions are not understood and many hypotheses have been formed to explain such effects. We discuss a role of drug target--calcineurin in neuroprotective action of immunosuppressants. Protein dephosphorylation by calcineurin plays an important role in neuronal signal transduction due to its ability to regulate the activity of ion channels, glutamate release, and synaptic plasticity. In vitro FK506 protects cortex neurons from NMDA-induced death, augments NOS phosphorylation inhibiting its activity and NO synthesis. However, in vivo experiments demonstrated that FK506 in neuroprotective doses did not block excitotoxic cell death nor did it alter NO production during ischemia/reperfusion. Tissue damage in ischemia is the result of a complex pathophysiological cascade, which comprises a variety of distinct pathological events. Resident non-neuronal brain cells respond rapidly to neuronal cell death and may have both deleterious and useful role in neuronal damage. There is increasing evidence that reactive gliosis and post-ischemic inflammation involving microglia contribute to ischemic damage. We have demonstrated that FK506 modulates hypertrophic/proliferative responses and proinflammatory cytokine expression in astrocytes and microglia in vitro and in focal transient brain ischemia. Our findings suggest that astrocytes and microglia are direct targets of FK506 and modulation of glial response and inflammation is a possible mechanism of FK506-mediated neuroprotection in ischemia.

Detection and management of the first human anthrax outbreak in Togo.

PubMed

Patassi, Akouda Akessiwe; Saka, Bayaki; Landoh, Dadja Essoya; Agbenoko, Kodjo; Tamekloe, Tsidi; Salmon-Ceron, Dominique

2016-07-01

The aim of this study was to describe and define an outbreak of human anthrax in two villages in the northern savannah region of Togo. In December 2009, localised groups of deaths occurred among villagers and their livestock, confirmed to be due to anthrax at the district hospital of Dapaong in Northern Togo. The National Disease Control department undertook an investigation to describe the epidemiological, clinical and bacteriological characteristics of this outbreak. Thirty-four individuals presented with clinical manifestations of anthrax. All patients were known to have consumed meat from cattle who had died of unknown causes or had been killed as a result of unknown illness. All patients presented with muco-cutaneous lesions; some had gastro-intestinal, neurological or meningeal symptoms, or septicaemia. One patient was co-infected with Plasmodium falciparum. Six deaths (17.6%) were reported at the beginning of the epidemic; 28 patients were successfully treated with a 10-day course of intravenous Penicillin or oral Amoxicillin. The two factors that contributed to the ultimate resolution of the anthrax outbreak were the increase of community awareness toward health promotion and vaccination of all farm animals. Although six deaths occurred among families' members who were infected, new human anthrax cases were prevented by rapid treatment of victims as well as aggressive public health interventions. However the risk of re-emergence of infection and exposure still exists as there are no existing epidemiological mapping and no identification of infected zones; and furthermore, no functional anthrax surveillance system exists in the affected region. © The Author(s) 2015.

Mortality and Disability-Adjusted Life-Years (Dalys) for Common Neglected Tropical Diseases in Ethiopia, 1990-2015: Evidence from the Global Burden of Disease Study 2015

PubMed Central

Deribew, A; Kebede, B; Tessema, GA; Adama, YA; Misganaw, A; Gebre, T; Hailu, A; Biadgilign, S; Amberbir, A; Desalegn, B; Abajobir, AA; Shafi, O; Abera, SF; Negussu, N; Mengistu, B; Amare, AT; Mulugeta, A; Kebede, Z; Mengistu, B; Tadesse, Z; Sileshi, M; Tamiru, M; Chromwel, EA; Glenn, SD; Stanaway, JD; Deribe, K

2017-01-01

Introduction Neglected tropical diseases (NTDs) are important public health problems in Ethiopia. In 2013, the Federal Ministry of Health (FMOH) has launched a national NTD master plan to eliminate major NTDs of public health importance by 2020. Benchmarking the current status of NTDs in the country is important to monitor and evaluate the progress in the implementation of interventions and their impacts. Therefore, this study aims to assess the trends of mortality and Disability-adjusted Life-Years (DALY) for the priority NTDs over the last 25 years. Methods We used the Global Burden of Disease (GBD) 2015 estimates for this study. The GBD 2015 data source for cause of death and DALY estimation included verbal autopsy (VA), Demographic and Health Surveys (DHS), and other disease specific surveys, Ministry of Health reports submitted to United Nations (UN) agencies and published scientific articles. Cause of Death Ensemble modeling (CODEm) and/or natural history models were used to estimate NTDs mortality rates. DALY were estimated as the sum of Years of Life Lost (YLL) due to premature mortality and Years Lived with Disability (YLD). Results All NTDs caused an estimated of 6,293 deaths (95% uncertainty interval (UI): 3699-10,080) in 1990 and 3,593 deaths (95% UI: 2051 – 6178) in 2015, a 43% reduction over the 25 years. Age-standardized mortality rates due to schistosomiasis, STH and leshmaniasis have declined by 91.3%, 73.5% and 21.6% respectively between 1990 to 2015. The number of DALYs due to all NTDs has declined from 814.4 thousand (95% UI: 548 thousand–1.2million) in 1990 to 579.5 thousand (95%UI: 309.4 thousand–1.3 million) in 2015. Age-standardized DALY rates due to all NTDs declined by 30.7%, from 17.6 per 1000(95%UI: 12.5-26.5) in 1990 to 12.2 per 1000(95%UI: 6.5 – 27.4) in 2015. Age-standardized DALY rate for trachoma declined from 92.7 per 100,000(95% UI: 63.2 – 128.4) in 1990 to 41.2 per 100,000(95%UI: 27.4–59.2) in 2015, a 55.6% reduction between 1990 and 2015. Age-standardized DALY rates for onchocerciasis, schistosomiasis and lymphiaticfilariasis decreased by 66.2%, 29.4% and 12.5% respectively between 1990 and 2015. DALY rate for ascariasis fell by 56.8% over the past 25 years. Conclusions Ethiopia has made a remarkable progress in reducing the DALY rates for most of the NTDs over the last 25 years. The rapid scale of interventions and broader system strengthening may have a lasting impact on achieving the 2020 goal of elimination of most of NTDs. Ethiopia should strengthen the coverage of integrated interventions of NTD through proper coordination with other health programs and sectors and community participation to eliminate NTDs by 2020. PMID:28878427

Transcription Analysis of the Beta-Glucosidase Precursor in Wild-Type and l-4i Mutant Bombyx mori (Lepidoptera: Bombycidae).

PubMed

Kang, Lequn; Huang, Fei; Wu, Fan; Zhao, Qiaoling

2015-01-01

Lethal fourth-instar larvae (l-4i) mutant of Bombyx mori, a recently discovered novel mutant, die from energy depletion due to genetic mutation. Beta-glucosidase is a common digestive enzyme that hydrolyzes cellulose in the diet to provide energy. In this study, the mRNA expression profiles of B. mori beta-glucosidase precursor (BmpreBG) were characterized by reverse transcription polymerase chain reaction and quantitative real-time polymerase chain reaction. The transcription level of BmpreBG varied in different tissues and developmental stages, except in the pupa and moth, which are the no-diet period. Remarkably, the mRNA expression level of BmpreBG was sharply reduced in l-4i but not in the wild type, which suggested that the digestive function of the mutant was severely damaged. This was consistent with the l-4i phenotypic traits of not eating mulberries, lack of energy, and ultimate death. 5'-rapid amplification of cDNA ends showed, for the first time, that BmpreBG has a 160-bp 5'-untranslated region. These findings suggested that B. mori β-glucosidase precursor was involved in the death process of l-4i mutant larvae. © The Author 2015. Published by Oxford University Press on behalf of the Entomological Society of America.

Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements.

PubMed

Twigg, John; Christie, Nicola; Haworth, James; Osuteye, Emmanuel; Skarlatidou, Artemis

2017-02-01

Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum) settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix.

Proteomic characterization of EL4 lymphoma-derived tumors upon chemotherapy treatment reveals potential roles for lysosomes and caspase-6 during tumor cell death in vivo.

PubMed

Kramer, David A; Eldeeb, Mohamed A; Wuest, Melinda; Mercer, John; Fahlman, Richard P

2017-06-01

The murine mouse lymphoblastic lymphoma cell line (EL4) tumor model is an established in vivo apoptosis model for the investigation of novel cancer imaging agents and immunological treatments due to the rapid and significant response of the EL4 tumors to cyclophosphamide and etoposide combination chemotherapy. Despite the utility of this model system in cancer research, little is known regarding the molecular details of in vivo tumor cell death. Here, we report the first in-depth quantitative proteomic analysis of the changes that occur in these tumors upon cyclophosphamide and etoposide treatment in vivo. Using a label-free quantitative proteomic approach a total of 5838 proteins were identified in the treated and untreated tumors, of which 875 were determined to change in abundance with statistical significance. Initial analysis of the data reveals changes that may have been predicted, such as the downregulation of ribosomes, but demonstrates the robustness of the dataset. Analysis of the dataset also reveals the unexpected downregulation of caspase-3 and an upregulation of caspase-6 in addition to a global upregulation of lysosomal proteins in the bulk of the tumor. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Human Stem Cell Derived Cardiomyocytes: An Alternative ...

EPA Pesticide Factsheets

Chemical spills and associated deaths in the US has increased 2.6-fold and 16-fold from 1983 to 2012, respectfully. In addition, the number of chemicals to which humans are exposed to in the environment has increased almost 10-fold from 2001 to 2013 within the US. Internationally, a WHO report on the global composite impact of chemicals on health reported that 16% of the total burden of cardiovascular disease was attributed to environmental chemical exposure with 2.5 million deaths per year. Clearly, the cardiovascular system, at all its various developmental and life stages, represents a critical target organ system that can be adversely affected by existing and emerging chemicals (e.g., engineered nanomaterials) in a variety of environmental media. The ability to assess chemical cardiac risk and safety is critically needed but extremely challenging due to the number and categories of chemicals in commerce, as indicated. This presentation\\session will evaluate the use of adult human stem cell derived cardiomyocytes, and existing platforms, as an alternative model to evaluate environmental chemical cardiac toxicity as well as provide key information for the development of predictive adverse outcomes pathways associated with environmental chemical exposures. (This abstract does not represent EPA policy) Rapid and translatable chemical safety screening models for cardiotoxicity current status for informing regulatory decisions, a workshop sponsored by the Society

Rib fractures and death from deletion of osteoblast βcatenin in adult mice is rescued by corticosteroids.

PubMed

Duan, JinZhu; Lee, Yueh; Jania, Corey; Gong, Jucheng; Rojas, Mauricio; Burk, Laurel; Willis, Monte; Homeister, Jonathon; Tilley, Stephen; Rubin, Janet; Deb, Arjun

2013-01-01

Ribs are primarily made of cortical bone and are necessary for chest expansion and ventilation. Rib fractures represent the most common type of non-traumatic fractures in the elderly yet few studies have focused on the biology of rib fragility. Here, we show that deletion of βcatenin in Col1a2 expressing osteoblasts of adult mice leads to aggressive osteoclastogenesis with increased serum levels of the osteoclastogenic cytokine RANKL, extensive rib resorption, multiple spontaneous rib fractures and chest wall deformities. Within days of osteoblast specific βcatenin deletion, animals die from respiratory failure with a vanishing rib cage that is unable to sustain ventilation. Increased bone resorption is also observed in the vertebrae and femur. Treatment with the bisphosphonate pamidronate delayed but did not prevent death or associated rib fractures. In contrast, administration of the glucocorticoid dexamethasone decreased serum RANKL and slowed osteoclastogenesis. Dexamethasone preserved rib structure, prevented respiratory compromise and strikingly increased survival. Our findings provide a novel model of accelerated osteoclastogenesis, where deletion of osteoblast βcatenin in adults leads to rapid development of destructive rib fractures. We demonstrate the role of βcatenin dependent mechanisms in rib fractures and suggest that glucocorticoids, by suppressing RANKL, may have a role in treating bone loss due to aggressive osteoclastogenesis.

Rib Fractures and Death from Deletion of Osteoblast βcatenin in Adult Mice Is Rescued by Corticosteroids

PubMed Central

Duan, JinZhu; Lee, Yueh; Jania, Corey; Gong, Jucheng; Rojas, Mauricio; Burk, Laurel; Willis, Monte; Homeister, Jonathon; Tilley, Stephen; Rubin, Janet; Deb, Arjun

2013-01-01

Ribs are primarily made of cortical bone and are necessary for chest expansion and ventilation. Rib fractures represent the most common type of non-traumatic fractures in the elderly yet few studies have focused on the biology of rib fragility. Here, we show that deletion of βcatenin in Col1a2 expressing osteoblasts of adult mice leads to aggressive osteoclastogenesis with increased serum levels of the osteoclastogenic cytokine RANKL, extensive rib resorption, multiple spontaneous rib fractures and chest wall deformities. Within days of osteoblast specific βcatenin deletion, animals die from respiratory failure with a vanishing rib cage that is unable to sustain ventilation. Increased bone resorption is also observed in the vertebrae and femur. Treatment with the bisphosphonate pamidronate delayed but did not prevent death or associated rib fractures. In contrast, administration of the glucocorticoid dexamethasone decreased serum RANKL and slowed osteoclastogenesis. Dexamethasone preserved rib structure, prevented respiratory compromise and strikingly increased survival. Our findings provide a novel model of accelerated osteoclastogenesis, where deletion of osteoblast βcatenin in adults leads to rapid development of destructive rib fractures. We demonstrate the role of βcatenin dependent mechanisms in rib fractures and suggest that glucocorticoids, by suppressing RANKL, may have a role in treating bone loss due to aggressive osteoclastogenesis. PMID:23393600

Age, period, and cohort effects in motor vehicle mortality in the United States, 1980-2010: the role of sex, alcohol involvement, and position in vehicle.

PubMed

Macinko, James; Silver, Diana; Bae, Jin Yung

2015-02-01

Although substantive declines in motor vehicle fatalities in 1980-2010 have been observed, declines by position in the vehicle and alcohol involvement have not been well elucidated. Analyses of FARS data use the Intrinsic Estimator (IE) to produce estimates of all age, period, and cohort effects simultaneously by position in the car and by alcohol involvement. Declines in MVC deaths by position in the car vary for men and women by age and cohort over time. Cohorts born before 1970 had higher risks than those born later. Analyses using proxy indicators of alcohol involvement found the highest risks for those aged 16-24. By period, these risks declined more rapidly than non- alcohol related traffic fatalities. Changes in risk patterns are consistent with evidence regarding the contributions of new technologies and public policy efforts to reduce fatalities, but gains have not been shared evenly by sex or position in the car. Greater attention is needed in reducing deaths among older drivers and pedestrians. Gender differences should be addressed in prevention efforts aimed at reducing MVCs due to alcohol involvement. Copyright © 2014 Elsevier Ltd and National Safety Council. All rights reserved.

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

PubMed

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

2016-03-01

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

Evaluation of treatment-related mortality among paediatric cancer deaths: a population based analysis

PubMed Central

Pole, Jason D; Gibson, Paul; Ethier, Marie-Chantal; Lazor, Tanya; Johnston, Donna L; Portwine, Carol; Silva, Mariana; Alexander, Sarah; Sung, Lillian

2017-01-01

Background: Objectives were to describe the proportion of deaths due to treatment-related mortality (TRM) and to identify risk factors and probable causes of TRM among paediatric cancer deaths in a population-based cohort. Methods: We included children with cancer ⩽18 years diagnosed and treated in Ontario who died between January 2003 and December 2012. Deaths were identified using a provincial registry, the Pediatric Oncology Group of Ontario Networked Information System. Probable causes of TRM were described. Results: Among the 964 deaths identified, 821 were included. The median age at diagnosis was 6.6 years (range 0–18.8) and 51.8% had at least one relapse. Of the deaths examined, TRM occurred in 217/821 (26.4%) while 604/821 (73.6%) were due to progressive cancer. Deaths from TRM did not change over time. Using multiple regression, younger age, leukaemia diagnosis and absence of relapse were independently positively associated with TRM. The most common probable causes of TRM were respiratory, infection and haemorrhage. Conclusions: TRM was responsible for 26.4% of deaths in paediatric cancer. Underlying diagnosis, younger age and absence of relapse were associated with TRM and causes of TRM differed by diagnosis group. Future work should evaluate TRM rate and risk factors among newly diagnosed cancer patients. PMID:28095399

Insulation workers in Belfast. A further study of mortality due to asbestos exposure (1940-75).

PubMed Central

Elmes, P C; Simpson, M J

1977-01-01

A follow-up study of 162 men already working as insulators (laggers) in 1940 has been extended from 1965 to 1975. By the end of 1975 there were 40 survivors when 108 had been expected. Until 1965 there had been an overall excess of deaths; these were due to asbestosis with or without tuberculosis and to alimentary cancer, as well as to bronchial carcinoma and mesothelioma. From 1965 onwards the overall death rate among survivors is not so excessive but there is still a marked excess of deaths from bronchial cancer and mesothelioma. The continued risk of death attributable to malignancy after asbestosis had ceased to contribute directly, does not appear to be caused by any changes which occurred before 1940 in the conditions at work. PMID:911687

Years of potential life lost and productivity costs due to premature cancer-related mortality in Iran.

PubMed

Khorasani, Soheila; Rezaei, Satar; Rashidian, Hamideh; Daroudi, Rajabali

2015-01-01

Cancer is recently one of the major concerns of the public health both in the world and Iran. To inform priorities for cancer control, this study estimated years of potential life lost (YPLL) and productivity losses due to cancer-related premature mortality in Iran in 2012. The number of cancer deaths by sex for all cancers and the ten leading causes of cancer deaths in Iran in 2012 were obtained from the GLOBOCAN database. The life expectancy method and the human capital approach were used to estimate the YPLL and the value of productivity lost due to cancer-related premature mortality. There were 53,350 cancer-related deaths in Iran. We estimated that these cancer deaths resulted in 1,112,680 YPLL in total, 563,332 (50.6%) in males and 549,348 (49.4%) in females. The top 10 ranked cancers accounted for 75% of total death and 70% of total YPLL in the males and 69% for both death and YPLL in the females. The largest contributors for YPLL in the two genders were stomach and breast cancers, respectively. The total cost of lost productivity due to cancer-related premature mortality discounted at 3% rate in Iran, was US$ 1.93 billion. The most costly cancer for the males was stomach, while for the females it was breast cancer. The percentage of the total costs that were attributable to the top 10 cancers was 67% in the males and 71% in the females. The YPLL and productivity losses due to cancer-related premature mortality are substantial in Iran. Setting resource allocation priorities to cancers that occur in younger working-age individuals (such as brain and central nervous system) and/or cancers with high incidence and mortality rates (such as stomach and breast) could potentially decrease the productivity losses and the YPLL to a great extent in Iran.

Rapidly responsive silk fibroin hydrogels as an artificial matrix for the programmed tumor cells death.

PubMed

Ribeiro, Viviana P; Silva-Correia, Joana; Gonçalves, Cristiana; Pina, Sandra; Radhouani, Hajer; Montonen, Toni; Hyttinen, Jari; Roy, Anirban; Oliveira, Ana L; Reis, Rui L; Oliveira, Joaquim M

2018-01-01

Timely and spatially-regulated injectable hydrogels, able to suppress growing tumors in response to conformational transitions of proteins, are of great interest in cancer research and treatment. Herein, we report rapidly responsive silk fibroin (SF) hydrogels formed by a horseradish peroxidase (HRP) crosslinking reaction at physiological conditions, and demonstrate their use as an artificial biomimetic three-dimensional (3D) matrix. The proposed SF hydrogels presented a viscoelastic nature of injectable hydrogels and spontaneous conformational changes from random coil to β-sheet conformation under physiological conditions. A human neuronal glioblastoma (U251) cell line was used for screening cell encapsulation and in vitro evaluation within the SF hydrogels. The transparent random coil SF hydrogels promoted cell viability and proliferation up to 10 days of culturing, while the crystalline SF hydrogels converted into β-sheet structure induced the formation of TUNEL-positive apoptotic cells. Therefore, this work provides a powerful tool for the investigation of the microenvironment on the programed tumor cells death, by using rapidly responsive SF hydrogels as 3D in vitro tumor models.

Glyphosate resistance in Ambrosia trifida: Part 1. Novel rapid cell death response to glyphosate.

PubMed

Van Horn, Christopher R; Moretti, Marcelo L; Robertson, Renae R; Segobye, Kabelo; Weller, Stephen C; Young, Bryan G; Johnson, William G; Schulz, Burkhard; Green, Amanda C; Jeffery, Taylor; Lespérance, Mackenzie A; Tardif, François J; Sikkema, Peter H; Hall, J Christopher; McLean, Michael D; Lawton, Mark B; Sammons, R Douglas; Wang, Dafu; Westra, Philip; Gaines, Todd A

2018-05-01

Glyphosate-resistant (GR) Ambrosia trifida is now present in the midwestern United States and in southwestern Ontario, Canada. Two distinct GR phenotypes are known, including a rapid response (GR RR) phenotype, which exhibits cell death within hours after treatment, and a non-rapid response (GR NRR) phenotype. The mechanisms of resistance in both GR RR and GR NRR remain unknown. Here, we present a description of the RR phenotype and an investigation of target-site mechanisms on multiple A. trifida accessions. Glyphosate resistance was confirmed in several accessions, and whole-plant levels of resistance ranged from 2.3- to 7.5-fold compared with glyphosate-susceptible (GS) accessions. The two GR phenotypes displayed similar levels of resistance, despite having dramatically different phenotypic responses to glyphosate. Glyphosate resistance was not associated with mutations in EPSPS sequence, increased EPSPS copy number, EPSPS quantity, or EPSPS activity. These encompassing results suggest that resistance to glyphosate in these GR RR A. trifida accessions is not conferred by a target-site resistance mechanism. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Ethylene Synthesis Regulated by Biphasic Induction of 1-Aminocyclopropane-1-Carboxylic Acid Synthase and 1-Aminocyclopropane-1-Carboxylic Acid Oxidase Genes Is Required for Hydrogen Peroxide Accumulation and Cell Death in Ozone-Exposed Tomato1

PubMed Central

Moeder, Wolfgang; Barry, Cornelius S.; Tauriainen, Airi A.; Betz, Christian; Tuomainen, Jaana; Utriainen, Merja; Grierson, Donald; Sandermann, Heinrich; Langebartels, Christian; Kangasjärvi, Jaakko

2002-01-01

We show that above a certain threshold concentration, ozone leads to leaf injury in tomato (Lycopersicon esculentum). Ozone-induced leaf damage was preceded by a rapid increase in 1-aminocyclopropane-1-carboxylic acid (ACC) synthase activity, ACC content, and ethylene emission. Changes in mRNA levels of specific ACC synthase, ACC oxidase, and ethylene receptor genes occurred within 1 to 5 h. Expression of the genes encoding components of ethylene biosynthesis and perception, and biochemistry of ethylene synthesis suggested that ozone-induced ethylene synthesis in tomato is under biphasic control. In transgenic plants containing an LE-ACO1 promoter-β-glucuronidase fusion construct, β-glucuronidase activity increased rapidly at the beginning of the O3 exposure and had a spatial distribution resembling the pattern of extracellular H2O2 production at 7 h, which coincided with the cell death pattern after 24 h. Ethylene synthesis and perception were required for active H2O2 production and cell death resulting in visible tissue damage. The results demonstrate a selective ozone response of ethylene biosynthetic genes and suggest a role for ethylene, in combination with the burst of H2O2 production, in regulating the spread of cell death. PMID:12481074

Emerging chronic non-communicable diseases in rural communities of Northern Ethiopia: evidence using population-based verbal autopsy method in Kilite Awlaelo surveillance site.

PubMed

Weldearegawi, Berhe; Ashebir, Yemane; Gebeye, Ejigu; Gebregziabiher, Tesfay; Yohannes, Mekonnen; Mussa, Seid; Berhe, Haftu; Abebe, Zerihun

2013-12-01

In countries where most deaths are outside health institutions and medical certification of death is absent, verbal autopsy (VA) method is used to estimate population level causes of death. VA data were collected by trained lay interviewers for 409 deaths in the surveillance site. Two physicians independently assigned cause of death using the International Classification of Diseases manual. In general, infectious and parasitic diseases accounted for 35.9% of death, external causes 15.9%, diseases of the circulatory system 13.4% and perinatal causes 12.5% of total deaths. Mortalities attributed to maternal causes and malnutrition were low, 0.2 and 1.5%, respectively. Causes of death varied by age category. About 22.1, 12.6 and 8.4% of all deaths of under 5-year-old children were due to bacterial sepsis of the newborn, acute lower respiratory infections such as neonatal pneumonia and prematurity including respiratory distress, respectively. For 5-15-year-old children, accidental drowning and submersion, accounting for 34.4% of all deaths in this age category, and accidental fall, accounting for 18.8%, were leading causes of death. Among 15-49-year-old adults, HIV/AIDS (16.3%) and tuberculosis (12.8%) were commonest causes of death, whereas tuberculosis and cerebrovascular diseases were major killers of those aged 50 years and above. In the rural district, mortality due to chronic non-communicable diseases was very high. The observed magnitude of death from chronic non-communicable disease is unlikely to be unique to this district. Thus, formulation of chronic disease prevention and control strategies is recommended.

Are pre-hospital deaths from accidental injury preventable?

PubMed Central

Hussain, L. M.; Redmond, A. D.

1994-01-01

OBJECTIVE--To determine what proportion of pre-hospital deaths from accidental injury--deaths at the scene of the accident and those that occur before the person has reached hospital--are preventable. DESIGN--Retrospective study of all deaths from accidental injury that occurred between 1 January 1987 and 31 December 1990 and were reported to the coroner. SETTING--North Staffordshire. MAIN OUTCOME MEASURES--Injury severity score, probability of survival (probit analysis), and airway obstruction. RESULTS--There were 152 pre-hospital deaths from accidental injury (110 males and 42 females). In the same period there were 257 deaths in hospital from accidental injury (136 males and 121 females). The average age at death was 41.9 years for those who died before reaching hospital, and their average injury severity score was 29.3. In contrast, those who died in hospital were older and equally likely to be males or females. Important neurological injury occurred in 113 pre-hospital deaths, and evidence of airway obstruction in 59. Eighty six pre-hospital deaths were due to road traffic accidents, and 37 of these were occupants in cars. On the basis of the injury severity score and age, death was found to have been inevitable or highly likely in 92 cases. In the remaining 60 cases death had not been inevitable and airway obstruction was present in up to 51 patients with injuries that they might have survived. CONCLUSION--Death was potentially preventable in at least 39% of those who died from accidental injury before they reached hospital. Training in first aid should be available more widely, and particularly to motorists as many pre-hospital deaths that could be prevented are due to road accidents. PMID:8173428

Trends of premature mortality in Swietokrzyskie Province (Poland), years 2002-2010.

PubMed

Gózdz, Stanislaw; Krzyzak, Michalina; Maślach, Dominik; Wróbel, Monika; Bielska-Lasota, Magdalena

2013-01-01

Premature mortality in younger age groups influences the society as far as social and economic aspects are concerned. Therefore, it is important to come up with a tool which will allow to assess them, and will enable to implement only these health care measures that bring tangible benefits. That is the reason for introducing PYLL rate (PYLL - potential years of life lost), which is an addition to the analysis of premature mortality as it includes the number of deaths due to a particular cause and the age at death. The purpose of this study was to analyse the level and trends of PYLL rate according to death causes in years 2002 -2010 in Swietokrzyskie Province. The material for the analysis was the information from the Central Statistical Office on the number of deaths due to all causes registered among the inhabitants of Swiytokrzyskie Province in years 2002-2010. Causes of death were coded according to the 10th revision of the International Classification of Diseases. The analysis of premature mortality was carried out with the use of PYLL rate. PYLL rate was calculated according to the method proposed by Romeder, according to which the premature mortality was defined as death before the age of 70. The analysis of time trends of PYLL rate and the APC (annual percent change) of the PYLL rate were calculated using jointpoint model as well as the Jointpoint Regression Program (Version 4.0.1 - January 2013). In men, in years 2002 - 2007 PYLL rate increased by 1.5% per year (p<0.05). From year 2007 the trend went downward and PYLL rate decreased on average by 3.1% per year till year 2010. External causes of death, cardiovascular diseases and cancers in years 2002 - 2010 were the reason for almost 74.0% PYLL in men. In year 2010 PYLL rate due to all death causes amounted to 8913.8/105 and was three times higher than in women (2975.5/10(5)). In women, however, during the analysed period PYLL rate did not change significantly, and was dominated by cancers, cardiovascular diseases and external death causes. Similarly to men, those three groups of death causes were responsible for an average 76.0% PYLL. The analysis of the causes of premature mortality in Swietokrzyskie Province shows that in the majority of cases it is due to preventable deaths, which calls for the necessity of more intensive measures in primary and secondary prevention as well as the improvement in treatment standards, mainly of cardiovascular diseases, cancers, injuries and accidents.

Early-phase transmission of Yersinia pestis by unblocked fleas as a mechanism explaining rapidly spreading plague epizootics.

PubMed

Eisen, Rebecca J; Bearden, Scott W; Wilder, Aryn P; Montenieri, John A; Antolin, Michael F; Gage, Kenneth L

2006-10-17

Plague is a highly virulent disease believed to have killed millions during three historic human pandemics. Worldwide, it remains a threat to humans and is a potential agent of bioterrorism. Dissemination of Yersinia pestis, the etiological agent of plague, by blocked fleas has been the accepted paradigm for flea-borne transmission. However, this mechanism, which requires a lengthy extrinsic incubation period before a short infectious window often followed by death of the flea, cannot sufficiently explain the rapid rate of spread that typifies plague epidemics and epizootics. Inconsistencies between the expected rate of spread by blocked rat fleas and that observed during the Black Death has even caused speculation that plague was not the cause of this medieval pandemic. We used the primary vector to humans in North America, Oropsylla montana, which rarely becomes blocked, as a model for studying alternative flea-borne transmission mechanisms. Our data revealed that, in contrast to the classical blocked flea model, O. montana is immediately infectious, transmits efficiently for at least 4 d postinfection (early phase) and may remain infectious for a long time because the fleas do not suffer block-induced mortality. These factors match the criteria required to drive plague epizootics as defined by recently published mathematical models. The scenario of efficient early-phase transmission by unblocked fleas described in our study calls for a paradigm shift in concepts of how Y. pestis is transmitted during rapidly spreading epizootics and epidemics, including, perhaps, the Black Death.

Proteomic Analysis of Cerebrospinal Fluid in a Fulminant Case of Multiple Sclerosis

PubMed Central

Füvesi, Judit; Hanrieder, Jörg; Bencsik, Krisztina; Rajda, Cecilia; Kovács, S. Krisztián; Kaizer, László; Beniczky, Sándor; Vécsei, László; Bergquist, Jonas

2012-01-01

Multiple Sclerosis (MS) is a chronic disease, but in rare fulminant cases rapid progression may lead to death shortly after diagnosis. Currently there is no diagnostic test to predict disease course. The aim of this study was to identify potential biomarkers/proteins related to rapid progression. We present the case history of a 15-year-old male MS patient. Cerebrospinal fluid (CSF) was taken at diagnosis and at the time of rapid progression leading to the patient’s death. Using isobaric tag labeling and nanoflow liquid chromatography in conjunction with matrix assisted laser desorption/ionization time of flight tandem mass spectrometry we quantitatively analyzed the protein content of two CSF samples from the patient with fulminant MS as well as one relapsing-remitting (RR) MS patient and one control headache patient, whose CSF analysis was normal. Seventy-eight proteins were identified and seven proteins were found to be more abundant in both fulminant MS samples but not in the RR MS sample compared to the control. These proteins are involved in the immune response, blood coagulation, cell proliferation and cell adhesion. In conclusion, in this pilot study we were able to show differences in the CSF proteome of a rapidly progressing MS patient compared to a more typical clinical form of MS and a control subject. PMID:22837721

Factors associated with prehospital death among traffic accident patients in Osaka City, Japan: A population-based study.

PubMed

Katayama, Yusuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Hayashida, Sumito; Ogura, Hiroshi; Shimazu, Takeshi

2018-01-02

Although it is important to assess the factors associated with traffic accident fatalities to decrease them as a matter of public health, such factors have not been fully identified. Using a large-scale data set of ambulance records in Osaka City, Japan, we retrospectively analyzed all traffic accident patients transported to hospitals by emergency medical service personnel from 2013 to 2014. In this study, prehospital death was defined as that occurring at the scene or in the emergency department immediately after hospital arrival. We assessed prehospital factors associated with prehospital death due to traffic accidents by logistic regression models. This study enrolled 28,903 emergency patients involved in traffic accidents, of whom 68 died prehospital. In a multivariate model, elderly patients aged ≥75 years (adjusted odds ratio [AOR] = 4.34; 95% confidence interval [CI], 2.29-8.23), nighttime (AOR = 2.75; 95% CI, 1.65-4.70), and type of injured person compared to bicyclists such as pedestrians (AOR = 9.58; 95% CI, 5.07-17.99), motorcyclists (AOR = 2.75; 95% CI, 1.21-6.24), and car occupants (AOR = 2.98; 95% CI, 1.39-6.40) were significantly associated with prehospital death due to traffic accidents. In addition, the AOR for automobile versus nonautomobile as the collision opponent was 4.76 (95% CI, 2.30-9.88). In this population, the factors associated with prehospital death due to traffic accidents were elderly people, nighttime, and pedestrian as the type of patient. The proportion of prehospital deaths due to traffic accidents was also high when the collision component was an automobile.

Improving the maternal mortality ratio in Zhejiang Province, China, 1988-2008.

PubMed

Qiu, Liqian; Lin, Jun; Ma, Yuanying; Wu, Weiwei; Qiu, Ling; Zhou, Aizhen; Shi, Wenjun; Lee, Andy; Binns, Colin

2010-10-01

maternal mortality remains a major public health problem in many countries. The aim of this paper is to describe the progress made in maternal health care in Zhejiang Province, China over 20 years in reducing the maternal mortality ratio (MMR). Zhejiang Province is located on the mid-east coast of China, approximately 180km south of Shanghai, and has a population of 49 million. Almost all mothers give birth in hospitals or maternal and infant health institutes. the annual maternal death audit reports from 1988 to 2008 were analysed. These reports were prepared annually by the Zhejiang Prenatal Health Committee after auditing each individual case. China has made considerable progress in reducing the MMR. Zhejiang has one of fastest developing economies in China, and since the 86 economic reforms of 1978, health care has improved rapidly and the MMR has declined. During the 1988-2008 period, 2258 maternal deaths were reported from 8,880,457 live births. During these two decades, the MMR decreased dramatically from 48.50 in 1988 to 6.57 per 100,000 in 2008. The MMR in migrant women dropped from 66.87 in 2003 to 21.67 per 100,000 in 2008. The rate of decline was more rapid in rural areas than in the city. There has been a decline in the proportion of deaths with direct obstetric causes and a corresponding increase in the proportion of indirect causes. The proportion of deaths classified as preventable has declined in the past two decades. Social factors are important in maternal safety, and on average 26.8% of maternal deaths were influenced by these factors. as the economy was developing, maternal safety was made a priority health issue by the Government and health workers. The provincial MMR has dropped rapidly and is now similar to the rates in developed countries and lower than that in the USA. However, more work is still needed to ensure that all mothers, including migrant workers, continue to have these low rates. Copyright © 2010 Elsevier Ltd. All rights reserved.

5 CFR 178.204 - Order of payment precedence.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., money due an employee at the time of the employee's death shall be paid to the person or persons surviving at the date of death, in the following order of precedence, and the payment bars recovery by... employee in a writing received in the employing agency prior to the employee's death; (b) Second, if there...

Deaths from chickenpox in England and Wales 1995-7: analysis of routine mortality data

PubMed Central

Rawson, Helen; Crampin, Amelia; Noah, Norman

2001-01-01

Objective To evaluate the epidemiology and impact of mortality from chickenpox in England and Wales. Design Review of death certificates from the Office for National Statistics on which codes for “chickenpox” or “varicella” were mentioned. Further information ascertained from certifying physician. Participants Those certified as having died from chickenpox in England and Wales, 1995-7. Main outcome measures Diagnosis and age and sex distributions of deaths from chickenpox. Results On average, 25 people a year die from chickenpox. Overall case fatality was 9.22 per 100 000 consultations for chickenpox. Adults accounted for 81% of deaths and 19% of consultations. Deaths were twice as common in men as in women. More of those who died were born outside United Kingdom than expected (12% v 4%). Conclusions Chickenpox is not a mild disease. Deaths in adults are increasing, both in number and proportion. What is already known on this topicChickenpox can be fatal, especially in immunosuppressed people and adultsThe age distribution of cases has been shifting upwards for about 30 yearsWhat this study addsAbout 80% of deaths certified as due to chickenpox are due to chickenpoxChickenpox accounts for about 25 deaths annually in England and Wales, more than from measles, mumps, pertussis, and Hib meningitis combinedMortality in adults has been increasing for at least 30 years and now 80% of deaths from chickenpox are in adultsDeaths were twice as common in men as in women PMID:11701571

Years of life lost due to encounters with law enforcement in the USA, 2015-2016.

PubMed

Bui, Anthony L; Coates, Matthew M; Matthay, Ellicott C

2018-05-07

To inform discussions on rates, burden and priority-setting in relation to police violence, we quantified the number and rate of years of life lost (YLLs) due to police violence by race/ethnicity and age in the USA, 2015-2016. We used data on the number of deaths due to police violence from 'The Counted', a media-based source compiled by The Guardian . YLLs are the difference between an individual's age at death and their corresponding standard life expectancy at age of death. There were 57 375 and 54 754 YLLs due to police violence in 2015 and 2016, respectively. People of colour comprised 38.5% of the population, but 51.5% of YLLs. YLLs were greatest among those aged 25-34 years, and the number of YLLs at younger ages was greater among people of colour than whites. The number of YLLs due to police violence is substantial. YLLs highlight that police violence disproportionately impacts young people, and the young people affected are disproportionately people of colour. Framing police violence as an important cause of deaths among young adults provides another valuable lens to motivate prevention efforts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

PubMed

Schackman, Bruce R; Neukermans, Christopher P; Fontain, Sandy N Nerette; Nolte, Claudine; Joseph, Patrice; Pape, Jean W; Fitzgerald, Daniel W

2007-05-01

New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti. A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care), rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care), and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs) of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000. In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource-poor countries that are scaling up prenatal HIV testing.

Deaths among women of reproductive age: a forensic autopsy study.

PubMed

Padubidri, Jagadish Rao; Menezes, Ritesh G; Pant, Sadip; Shetty, Soumya B

2013-08-01

Unnatural deaths in women of reproductive age (range 12-49 years) have a serious psychological and social impact on the family and community. Deaths among women of reproductive age reported as medico-legal cases were investigated to see the trend in terms of cause and manner of death. The study group consisted of a series of 328 consecutive forensic autopsies on women in the reproductive age group, performed between 2009 and 2011 at the Government Wenlock District Hospital, Mangalore, India by qualified specialist forensic medicine experts. Unnatural deaths formed 93.6% of the cohort. The top three causes of death included burns, poisoning and hanging forming 69.5% of the cases. The manner of death was suicide in 45.4% cases, accident in 43.6% cases and homicide in 4.6% cases. The circumstances of death were related to alleged medical negligence in 2.4% cases. Death in 4% cases was natural mannered with a disease being the cause of death. Three-fourths of the victims were married. Married women formed 63.1% of the suicidal victims. Homicidal deaths were not reported among unmarried women. The preponderant method of suicide was by poisoning at 42.3% (63 cases), followed by hanging (34.9%), burns (11.4%) and drowning (9.4%). These four methods comprised 98% of the total suicidal deaths in this study cohort. Accidental deaths were predominantly caused by burns (62.2%) and road traffic accident (23.1%). Two-thirds of the homicidal deaths were due to assault caused by blunt-force trauma, ligature strangulation and sharp-force trauma. One-third of the homicidal victims died due to burns. With a clear understanding of the cause and manner of death, it may be possible to predict, and hopefully prevent, future cases of unnatural deaths in women of reproductive age who form a very important group of society. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

The impact of early outcome events on the effect of tranexamic acid in post-partum haemorrhage: an exploratory subgroup analysis of the WOMAN trial.

PubMed

Brenner, Amy; Shakur-Still, Haleema; Chaudhri, Rizwana; Fawole, Bukola; Arulkumaran, Sabaratnam; Roberts, Ian

2018-06-07

In severe post-partum haemorrhage, death can occur within hours of bleeding onset so interventions to control the bleeding must be given immediately. In clinical trials of treatments for life-threatening bleeding, established treatments are given priority and the trial treatment is usually given last. However, enrolling patients in whom severe maternal morbidity or death is imminent or inevitable at the time of randomisation may dilute the effects of a trial treatment. We conducted an exploratory analysis of data from the WOMAN trial, an international, randomised placebo-controlled trial of the effects of tranexamic acid on death and surgical intervention in 20,060 women with post-partum haemorrhage. We assessed the impact of early maternal death or hysterectomy due to exsanguination on the effect of tranexamic acid on each of these respective outcomes. We conducted repeated analyses excluding patients with these outcomes at increasing intervals from the time of randomisation. We quantified treatment effects using risk ratios (RR) and 99% confidence intervals (CI) and prepared cumulative failure plots. Among 14,923 women randomised within 3 h of delivery (7518 tranexamic acid and 7405 placebo), there were 216 bleeding deaths (1.5%) and 383 hysterectomies due to bleeding (2.8%). After excluding deaths from exsanguination at increasing time intervals following randomization, there was a significant reduction in the risk of death due to bleeding with tranexamic acid (RR = 0.41; 99% CI 0.19-0.89). However, after excluding hysterectomies at increasing time intervals post-randomization, there was no reduction in the risk of hysterectomy due to bleeding with tranexamic acid (RR = 0.79; 99% CI 0.33-1.86). Findings from this analysis provide further evidence that tranexamic acid reduces the risk of death from exsanguination in women who experience postpartum haemorrhage. It is uncertain whether tranexamic acid reduces the risk of hysterectomy for bleeding after excluding early hysterectomies. ISRCTN trial registration number ISRCTN76912190, 8 Dec 2008; ClinicalTrials.gov number NCT00872469, 30 March 2009; PACTR number PACTR201007000192283, 9 Feb 2010; EudraCT number 2008-008441-38, 8 Dec 2010 (retrospectively registered).

Mortality among employees at a plastics and resins research and development facility.

PubMed Central

Cowles, S R; Tsai, S P; Gilstrap, E L; Ross, C E

1994-01-01

OBJECTIVES--The study was undertaken to update a previous study of employees from a resins and plastics research and development facility and to further examine the mortality of these employees with particular emphasis on deaths due to pancreatic cancer. METHODS--This retrospective cohort study examined mortality from 1962 to 1992 for 257 men who were employed for at least one year during a 14 year period from 1962 to 1975 at a plastics and resins research and development facility. During the operative period, the primary activities involved applications and process development for polypropylene, polystyrene, epoxy resins, and to a lesser extent high density polyethylene. RESULTS--The cohort was young and was followed up for an average of 26 years. Although mortality for all causes among employees who worked at least one year at this facility was low (standardised mortality ratio (SMR) 0.74), the death rate from cancer was moderately higher than that of the general population (14 observed and 9.4 expected deaths). There were four observed and 0.5 expected deaths from pancreatic cancer among men who worked at this facility for at least one year, which resulted in a statistically increased SMR of 8.88 (95% confidence interval 2.42-22.74). All cases of pancreatic cancer had "laboratory" jobs, and their ages at death were relatively young compared with deaths in the general population from pancreatic cancer. Lung cancer mortality was high but not significant with seven observed and 3.5 expected deaths. There were no deaths due to non-malignant respiratory disease (1.9 expected). CONCLUSIONS--The increased cancer mortality was entirely due to excess deaths from pancreatic and lung cancers. No causative agent or process for these cases of pancreatic cancer has been identified. This study shows no increased colorectal cancer mortality as was found among another group of workers involved in the manufacture of polypropylene. PMID:7849862

Mortality causes in cancer patients with type 2 diabetes mellitus.

PubMed

Liu, Xiangdong; Ji, Jianguang; Sundquist, Kristina; Sundquist, Jan; Hemminki, Kari

2012-05-01

Cancer patients diagnosed with type 2 diabetes mellitus (T2DM) are at an increased risk of death due to cancer. However, whether T2DM comorbidity increases other causes of death in cancer patients is the novel theme of this study. Patients with T2DM were identified from the nationwide Swedish Hospital Discharge Register and linked with patients with cancer recorded from the Swedish Cancer Registry. Hazard ratios (HRs) were calculated for death due to all causes among cancer patients with and without T2DM; both underlying and multiple causes of death were examined using the Cox regression model. A total of 13 325 cancer patients were identified with comorbidity of T2DM. The total number of deaths of cancer patients was 276 021. Of these, 5900 occurred after T2DM diagnosis. For underlying causes of death, except for T2DM, the highest cause-specific HRs were found for complications of bacterial disease (HR, 3.93; 95% CI, 3.04-5.09), urinary system disease (HR, 3.39; 95% CI, 2.78-4.12), and myocardial infarction (HR, 2.93; 95% CI, 2.75-3.12). When risk of death was examined for both underlying and multiple causes of death, the highest HRs were found for hypertensive disease (HR, 3.42; 95% CI, 3.15-3.72), urinary system disease (HR, 3.39; 95% CI, 3.17-3.63), and arterial disease (HR, 3.26; 95% CI, 3.08-3.46). The diagnosis of T2DM in cancer patients is associated with an increased risk of death due to various causes, including myocardial infarction, other bacterial disease, urinary system disease, hypertensive disease, arterial disease, and so on, which may be related to both cancer and treatment. Clinicians that treat cancer patients with T2DM should pay more attention to comorbidities.

Amphetamine-type stimulant use and the risk of injury or death as a result of a road-traffic accident: A systematic review of observational studies.

PubMed

Hayley, Amie C; Downey, Luke A; Shiferaw, Brook; Stough, Con

2016-06-01

Amphetamine-type substances are frequently detected among drivers injured or killed due to road-trauma. However, the role of this substance in crash causation remains equivocal. We performed a systematic review to evaluate existing evidence regarding the association between amphetamine use and the risk of injury or death due to road traffic accidents. A bibliographical search of PubMed, SafetyLit, Scopus, and Science Direct literature databases from 01 January 1980 until May 2015 was performed. The quality of included studies was assessed using the Newcastle-Ottowa Scale (NOS) (cut-off of ≥7 indicated high quality). Inter-rater reliability between three independent reviewers for the NOS was calculated using Cohens kappa (κ) statistic, and best-evidence synthesis was performed. A total of 182 articles were found. Nine studies met eligibility criteria for inclusion for review, and seven studies were included for best-evidence synthesis. Best-evidence synthesis demonstrated a conflicting level of evidence for associations between the use of-amphetamine-type substances and the risk of sustaining an injury, and a moderate level of evidence between amphetamine use and the risk of death due to road trauma. This is the first review to synthesise evidence regarding the association between amphetamine-type substance use and the risk of injury or death due to a road traffic accident. More conclusive evidence of death due to road trauma among amphetamine users may reflect significant and global deficits in functioning associated with effective vehicular control under the influence of this substance. Additional high quality, sufficiently powered studies are required to elucidate the magnitude of these associations. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

Increases in Drug and Opioid-Involved Overdose Deaths - United States, 2010-2015.

PubMed

Rudd, Rose A; Seth, Puja; David, Felicita; Scholl, Lawrence

2016-12-30

The U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999-2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647 (60.9%) involved an opioid (1). Illicit opioids are contributing to the increase in opioid overdose deaths (2,3). In an effort to target prevention strategies to address the rapidly changing epidemic, CDC examined overall drug overdose death rates during 2010-2015 and opioid overdose death rates during 2014-2015 by subcategories (natural/semisynthetic opioids, methadone, heroin, and synthetic opioids other than methadone).* Rates were stratified by demographics, region, and by 28 states with high quality reporting on death certificates of specific drugs involved in overdose deaths. During 2015, drug overdoses accounted for 52,404 U.S. deaths, including 33,091 (63.1%) that involved an opioid. There has been progress in preventing methadone deaths, and death rates declined by 9.1%. However, rates of deaths involving other opioids, specifically heroin and synthetic opioids other than methadone (likely driven primarily by illicitly manufactured fentanyl) (2,3), increased sharply overall and across many states. A multifaceted, collaborative public health and law enforcement approach is urgently needed. Response efforts include implementing the CDC Guideline for Prescribing Opioids for Chronic Pain (4), improving access to and use of prescription drug monitoring programs, enhancing naloxone distribution and other harm reduction approaches, increasing opioid use disorder treatment capacity, improving linkage into treatment, and supporting law enforcement strategies to reduce the illicit opioid supply.

Maternal mortality following caesarean sections.

PubMed

Sikdar, K; Kundu, S; Mandal, G S

1979-08-01

A study of 26 maternal deaths following 3647 caesarean sections was conducted in Eden Hospital from 1974-1977. During the time period there were 35,544 births and 308 total maternal deaths (8.74/1000). Indications for Caesarean sections included: 1) abnormal presentation; 2) cephalopelvic disproportion; 3) toxemia; 4) prolonged labor; 5) fetal distress; and 6) post-caesarean pregnancies. Highest mortality rates were among cephalopelvic disproportion, toxemia, and prolonged labor patients. 38.4% of the patients died due to septicaemia and peritonitis, but other deaths were due to preclampsia, shock, and hemorrhage. Proper antenatal care may have prevented anemia and preclampsia and treated other pre-existing or superimposed diseases.

Severe peri-ictal respiratory dysfunction is common in Dravet syndrome

PubMed Central

Kim, YuJaung; Bravo, Eduardo; Thirnbeck, Caitlin K.; Smith-Mellecker, Lori A.; Kim, Se Hee; Gehlbach, Brian K.; Laux, Linda C.; Zhou, Xiuqiong; Nordli, Douglas R.

2018-01-01

Dravet syndrome (DS) is a severe childhood-onset epilepsy commonly due to mutations of the sodium channel gene SCN1A. Patients with DS have a high risk of sudden unexplained death in epilepsy (SUDEP), widely believed to be due to cardiac mechanisms. Here we show that patients with DS commonly have peri-ictal respiratory dysfunction. One patient had severe and prolonged postictal hypoventilation during video EEG monitoring and died later of SUDEP. Mice with an Scn1aR1407X/+ loss-of-function mutation were monitored and died after spontaneous and heat-induced seizures due to central apnea followed by progressive bradycardia. Death could be prevented with mechanical ventilation after seizures were induced by hyperthermia or maximal electroshock. Muscarinic receptor antagonists did not prevent bradycardia or death when given at doses selective for peripheral parasympathetic blockade, whereas apnea, bradycardia, and death were prevented by the same drugs given at doses high enough to cross the blood-brain barrier. When given via intracerebroventricular infusion at a very low dose, a muscarinic receptor antagonist prevented apnea, bradycardia, and death. We conclude that SUDEP in patients with DS can result from primary central apnea, which can cause bradycardia, presumably via a direct effect of hypoxemia on cardiac muscle. PMID:29329111

Electrocution fatalities in military personnel in Ankara, Turkey

PubMed Central

Tugcu, Harun; Ozsoy, Sait; Balandiz, Huseyin

2015-01-01

Objectives: To investigate various cases of death caused by electrical injuries among Turkish military personnel. Methods: We retrospectively reviewed fatality cases of military personnel between 1994 and 2013 at the Department of Forensic Medicine, Gulhane Military Medical Academy, School of Medicine, Ankara, Turkey, the only forensic medicine center for the Turkish Armed Forces. Medical records and autopsy reports of cases of electrical fatalities were reviewed and analyzed in terms of age and gender-specific incidence, voltage, contact details, body region distribution, location, and season of incident, site, and severity of injuries sustained, and histopathological and toxicological findings. Results: Sixteen (3.5%) out of the 450 autopsy cases involved electrocution. All deaths were accidental and most frequently occurred outdoors (75%). Eight (50%) died due to high voltage while 6 (37.5%) died due to low voltage. The entry and exit lesions were determined most frequently in cases with high voltage injury. The low voltage deaths commonly occurred at the scene of the event (66.6%), while almost all high voltage deaths occurred in the hospital (87.5%, p=0.03). Electrical burns were most commonly detected in the upper extremities (32.6%, n=14). Conclusion: The present study shows that deaths due to high voltage electrocution are more frequent than low voltage electrocution among military personnel. PMID:25630009

Death by Ulva

EPA Science Inventory

We report on a series of field and laboratory mesocosm experiments where we examined the effects of two levels of decomposing Ulva on Spartina alterniflora growth, soil biogeochemistry, and nitrogen dynamics. Monitoring of porewater revealed rapid mineralization to ammonium from...

What has contributed to the change in life expectancy in Italy between 1980 and 1992?

PubMed

Ngongo, K N; Nante, N; Chenet, L; McKee, M

1999-07-01

Life expectancy at birth in southern Europe is known to be greater than expected in comparison with levels of economic development. This has been attributed to the 'Mediterranean diet'. There are, however, concerns that this comparative advantage is being lost. This paper examines the factors underlying changing life expectancy in Italy since 1980. The subjects of this analysis are obtained from data on all deaths in Italy between 1980 and 1992. Change in age specific death rates is calculated from selected causes and, using the method developed by Pollard, the contribution of deaths from different causes and at different ages to changing life expectancy at birth is estimated. Between 1980 and 1992, life expectancy at birth increased by 2.70 years for men and 2.75 years for women. Death rates have fallen among children and those over 40. In contrast, death rates have increased among men aged between 20 and 39 and have increased very slightly among women aged 25-29. Falling death rates from ischaemic heart disease are continuing to contribute to increasing life expectancy. Death rates from lung and breast cancer are rising among women but are compensated for by falling death rates from other cancers. Among men, falling death rates from cancer at younger ages are being offset by increases at older ages. The rising death rate among younger men is almost entirely due to AIDS, with accidents also making a small contribution. Life expectancy in Italy has improved throughout the 1980s, largely driven by falling death rates from cardiovascular diseases. Here are, however, some worrying trends, most notably the rising death rate among young men, due almost entirely to AIDS. The changing pattern of mortality has some similarities with Spain, another Mediterranean country, but there are also important differences.

Fatalities due to indigenous and exotic species in Florida.

PubMed

Wolf, Barbara C; Harding, Brett E

2014-01-01

Florida's climate is suitable for many potentially hazardous animals, including both indigenous and exotic species, which are frequently kept as in zoos or as pets. This has resulted in many unforeseen fatal encounters between animals and the ever expanding human population. While the literature and knowledge pool for more common types of deaths referred to medical examiner/coroner's offices is abundant, the appreciation of wildlife and exotic pet-related deaths is far less widespread. We report seven animal attack-related deaths that occurred in Florida. The inflicted injuries included blunt and sharp force injuries, asphyxia, drowning, and envenomation. The underlying cause of death, however, was always a result of the human/animal interaction and in many cases related to human error and failure to appreciate the potentially dangerous behavior of nondomesticated species. These cases illustrate the varied circumstances and pathophysiologies associated with deaths due to indigenous and exotic species and the importance of the multidisciplinary approach in the medicolegal investigation of these cases. © 2013 American Academy of Forensic Sciences.

[Causes of death of German refugee children in 1945].

PubMed

Lylloff, K

2000-02-28

In the last months of the second World War, 250,000 German refugees landed in Denmark. A third of them were children under the age of 15. Seven thousand German refugee children under the age of five died in Denmark in 1945. Using birth certificates and death certificates from the Danish national archives and burial lists from the German refugee cemetaries I have collected data to reveal causes of death, age distributions and time of the deaths of the 7000 fatal cases among children under the age of five. Three thousand children under the age of one, 2000 children one year old and 2000 children 2-4 years old died. Most of them died just before and after the German surrender, but many died in the months following the German surrender. The infant mortality was extremely high all during 1945. The infants died from diseases due to malnutrition, but the older the children the more likely the causes of death were due to infectious diseases such as pneumonia, measles, diphtheria and gastroenteritis.

Productivity losses from road traffic deaths in Turkey.

PubMed

Naci, Huseyin; Baker, Timothy D

2008-03-01

The importance of road traffic injuries in Turkey is not generally appreciated, in part due to lack of knowledge of its economic burden and in part due to major underestimation in official statistics. The total years of potential life lost and potentially productive years of life lost from mortality were calculated in order to estimate the cost of productivity losses from road traffic deaths in Turkey. More years of potentially productive life are lost due to road traffic deaths than to respiratory tract illnesses or diabetes mellitus, two other serious health problems in Turkey. Road traffic deaths cost Turkey an estimated USD 2.6 billion every year in productivity losses alone, more than the World Bank estimate of the indirect costs from the 1999 Marmara earthquake (USD 1.2-2 billion), Turkey's worst earthquake since 1939 (World Bank Turkey Country Office, 1999). This study highlights the importance of accurate information in ameliorating the burden of road traffic safety in Turkey. Turkey has great opportunities to implement cost-effective interventions to reduce the economic burden of fatal and non-fatal road traffic injuries.

School illness absenteeism during 2009 influenza A (H1N1) pandemic--South Dakota, 2009-2010.

PubMed

Kightlinger, Lon; Horan, Vickie

2013-05-01

Schools are important amplification settings of influenza virus transmission. We demonstrated correlation of school absenteeism (due to any illness) with other influenza A (H1N1) activity surveillance data during the 2009 pandemic. We collected nonspecific illness student absenteeism data from August 17, 2009 through April 3, 2010 from 187 voluntarily participating South Dakota schools using weekly online surveys. Relative risks (RR) were calculated as the ratio of the probability of absenteeism during elevated weeks versus the probability of absenteeism during the baseline weeks (RR = 1.89). We used Pearson correlation to associate absenteeism with laboratory-confirmed influenza cases, influenza cases diagnosed by rapid tests, influenza-associated hospitalizations and deaths reported in South Dakota during the 2009 H1N1 pandemic period. School-absenteeism data correlated strongly with data from these other influenza surveillance sources.

Temperature preference as an indicator of the chronic toxicity of cupric ions to Mozambique Tilapia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Welch, T.J.; Stauffer, J.R. Jr.; Morgan, R.P. II

1989-11-01

Evaluation of the effects of environmental contaminants on aquatic communities has focused primarily on acute bioassays. These bioassays provide rapid and reproducible concentration response curves based on death as an endpoint. In recent years, however, emphasis has shifted towards monitoring sublethal effects of toxicants. Temperature is an easily quantifiable parameter influencing both the behavior and survival of fishes. As poikilotherms, fish use behavioral responses to help regulate body temperature. Fish thermoregulatory behavior may be altered by various toxic substances. Some researchers found that a 24 hr exposure of sublethal concentrations of copper caused a significant decrease in preferred temperature ofmore » fathead minnows (Pimephales promelas), although the results were confounded due to variations in copper concentrations. In this study, the authors examined the feasibility of using acute temperature preference tests to assess the chronic toxicity of low concentrations of free cupric ions to Mozambique tilapia, Oreochromis mossambicus (Peters).« less

Toxic shock syndrome post open reduction and Kirschner wire fixation of a humeral lateral condyle fracture

PubMed Central

Chan, Yuen; Selvaratnam, Veenesh; Garg, Neeraj

2015-01-01

Use of Kirschner wires (K-wires) is the most common method of fracture stabilisation in lateral condyle fracture fixation in children. We report a case of toxic shock syndrome (TSS) following an open reduction and internal fixation using K-wires for a humeral lateral condyle fracture in a 5-year-old girl. TSS is a toxin-mediated multisystem illness. It typically presents with shock and it is most often attributed to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. It can lead to multiorgan failure and, ultimately, death. It is important to be aware of TSS, as it can present within any setting. Patients often have non-specific symptoms and their condition can worsen rapidly. TSS postorthopaedic surgery is rare; however, due to the serious nature of this disease, it is important to promptly recognise and diagnose TSS, and to ensure appropriate treatment is started without delay. PMID:26264942

Biomaterial-based delivery for skeletal muscle repair

PubMed Central

Cezar, Christine A.; Mooney, David J.

2015-01-01

Skeletal muscle possesses a remarkable capacity for regeneration in response to minor damage, but severe injury resulting in a volumetric muscle loss can lead to extensive and irreversible fibrosis, scarring, and loss of muscle function. In early clinical trials, the intramuscular injection of cultured myoblasts was proven to be a safe but ineffective cell therapy, likely due to rapid death, poor migration, and immune rejection of the injected cells. In recent years, appropriate therapeutic cell types and culturing techniques have improved progenitor cell engraftment upon transplantation. Importantly, the identification of several key biophysical and biochemical cues that synergistically regulate satellite cell fate has paved the way for the development of cell-instructive biomaterials that serve as delivery vehicles for cells to promote in vivo regeneration. Material carriers designed to spatially and temporally mimic the satellite cell niche may be of particular importance for the complete regeneration of severely damaged skeletal muscle. PMID:25271446

Multimodal MR imaging in hepatic encephalopathy: state of the art.

PubMed

Zhang, Xiao Dong; Zhang, Long Jiang

2018-06-01

Hepatic encephalopathy (HE) is a neurological or neuropsychological complication due to liver failure or portosystemic shunting. The clinical manifestation is highly variable, which can exhibit mild cognitive or motor impairment initially, or gradually progress to a coma, even death, without treatment. Neuroimaging plays a critical role in uncovering the neural mechanism of HE. In particular, multimodality MR imaging is able to assess both structural and functional derangements of the brain with HE in focal or neural network perspectives. In recent years, there has been rapid development in novel MR technologies and applications to investigate the pathophysiological mechanism of HE. Therefore, it is necessary to update the latest MR findings regarding HE by use of multimodality MRI to refine and deepen our understanding of the neural traits in HE. Herein, this review highlights the latest MR imaging findings in HE to refresh our understanding of MRI application in HE.

Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines

PubMed Central

Min, Seung-Kee; Kim, Young Hwan; Joh, Jin Hyun; Kang, Jin Mo; Park, Ui Jun; Kim, Hyung-Kee; Chang, Jeong-Hwan; Park, Sang Jun; Kim, Jang Yong; Bae, Jae Ik; Choi, Sun Young; Kim, Chang Won; Park, Sung Il; Yim, Nam Yeol; Jeon, Yong Sun; Yoon, Hyun-Ki; Park, Ki Hyuk

2016-01-01

Lower extremity deep vein thrombosis is a serious medical condition that can result in death or major disability due to pulmonary embolism or post-thrombotic syndrome. Appropriate diagnosis and treatment are required to improve symptoms and salvage the affected limb. Early thrombus clearance rapidly resolves symptoms related to venous obstruction, restores valve function and reduces the incidence of post-thrombotic syndrome. Recently, endovascular treatment has been established as a standard method for early thrombus removal. However, there are a variety of views regarding the indications and procedures among medical institutions and operators. Therefore, we intend to provide evidence-based guidelines for diagnosis and treatment of lower extremity deep vein thrombosis by multidisciplinary consensus. These guidelines are the result of a close collaboration between interventional radiologists and vascular surgeons. The goals of these guidelines are to improve treatment, to serve as a guide to the clinician, and consequently to contribute to public health care. PMID:27699156

ResQFoam for the Treatment of Non-Compressible Hemorrhage on the Front Line.

PubMed

Chang, Julius C; Holloway, Brian C; Zamisch, Monica; Hepburn, Matthew J; Ling, Geoffrey S F

2015-09-01

Noncompressible torso hemorrhage is the leading cause of potentially survivable death on the battlefield. While medical advances have decreased the rate of "died of wounds" to less than 5%, significant treatment limitations in pre-hospital care remain. To address this persistent capability gap, the Defense Advanced Research Projects Agency launched the Wound Stasis System program in 2010. Under that program, Arsenal Medical, in collaboration with Massachusetts General Hospital and Harvard Medical School, developed a novel, self-expanding polyurethane foam that rapidly treats major abdominal bleeding due to trauma, for use at the point of care. This foam treatment is envisioned as an emergency "bridge to surgery" for warfighters who would otherwise die in the field. This commentary presents this emerging technology with the objective to bring to the community's attention a potentially promising device for the treatment of noncompressible abdominal hemorrhage. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

An international randomized study of a home-based self-management program for severe COPD: the COMET.

PubMed

Bourbeau, Jean; Casan, Pere; Tognella, Silvia; Haidl, Peter; Texereau, Joëlle B; Kessler, Romain

2016-01-01

Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET) is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions. Multicenter parallel randomized controlled, open-label superiority trial. Thirty-three hospitals in four European countries. A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD. The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease), an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center's routine practice. Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs.

Oxidant-induced damage to equine erythrocytes from exposure to Pistacia atlantica, Pistacia terebinthus, and Pistacia chinensis.

PubMed

Walter, Kyla M; Moore, Caroline E; Bozorgmanesh, Rana; Magdesian, K Gary; Woods, Leslie W; Puschner, Birgit

2014-11-01

Two horses were referred for methemoglobinemia and hemolytic anemia following 5 acute deaths in their herd from an unidentified toxin source. Horses have a greater risk than other mammalian species of developing methemoglobinemia and hemolytic anemia following ingestion of oxidizing toxins, due to deficiencies in the mechanisms that protect against oxidative damage in erythrocytes. Their susceptibility to oxidative erythrocyte damage is evident in the numerous cases of red maple (Acer rubrum) toxicosis. The suspected toxins causing A. rubrum toxicosis are tannic acid, gallic acid, and a metabolite of gallic acid, pyrogallol. These compounds can be found in a variety of plants, posing a risk to equine health. In order to quickly identify toxin sources, 2 rapid in vitro assays were developed to screen plant extracts for the ability to induce methemoglobin formation or cause hemolysis in healthy equine donor erythrocytes. The plant extract screening focused on 3 species of the genus Pistacia: P. atlantica, P. terebinthus, and P. chinensis, which were located in the horse pasture. Extracts of the seeds and leaves of each species induced methemoglobin formation and resulted in hemolysis, with seed extracts having greater potency. The in vitro assays used in the current study provide a useful diagnostic method for the rapid identification of oxidizing agents from unidentified sources. There is no effective treatment for oxidative erythrocyte damage in horses, making rapid identification and removal of the source essential for the prevention of poisoning. © 2014 The Author(s).

Oxidant-induced damage to equine erythrocytes from exposure to Pistacia atlantica, Pistacia terebinthus, and Pistacia chinensis

PubMed Central

Walter, Kyla M.; Moore, Caroline E.; Bozorgmanesh, Rana; Magdesian, K. Gary; Woods, Leslie W.; Puschner, Birgit

2017-01-01

Two horses were referred for methemoglobinemia and hemolytic anemia following 5 acute deaths in their herd from an unidentified toxin source. Horses have a greater risk than other mammalian species of developing methemoglobinemia and hemolytic anemia following ingestion of oxidizing toxins, due to deficiencies in the mechanisms that protect against oxidative damage in erythrocytes. Their susceptibility to oxidative erythrocyte damage is evident in the numerous cases of red maple (Acer rubrum) toxicosis. The suspected toxins causing A. rubrum toxicosis are tannic acid, gallic acid, and a metabolite of gallic acid, pyrogallol. These compounds can be found in a variety of plants, posing a risk to equine health. In order to quickly identify toxin sources, 2 rapid in vitro assays were developed to screen plant extracts for the ability to induce methemoglobin formation or cause hemolysis in healthy equine donor erythrocytes. The plant extract screening focused on 3 species of the genus Pistacia: P. atlantica, P. terebinthus, and P. chinensis, which were located in the horse pasture. Extracts of the seeds and leaves of each species induced methemoglobin formation and resulted in hemolysis, with seed extracts having greater potency. The in vitro assays used in the current study provide a useful diagnostic method for the rapid identification of oxidizing agents from unidentified sources. There is no effective treatment for oxidative erythrocyte damage in horses, making rapid identification and removal of the source essential for the prevention of poisoning. PMID:25227420

A Single-Amino-Acid Substitution in Obg Activates a New Programmed Cell Death Pathway in Escherichia coli.

PubMed

Dewachter, Liselot; Verstraeten, Natalie; Monteyne, Daniel; Kint, Cyrielle Ines; Versées, Wim; Pérez-Morga, David; Michiels, Jan; Fauvart, Maarten

2015-12-22

Programmed cell death (PCD) is an important hallmark of multicellular organisms. Cells self-destruct through a regulated series of events for the benefit of the organism as a whole. The existence of PCD in bacteria has long been controversial due to the widely held belief that only multicellular organisms would profit from this kind of altruistic behavior at the cellular level. However, over the past decade, compelling experimental evidence has established the existence of such pathways in bacteria. Here, we report that expression of a mutant isoform of the essential GTPase ObgE causes rapid loss of viability in Escherichia coli. The physiological changes that occur upon expression of this mutant protein--including loss of membrane potential, chromosome condensation and fragmentation, exposure of phosphatidylserine on the cell surface, and membrane blebbing--point to a PCD mechanism. Importantly, key regulators and executioners of known bacterial PCD pathways were shown not to influence this cell death program. Collectively, our results suggest that the cell death pathway described in this work constitutes a new mode of bacterial PCD. Programmed cell death (PCD) is a well-known phenomenon in higher eukaryotes. In these organisms, PCD is essential for embryonic development--for example, the disappearance of the interdigital web--and also functions in tissue homeostasis and elimination of pathogen-invaded cells. The existence of PCD mechanisms in unicellular organisms like bacteria, on the other hand, has only recently begun to be recognized. We here demonstrate the existence of a bacterial PCD pathway that induces characteristics that are strikingly reminiscent of eukaryotic apoptosis, such as fragmentation of DNA, exposure of phosphatidylserine on the cell surface, and membrane blebbing. Our results can provide more insight into the mechanism and evolution of PCD pathways in higher eukaryotes. More importantly, especially in the light of the looming antibiotic crisis, they may point to a bacterial Achilles' heel and can inspire innovative ways of combating bacterial infections, directed at the targeted activation of PCD pathways. Copyright © 2015 Dewachter et al.

Forensic issues in suicide due to acid ingestion in a case of major depressive disorder.

PubMed

Vijayanath, V; Nagaraja Rao, K; Raju, G M; Anitha, M R

2012-06-01

Although rare, suicide using caustic substances in psychiatric practice is not infrequent. Such circumstances involve important forensic and psychiatric issues. In this case report, death due to sulfuric acid ingestion in a patient with major depressive disorder is reported. The legal issues concerning suicide in a patient with mental illness, autopsy findings, forensic issues, and pathophysiology concerning death by acid ingestion have been discussed.

Causes of child mortality (1 to 4 years of age) from 1983 to 2012 in the Republic of Korea: national vital data.

PubMed

Choe, Seung Ah; Cho, Sung-Il

2014-11-01

Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

Chronic Conditions and Mortality Among the Oldest Old

PubMed Central

Lee, Sei J.; Go, Alan S.; Lindquist, Karla; Bertenthal, Daniel; Covinsky, Kenneth E.

2008-01-01

Objectives. We sought to determine whether chronic conditions and functional limitations are equally predictive of mortality among older adults. Methods. Participants in the 1998 wave of the Health and Retirement Study (N=19430) were divided into groups by decades of age, and their vital status in 2004 was determined. We used multivariate Cox regression to determine the ability of chronic conditions and functional limitations to predict mortality. Results. As age increased, the ability of chronic conditions to predict mortality declined rapidly, whereas the ability of functional limitations to predict mortality declined more slowly. In younger participants (aged 50–59 years), chronic conditions were stronger predictors of death than were functional limitations (Harrell C statistic 0.78 vs. 0.73; P=.001). In older participants (aged 90–99 years), functional limitations were stronger predictors of death than were chronic conditions (Harrell C statistic 0.67 vs. 0.61; P=.004). Conclusions. The importance of chronic conditions as a predictor of death declined rapidly with increasing age. Therefore, risk-adjustment models that only consider comorbidities when comparing mortality rates across providers may be inadequate for adults older than 80 years. PMID:18511714

Changing pattern of premature mortality burden over 6 years of rapid growth of the economy in suburban south-west China: 1998-2003.

PubMed

Cai, Le; Chongsuvivatwong, Virasakdi; Geater, Alan

2008-05-01

This study was conducted in Kunming, the capital of Yunnan, a poor province in south-west China experiencing rapid economic growth. The study examined the short-term trend in premature mortality burden from common causes of death in a suburban region between 1998 and 2003. Years of life lost (YLL) per 1000 population and mortality rate per 100,000 population were calculated from medical death certificates, and broken down by cause of death, sex and year without age weighting but with a discounting rate of 3%. Non-communicable diseases contributed over 80% of all causes of YLL, with a slightly increasing trend. The combined rate for communicable, maternal, prenatal and nutritional deficiencies declined from 4.7 to 2.4 per 1000 population. Remarkably, declining trends in YLL were also seen for chronic obstructive pulmonary disease, drug use and road traffic accidents, whereas increasing trends were seen for ischaemic heart disease (IHD) and liver cancer (males). The YLL rate for stroke, self-inflicted injuries, lung cancer and stomach cancer fluctuated over time. The region should focus on further control of IHD and liver cancer.

Effects of mass fires on personnel in shelters

Treesearch

A. Broido; A.W. McMasters

1960-01-01

In the mass fires resulting from air attack during World War II, many people lost their lives in shelters in fire areas. The greatest number of deaths occurred in basements or makeshift shelters. In many cases, positions of the corpses indicated that death came peacefully and unexpectedly. A frequent assumption is that death was due to carbon monoxide poisoning....

20 CFR 410.471 - Conclusion by physician regarding miner's disability or death.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Conclusion by physician regarding miner's disability or death. 410.471 Section 410.471 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.471 Conclusion...

Fulminant fatal swine influenza (H1N1): Myocarditis, myocardial infarction, or severe influenza pneumonia?

PubMed

Cunha, Burke A; Syed, Uzma; Mickail, Nardeen

2010-01-01

The swine influenza (H1N1) pandemic began in Mexico and rapidly spread worldwide. As is the case with pandemic influenza A, the majority of early deaths have been in young healthy adults. The complications of pandemic H1N1 have been reported from several centers. Noteworthy has been the relative rarity of bacterial coinfection in bacterial pneumonia in hospitalized adults with H1N1 pneumonia. Simultaneous bacterial community-acquired pneumonia due to methicillin-sensitive Staphylococcus aureus or community-acquired methicillin resistant S. aureus and subsequent bacterial community-acquired pneumonia due to S. pneumoniae or Haemophilus influenzae have been reportedly rare (0.4%-4% of well-documented cases). Cardiac complications of H1N1 infection have been uncommon. Young healthy adults without a cardiac history who have H1N1 and chest pain usually have either acute myocardial infarction or acute myocarditis. Cardiac symptomatology with H1N1 often overshadows pulmonary manifestations, that is, influenza pneumonia. With H1N1 pneumonia, clinicians should be alert for otherwise unexplained tachycardia or chest pain that may represent acute myocardial infarction or myocarditis. We present a case of rapidly fatal H1N1 in a young adult treated with oseltamivir and peramivir. He was initially tachycardic, thought to represent myocarditis. He subsequently became hypotensive and expired. At autopsy there was cardiomegaly present but there were no signs of acute myocardial infarction or myocarditis. Pathologically, he died of severe H1N1 pneumonia and not bacterial pneumonia. Copyright © 2010 Elsevier Inc. All rights reserved.

Melioidosis in Thailand: Present and Future

PubMed Central

Hinjoy, Soawapak; Hantrakun, Viriya; Kongyu, Somkid; Kaewrakmuk, Jedsada; Wangrangsimakul, Tri; Jitsuronk, Siroj; Saengchun, Weerawut; Bhengsri, Saithip; Akarachotpong, Thantapat; Thamthitiwat, Somsak; Sangwichian, Ornuma; Anunnatsiri, Siriluck; Sermswan, Rasana W; Lertmemongkolchai, Ganjana; Tharinjaroen, Chayada Sitthidet; Preechasuth, Kanya; Udpaun, Ratchadaporn; Chuensombut, Poomin; Waranyasirikul, Nisarat; Anudit, Chanihcha; Narenpitak, Surapong; Jutrakul, Yaowaruk; Teparrukkul, Prapit; Teerawattanasook, Nittaya; Thanvisej, Kittisak; Suphan, Alisa; Sukbut, Punchawee; Ploddi, Kritchavat; Sirichotirat, Poolsri; Chiewchanyon, Bongkoch; Rukseree, Kamolchanok; Hongsuwan, Maliwan; Wongsuwan, Gumphol; Sunthornsut, Pornpan; Wuthiekanun, Vanaporn; Sachaphimukh, Sandy; Wannapinij, Prapass; Chierakul, Wirongrong; Chewapreecha, Claire; Thaipadungpanit, Janjira; Chantratita, Narisara; Korbsrisate, Sunee; Taunyok, Apichai; Dunachie, Susanna; Palittapongarnpim, Prasit; Sirisinha, Stitaya; Kitphati, Rungrueng; Iamsirithaworn, Sopon; Chaowagul, Wipada; Chetchotisak, Ploenchan; Whistler, Toni; Wongratanacheewin, Surasakdi; Limmathurotsakul, Direk

2018-01-01

A recent modelling study estimated that there are 2800 deaths due to melioidosis in Thailand yearly. The Thailand Melioidosis Network (formed in 2012) has been working closely with the Ministry of Public Health (MoPH) to investigate and reduce the burden of this disease. Based on updated data, the incidence of melioidosis is still high in Northeast Thailand. More than 2000 culture-confirmed cases of melioidosis are diagnosed in general hospitals with microbiology laboratories in this region each year. The mortality rate is around 35%. Melioidosis is endemic throughout Thailand, but it is still not uncommon that microbiological facilities misidentify Burkholderia pseudomallei as a contaminant or another organism. Disease awareness is low, and people in rural areas neither wear boots nor boil water before drinking to protect themselves from acquiring B. pseudomallei. Previously, about 10 melioidosis deaths were formally reported to the National Notifiable Disease Surveillance System (Report 506) each year, thus limiting priority setting by the MoPH. In 2015, the formally reported number of melioidosis deaths rose to 112, solely because Sunpasithiprasong Hospital, Ubon Ratchathani province, reported its own data (n = 107). Melioidosis is truly an important cause of death in Thailand, and currently reported cases (Report 506) and cases diagnosed at research centers reflect the tip of the iceberg. Laboratory training and communication between clinicians and laboratory personnel are required to improve diagnosis and treatment of melioidosis countrywide. Implementation of rapid diagnostic tests, such as a lateral flow antigen detection assay, with high accuracy even in melioidosis-endemic countries such as Thailand, is critically needed. Reporting of all culture-confirmed melioidosis cases from every hospital with a microbiology laboratory, together with final outcome data, is mandated under the Communicable Diseases Act B.E.2558. By enforcing this legislation, the MoPH could raise the priority of this disease, and should consider implementing a campaign to raise awareness and melioidosis prevention countrywide. PMID:29725623

Guidelines and recommendations on yeast cell death nomenclature

PubMed Central

Carmona-Gutierrez, Didac; Bauer, Maria Anna; Zimmermann, Andreas; Aguilera, Andrés; Austriaco, Nicanor; Ayscough, Kathryn; Balzan, Rena; Bar-Nun, Shoshana; Barrientos, Antonio; Belenky, Peter; Blondel, Marc; Braun, Ralf J.; Breitenbach, Michael; Burhans, William C.; Büttner, Sabrina; Cavalieri, Duccio; Chang, Michael; Cooper, Katrina F.; Côrte-Real, Manuela; Costa, Vítor; Cullin, Christophe; Dawes, Ian; Dengjel, Jörn; Dickman, Martin B.; Eisenberg, Tobias; Fahrenkrog, Birthe; Fasel, Nicolas; Fröhlich, Kai-Uwe; Gargouri, Ali; Giannattasio, Sergio; Goffrini, Paola; Gourlay, Campbell W.; Grant, Chris M.; Greenwood, Michael T.; Guaragnella, Nicoletta; Heger, Thomas; Heinisch, Jürgen; Herker, Eva; Herrmann, Johannes M.; Hofer, Sebastian; Jiménez-Ruiz, Antonio; Jungwirth, Helmut; Kainz, Katharina; Kontoyiannis, Dimitrios P.; Ludovico, Paula; Manon, Stéphen; Martegani, Enzo; Mazzoni, Cristina; Megeney, Lynn A.; Meisinger, Chris; Nielsen, Jens; Nyström, Thomas; Osiewacz, Heinz D.; Outeiro, Tiago F.; Park, Hay-Oak; Pendl, Tobias; Petranovic, Dina; Picot, Stephane; Polčic, Peter; Powers, Ted; Ramsdale, Mark; Rinnerthaler, Mark; Rockenfeller, Patrick; Ruckenstuhl, Christoph; Schaffrath, Raffael; Segovia, Maria; Severin, Fedor F.; Sharon, Amir; Sigrist, Stephan J.; Sommer-Ruck, Cornelia; Sousa, Maria João; Thevelein, Johan M.; Thevissen, Karin; Titorenko, Vladimir; Toledano, Michel B.; Tuite, Mick; Vögtle, F.-Nora; Westermann, Benedikt; Winderickx, Joris; Wissing, Silke; Wölfl, Stefan; Zhang, Zhaojie J.; Zhao, Richard Y.; Zhou, Bing; Galluzzi, Lorenzo; Kroemer, Guido; Madeo, Frank

2018-01-01

Elucidating the biology of yeast in its full complexity has major implications for science, medicine and industry. One of the most critical processes determining yeast life and physiology is cellular demise. However, the investigation of yeast cell death is a relatively young field, and a widely accepted set of concepts and terms is still missing. Here, we propose unified criteria for the definition of accidental, regulated, and programmed forms of cell death in yeast based on a series of morphological and biochemical criteria. Specifically, we provide consensus guidelines on the differential definition of terms including apoptosis, regulated necrosis, and autophagic cell death, as we refer to additional cell death routines that are relevant for the biology of (at least some species of) yeast. As this area of investigation advances rapidly, changes and extensions to this set of recommendations will be implemented in the years to come. Nonetheless, we strongly encourage the authors, reviewers and editors of scientific articles to adopt these collective standards in order to establish an accurate framework for yeast cell death research and, ultimately, to accelerate the progress of this vibrant field of research. PMID:29354647

Actual management and prognosis of severe isolated tricuspid regurgitation associated with atrial fibrillation without structural heart disease.

PubMed

Takahashi, Yusuke; Izumi, Chisato; Miyake, Makoto; Imanaka, Miyako; Kuroda, Maiko; Nishimura, Shunsuke; Yoshikawa, Yusuke; Amano, Masashi; Imamura, Sari; Onishi, Naoaki; Tamaki, Yodo; Enomoto, Soichiro; Tamura, Toshihiro; Kondo, Hirokazu; Kaitani, Kazuaki; Nakagawa, Yoshihisa

2017-09-15

Patients with atrial fibrillation (AF) without structural heart diseases can show severe tricuspid regurgitation (TR), especially among aged people. The aim of this study was to clarify the actual management, prognosis, and prognostic factors for severe isolated TR associated with AF without structural heart diseases. We retrospectively investigated actual management in 178 consecutive patients with severe isolated TR associated with AF between 1999 and 2011 in our institution. Prognosis and its predictors were also investigated in 115 patients (68 persistent TR and 47 transient TR) who were followed-up for >1year. During the follow-up period (mean: 5.9years), event free rate from death due to right-sided heart failure (RHF) was 97% at 5years. Persistent TR was associated with higher risk of hospitalization due to RHF than transient TR (log-rank P=0.048) and death due to RHF were all seen in patients with persistent TR who experienced hospitalization due to RHF. Among patients with persistent TR, right ventricular outflow tract dimension >35.3mm, right atrial area >40.3cm 2 , and tenting height >2.1mm were associated with higher risk of hospitalization due to RHF (adjusted hazard ratio: 3.32, 3.83, and 2.89, respectively; P=0.003, 0.002, and 0.009, respectively). The prognosis of severe isolated TR associated with AF was good with a focus on cardiac death. However, the incidence of cardiac death increased among patients who experienced hospitalization due to RHF. Larger right ventricular outflow tract dimension, right atrial area and tenting height were predictors of hospitalization due to RHF. Copyright © 2017 Elsevier B.V. All rights reserved.

Mouse embryonic stem cells undergo charontosis, a novel programmed cell death pathway dependent upon cathepsins, p53, and EndoG, in response to etoposide treatment.

PubMed

Tichy, Elisia D; Stephan, Zachary A; Osterburg, Andrew; Noel, Greg; Stambrook, Peter J

2013-05-01

Embryonic stem cells (ESCs) are hypersensitive to many DNA damaging agents and can rapidly undergo cell death or cell differentiation following exposure. Treatment of mouse ESCs (mESCs) with etoposide (ETO), a topoisomerase II poison, followed by a recovery period resulted in massive cell death with characteristics of a programmed cell death pathway (PCD). While cell death was both caspase- and necroptosis-independent, it was partially dependent on the activity of lysosomal proteases. A role for autophagy in the cell death process was eliminated, suggesting that ETO induces a novel PCD pathway in mESCs. Inhibition of p53 either as a transcription factor by pifithrin α or in its mitochondrial role by pifithrin μ significantly reduced ESC death levels. Finally, EndoG was newly identified as a protease participating in the DNA fragmentation observed during ETO-induced PCD. We coined the term charontosis after Charon, the ferryman of the dead in Greek mythology, to refer to the PCD signaling events induced by ETO in mESCs. Copyright © 2013 Elsevier B.V. All rights reserved.

Effectiveness of an NGO primary health care programme in rural Bangladesh: evidence from the management information system.

PubMed

Mercer, Alec; Khan, Mobarak Hossain; Daulatuzzaman, Muhammad; Reid, Joanna

2004-07-01

This paper considers evidence of the effectiveness of a non-governmental organization (NGO) primary health care programme in rural Bangladesh. It is based on data from the programme's management information system reported by 27 partner NGOs from 1996-2002. The data indicate relatively high coverage has been achieved for reproductive and child health services, as well as lower infant and child mortality. On the basis of a crude indicator of socio-economic status, the programme is poverty-focused. There is good service coverage among the poorest one-third and others, and the infant and child mortality differential has been eliminated over recent years. A rapid decline in infant mortality among the poorest from 1999-2002 reflects a reduction in neonatal mortality of about 50%. Allowing for some under-reporting and possible misclassification of deaths to the stillbirths category, neonatal mortality is relatively low in the NGO areas. The lower child and maternal mortality for the NGO areas combined, compared with estimates for Bangladesh in recent years, may at least in part be due to high coverage of reproductive and child health services. Other development programmes implemented by many of the NGOs could also have contributed. Despite the limited resources available, and the lower infant and child mortality already achieved, there appears to be scope for further prevention of deaths, particularly those due to birth asphyxia, acute respiratory infection, diarrhoeal disease and accidents. Maternal mortality in the NGO areas was lower in 2000-02 than the most recent estimate for Bangladesh. Further reduction is likely to depend on improved access to qualified community midwives and essential obstetric care at government referral facilities.

Increased prescribing of Valium, Librium, and other drugs--an example of the influence of economic and social factors on the practice of medicine.

PubMed

Waldron, I

1977-01-01

Drug prescriptions per capita in the United States have more than doubled since 1950 without a commensurate improvement in health. Drugs are often prescribed for clinical conditions in which therapeutic benefits do not outweigh the risk of adverse drug reactions. Deaths due to adverse drug reactions are roughly as frequent as deaths due to automobile accidents. Valium and Librium are the first and fourth most commonly prescribed drugs in the U.S., used by one ten adults each year. The rapid rise in use of these drugs has occurred during a period of rising social stress, as indicated by increases in alcohol consumption, suicide, and homicide, Valium and Librium are frequently prescribe for patients who go to doctors with social or other nonmedical problems, often in lieu of attempts to resolve these underlying problems. Overprescribing occurs because the decision to prescribe is influenced not only by consideration of therapeutic benefit, but also by nonmedical factors, for example the widespread expectation by both patient and doctor that the doctor will provide a drug or some other technological treatment. Prescribing decisions are also influenced by the profit-motivated activities of drug companies, including the expenditure of almost one-quarter of every sales dollar on drug promotion. The most widely used source of drug information for doctors is the industry-sponsored Physicians' Desk Reference, which overrates the therapeutic value of Valium and Librium as compared to disinterested medical sources. Drug companies also contribute to overprescribing by introducing numerous minor variants of existing drugs. The therapeutic benefits of such new drugs are often overestimated in the early years of use when adverse side effects are not well known and apparent efficacy is enhanced by placebo effects in uncontrolled observations.

Dronedarone: an amiodarone analogue.

PubMed

Doggrell, Sheila A; Hancox, Jules C

2004-04-01

Of the antiarrhythmic drugs in current use, amiodarone is one of the most effective and is associated with a comparatively low risk of drug-induced pro-arrhythmia, probably due to its multiple pharmacological actions on cardiac ion channels and receptors. However, amiodarone is associated with significant extra-cardiac side effects and this has driven development of amiodarone analogues. These analogues include short acting analogues (e.g., AT-2001) with similar acute effects to amiodarone, the thyroid receptor antagonist KB-130015 and dronedarone. Dronedarone, (SR-33589; Sanofi-Synthelabo), is a non-iodinated amiodarone derivative that inhibits Na +, K + and Ca 2+ currents. It is a potent inhibitor of the acetylcholine-activated K + current from atrial and sinoatrial nodal tissue, and inhibits the rapid delayed rectifier more potently than slow and inward rectifier K + currents and inhibits L-type calcium current. Dronedarone is an antagonist at alpha- and beta-adrenoceptors and unlike amiodarone, has little effect at thyroid receptors. Dronedarone is more potent than amiodarone in inhibiting arrhythmias and death in animal models of ischaemia- and reperfusion-induced arrhythmias. In the Dronedarone Atrial Fibrillation Study After Electrical Cardioversion (DAFNE) clinical trial, dronedarone 800 mg/day appeared to be effective and safe for the prevention of atrial fibrillation relapses after cardioversion. The Antiarrhythmic Trial with Dronedarone in Moderate-to-Severe Congestive Heart Failure Evaluating Morbidity Decrease (ANDROMEDA) trial was stopped due to a potential increased risk of death in the dronedarone group. Trials of dronedarone in the maintenance of sinus rhythm in patients with atrial fibrillation and a safety and tolerability study in patients with an implantable cardioverter defibrillator are ongoing. Further experimental and clinical studies are required before we have a definitive answer to whether dronedarone has advantages over amiodarone and other amiodarone analogues.

Infrequent physician use of implantable cardioverter-defibrillators risks patient safety.

PubMed

Lyman, Stephen; Sedrakyan, Art; Do, Huong; Razzano, Renee; Mushlin, Alvin I

2011-10-01

Implantable cardioverter-defibrillators (ICDs) have diffused rapidly into clinical practice with little evaluation of their real-world effectiveness. To determine the effect of the adoption of ICD on patient safety, particularly with respect to physician volume and early outcomes. Retrospective cohort of all ICD implantations in New York state from 1997 to 2006, with follow-up at 90 days and 1 year. Setting New York state non-federal hospital discharges in which an ICD was implanted during the admission. Patients were followed forward for 1 year for subsequent admissions. Patients New York state residents undergoing ICD implantation. Effects of annual and career ICD implantation volume on 90-day complication, readmission, reprogramming, mortality and revision of the ICD within 1 year. This cohort (N = 38,992) represents a period of rapid adoption and implementation of this new technology, with frequency more than tripling between 1997 and 2006. We identified 6439 (16.5%) post-implantation complications and 1093 (2.8%) deaths within 90 days of implantation. The majority (73.4%) of physicians implanted one or fewer ICDs per year, and 11.0% of all implantations were performed by these very-low-volume operators. Patients treated by very-low-volume operators were more likely to die (RR = 1.8, 95% CI 1.3 to 2.4) or experience cardiac complications (RR = 4.7, 95% CI 3.3 to 6.8) even after the adjustment for case mix compared to operators who frequently performed ICD implantation. These findings suggest a need for safe and effective implementation strategies for new medical technologies, which minimize patient risk due to rapid diffusion among inexperienced providers and assure that the intended benefit can be maximised rapidly.

Mortality due to poisoning in a developing agricultural country: trends over 20 years.

PubMed

Senanayake, N; Peiris, H

1995-10-01

The cause of death as recorded in 37,125 death certificates (DCs) issued in the Kandy District over 20 years at 5-year intervals beginning in 1967 were analysed to determine the trends in mortality caused by poisoning in the community. Poisoning accounted for 718 (19.3 per 1000) deaths, the highest number being in the third decade of life (41.9%). Male:female ratio was 3:1. The agent responsible for 77% of the deaths was pesticides. Acids and chemicals accounted for 6.9% of the deaths. Other poisons each contributing to less than 1% of the deaths were: plant poisons, food items, drugs, kerosine oil and alcohol. Nearly half the deaths had occurred outside the town area, at home or in small hospitals in the periphery. Mortality due to poisoning showed an increasing trend during the 20 years, from 11.8 to 43/1000 deaths, and this increase was most marked in the periphery, from 8/1000 to 70/1000. This increase paralleled the increase in suicide figures in the country. Our findings call for a shift in emphasis in public education towards first-aid management of intoxication. Health services of developing countries should provide appropriate resuscitative equipment, and ensure a regular supply of antidotes and other medication to all rural hospitals. Management of pesticide poisoning should be emphasised in the curricula for medical graduates, nurses, and paramedics.

Hepatitis C Virus Recurrence Occurs Earlier in Patients Receiving Donation After Circulatory Death Liver Transplant Grafts Compared With Those Receiving Donation After Brainstem Death Grafts.

PubMed

Townsend, S A; Monga, M A; Nightingale, P; Mutimer, D; Elsharkawy, A M; Holt, A

2017-11-01

Hepatitis C virus (HCV)-related cirrhosis remains the commonest indication for liver transplantation worldwide, yet few studies have investigated the impact of donation after circulatory death (DCD) graft use on HCV recurrence and patient outcomes. DCD grafts have augmented the limited donor organ pool and reduced wait-list mortality, although concerns regarding graft longevity and patient outcome persist. This was a single-center study of all HCV + adults who underwent DCD liver transplantation between 2004 and 2014. 44 HCV+ patients received DCD grafts, and were matched with 44 HCV+ recipients of donation after brainstem death (DBD) grafts, and their outcomes examined. The groups were matched for age, sex, and presence of hepatocellular carcinoma; no significant differences were found between the group's donor or recipient characteristics. Paired and unpaired analysis demonstrated that HCV recurrence was more rapid in recipients of DCD organs compared with DBD grafts (408 vs 657 days; P = .006). There were no significant differences in graft survival, patient survival, or rates of biliary complications between the cohorts despite DCD donors being 10 years older on average than those used in other published experience. In an era of highly effective direct acting antiviral therapy, rapid HCV recrudescence in grafts from DCD donors should not compromise long-term morbidity or mortality. In the context of rising wait-list mortality, it is prudent to use all available sources to expand the pool of donor organs, and our data support the practice of using extended-criteria DCD grafts based on donor age. Notwithstanding that, clinicians should be aware that HCV recrudescence is more rapid in DCD recipients, and early post-transplant anti-viral therapy is indicated to prevent graft injury. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Type I interferon induces necroptosis in macrophages during infection with Salmonella enterica serovar Typhimurium

PubMed Central

Robinson, Nirmal; McComb, Scott; Mulligan, Rebecca; Dudani, Renu; Krishnan, Lakshmi; Sad, Subash

2014-01-01

Salmonella enterica serovar Typhimurium (S. Typhimurium) is a virulent pathogen that induces rapid host death. Here we observed that host survival after infection with S. Typhimurium was enhanced in the absence of type I interferon signaling, with improved survival of mice deficient in the receptor for type I interferons (Ifnar1−/− mice) that was attributed to macrophages. Although there was no impairment in cytokine expression or inflammasome activation in Ifnar1−/− macrophages, they were highly resistant to S. Typhimurium–induced cell death. Specific inhibition of the kinase RIP1or knockdown of the gene encoding the kinase RIP3 prevented the death of wild-type macrophages, which indicated that necroptosis was a mechanism of cell death. Finally, RIP3-deficient macrophages, which cannot undergo necroptosis, had similarly less death and enhanced control of S. Typhimurium in vivo. Thus, we propose that S. Typhimurium induces the production of type I interferon, which drives necroptosis of macrophages and allows them to evade the immune response. PMID:22922364

Sudden and unexpected death. The pediatrician's response.

PubMed

Mandell, F; McClain, M; Reece, R M

1987-07-01

When an infant dies suddenly and unexpectedly, the sense of loss and terrible grief may overwhelm not only the parents but also the physician. When that sudden death is due to a known cause, the concrete character of the event can be incorporated into the normal rationalization of mourning. However, when death is due to an unknown mechanism, as in the sudden infant death syndrome, feelings of inadequacy in caring for the child are reinforced. The essential need for support of these families is clear. For physicians, this kind of loss is disquieting and anxiety-provoking. Forty-seven physicians responded to a survey exploring the relationship between the physician and the family after the death of an infant, the feelings of the physician about the death and his or her own sense of loss, and the physician's need for personal support and educational preparation for such an event. While 41 of the physicians indicated they had discussed the death with the family, six had made no contact with the survivors. Thirty-six of the respondents indicated that their relationship with the family continued, and ten physicians stated that their relationship terminated after the death. Physicians characterized their initial responses to the death as frustration, sadness, shock, anger, guilt, regret, hurt, and inadequacy. Most of the physicians believed that they had "missed" something and feared they might be blamed for the death. The competence, sincerity, and sensitivity shown to families during this tragic experience can positively influence the family's mourning and recovery. The pediatrician can provide a rational voice and a medical understanding of tragedy without blame.

Age as an independent risk factor for intensive care unit admission or death due to 2009 pandemic influenza A (H1N1) virus infection.

PubMed

Nickel, Katelin B; Marsden-Haug, Nicola; Lofy, Kathryn H; Turnberg, Wayne L; Rietberg, Krista; Lloyd, Jennifer K; Marfin, Anthony A

2011-01-01

This study evaluated risk factors for intensive care unit (ICU) admission or death among people hospitalized with 2009 pandemic influenza A (pH1N1) virus infection. We based analyses on data collected in Washington State from April 27 to September 18, 2009, on deceased or hospitalized people with laboratory-confirmed pH1N1 infection reported by health-care providers and hospitals as part of enhanced public health surveillance. We used bivariate analyses and multivariable logistic regression to identify risk factors associated with ICU admission or death due to pH1N1. We identified 123 patients admitted to the hospital but not an ICU and 61 patients who were admitted to an ICU or died. Independent of high-risk medical conditions, both older age and delayed time to hospital admission were identified as risk factors for ICU admission or death due to pH1N1. Specifically, the odds of ICU admission or death were 4.44 times greater among adults aged 18-49 years (95% confidence interval [CI] 1.97, 10.02) and 5.93 times greater among adults aged 50-64 years (95% CI 2.24, 15.65) compared with pediatric patients < 18 years of age. Likewise, hospitalized cases admitted more than two days after illness onset had 2.17 times higher odds of ICU admission or death than those admitted within two days of illness onset (95% CI 1.10, 4.25). Although certain medical conditions clearly influence the need for hospitalization among people infected with pH1N1 virus, older age and delayed time to admission each played an independent role in the progression to ICU admission or death among hospitalized patients.

Molecular pathology of brain edema after severe burns in forensic autopsy cases with special regard to the importance of reference gene selection.

PubMed

Wang, Qi; Ishikawa, Takaki; Michiue, Tomomi; Zhu, Bao-Li; Guan, Da-Wei; Maeda, Hitoshi

2013-09-01

Brain edema is believed to be linked to high mortality incidence after severe burns. The present study investigated the molecular pathology of brain damage and responses involving brain edema in forensic autopsy cases of fire fatality (n = 55) compared with sudden cardiac death (n = 11), mechanical asphyxia (n = 13), and non-brain injury cases (n = 22). Postmortem mRNA and immunohistochemical expressions of aquaporins (AQPs), claudin5 (CLDN5), and matrix metalloproteinases (MMPs) were examined. Prolonged deaths due to severe burns showed an increase in brain water content, but relative mRNA quantification, using different normalization methods, showed inconsistent results: in prolonged deaths due to severe burns, higher expression levels were detected for all markers when three previously validated reference genes, PES1, POLR2A, and IPO8, were used for normalization, higher for AQP1 and MMP9 when GAPDH alone was used for normalization and higher for MMP9, but lower for MMP2 when B2M alone was used for normalization. Additionally, when B2M alone was used for normalization, higher expression of AQP4 was detected in acute fire deaths. Furthermore, the expression stability values of these five reference genes calculated by geNorm demonstrated that B2M was the least stable one, followed by GAPDH. In immunostaining, only AQP1 and MMP9 showed differences among the causes of death: they were evident in most prolonged deaths due to severe burns. These findings suggest that systematic analysis of gene expressions using real-time PCR might be a useful procedure in forensic death investigation, and validation of reference genes is crucial.

Trends in Mortality from Cerebrovascular and Hypertensive Diseases in Brazil Between 1980 and 2012.

PubMed

Villela, Paolo Blanco; Klein, Carlos Henrique; Oliveira, Gláucia Maria Moraes de

2016-07-01

Cerebrovascular and hypertensive diseases are among the main causes of death worldwide. However, there are limited data about the trends of these diseases over the years. To evaluate the temporal trends in mortality rates and proportional mortality from cerebrovascular and hypertensive diseases according to sex and age in Brazil between 1980 and 2012. We evaluated the underlying causes of death between 1980 and 2012 in both sexes and by age groups for circulatory diseases (CD), cerebrovascular diseases (CBVD), and hypertensive diseases (HD). We also evaluated death due to all causes (AC), external causes (EC), and ill-defined causes of death (IDCD). Data on deaths and population were obtained from the Department of Information Technology of the Unified Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS/MS). We estimated crude and standardized annual mortality rates per 100,000 inhabitants and percentages of proportional mortality rates. With the exception of EC, the mortality rates per 100,000 inhabitants of all other diseases increased with age. The proportional mortality of CD, CBVD, and HD increased up to the age range of 60-69 years in men and 70-79 years in women, and reached a plateau in both sexes after that. The standardized rates of CD and CBVD declined in both sexes. However, the HD rates showed the opposite trend and increased mildly during the study period. Despite the decline in standardized mortality rates due to CD and CBVD, there was an increase in deaths due to HD, which could be related to factors associated with the completion of the death certificates, decline in IDCD rates, and increase in the prevalence of hypertension.

Causes of sudden death in Addis Ababa, Ethiopia.

PubMed

Schneider, J; Bezabih, K

2001-10-01

The aim of this study was to evaluate the causes of death in individuals who died suddenly in Addis Ababa, Ethiopia. The selection of the cases was based on police reports, which contained a description of sudden unexpected or instantaneous death. The study was performed on necropsies of the Medico legal Department of Menelik II Hospital, in Addis Ababa during the years 1998 and 1999. According to the pathological features of the heart, we classified 92 dead bodies in 3 groups: Group A: Hearts showing adequate morphological changes to explain sudden death (n = 63). Group B: Hearts showing some structural changes, but inadequate to explain sudden death (n = 20). Group C: Normal hearts (n = 7). In two bodies the general autopsy revealed an extra cardiac cause of death. The single most relevant cause of death in group A was coronary artery disease (44 cases) followed by excessive myocardial hypertrophy due to post-rheumatic valvular lesions (7 cases). While the high prevalence of rheumatic heart disease in Ethiopia is well known, the proportion of cases who died due to coronary heart disease is surprising. Though during the last years some African authors assumed that coronary atherosclerosis is on the increase in developing countries the percentage is higher than expected and higher than in other countries where similar studies exist.

Fatal Rocky Mountain Spotted Fever along the United States–Mexico Border, 2013–2016

PubMed Central

Yaglom, Hayley; Casal, Mariana; Fierro, Maria; Kriner, Paula; Murphy, Brian; Kjemtrup, Anne; Paddock, Christopher D.

2017-01-01

Rocky Mountain spotted fever (RMSF) is an emerging public health concern near the US–Mexico border, where it has resulted in thousands of cases and hundreds of deaths in the past decade. We identified 4 patients who had acquired RMSF in northern Mexico and subsequently died at US healthcare facilities. Two patients sought care in Mexico before being admitted to US-based hospitals. All patients initially had several nonspecific signs and symptoms, including fever, headache, nausea, vomiting, or myalgia, but deteriorated rapidly without receipt of a tetracycline-class antimicrobial drug. Each patient experienced respiratory failure late in illness. Although transborder cases are not common, early recognition and prompt initiation of appropriate treatment are vital for averting severe illness and death. Clinicians on both sides of the US–Mexico border should consider a diagnosis of RMSF for patients with rapidly progressing febrile illness and recent exposure in northern Mexico. PMID:28930006

Fatal Rocky Mountain Spotted Fever along the United States-Mexico Border, 2013-2016.

PubMed

Drexler, Naomi A; Yaglom, Hayley; Casal, Mariana; Fierro, Maria; Kriner, Paula; Murphy, Brian; Kjemtrup, Anne; Paddock, Christopher D

2017-10-01

Rocky Mountain spotted fever (RMSF) is an emerging public health concern near the US-Mexico border, where it has resulted in thousands of cases and hundreds of deaths in the past decade. We identified 4 patients who had acquired RMSF in northern Mexico and subsequently died at US healthcare facilities. Two patients sought care in Mexico before being admitted to US-based hospitals. All patients initially had several nonspecific signs and symptoms, including fever, headache, nausea, vomiting, or myalgia, but deteriorated rapidly without receipt of a tetracycline-class antimicrobial drug. Each patient experienced respiratory failure late in illness. Although transborder cases are not common, early recognition and prompt initiation of appropriate treatment are vital for averting severe illness and death. Clinicians on both sides of the US-Mexico border should consider a diagnosis of RMSF for patients with rapidly progressing febrile illness and recent exposure in northern Mexico.

Lessons Learned during Public Health Response to Cholera Epidemic in Haiti and the Dominican Republic

PubMed Central

Tappero, Jordan W.

2011-01-01

After epidemic cholera emerged in Haiti in October 2010, the disease spread rapidly in a country devastated by an earthquake earlier that year, in a population with a high proportion of infant deaths, poor nutrition, and frequent infectious diseases such as HIV infection, tuberculosis, and malaria. Many nations, multinational agencies, and nongovernmental organizations rapidly mobilized to assist Haiti. The US government provided emergency response through the Office of Foreign Disaster Assistance of the US Agency for International Development and the Centers for Disease Control and Prevention. This report summarizes the participation by the Centers and its partners. The efforts needed to reduce the spread of the epidemic and prevent deaths highlight the need for safe drinking water and basic medical care in such difficult circumstances and the need for rebuilding water, sanitation, and public health systems to prevent future epidemics. PMID:22099111

THE EFFECT OF DINITROPHENOL AND THYROXIN ON THE SUSCEPTIBILITY OF MICE TO STAPHYLOCOCCAL INFECTIONS

PubMed Central

Smiths, J. Maclean; Dubos, René J.

1956-01-01

Mice were given daily per os amounts of dinitrophenol or of thyroid extract sufficient to prevent or retard the normal weight gain of uninfected animals, but not large enough to cause their death. When mice maintained on these regimens for 1 or 2 weeks were infected with staphylococci, most of them died within 12 days—much more rapidly than did mice fed a normal diet. Deaths occurred even when the organism injected was a non-virulent staphylococcus, unable to cause fatal disease in mice fed a normal diet. There was some suggestion that thyroid treatment interfered with the bactericidal mechanism in the liver, spleen, and kidneys of mice during the initial phase of infection. In contrast there was no clear evidence at any time thereafter that either thyroid extract or dinitrophenol caused the staphylococci to multiply more rapidly in the various organs. PMID:13278459

The GYF domain protein PSIG1 dampens the induction of cell death during plant-pathogen interactions

PubMed Central

Matsui, Hidenori; Nomura, Yuko; Egusa, Mayumi; Hamada, Takahiro; Hyon, Gang-Su; Kaminaka, Hironori; Ueda, Takashi

2017-01-01

The induction of rapid cell death is an effective strategy for plants to restrict biotrophic and hemi-biotrophic pathogens at the infection site. However, activation of cell death comes at a high cost, as dead cells will no longer be available for defense responses nor general metabolic processes. In addition, necrotrophic pathogens that thrive on dead tissue, take advantage of cell death-triggering mechanisms. Mechanisms by which plants solve this conundrum remain described. Here, we identify PLANT SMY2-TYPE ILE-GYF DOMAIN-CONTAINING PROTEIN 1 (PSIG1) and show that PSIG1 helps to restrict cell death induction during pathogen infection. Inactivation of PSIG1 does not result in spontaneous lesions, and enhanced cell death in psig1 mutants is independent of salicylic acid (SA) biosynthesis or reactive oxygen species (ROS) production. Moreover, PSIG1 interacts with SMG7, which plays a role in nonsense-mediated RNA decay (NMD), and the smg7-4 mutant allele mimics the cell death phenotype of the psig1 mutants. Intriguingly, the psig1 mutants display enhanced susceptibility to the hemi-biotrophic bacterial pathogen. These findings point to the existence and importance of the SA- and ROS-independent cell death constraining mechanism as a part of the plant immune system. PMID:29073135