Expressing another new concept, ICD-10 defines “pregnancy-related death” as death during pregnancy or within 42 days of the termination of pregnancy, regardless of the cause ofdeath. ICD-10 also proposes calculat- ing a ratio for pregnancy-related mor- tality in which the numerator repre- sents maternal deaths from direct and indirect obstetric causes plus deaths attributed to any other cause (nonob- stetric). It is clear that this ratio can be calculated only in countries where information recorded on the death cer- tificate includes information about pregnancy in progress at the timeofdeath or pregnancy occurring during the year preceding death. Since the causes of maternal death are generally not clearly indicated on death certifi- cates, it is possible to conclude that the new definition, as well as calculation of the ratio, is directed at capturing cases of maternal death not character- ized as such.
The computer program thus does not have to wait until an individual dies. Already at birth the timeofdeath is programmed in the genome. Thus when a baby is born, the histogram element H (i; k) of the correlation matrix H is increased by unity, where i is the genetic age ofdeath for the parent and k that for the newly born child. Complete correlation would mean that the matrix H (i; k) is diagonal while complete statistical independence for the ages ofdeath would mean that the matrix elements have the same shape as a function of k, independent of the line i of the matrix.
Objective: The aim of this study is to identify the causes for discarding corneas at the Eye Bank of the Federal District in Brasilia, Brazil, and describe the social and demographic variables and Causa Mortis of cornea donors from 2014 to 2017. Methods: We conducted an exploratory and social-epidemiologic descriptive study regarding cornea donation. The data base information was obtained from the corneal donor’s medical records analysis. All of the potential donors’ records (cause ofdeath, cause of cornea discard, month of donation, age, gender, and timeofdeath, corneal enucleation and preservation), from 2014 to 2017 were included in the study. Results: We looked at 1,574 corneal donor notifications. Demographic characteristics displayed significant differences in gender distribution (male, 74.8% and female, 25.2%), and the average donor age was 40 ± 15.9 years. 25% of the causes ofdeath were from cardiovascular disease followed by 19.6% from sharp or blunt instrument injury, 14.2% resulted from multiple traumas. We described 3,074 donated corneas from the DF Eye Bank, where 2.6% has not been uptaken. Of those 3,074 corneal tissues, nearly 60% (n=1,836) have been transplanted and 40% (n=1,238) were discarded. Regarding the causes of discard, 68% (n=841) were due to positive or indeterminate serological blood tests and 39% (n=486) because of matureness (expired medium guaranteed period of corneal preservation). Conclusions: Specific issues such as violent causes ofdeath, gender disproportion and total timeof corneal processing can be better managed to reduce procurement times, and availability, of corneal tissue for transplantation.
Understanding the sensitivity and specificity of a diagnostic test is central to its appropriate use in clinical practice. Culture is the leading investigation for patients with suspected infection from a wide range of pathogens, but ascertaining the true sensitivity of this test is difficult. Here, we describe an approach to define the sensitivity of culture using melioidosis as a model system, in which Bayesian LCM with conditional dependence gave an estimated sensitivity of 60.2%. Bayesian LCM also gave an estimated prevalence of 61.6% in patients who were investigated for suspected melioidosis, compared with 37.2% based on culture alone. This higher estimated prevalence is credible, since the study was performed at a hospital where melioidosis is the most common cause of community-acquired bacteremia , and during the rainy season when most cases of melioidosis occur. These findings have important implications for clinical care. Influenced by the high associated death rate from melioidosis in our setting of 45% , we propose that all patients suspected to have this infection should be commenced on empirical intravenous antimicrobials to cover B. pseudomallei, and that this be discontinued or changed to another agent only if an alternative diagnosis is made or melioidosis is considered unlikely. The decision to proceed to a course of oral antimicrobial therapy (which is required for 12–20 weeks to eradicate B. pseudomallei) should be based on a summary of all available information.
SaTScan 9.2 software was used to identify spatial clusters. As the events studied (deaths) are counts and rare in the population, Poisson’s discrete model was used.The following conditions were adopted: no geographical overlapping of clusters, the maximum cluster size equals 50% of the population exposed, and the cluster has a circular form and 999 replications. It should be highlighted that, in this phase, the information about the year when the event occurred was not used.
The frequency of bacterial isolation was higher among the avian strains, which were also more pathogenic. Other studies also showed higher success in recovering samples from organs of animals that died within 24 to 48 hours after inoculation with avian P. multocida strains (Balakrishan; Roy, 2012). According to Ozbey and Muz (2006), it is possible that non- reisolated strains are not lethal to mice because when the virulence is lower, the difficulty of detecting the strains in this animal model is increased. The data in Table 2 verified that the isolation was higher in the first and second days ofdeath. This finding probably explains the fact that the majority of swine strains presented low mortality, less macroscopic lesions, and lower frequency of bacterial isolation.
Objective: To describe the profile of corneal donations obtained by Ocular Tissue Bank, Hospital Getúlio Vargas (BTOC-HGV), assess the quality of the captured tissue and list the indications for corneal transplant. Methods: Retrospective study of registered donors in BTOC-HGV in the period 2008-2011. Collected data were: age, gender and cause ofdeathof the donor, enucleation time, preservation time, quality of the donated cornea, causes of discards and indications for penetrating keratoplasty in BTOC. Results: Were analyzed 311 records of donor cornea BTOC-HGV. The number of donations increased from 9 in 2008 to 80 in 2009, 109 in 2010 and 113 in 2011. Most donors were male. The average age of the donors was 43.00 ± 16.01 years. The majority of transplanted corneas (78.6%) was optics. Were discarded 7.16% of corneal optics, mostly by new tectonic classification and detection of positive serology. The timeof enucleation was 3.77 ± 2.18 hours and preservation was 6.86 ± 6.10 hours. The most frequent causes ofdeath were external causes, followed by diseases of the circulatory, respiratory, digestive and genitourinary systems. The main indication for transplantation was bullous keratopathy, followed by keratoconus and corneal perforation. Conclusion: This study demonstrated the existence of factors associated with quality of corneas by BTOC as age, time between enucleation and preservation and cause ofdeath. The main indication for transplantation was bullous keratopathy.
Time-series analysis is characterized, as a data mining tool which facilitates understanding nature of manufacturing processes and permits prediction of future values of the process parameters or production results on the basis of the past data, recorded in regular intervals. The main methods and problems of the time-series analysis are presented. The authors’ research results, based on green molding sand proper- ties data collected in a foundry with Disamatic molding line, are presented. The work was aimed at finding optimal settings and models of the time-series analysis for that data as well as detection of possible periodicities appearing in the sand properties. It is concluded that although the time-series analysis requires individual approach to each particular problem, some general recommendations can be also formulated. It can be a useful tool for analysis and predictions of outcomes of foundry processes.
he high rate of levothyroxine use in Phase 2 (87.5%) denotes a higher degree of care with regard to the potential donors; however, it is not possible to attribute pharmacological advantages to this drug, due to the lack of information on the action of its enteral administration and the overall lack of understanding of the actual role of thyroid hormones in the maintenance of potential donors. Conversely, methylprednisolone, which was administered in high doses to 95% of the potential donors in Phase 2, might have contributed to compensating for an eventual adrenal insuiciency and the consequent achievement of better hemodynamic control. Nevertheless, the use of that corticosteroid might have been the cause of the frequent occurrence of hyperglycemia in Phase 2 (Table 2). he detrimental efects of hyperglycemia on kidney function following transplantation and on the water-electrolytic balance emphasize the need for the strict control of the potential donors’ glycemia, especially following the administration of corticosteroids. (12,29)
he irst discussion meeting was conducted in Buenos Aires, Argentina in June 2012, in which the members of the consensus presented their indings and opinions. After the irst meeting, participants were divided into groups of 2-3 members; groups were formed based on diferent levels of experience. Each group focused on answering questions about relevant aspects of the topic, and the information was shared via the Internet. With the responses of each group and the results of the respective literature reviews, opinions, and suggestions, the consensus coordinator prepared an initial manuscript. he manuscript was discussed at a second meeting in Buenos Aires in June of 2013. Prior to this second meeting, a new search of the literature published in the period between the two meetings was performed, and 71 additional articles were reviewed.
A phase IIb multicentric controlled trial was developed to assess TG4010 –an active targeted immunotherapy based on a viral MVA vector which codes for MUC1 tumor-associated anti- gen and interleukine 2 –in combination with first-line chemotherapy in patients with advanced NSCLC. The primary objective of the study was to show that the addition of TG4010 to chemo- therapy improved the progression-free survival (PFS) at 6 months. Both OS and HRQOL were assessed as secondary objectives. The study achieved its primary endpoint on the whole study population and in an exploratory analysis put in evidence a significant benefit on several parameters including OS in a large subgroup of 101 patients defined by pre-treatment normal levels of CD16+CD56+CD69+, a phenotype of activated Natural Killer (aNK) cells also called TrPAL (Triple Positive Activated Lymphocytes) . We report here the results of the HRQOL analyses associated to this clinical trial. To our knowledge this is the first time that the impact of immunotherapy on HRQOL has been studied in the context of a combination with standard chemotherapy for NSCLC patients. The main objective was to describe prospectively HRQOL using the Functional Assessment of Cancer Therapy-Lung (FACT-L) questionnaire by treatment arm. Time until definitive deterioration (TUDD) of the FACT-L domains was defined as a modality of longitudinal HRQOL analysis .
In order to characterize the therapeutic itinerary, the cases of deaths due to oral cancer (CID C00 to C10) reported to the Mortality Information System (SIM) were identified in residents of Olinda, in the years of 2012 and 2013, with full assistance provided by SUS. Through the address records contained in the death certificates notified to SIM, interviews were conducted with the key informants of each case, through active residential search. These interviews were performed using the principles of the Verbal Autopsy (AV) protocol. AV is a questionnaire applied to the relatives and / or caregivers of the deceased person and used to obtain information about death in order to know the structure of mortality in these areas.The person who provides the information is the key to a successful investigation. In this case, a person of age who maintained direct contact with the case, must be responsible for the infor- mation provided 14 .
These results reinforce the need to include the theme ofdeath and dying in healthcare courses from the irst semesters. It is necessary to create spaces which allows students to explain, listen and accept suffering, helping them to deal with losses of all kinds in a better way by using different pedagogical strategies. Although pedagogical and therapeutic scenarios cannot be confused, it should not be denied that a psychopedagogical approach can mitigate the impact that the experience ofdeath can have on the personal and academic lives of these young people. From this point of view, the discus- sion about the subject at the very beginning of the training, can favor a more comprehensive prepara- tion of the undergraduate students, enabling them to practice their profession, not only in the perspec- tive of healing, but also of caring.
there were 211 workers who were either lost to follow-up (79 workers) or had a last known address prior to the study end date (132 workers). These 211 workers were submitted to the Social Security Death Index searching on name, date of birth, and Social Security Number. This search yielded three deaths and dates ofdeath. For 1979 onward, we relied on the National Death Index for deaths and dates ofdeath. We also submitted 132 workers lost to follow-up after these searches to TransUnion and located 75 (57%). We relied on cause ofdeath codes from NDI when an exact match was identified. For less certain NDI matches and for deaths occurring before 1979, we requested death certificates from the state ofdeath. Causes ofdeath on death certificates were coded by a nosologist according to the revision of the International Classification of Diseases (ICD) in effect when the death occurred. Workers accrued person-years at risk from their facility start date until the earliest of the death date, the date lost to follow-up, or 2011. Investigators from the original study provided vital status as of 2007 for all workers. Although information from the original investigators’ vital status information was provided, the present study conducted the vital status update without previous knowledge of the original cause or location ofdeath. The study conduct was pursuant to review and oversight by IRB0007144, the Dow Human Studies Review Board in Midland, Michigan, USA. A consent waiver was granted because the study subject records were anonymized and de-identified prior to analysis.
Objectives: Acute kidney injury is characterized by sudden and generally revertible renal function impairment involving inability to maintain home- ostasis. In pediatrics, the main causes of acute kidney injury are sepsis, use of nephrotoxic drugs and renal ischemia in critically ill patients. he incidence of acute kidney injury in these patients ranges from 20 to 30%, resulting in in- creased morbid-mortality, a 40 to 90% rate. his study aimed to evaluate the incidence of acute kidney injury in in- tensive care unit patients, to categorize the severity of the acute kidney injury according to the Pediatric Risk, Injury, Failure, Loss, End-Stage (pRIFLE), examine the relationship between the acute kidney injury and severity using the Pediatric Index of Mortality (PIM) and to analyze outcome predictors.
Newcastle disease vaccines hitherto in vogue are produced from embryonated chicken eggs. Egg- adapted mesogenic vaccines possess several drawbacks such as paralysis and mortality in 2-week- old chicks and reduced egg production in the egg-laying flock. Owing to these possible drawbacks, we attempted to reduce the vaccine virulence for safe vaccination by adapting the virus in a chicken embryo fibroblast cell culture (CEFCC) system. Eighteen passages were carried out by CEFCC, and the pathogenicity was assessed on the basis of the mean deathtime, intracerebral pathogenicity index, and intravenous pathogenicity index, at equal passage intervals. Although the reduction in virulence demonstrated with increasing passage levels in CEFCC was encouraging, 20% of the 2-week-old birds showed paralytic symptoms with the virus vaccine from the 18 th (final) passage. Thus, a tis- sue-culture-adapted vaccine would demand a few more passages by CEFCC in order to achieve a complete reduction in virulence for use as a safe and effective vaccine, especially among younger chicks. Moreover, it can be safely administered even to unprimed 8-week-old birds.