Basic Cause Of Death Research Articles

Mortality trends from congenital malformations of the heart and the great vessels in children and adults in the seven socioeconomic regions of Mexico, 2000-2015.

Congenital heart disease (CHD) represents a global health problem. In Mexico, in children<1year of age it is the second cause of mortality. The aim was to determine mortality trends from CHD and the great vessels in children and adults nationwide, by state and socioeconomic region. Records of mortality associated to CHD and the great vessels for 2000-2015 were obtained from the National Institute of Statistics and Geography. This information is collected from death certificates issued nationwide. International Classification of Diseases, 10th revision, codes corresponding to the basic cause of death from CHD and the great vessels. To calculate mortality rates for individuals≥1year of age, population counts from the national population, estimated by the National Population Council for 2000-2015, were used in the denominator; for infant mortality, live birth counts were used. Rates of mortality nationwide, by state, and by socioeconomic region were calculated. The seven socioeconomic regions were elaborated by the National Institute of Statistics and Geography and include the 31 states and Mexico City according to indicators that are related to well-being such as education, occupation, health, housing, and employment. In the period 2000-2015, 70741 individuals among children and adults died from CHD. Age-adjusted mortality rate per 100000 individuals increased from 3.3 to 4. In the age group<1year of age, mortality rate per 100000 live births increased from 143.9 to 217.3. In the period 2000-2015, age-adjusted mortality rate per 100000 individuals increased from 3.3 to 4. Mexico City as region 7 had the highest mortality from CHD and the great vessels.

Hospitals by day, dispensaries by night: Hourly fluctuations of maternal mortality within Mexican health institutions, 2010-2014.

BackgroundQuality of obstetric care may not be constant within clinics and hospitals. Night shifts and weekends experience understaffing and other organizational hurdles in comparison with the weekday morning shifts, and this may influence the risk of maternal deaths.ObjectiveTo analyze the hourly variation of maternal mortality within Mexican health institutions.MethodsWe performed a cross-sectional multivariate analysis of 3,908 maternal deaths and 10,589,444 births that occurred within health facilities in Mexico during the 2010–2014 period, using data from the Health Information Systems of the Mexican Ministry of Health. We fitted negative binomial regression models with covariate adjustment to all data, as well as similar models by basic cause of death and by weekdays/weekends. The outcome was the Maternal Mortality Ratio (MMR), defined as the number of deaths occurred per 100,000 live births. Hour of day was the main predictor; covariates were day of the week, c-section, marginalization, age, education, and number of pregnancies.ResultsRisk rises during early morning, reaching 52.5 deaths per 100,000 live births at 6:00 (95% UI: 46.3, 62.2). This is almost twice the lowest risk, which occurred at noon (27.1 deaths per 100,000 live births [95% U.I.: 23.0, 32.0]). Risk shows peaks coinciding with shift changes, at 07:00, and 14:00 and was significantly higher on weekends and holidays.ConclusionsEvidence suggests strong hourly fluctuations in the risk of maternal death with during early morning hours and around the afternoon shift change. These results may reflect institutional management problems that cause an uneven quality of obstetric care.

Autopsy Patients With Obesity or Metabolic Syndrome as Basic Cause of Death: Are There Pathological Differences Between These Groups?

Background:The objectives of this study were the evaluation of pathological characteristics of patients with obesity or metabolic syndrome (MS) as basic cause of death, associating the autopsy findings with some clinical aspects and the abdominal adipose panicle thickness.Methods:A total of 88 autopsy cases were studied, divided into 2 groups based on the main cause of death: group 1 (n = 15) obesity and group 2 (n = 73) MS. Clinical summaries of autopsy requests, macroscopic findings, and histologic sections were reviewed.Results:The definition of obesity as the basic cause of death is associated with larger thickness of the abdominal adipose panicle, being 8.5 cm (P = .001) the best measurement, according to the receiver operating characteristic curve. Hypertensive cardiopathy (P = .001), ischemic cardiopathy (P = .003), coronary (P = .008)/systemic (P = .005) atherosclerosis, and arterial (P = .014)/arteriolar (P = .027) nephrosclerosis are associated with the diagnosis of MS. Steatohepatitis is associated with the diagnosis of obesity (P = .030); however, its association with the thickness of the abdominal adipose panicle is not statistically significant (P = .211).Conclusions:In the context of an obese patient in autopsy, pathologist may use the information about abdominal adipose panicle associated with heart, kidney, and liver findings, even macroscopic ones, to decide the basic cause death between obesity and MS.

Profile Matching of Brazilian Birth and Mortality Records where microcephaly is recorded.

ABSTRACT&#x0D; BackgroundIn Profile Matching the term "Profile" means that the information available about an individual could be the same as that available for some other individuals.&#x0D; Reduced versions of birth and mortality records are made publicly available by the Brazilian Ministry of Health and this study covers the years 1996 to 2013. Date of birth, sex and municipality of residence are available in both types of record, so their combination could be studied as a pseudo-identifier. The municipality could be different at the two events so the results outlined here must be seen as a first cut.&#x0D; MethodThe ICD 10 code for microcephaly is Q02. Among the mortality records where Q02 was recorded either as a basic cause or in one of the other lines there were 1676 combinations of the three variables. All but three of them were unique and the remaining three each occcurred with only two records. For 1324 of these records the year of birth was between 1996 and 2013 so that we could reasonably expect these combinations of values among the birth records. However, there were only 204 birth records with combinations that matched and where Q02 was recorded. Possible reasons for the difference could include i) underreporting of births, ii) the failure to detect microcephaly at birth registration and iii) the possibility that microcephaly can only be securely identified sometime after a birth would normally be registered.&#x0D; ResultsAmong the birth records there were 2349 combinations where Q02 was mentioned as a birth anomaly. All but seven of them were unique and the remaining seven each occcurred with only two records. Corresponding to these combinations there were 1416 combinations found among the mortality records. These were found in 2149 records. However in only 541 of the mortality records was there a mention of Q02. It appears as the basic cause of death in 204 of these 541 records. It could be that such a small number of deaths attributed to Q02 is consistent with best medical opinion.&#x0D; ConclusionIt is easy to dismiss these apparent discrepancies as poor recording. Some of it may be, but it could be that doctors were faithful to what they observed. The next step is have a clear picture of what was recorded, like other types of birth defect, when Q02 was not observed in both records of a match.

Regional-level estimation of expected years of life lost attributable to overweight and obesity among Mexican adults

BackgroundExcess body weight has become a major public health problem worldwide, and the burden of overweight and obesity was calculated in this work from a health economics perspective.ObjectiveTo estimate the burden of disease attributable to overweight and obesity among males and females aged 20 years and older using years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to rank the leading causes of premature death.DesignA cross-sectional study took place (2010–2014) and 6,054 deaths were analyzed. Thirteen basic causes of death associated with overweight or obesity were included. The population attributable fraction (PAF), YLL, and ASYLL were calculated.ResultsThe overall burden attributable to overweight and obesity was 36,087 YLL, and the estimated ASYLL per 10,000 persons was 1,098 and 1,029 in males and females, respectively. Type 2 diabetes mellitus was the main cause of premature death (males, 968 ASYLL; females, 772 ASYLL).ConclusionsOverweight and obesity are major risk factors of chronic diseases that are main causes of premature death in the study population. Strategies for preventing overweight and obesity may decrease the incidence and mortality associated with these non-communicable diseases. ASYLL seems to be an indicator that is particularly well adapted to decision-making in public health.

Mortality trends and years of potential life lost from gastric cancer in Mexico, 2000-2012

BackgroundIn 2013 in Mexico, gastric cancer (GC) was the third leading cause of death from cancer in individuals 20 years of age or older. GC remains a public health problem in Mexico due to its high mortality and low survival rates, and the significantly lower quality of life of patients with this condition. ObjectivesThe aims of this study were to determine mortality trends nationwide, by state and socioeconomic region, and to determine rates of age-adjusted years of potential life lost due to GC, by state and socioeconomic region, within the period of 2000-2012. MethodsMortality records associated with GC for 2000-2012 were obtained from the National Health Information System of the Mexican Department of Health. Codes from the Tenth Revision of the International Classification of Diseases corresponding to the basic cause of death from GC were identified. Mortality and age-adjusted years of potential life lost rates, by state and socioeconomic region, were also calculated. ResultsIn Mexico, 69,107 individuals died from GC within the time frame of 2000-2012. The age-adjusted mortality rate per 100,000 inhabitants decreased from 7.5 to 5.6. The male:female ratio was 1.15:1.0. Chiapas had the highest death rate from GC (9.2, 95% CI 8.2-10.3 [2000] and 8.2, 95% CI 7.3-9 [2012]), as well as regions 1, 2, and 5. Chiapas and socioeconomic region 1 had the highest rate of years of potential life lost. ConclusionsUsing the world population age distribution as the standard, the age-adjusted mortality rate in Mexico per 100,000 inhabitants that died from GC decreased from 7.5 to 5.6 between 2000 and 2012. Chiapas and socioeconomic regions 1, 2, and 5 had the highest mortality from GC (Chiapas: 9.2, 95% CI 8.2-10.3 [2000] and 8.2, 95% CI 7.3-9 [2012], region 1: 5.5, 95% CI 5.2-5.9 [2000] and 5.3, 95% CI 4.9-5.7 [2012]; region 2: 5.3, 95% CI 5-5.6 [2000] and 5.4, 95% CI 5.1-5.8 [2012]; region 5: 6.1, 95% CI 5.6-6.6 [2000] and 4.6, 95% CI 4.2-5 [2012]). Chiapas and socioeconomic region 1 had the highest rate of years of potential life lost (Chiapas: 97.4 [2000] and 79.6 [2012] and region 1: 73.5 [2000] 65 [2012]).

Mortality trends and years of potential life lost from gastric cancer in Mexico, 2000-2012.

In 2013 in Mexico, gastric cancer (GC) was the third leading cause of death from cancer in individuals 20 years of age or older. GC remains a public health problem in Mexico due to its high mortality and low survival rates, and the significantly lower quality of life of patients with this condition. The aims of this study were to determine mortality trends nationwide, by state and socioeconomic region, and to determine rates of age-adjusted years of potential life lost due to GC, by state and socioeconomic region, within the period of 2000-2012. Mortality records associated with GC for 2000-2012 were obtained from the National Health Information System of the Mexican Department of Health. Codes from the Tenth Revision of the International Classification of Diseases corresponding to the basic cause of death from GC were identified. Mortality and age-adjusted years of potential life lost rates, by state and socioeconomic region, were also calculated. In Mexico, 69,107 individuals died from GC within the time frame of 2000-2012. The age-adjusted mortality rate per 100,000 inhabitants decreased from 7.5 to 5.6. The male:female ratio was 1.15:1.0. Chiapas had the highest death rate from GC (9.2, 95% CI 8.2-10.3 [2000] and 8.2, 95% CI 7.3-9 [2012]), as well as regions 1, 2, and 5. Chiapas and socioeconomic region 1 had the highest rate of years of potential life lost. Using the world population age distribution as the standard, the age-adjusted mortality rate in Mexico per 100,000 inhabitants that died from GC decreased from 7.5 to 5.6 between 2000 and 2012. Chiapas and socioeconomic regions 1, 2, and 5 had the highest mortality from GC (Chiapas: 9.2, 95% CI 8.2-10.3 [2000] and 8.2, 95% CI 7.3-9 [2012], region 1: 5.5, 95% CI 5.2-5.9 [2000] and 5.3, 95% CI 4.9-5.7 [2012]; region 2: 5.3, 95% CI 5-5.6 [2000] and 5.4, 95% CI 5.1-5.8 [2012]; region 5: 6.1, 95% CI 5.6-6.6 [2000] and 4.6, 95% CI 4.2-5 [2012]). Chiapas and socioeconomic region 1 had the highest rate of years of potential life lost (Chiapas: 97.4 [2000] and 79.6 [2012] and region 1: 73.5 [2000] 65 [2012]).

Óbitos infantis evitáveis em Belo Horizonte: análise de concordância da causa básica, 2010-2011

Resumo Objetivos: analisar o perfil dos óbitos infantis evitáveis investigados e a concordância entre a causa básica da declaração de óbito (DO) original e da DO após investigação. Métodos: estudo de base populacional com análise dos óbitos infantis e dos óbitos evitáveis investigados pelo Comitê de Prevenção de Óbitos de Belo Horizonte (CMPOFI), em 2010 e 2011. A DO após investigação baseou-se na análise dos dados ambulatorial, hospitalar e domiciliar realizada pelo CMPOFI. As causas de morte foram codificadas segundo a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde - 10º Revisão e a causa básica selecionada. A concordância entre a causa básica da DO original e da DO após investigação, analisada de acordo com lista reduzida de tabulação de causas de mortalidade infantil (LIR-MI), foi determinada pelo índice Kappa. Resultados: o Kappa foi fraco (K=0,389; IC95%: 0,192-05,76) quando avaliado pelos grupos da LIRMI. Houve mudanças relevantes na causa de óbito após investigação, com aumento da proporção de óbitos por asfixia, fatores maternos, infecções da criança, infecções perinatais, causas externas e morte súbita na infância. Conclusões: a investigação de óbitos possibilitou maior esclarecimento sobre as circunstâncias dos óbitos infantis evitáveis e a qualificação da causa básica, passos fundamentais para orientar as ações para sua prevenção.

Mortalidad evitable en los estados de la frontera del norte de México: posibles implicaciones sociales y para los servicios de salud

Objetivo: analizar la mortalidad evitable en los estados de la frontera del norte de México entre 1998 y 2007 para indirectamente evaluar la calidad de los servicios de salud en la región. Metodología: se analizó la información sobre mortalidad del Sistema Nacional de Información en Salud (SINAIS). La unidad de análisis fue la causa básica de la defunción codificada según la décima revisión de la CIE. La mortalidad evitable fue clasificada según el catálogo de causas de muerte propuesto por Gómez. Se hizo un análisis exploratorio de la relación entre la mortalidad evitable y la derechohabiencia y el nivel socioeconómico de los municipios correspondientes a las muertes. Resultados: la tasa de mortalidad evitable global fue de 350,2 muertes por mil habitantes en la región. La mortalidad evitable por diagnóstico y tratamiento médico precoz, violencia y VIH/SIDA tuvo tasas de 223, 60 y 5 por mil habitantes, respectivamente, presentando variaciones de magnitud, sociodemográficas y por derechohabiencia entre estados. Discusión y conclusiones: las poblaciones de los estados de la frontera norte de México se caracterizan por tener una dinámica sociodemográfica y de los servicios de salud muy intensa. Los resultados sugieren que el sistema de salud está siendo rebasado en su respuesta a una alta frecuencia de enfermedades no transmisibles. En el aspecto social existen condiciones estructurales en México que favorecen la presencia de narcotráfico y su consecuente causa de violencia y consumo de drogas ilegales que podrían estar relacionadas con la frecuencia de muertes violentas y en forma subsidiaria con las causadas por el VIH/SIDA.

Enfermedad fibroquística del páncreas en el recién nacido

Objetivo: Presentar casos con lesiones de fibrosis quística del páncreas (mucoviscidosis), identificados en necropsias neonatales, y verificar si hay un perfil clínico que facilite su identificación. Diseño: Estudio histológico descriptivo, retrospectivo, con componente analítico. Lugar: Instituto Nacional Materno Perinatal (INMP), de Lima, Perú. Materiales: Lesiones pancreáticas de fibrosis quística en necropsias de neonatos. Intervenciones: Serie de 17 casos con lesiones de fibrosis quística del páncreas (mucoviscidosis) identificados por examen histológico, en 144 necropsias neonatales, practicadas en el primer semestre de 1995. En dicho período, nacieron vivos 18 011 niños. De manera de verificar si en este grupo hay un perfil que facilitara su identificación, se le comparó con otros tres, de dicha serie de autopsias, cuya causa básica de muerte fue la misma, pero sin signos de mucoviscidosis. Para determinar la significación de la diferencia entre las proporciones, de las características clínicas que se estudia entre los grupos, se usó la distribución Z. Establecida la frecuencia de homocigotos afectados en los recién nacidos de esta muestra, se determinó la frecuencia de heterocigotos en esa población. Principales medidas de resultados: Perfil clínico de niños con mucoviscidosis y diferencia de casos con la misma causa básica de muerte pero sin lesiones de mucoviscidosis. Resultados: Hubo 12% de casos con signos de fibrosis quística del páncreas y una frecuencia aproximada de 1/600 sobre el total de nacidos vivos. No se encontró diferencia significativa en la comparación entre dicho grupo y otros con la misma causa básica de muerte, pero sin lesiones de la enfermedad en estudio. Conclusiones: Las cifras encontradas permiten plantear la hipótesis que, cada año nacen en el INMP aproximadamente 34 homocigotos afectados y 1 800 neonatos heterocigotos con un alelo anormal.

Under-reporting of Parkinson's disease on death certificates: A population-based study (NEDICES)

BackgroundParkinson's disease is frequently omitted as a cause of death from death certificates. A limitation of previous studies that attempted to assess the validity of death certificates is that population-dwelling cases, with milder, undiagnosed Parkinson's disease were likely excluded. As a result, those studies likely overestimated the validity of death certificates because they did not include these milder cases. We assessed the validity of death certificates in a prospective population-based study (NEDICES), which includes previously undiagnosed Parkinson's disease cases detected during the assessment. Methods3926 community-dwelling elderly subjects with and without Parkinson's disease were followed during a median of 12.6years, after which the death certificates of those who died were examined. We calculated the proportion of cases of clinically diagnosed Parkinson's disease for whom a diagnosis of Parkinson's disease was certified as the basic cause of death on death certificates. Results1791 (45.6%) of the 3926 participants died over a median follow-up of 7.1years, including 82 (73.9%) deaths among 111 participants with Parkinson's disease. Parkinson's disease was rarely certified as the basic cause of death (14.6%). Gender, disease stage and the period during which the study was conducted (i.e., 1994 to 2007) did not influence the likelihood that Parkinson's disease would be reported. ConclusionsOur findings reinforce the notion that the reporting of Parkinson's disease on death certificates remains poor. This suggests a lack of awareness of the importance of Parkinson's disease as a cause of death.

Utilidad de los certificados de defunción en la evaluación de las causas de muerte por cáncer de cérvix en Colombia

&lt;div class="page" title="Page 1"&gt;&lt;div class="layoutArea"&gt;&lt;div class="column"&gt;&lt;p&gt;&lt;span&gt;Objetivo: &lt;/span&gt;&lt;span&gt;Evaluar la calidad de los certificados de defunción en la identificación de las causas de muerte por cáncer de cérvix en Colombia y las características epidemiológicas de las mujeres fallecidas. &lt;/span&gt;Material y Métodos: Se revisaron las causas directas de muerte en 1648 mujeres cuya causa básica de defunción fue tumor maligno del cuello uterino según el registro de defunciones del Departamento Nacional de Estadística de Colombia (DANE) en el año 2008. Se evalúan mediante el uso de una aplicación de Excel su distribución por código de diagnóstico de la causa directa de muerte, grupos de edad, nivel educativo, estado civil, seguridad social y sitio de defunción. Resultados: El promedio de edad en que ocurrieron las muertes fue de 58 años (13-99 años) en un total de 1648 casos. Las principales causas directas de muerte fueron cáncer de cuello uterino 324 defunciones (19,6%), insuficiencia o falla respiratoria en 276 (16,7%), paro cardiorrespirato- rio en 225 (13,6%) y falla orgánica múltiple o multisistémica en 196 (11,8%). Conclusiones: Las principales denominaciones anotadas en los registros de defunción como causa directa de muerte por cáncer de cérvix fueron cáncer de cuello uterino, insuficiencia o falla respiratoria, paro cardiorrespiratorio y falla orgánica múltiple. Sin embargo, se evidencia que esto surge por problemas en el registro que da cabida a registrar la causa básica de los certificados de defunción como la causa directa de muerte y a causas asociadas con otras patologías, sin tener en cuenta la Clasificación Internacional de Enfermedades (CIE-10). Se requiere mejorar la calidad de los registros de defunción para aprovechar la información que da este documento. &lt;/p&gt;&lt;/div&gt;&lt;/div&gt;&lt;/div&gt;

Analysis of Online Report Data of Death Cases in 2009–2013 in the Emergency Department of a General Hospital

AbstractObjective. To discuss the distribution of the epidemiological characteristics of the death cases in the emergency department such as age, gender, occupation, and the basic cause of death, and to provide the basis for the improvements in abilities to treat and cure critically ill emergency cases and the stipulation of preventive measures. Methods. Through the national cause-of-death registration reporting information system and according to the International Classification of Diseases (ICD-10), the 2009–2013 report data about the death cases in the emergency department of a general hospital were analyzed. Results. A total of 43.83% of the 2,763 death cases of the emergency department were an elderly group of people ranging in ages from 60 to 79 and only 3.47% of the 2,763 death cases were a young group of people of age less than or equal to 44; the male-female ratio was 1.18: 1; the basic causes of death were mainly diseases of the circulatory system (49.84%) and malignant neoplasms (22.26%); the o...

Classificação das mortes infantis em Belo Horizonte: utilização da lista atualizada de causas de mortes evitáveis por intervenções do Sistema Único de Saúde do Brasil

Objetivos: analisar os óbitos de menores de um ano residentes em Belo Horizonte, segundo critérios de evitabilidadepropostos na Atualização da Lista de Causas de Mortes Evitáveis por Intervenção do Sistema Único de Saúde. Métodos: estudo descritivo que utilizou dados dos bancos dos Sistemas de Informação sobre Mortalidade e sobre Nascidos Vivos do Ministério da Saúde (DATASUS), no período de 2006 a 2011. As causas básicas de morte foram classificadas segundo critérios de evitabilidade. Foram calculados os coeficientes de mortalidade, a mortalidade proporcional por componentes e por principais grupos de causas. Resultados: o coeficiente de mortalidade infantil apresentou decréscimo de (18,7%) no período. Dentre as causas evitáveis, observou-se que as taxas declinaram nos subgrupos: reduzíveis por ações adequadas de diagnóstico e tratamento (38,8%) e reduzíveis por adequada atenção ao feto e ao recém nascido (30,6%). Os subgrupos reduzíveis por adequadas atenção à mulher na gestação e ações de promoção a saúde, vinculadas às ações de atenção cresceram (17,1% e 22,7%), respectivamente. Conclusões: a utilização da referida lista, permitiu identificar quais óbitos são mais passíveis de prevenção e avaliar qual categoria requer maior investimento para redução da mortalidade. Mostrou boa aplicabilidade para evitabilidade de óbitos nos recém-nascidos menores de 1000 gramas.

Survival of patients with operable breast cancer (Stages I-III) at a Brazilian public hospital - a closer look into cause-specific mortality

BackgroundBreast cancer incidence is increasing. The survival rate varies and is longer in high-income countries. In Brazil, lower-income populations rely on the Unified Public Health System (Sistema Único de Saude, SUS) for breast cancer care. The goal of our study is to evaluate the survival of patients with operable breast cancer stages I-III at a Brazilian public hospital that treats mostly patients from the SUS.MethodsA cohort study of patients who underwent surgery for breast cancer treatment at the Clinical Hospital of the Federal University of Minas Gerais from 2001 to 2008 was performed, with a population of 897 cases. Information on tumor pathology and staging, as well as patients’ age and type of health coverage (SUS or private system) was collected. A probabilistic record linkage was performed with the database of the Mortality Information System to identify patients who died by December 31th, 2011. The basic cause of death was retrieved, and breast cancer-specific survival rates were estimated with the Kaplan-Meier method. The Cox proportional hazards model was used for univariate and multivariate analysis of factors related to survival.ResultsA total of 282 deaths occurred during the study’s period, 228 of them due to breast cancer. Five-year breast cancer-specific survival rates were 95.5% for stage I, 85.1% for stage II and 62.1% for stage III disease. Patients from the SUS had higher stages at diagnosis (42% was in stage III, and from the private system only 17.6% was in this stage), and in the univariate but not multivariate analysis, being treated by the SUS was associated with shorter survival (hazard ratio, HR = 2.22, 95% CI 1.24-3.98). In the multivariate analysis, larger tumor size, higher histologic grade, higher number of positive nodes and age older than 70 years were associated with a shorter breast cancer-specific survival.ConclusionsFive-year breast cancer survival was comparable to other Brazilian cohorts. Patients treated by the SUS, rather than by the private system, had shorter survival times, mostly due to higher initial stage of the disease.

Fatores determinantes da mortalidade neonatal em um município da Região Sul do Brasil

This is an ecological quantitative study to identify risk factors that determined neonatal death between the years of 2000 to 2009 in Londrina, Paraná, using data from Birth Certificates, Death Certificates and Infant Death Investigation Forms. The variables maternal age, years of education, family income, occupation, marital status, type of delivery, and number of prenatal appointments were not associated to neonatal death. To the contrary, birth weight, gestational age, Apgar score at 1 and 5 minutes, and place of birth were identified as statistically significant variables. More than 73.0% of newborns died within early neonatal period. The predominant basic cause of death was perinatal problems (77.7%), 72.6% of which were preventable, and the majority of which could be reduced with adequate control over pregnancy/birth. These results highlight the need for investments in prevention of premature delivery by improvement of health care in prenatal and birth periods, in an equanimous, accessible and comprehensive manner in all levels of maternal and child health care.

Fatores determinantes da mortalidade neonatal em um municipio da Regiao Sul do Brasil

This is an ecological quantitative study to identify risk factors that determined neonatal death between the years of 2000 to 2009 in Londrina, Parana, using data from Birth Certificates, Death Certificates and Infant Death Investigation Forms. The variables maternal age, years of education, family income, occupation, marital status, type of delivery, and number of prenatal appointments were not associated to neonatal death. To the contrary, birth weight, gestational age, Apgar score at 1 and 5 minutes, and place of birth were identified as statistically significant variables. More than 73.0% of newborns died within early neonatal period. The predominant basic cause of death was perinatal problems (77.7%), 72.6% of which were preventable, and the majority of which could be reduced with adequate control over pregnancy/birth. These results highlight the need for investments in prevention of premature delivery by improvement of health care in prenatal and birth periods, in an equanimous, accessible and comprehensive manner in all levels of maternal and child health care.

Mortalidade devido a acidentes de bicicletas em Pernambuco, Brasil

The scope of this paper was to conduct a quantitative analysis of deaths resulting from bicycle accidents in the state of Pernambuco by studying secondary data between 2001 and 2010. The sample consisted of all the Deaths recorded in the Mortality Information System of the Unified Health System Database that reported bicycle accidents between 2001 and 2010. Descriptive measures were determined for all variables. Socio-demographic variables were paired with the basic cause of death in order to find a statistical correlation. In Pernambuco, the aforementioned information system recorded 517 deaths resulting from bicycle accidents, with greater frequency in men between 25 and 59 years of age, Afro-Brazilians, single and of unknown schooling. The mean age was 36.82 years (SD = 17.026), and the minimum and maximum age of 4 and 86 years old, respectively. The findings highlight the need for the creation of adequate infrastructure and effective legal measures to prevent traffic accidents involving this type of vehicle, relying on the evidence of distribution of cases in most Pernambuco municipalities.

The basic causes of death in hoofed mammals in the ussuri reserve and in the adjacent territory

The basic causes of death in hoofed mammals in the Urruri reserve and in the adjacent territory during the period from 1974 to 2011 are hunting and poaching, tiger predation, and exhaustion. The sika deer has accounted for the largest number of the established deaths since the 1990s, because this species has become dominant in the fauna of hoofed animals in the reserve as a result of acclimatization. Before the 1980s, the main prey for tigers were the red deer (52%) and wild boar (44%): the share of the sika deer in the prey was 4%. During the most recent 10 years, the share of the sika deer, wild boar, and red deer in the tiger-prey trophic link at separate stations of the reserve has been 68%, 20.6%, and 6.9%, respectively.

Perfil de mortalidade do idoso: análise da evolução temporal em uma capital do Nordeste brasileiro de 1996 a 2007

OBJETIVO: Este trabalho objetivou analisar a evolução temporal da mortalidade de idosos no município de Recife no período de 1996 a 2007. MÉTODOS: Realizou-se estudo de evolução temporal, com o universo de óbitos da população idosa (&gt;60 anos). Os coeficientes de mortalidade foram calculados, padronizados por idade e sexo, pelo método direto para subgrupos etários, sexo, estado civil, causa básica de óbito, local de ocorrência e assistência médica na base de mil habitantes. Foram realizadas análises descritivas e análise de regressão linear. RESULTADOS: A mortalidade em idosos no Recife apresenta tendência de declínio na série analisada, com maiores coeficientes entre os idosos longevos (&gt;80 anos). Os idosos homens apresentam maior mortalidade em relação às idosas, com tendência de diminuição dos coeficientes. Quanto ao estado civil, houve aumento da mortalidade entre idosos solteiros e separados judicialmente. A maioria dos óbitos ocorreu em hospitais e com assistência médica no momento do óbito. Foi observada tendência de decréscimo da mortalidade por doenças do aparelho circulatório, doenças infecciosas e parasitárias, doenças do aparelho digestivo e sinais e sintomas mal definidos e aumento da mortalidade por doenças do aparelho geniturinário. A evolução da mortalidade por neoplasias, doenças endócrinas, nutricionais e metabólicas, doenças do aparelho respiratório e causas externas não sofreu variações. CONCLUSÕES: A mortalidade do idoso recifense apresentou padrão semelhante à realidade nacional, destacando-se a tendência de redução dos coeficientes de mortalidade.