Different Causes Of Death Research Articles

Evaluation of prognostic factors effect on survival time in patients with colorectal cancer, based on Weibull Competing-Risks Model.

The aim of this study was to assess the association between survival of patients with colorectal cancer and prognostic factors in a competing risk parametric model using Weibull distribution. The prognosis of colorectal cancer is relatively good in terms of survival time. In many prognostic studies, patients may be exposed to several types of competing events. These different causes of death are called competing risks. Data was recorded from 372 patients with colorectal cancer who registered in the Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences (Tehran, Iran) from 2004 to 2015 in a retrospective study. Analysis was performed using competing risks model and Weibull distribution. Software used for data analysis was R, and significance level was regarded as 0.05. The result indicated that, at the end of follow-up, 111 (29.8%) deaths were from colorectal cancer and 14 (3.8%) deaths were due to other diseases. The average body mass index (BMI) was 24.61(SD 3.98). The mean survival time for a patient in 372 was 62.05(SD 48.78) month with median equals to 48 months. According to competing-risks method, only stageIII (HR, 1.69; 95% CI, 1.246-2.315 ), stageIV( HR, 4.51; 95% CI,2.91-6.99 ) and BMI( HR, 0.96; 95% CI, 0.96-0.975) have a significant effect on patient's survival time. This study indicated pathologic stage (III,IV) and BMI as the prognosis, using a Weibull model with competing risks analysis, while other models without the competing events lead to significant predictors which may be due to over-estimation.

Causes of death in amyotrophic lateral sclerosis : Results from the Rhineland-Palatinate ALS registry

Amyotrophic lateral sclerosis (ALS) is associated with an increased mortality. Knowledge of possible causes of death could lead to an individualization of the palliative treatment concept and result in a differentiated palliative treatment pathway. Currently, only few systematic data are available on the heterogeneity of causes of death associated with ALS. Analysis of the various causes of death in aprospective population-based German cohort of ALS patients. Analysis of data of the Rhineland-Palatinate ALS registry in which newly diagnosed patients who had been identified between October 2009 and September 2012 were prospectively enrolled and followed up at regular intervals. From this prospective cohort study the causes of death were elicited based on information provided by the attending physicians, family members and by means of death certificates registered by the regional health authorities in Rhineland-Palatinate. Out of 200 ALS patients registered 148 died between register initiation on 1 October 2009 and the end of follow-up on 30 September 2015 (78males and 70females, death rate 74%). The most frequent cause of death was respiratory failure as aconsequence of weakness of respiratory muscles (n= 91, 61%). Less frequent causes of death were pneumonia (n= 13, 9%), terminal cachexia (n= 9, 6%) and death from cardiovascular causes including sudden death (n= 9, 6%). Cases of suicide were rare (n= 3, 2%) as were deaths due to concurrent diseases (n= 2). In 21cases (14%) the exact cause of death could not be clarified. Differences in the causes of death only showed a tendency towards the ALS phenotype. Respiratory failure was the cause of death in all patients with a respiratory phenotype and in 78% of patients with flail arm syndrome. Despite the low number of patients (8%) with additional frontotemporal dementia (FTD) adistinct difference in causes of death between those with and without FTD could be observed. Death due to respiratory failure was less frequent in ALS patients with FTD (33% vs. 65%) while pneumonia was more frequent (27% vs. 7%). Respiratory failure was the most frequent cause of death in our cohort of ALS patients. In contrast, pneumonia and nutritional disorders played aless important role as the cause of death. The phenotypic expression of ALS might in part allow the cause of the prospective death to be predicted. Differentiation of ALS phenotypes is an important foundation for patient counseling on the process of dying to be expected and for the determination of an individual palliative concept.

Autopsy after transcatheter aortic valve implantation

Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview of the autopsy findings in patients with TAVI in their medical history divided by the timing of death with specific interest in the added value of autopsy over a solely clinically determined cause of death. In 8 European centres, 72 cases with autopsy reports were available. Autopsies were divided according to the time interval of death and reports were analysed. In 32 patients who died ≤72 h postprocedure, mortality resulted from cardiogenic or haemorrhagic shock in 62.5 and 34.4%, respectively. In 31 patients with mortality >72 h to ≤30 days, cardiogenic shock was the cause of death in 51.6% followed by sepsis (22.6%) and respiratory failure (9.7%). Of the nine patients with death >30 days, 88.9% died of sepsis, caused by infective endocarditis in half of them. At total of 12 patients revealed cerebrovascular complications. Autopsy revealed unexpected findings in 61.1% and resulted in a partly or completely different cause of death as was clinically determined. Autopsy on patients who underwent TAVI reveals specific patterns of cardiovascular pathology that clearly relate to the time interval between TAVI and death and significantly adds to the clinical diagnosis. Our data support the role of autopsy including investigation of the cerebrum in the quickly evolving era of cardiac device technology.

Family of origin and educational inequalities in mortality: Results from 1.7 million Swedish siblings

Circumstances in the family of origin have short- and long-term consequences for people's health. Family background also influences educational achievements – achievements that are clearly linked to various health outcomes. Utilizing population register data, we compared Swedish siblings with different levels of education (1,732,119 individuals within 662,095 sibships) born between 1934 and 1959 and followed their death records until the end of 2012 (167,932 deaths).The educational gradient in all-cause mortality was lower within sibships than in the population as a whole, an attenuation that was strongest at younger ages (< 50 years of age) and for those with a working class or farmer background. There was substantial variation across different causes of death with clear reductions in educational inequalities in, e.g., lung cancer and diabetes, when introducing shared family factors, which may indicate that part of the association can be ascribed to circumstances that siblings have in common. In contrast, educational inequalities in suicide and, for women, other mental disorders increased when adjusting for factors shared by siblings.The vast variation in the role of childhood conditions for the education-mortality association may help us to further understand the interplay between family background, education, and mortality. The increase in the education gradient in suicide when siblings are compared may point towards individually oriented explanations (‘non-shared environment’), perhaps particularly in mental disorders, while shared family factors primarily seem to play a more important role in diseases in which health behaviors are most significant.

Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015

Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. To estimate the association between SBP of at least 110 to 115 mm Hg and SBP of 140 mm Hg or higher and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants. Spatiotemporal Gaussian process regression was used to generate estimates of mean SBP and adjusted variance for each age, sex, country, and year. Diseases with sufficient evidence for a causal relationship with high SBP (eg, ischemic heart disease, ischemic stroke, and hemorrhagic stroke) were included in the primary analysis. Mean SBP level, cause-specific deaths, and health burden related to SBP (≥110-115 mm Hg and also ≥140 mm Hg) by age, sex, country, and year. Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73 119 (95% uncertainty interval [UI], 67 949-78 241) to 81 373 (95% UI, 76 814-85 770) per 100 000, and SBP of 140 mm Hg or higher increased from 17 307 (95% UI, 17 117-17 492) to 20 526 (95% UI, 20 283-20 746) per 100 000. The estimated annual death rate per 100 000 associated with SBP of at least 110 to 115 mm Hg increased from 135.6 (95% UI, 122.4-148.1) to 145.2 (95% UI 130.3-159.9) and the rate for SBP of 140 mm Hg or higher increased from 97.9 (95% UI, 87.5-108.1) to 106.3 (95% UI, 94.6-118.1). For loss of DALYs associated with systolic blood pressure of 140 mm Hg or higher, the loss increased from 95.9 million (95% uncertainty interval [UI], 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million) [corrected], and for SBP of 140 mm Hg or higher, the loss increased from 5.2 million (95% UI, 4.6-5.7 million) to 7.8 million (95% UI, 7.0-8.7 million). The largest numbers of SBP-related deaths were caused by ischemic heart disease (4.9 million [95% UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0 million [95% UI, 1.6-2.3 million]; 58.3%), and ischemic stroke (1.5 million [95% UI, 1.2-1.8 million]; 50.0%). In 2015, China, India, Russia, Indonesia, and the United States accounted for more than half of the global DALYs related to SBP of at least 110 to 115 mm Hg. In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (≥110-115 and ≥140 mm Hg) increased substantially between 1990 and 2015, and DALYs and deaths associated with elevated SBP also increased. Projections based on this sample suggest that in 2015, an estimated 3.5 billion adults had SBP of at least 110 to 115 mm Hg and 874 million adults had SBP of 140 mm Hg or higher.

A 10 year post-mortem analysis of keratin matrix in Perugia (Italy): focus on cocaine involvement in several types of death

The use of keratin matrix, in detecting drug consumption, offers compelling advantages compared to other conventional biological matrices used for these types of investigation, and provides important information to surveys which are characterised by a general underestimation, especially in Italy. In our study we collected and analysed 424 hair samples from corpses autopsied in Perugia from January 2001 to December 2011 in order to detect traces of drugs and especially of cocaine, and evaluate their involvement in several types of death. Hair samples were analysed by gas chromatography–mass spectrometry in the Laboratory of Forensic Toxicology of the Department of Legal Medicine of the University of Perugia: 232 samples derived from cases of overdose deaths; 192 were connected to different causes of death. The average concentration of cocaine in the keratin matrix samples was of 3.74 ng/mg in people who died from overdose, 3.09 ng/mg in people who died from other causes. In 232 cases of overdose deaths, 135 were positive for cocaine (accounting for 58.18% of total); in 192 deaths from other causes, 39 were positive for cocaine (accounting for 20.31% of the total). Our study demonstrated the crucial role of cocaine in overdose deaths and in other deaths, as is well known in other research.

Changes in flood mortality during the last 50 years in Greece.

This work focuses on the changes that occur in the circumstances under which flood fatalities occur in Greece. To this aim, this paper develops and studies a database of 189 flood-related deaths, between 1960 and 2010, consisting of variables describing the conditions during the time of each incident. Changes in the number and the spatial distribution of fatalities, together with changes in the conditions, the surrounding environment and the demographics of the victims are investigated. Results showed that males, youngsters and elderly people presented an overrepresentation among the decedents, although individuals between 20 and 65 showed a significant increase among the victims, especially during the last decades of the study period. Fatal flood events were found to be approximately equally divided between urban and rural environments. However, fatal incidents appear to gradually migrate from urban centers to rural environments. Vehicle-related fatalities showed a gradual increase, whereas pedestrian victims and indoors incidents show an opposite trend. Fatalities per flood event presented a significant decline, although in absolute numbers, flood deaths did not show a respectively important decreasing trend. Among different causes of death drowning was found to be the most common throughout the study period.

20-year follow-up study of Danish HHT patients-survival and causes of death.

BackgroundHereditary Haemorrhagic Telangiectasia (HHT) is a dominantly inheritable disorder, with a wide variety of clinical manifestations due to presence of multiple arteriovenous manifestations. The most common mutations are found in HHT1 (ENG) and HHT2 (ACVRL1) patients, causing alterations in the TGF-β pathway which is responsible for angiogenesis. Modulations of angiogenesis may influence cancer rates. The objective of the study was to evaluate 20-year survival according to HHT subtype, as well as to evaluate differences in causes of death comparing HHT patients and controls. We also wanted to investigate whether cancer morbidity among HHT patients differs from that among controls.ResultsWe included all HHT patients in the County of Fyn, Denmark, prevalent as of January 1st 1995 in total 73 HHT patients. In addition three age- and sex- matched controls per HHT patient were evaluated, in total 218 controls (one was lost due to registration failure). The controls were defined at start of follow-up in 1995. Information on lifestyle factors was not available. A total of 32 (44%) HHT patients and 97 (44%) controls passed away during follow-up. The survival curves were evenly distributed showing similar survival rates in the two groups. Cancer diagnoses had been registered in the follow-up period in 4 (5%) HHT patients and in 38 (17%) controls.ConclusionThe mortality was not increased among Danish HHT patients compared to controls. This study is based on a clinical unselected series of HHT patients with the whole spectrum of severity, independent of need for medical care. Our data also suggest that HHT patients to a lesser degree than the background population are affected by cancer.Electronic supplementary materialThe online version of this article (doi:10.1186/s13023-016-0533-9) contains supplementary material, which is available to authorized users.

Mortality profile of patients with rheumatoid arthritis in France and its change in 10 years.

To study the mortality profile of patients with rheumatoid arthritis (RA) in France. Data were collected between 2000 and 2011 from the French Epidemiological Center for the Medical Causes of Death database; all death certificates from adults that either mentioned RA as an underlying cause of death (UCD) or as an associated cause of death (ACD) were evaluated using multiple-cause-of-death analysis. The different causes of death and their frequency were reported, together with the ratio of observed/expected number of death (O/E ratio) to measure the strength of association between RA listed as an ACD and the corresponding UCD. During the study period, 13,208 deaths related to RA were identified. The mean ± SD age at death was 79 ± 9 years (51% with ≥80 years) and the female/male ratio was 3.2. When RA was the UCD (n = 4597), the main causes of death were cardiovascular (29%) and infectious diseases (22%). When RA was an ACD (n = 8611), the most common UCDs were cardiovascular diseases (35%), neoplasms (14%), respiratory disease (9%), and infectious diseases (7%). The overall O/E ratio was >1 for infectious (3.58), respiratory (1.38), and cardiovascular diseases (1.25), but was <1 for neoplasms. We provide the most recent national multiple-cause-of-death analysis assessing the mortality profile of RA patients. Our results show that mortality related to cardiovascular, respiratory, and infectious diseases is highly associated with RA. These data support the need to expand new strategies to prevent infectious and cardiovascular diseases in order to improve survival of RA patients.

Coronary Angiography in Isolated Hearts and Its Forensic Application

To check the isolated heart by coronary angiography to discover the location, nature and degree of the coronary artery lesions more accurately and increase the comprehensive evaluation ability of cardiovascular disease. Ten fresh isolated hearts with different causes of death were extracted and injected with barium sulphate as contrast substance by ring injector, then developed under Xper FD20 angiography equipment. The obtained pictures and image data were handled by three-dimensional angiography images with the software attached to the angiography equipment. The coronary artery tissues were HE stained and observed by microscope. The HE staining results were compared with the angiographic results. The imaging data obtained from the 10 cases for examination showed 8 cases without coronary artery stenosis and 2 cases with Ⅲ, Ⅳ coronary artery stenosis, which were consistent with HE staining results of coronary artery organization and the both results were confirmed. Isolated coronary angiography has an unique advantage for accurate grading of classification of coronary artery stenosis, examination of vascular malformation and tiny lesions, which can provide reference for the localization of small lesions and basis during the autopsy for identification conclusion.

The Registry of the International Society for Heart and Lung Transplantation: Nineteenth Pediatric Heart Transplantation Report—2016; Focus Theme: Primary Diagnostic Indications for Transplant

The Registry of the International Society for Heart and Lung Transplantation: Nineteenth Pediatric Heart Transplantation Report—2016; Focus Theme: Primary Diagnostic Indications for Transplant

Tackling non-communicable diseases by a forecasting model for critical illness cover

Non-communicable diseases are the most frequent causes of death in most countries in the Americas, the Eastern Mediterranean, Europe, South-East Asia, and the Western Pacific. In the African Region, there are still more deaths from infectious diseases than NCDs. WHO projections show that NCDs will be responsible for a significantly increased total number of deaths in the next decade (WHO, 2014). In this context, the market of illness insurance is strongly being developed, allowing policyholders to reduce the financial impact of diseases. Indeed, critical illness insurance typically provides a payment of a lump sum in the event of the person insured suffering a condition covered under the policy. In other words, the insured receives a fixed sum on the diagnosis of a specified list of critical illnesses. The contract terms may also be structured to pay out regular income cash-flows on the policyholder. In general, since the policy face amount has to be paid on diagnosis, the incidence rates or diagnosis rates have to be accurately estimated. The research is here developed around the following focal and original points: • the estimation of the diagnosis rates by means of an analysis by cause of death for obtaining cause-specific diagnosis rates: in particular, the author modelі the probability of death by cause as a proxy of the estimate of the diagnosis rates; • the cause-specific death rates are modelled by a stratified stochastic model for avoiding the durable problem in literature of the dependence among different causes of death; • a fair valuation framework is adopted for pricing a specific product of critical illness insurance. The analysis is completed by empirical findings

MP57-17 EXTENT OF PELVIC LYMPH NODE DISSECTION IN LYMPH NODE NEGATIVE PROSTATE CANCER IS SIGNIFICANT IN PREDICTING RISK OF BIOCHEMICAL RECURRENCE

INTRODUCTION AND OBJECTIVES: Estimating the risk of competing mortality is of importance in men with early prostate cancer in order to choose the most appropriate way of management and to avoid overor undertreatment. We investigated the association the level of education with different causes of death after radical prostatectomy. METHODS: The study sample consisted of 2630 patients with complete data on level of education (college or university degree or master craftsmen or comparable profession versus others), histopathological tumor stage (organ confined versus extracapsular), lymph node status (negative versus positive) and prostatectomy specimen Gleason score (<7 versus 7 versus 8-10) who underwent radical prostatectomy between 1992 and 2007. Overall, prostate cancer-specific, competing and second cancer-related mortality were study endpoints. Cox proportional hazard models for competing risks were used to study combined effects of the variables on these endpoints. RESULTS: A higher level of education was independently associated with decreased overall mortality after radical prostatectomy (hazard ratio, HR, 0.75, 95% confidence interval, CI, 0.62-0.91, p1⁄40.0037). The mortality difference was attributable to decreased second cancer mortality (HR 0.59, 95% CI 0.40-0.85, p1⁄40.0052) and non-cancer mortality (HR 0.73, 95% CI 0.55-0.98, p1⁄40.0345) but not to differences in prostate cancer-specific mortality (HR 1.16, 95% CI 0.791.69, p1⁄40.4536 in the full model). CONCLUSIONS: The level of education might serve as an independent prognostic parameter supplementary to age, comorbidity and smoking status in order to estimate the risk of competing mortality and to choose optimal treatment for men with early prostate cancer who are candidates for radical prostatectomy.

Performance on Specific Cognitive Domains and Cause of Death: A Prospective Population-Based Study in Non-Demented Older Adults (NEDICES).

Evidence regarding the relationship between performance on specific cognitive domains and cause of death is scarce. We assessed whether specific cognitive domains predicted mortality and the presence of any association with specific causes of death in a population-dwelling sample of non-demented older adults. In this population-based, prospective study (NEDICES), 2,390 non-demented subjects ≥65 years completed a brief neuropsychological battery. Cox's proportional hazards models, adjusted by sociodemographic and comorbidity factors, global cognitive performance, educational level, and premorbid intelligence were used to assess the risk of death. Participants were followed for a median of 9.2 years (range 0.01-10.7), after which the death certificates of those who died were examined. 880 (36.8%) of 2,390 participants died over a median follow-up of 5.5 years (range 0.01-10.5). Using adjusted Cox regression models, we found that hazard ratios for mortality in participants within the lowest tertiles (worse performance) were 1.31 (speed of cognitive processing, p = 0.03); 1.22 (semantic fluency, p = 0.04), 1.32 (delayed free recall, p = 0.003), and 1.23 (delayed logical memory, p = 0.03). Poor performance on delayed recall and speed of cognitive processing tests were associated with dementia and cerebrovascular disease mortality, respectively. Further, poor performance on semantic fluency was associated with decreased cancer mortality. In this study of community dwelling non-demented older adults, worse neuropsychological performance was associated with increased risk of mortality. Performance on specific cognitive domains were related to different causes of death. Of particular note there appears to be an inverse association between poor semantic fluency and cancer mortality.

Life expectancy of type 1 diabetic patients during 1997-2010: a national Australian registry-based cohort study.

There is limited information about the impact of type 1 diabetes on life expectancy in a contemporary population. We examined the life expectancy of type 1 diabetic patients and explored the contribution of mortality at different ages and of different causes of death to years of life lost (YLL) compared with the general population. We derived mortality rates of Australians with type 1 diabetes listed on the National Diabetes Services Scheme (NDSS) between 1997 and 2010 (n = 85,547) by linking the NDSS to the National Death Index. The Chiang method was used to estimate life expectancy and Arriaga's method was used to estimate the contributions of age-specific and cause-specific mortality to the YLL. A total of 5,981 deaths were identified during the 902,136 person-years of follow up. Type 1 diabetic patients had an estimated life expectancy at birth of 68.6years (95% CI 68.1, 69.1), which was 12.2years (95% CI 11.8, 12.7) less than that in the general population. The improvement in life expectancy at birth in 2004-2010 compared with 1997-2003 was similar for both type 1 diabetic patients (men, 1.9years [95% CI 0.4, 3.3]; women, 1.5years [95% CI 0.0, 3.2]) and the general population (men, 2.2years; women, 1.4years). Deaths at age <60years accounted for 60% of the YLL from type 1 diabetes for men and 45% for women. The major contribution to YLL was mortality from endocrine and metabolic disease at age 10-39years (men, 39-59%; women, 35-50%) and from circulatory disease at age ≥40years (men, 43-75%; women, 34-75%). Data from 1997 to 2010 showed that Australian type 1 diabetic patients had an estimated loss in life expectancy at birth of 12.2years compared with the general population.

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

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

Anticitrullinated protein antibodies and rheumatoid factor are associated with increased mortality but with different causes of death in patients with rheumatoid arthritis: a longitudinal study in three European cohorts

ObjectivePatients with rheumatoid arthritis (RA)-related autoantibodies have an increased mortality rate. Different autoantibodies are frequently co-occurring and it is unclear which autoantibodies associate with increased mortality. In addition, association with...

Understanding epidemiological transition in urban population of Maharashtra

&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Background:&lt;/span&gt;&lt;/strong&gt;&lt;span lang="EN-US"&gt; Change in causes of death pattern is a reflection of epidemiological transition in which infectious and parasitic diseases shift to chronic and degenerative diseases of adulthood. Cause of death trend and pattern is important for future health policy planning.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Methods: &lt;/span&gt;&lt;/strong&gt;This study attempts to measure mortality trends by different causes of death for urban Maharashtra by using MCCD data for 1990-2010 by calculating proportion of major cause of death to total deaths by age and sex for all these years.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Results:&lt;/span&gt;&lt;/strong&gt;&lt;span lang="EN-US"&gt; Results reveal that there has been shift in the structure of mortality by cause. Diseases of circulatory system were the leading causes of death accounting for about 31% share of all medically certified deaths which is well above the national average of about 30%. Similarly, the proportion of deaths due to certain conditions originating in the perinatal period appears to be low in the state (3.9%) compared to national average (7%). The proportions of deaths due to certain infectious and parasitic diseases and disease of the respiratory system appear to be very high (15.7% and 12.1% respectively) compared to national average (13.1% and 9.5% respectively). &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Conclusions: &lt;/span&gt;&lt;/strong&gt;It was found that socio-economically developed and demographically advanced urban Maharashtra bears the double burden of disease specific mortality.&lt;/p&gt;

Assessment of neonatal mortality in the Neonatal Intensive Care Unit in Sabzevar City for the period of 2006-2013.

IntroductionThe neonatal mortality rate (NMR) is an essential index in the assessment of community health. With the rapid advancement of neonatal care, the causes of death in this group and the overall mortality rate have changed. For these reasons, the aim of this study was to determine the current NMR and its causes in Sabzevar City’s Neonatal Intensive Care Unit (NICU).MethodsThis cross-sectional study was conducted in the NICU at Sabzevar Hospital from 2006 through 2013. Based on previous studies, the sample size was determined to be 365 neonates who were admitted to the NICU and died before they were discharged. The study tool was a researcher-developed checklist related to deceased neonates in the NICU. The checklist was confirmed based on the validity of its content and its inter-rater reliability. We used chi-squared, the Mann-Whitney U test, and the Spearman correlation to analyze the data.ResultsThe NMR in Sabzevar’s NICU was 6.44 per 1000 during the seven-year period; this rate included the following cases per 1000 live births: very early mortality (2.16), early mortality (3.33), and late mortality (0.96). Among 58,270 live births, 3,667 of the neonates were admitted to the NICU during the seven-year period, which was equivalent to 62.93 admissions per 1000 live births. Of the 3,667 neonates admitted to the NICU, 375 (10.23%) died before they were discharged. The most recurrent diagnoses were respiratory distress syndrome (46%), followed by sepsis (12%). The one-sample chi-squared test as a goodness-of-fit test (95% CI) showed that the mortality rates were significantly different based on gender (p = 0.004), birth weight (p < 0.001), gestational age (p < 0.001), different causes of death (p < 0.001), and different years of death (2006–2013) (p < 0.001). There also was a significant difference between the duration of survival (very early mortality, early mortality, and late mortality) (p < 0.001).ConclusionNeonatal mortality in the present study was comparable with that reported in similar studies in Iran and in other countries. The strong association between the mortality rate in the NICU with premature birth and low birth weight indicates the necessity of prenatal care aimed at preventing pre-term labor. Comprehensive programs from antenatal care and care at and after birth are recommended, including the investigation of the risks for neonatal death and offering preventive strategies

Decomposition of Educational Differences in Life Expectancy by Age and Causes of Death among South Korean Adults.

Decomposition of socioeconomic inequalities in life expectancy by ages and causes allow us to better understand the nature of socioeconomic mortality inequalities and to suggest priority areas for policy and intervention. This study aimed to quantify age- and cause-specific contributions to socioeconomic differences in life expectancy at age 25 by educational level among South Korean adult men and women. We used National Death Registration records in 2005 (129,940 men and 106,188 women) and national census data in 2005 (15, 215, 523 men and 16,077,137 women aged 25 and over). Educational attainment as the indicator of socioeconomic position was categorized into elementary school graduation or less, middle or high school graduation, and college graduation or higher. Differences in life expectancy at age 25 by educational level were estimated by age- and cause-specific mortality differences using Arriaga’s decomposition method. Differences in life expectancy at age 25 between college or higher education and elementary or less education were 16.23 years in men and 7.69 years in women. Young adult groups aged 35–49 in men and aged 25–39 in women contributed substantially to the differences between college or higher education and elementary or less education in life expectancy. Suicide and liver disease were the most important causes of death contributing to the differences in life expectancy in young adult groups. For older age groups, cerebrovascular disease and lung cancer were important to explain educational differential in life expectancy at 25–29 between college or higher education and middle or higher education. The contribution of the causes of death to socioeconomic inequality in life expectancy at age 25 in South Korea varied by age groups and differed by educational comparisons. The age specific contributions for different causes of death to life expectancy inequalities by educational attainment should be taken into account in establishing effective policy strategies to reduce socioeconomic inequalities in life expectancy.