High incidence of preventable deaths during childhood in Porto Velho, Rondonia - Brazil

Background: We aimed to estimate and analyze epidemiological profile of deaths during childhood. Method: We used the databases of deaths provided by Information System of mortality between 2006 and 2010. We selected only those records where the occurrence of deaths corresponded to Porto Velho city and those who were aged between 12 and 48 months old at the moment of death. We examined only deaths from preventable causes and poorly defined. Results: The total number of deaths was estimated to be 103, 48.6% male. High frequencies of deaths occurred (39.8%) in children before reaching two years old. Vast majority of deaths (66.9%) was due to preventable causes, 18.4% by poorly defined causes and nearly one in three by external causes. Approximately one in four were due to traffic accidents, 41.9% by drowning and submersion. Also, there were significant frequencies of deaths associated with respiratory diseases (17.5%) and infectious and parasitic diseases (16.6%). Conclusion: These findings reinforce the importance of studies of infant mortality, drawing attention to the debate on policy design to reduce childhood deaths, especially in acting on preventable causes.

Estimating mortality in laying hens as the environmental temperature increases

Layer mortality due to heat stress is an important economic loss for the producer. The aim of this study was to determine the mortality pattern of layers reared in the region of Bastos, SP, Brazil, according to external environment and bird age. Data mining technique were used based on monthly mortality records of hens in production, 135 poultry houses, from January 2004 to August 2008. The external environment was characterized according maximum and minimum temperatures, obtained monthly at the meteorological station CATI in the city of Tupa, SP, Brazil. Mortality was classified as normal (<= 1.2%) or high (> 1.2%), considering the mortality limits mentioned in literature. Data mining technique produced a decision tree with nine levels and 23 leaves, with 62.6% of overall accuracy. The hit rate for the High class was 64.1% and 59.9% for Normal class. The decision tree allowed finding a pattern in the mortality data, generating a model for estimating mortality based on the thermal environment and bird age.

Characterization of heat waves affecting mortality rates of broilers between 29 days and market age

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mortality Risk in Insects

Understanding how and why insect numbers fluctuate through time and space has been a central theme in ecological research for more than a century. Life tables have been used to understand temporal and spatial patterns in insect numbers. In this study, we estimated cause-of-death probabilities for phytophagous insects using multiple decrement life tables and the irreplaceable mortality analytic technique. Multiple decrement life tables were created from 73 insect life tables published from 1954 to 2004. Irreplaceable mortality (the portion of mortality that cannot be replaced by another cause) from pathogens, predators, and parasitoids was 8.6 +/- 7.2, 7.8 +/- 4.9, and 6.2 +/- 1.6%, respectively. In contrast, the mean irreplaceable mortality from all non-natural enemy mortality factors (mortality from factors other than natural enemies) was 35.1 +/- 4.4%. Irreplaceable mortality from natural enemies was significantly lower compared with non-natural enemy factors. Our results may partially explain cases of unsuccessful efficacy in classical biological control, after successful establishment, by showing low irreplaceable mortality for natural enemies, including 5.2 +/- 1.6% for introduced natural enemies. We suggest that the environment (i.e., the degree of environmental stability) influences the magnitude of the irreplaceable mortality from natural enemies. Our results lead to several testable hypotheses and emphasize that it is not possible to estimate the effect of any mortality factor without considering its interaction with competing mortality factors, which has far-reaching consequences for population biology and applied ecology.

Effect of temperature on incubation period, embryonic mortality, hatch rate, egg water loss and partridge chick weight (Rhynchotus rufescens)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Mortality of Bemisia tabaci biotype B (sternorrhyncha: aleyrodidae) adults by aliphatic and aromatic synthetic sucrose esters

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mortalidade infantil em município da região Centro-Oeste Paulista, Brasil, 1990 a 1992

INTRODUÇÃO: A mortalidade infantil em Presidente Prudente, SP (Brasil), foi estudada no período de 1990 a 1992, a partir de aplicação de métodos para obtenção de diagnóstico coletivo que orientassem a identificação e escolha de estratégias de controle de problemas locais. MATERIAL E MÉTODO: Foram utilizadas declarações de óbito colhidas no cartório, cujos dados originais foram corrigidos por meio de pesquisa documental nos serviços de saúde e entrevistas domiciliares. Para estudar variáveis como idade materna e peso ao nascer foram utilizados os dados do Sistema de Informações sobre Nascidos Vivos (SINASC). A qualidade dos dados originais das declarações de óbitos foi inicialmente analisada pela quantidade de informações, sensibilidade, especificidade e valor de Kappa. RESULTADO: A sensibilidade global para a causa básica de óbito foi 78,84% e Kappa igual a 71,32 para o total de causas. Ocorreram 189 óbitos, sendo 66,15% no período neonatal (41,28% durante o primeiro dia de vida) e 33,85% no infantil tardio. O peso ao nascer de 58,28% dos óbitos foi menor que 2.500g. As causas básicas de óbito foram estudadas segundo a possibilidade de serem prevenidas (método desenvolvido por Erica Taucher) por grupos de causas reduzidas utilizadas no International Collaborative Effort (ICE), causas múltiplas e distribuição geográfica. Observou-se que nos óbitos ocorridos até 27 dias, 22,23% poderiam ser evitados por adequada atenção ao parto, 20,64% seriam redutíveis por diagnóstico e tratamento precoce, 13,75% por bom controle da gravidez e apenas 7,94% não evitáveis. Das mortes ocorridas no período infantil tardio, 12,17% foram classificadas como outras preveníveis e 4,23% foram consideradas não evitáveis. Segundo os grupos do ICE, 58,74% faleceram por imaturidade ou asfixias; 19,58% por infecções e, 12,17%, por anomalias congênitas. CONCLUSÃO: Os resultados sugerem prioridade para assistência obstétrica no trabalho de parto e atenção pediátrica por baixo peso ao nascer, entre outras. A análise por causas múltiplas mostra que 76,05% dos óbitos têm as causas básicas relacionadas a causas perinatais e confirma a relação entre as deficiências de peso e as complicações respiratórias do recém-nascido. As complicações maternas também relacionaram-se com o baixo peso. Identificaram-se grandes diferenças no coeficiente de mortalidade infantil entre as áreas da zona urbana não somente restritas aos valores, como também ao tipo de doenças responsáveis pela ocorrência do óbito. Conclui-se haver vantagem no uso associado das quatro técnicas que são complementares, tanto para estudo, como para planejamento de ações dirigidas à prevenção da mortalidade infantil.

The effect of phosphoethanolamine intake on mortality and macrophage activity in mice with solid ehrlich tumors

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Perioperative cardiac arrest and its mortality in children. A 9-year survey in a Brazilian tertiary teaching hospital

Background: the incidence of perioperative cardiac arrest and mortality in children is higher than in adults. This survey evaluated the incidence, causes, and outcome of perioperative cardiac arrests in a pediatric surgical population in a tertiary teaching hospital between 1996 and 2004.Methods: the incidence of cardiac arrest during anesthesia was identified from an anesthesia database. During the study period, 15 253 anesthetics were performed in children. Data collected included patient demographics, surgical procedures (elective, urgent, or emergency), ASA physical status classification, anesthesia provider information, type of surgery, surgical areas, and outcome. All cardiac arrests were reviewed and grouped by the cause of arrest and death into one of four groups: totally anesthesia-related, partially anesthesia-related, totally surgery-related, or totally child disease or condition-related.Results: There were 35 cardiac arrests (22.9 : 10 000) and 15 deaths (9.8 : 10 000). Major risk factors for cardiac arrest were neonates and children under 1 year of age (P < 0.05) with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05), and general anesthesia (P < 0.05). Child disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were seven cardiac arrests because of anesthesia (4.58 : 10 000) - four totally (2.62 : 10 000) and three partially related to anesthesia (1.96 : 10 000). There were no anesthesia attributable deaths reported. The main causes of anesthesia attributable cardiac arrest were respiratory events (71.5%) and medication-related events (28.5%).Conclusions: Perioperative cardiac arrests were relatively higher in neonates and infants than in older children with severe underlying disease and during emergency surgery. The fact that all anesthesia attributable cardiac arrests were related to airway management and medication administration is important in prevention strategies.

Delay from fracture to hospital admission: a new risk factor for hip fracture mortality?

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

MORTALITY IN ANESTHESIA: A SYSTEMATIC REVIEW

This systematic review of the Brazilian and worldwide literature aims to evaluate the incidence and causes of perioperative and anesthesia-related mortality. Studies were identified by searching the Medline and Scielo databases, followed by a manual search for relevant articles. Our review includes studies published between 1954 and 2007. Each publication was reviewed to identify author(s), study period, data source, perioperative mortality rates, and anesthesia-related mortality rates. Thirty-three trials were assessed. Brazilian and worldwide studies demonstrated a similar decline in anesthesia-related mortality rates, which amounted to fewer than 1 death per 10,000 anesthetics in the past two decades. Perioperative mortality rates also decreased during this period, with fewer than 20 deaths per 10,000 anesthetics in developed countries. Brazilian studies showed higher perioperative mortality rates, from 19 to 51 deaths per 10,000 anesthetics. The majority of perioperative deaths occurred in neonates, children under one year, elderly patients, males, patients of ASA III physical status or poorer, emergency surgeries, during general anesthesia, and cardiac surgery followed by thoracic, vascular, gastroenterologic, pediatric and orthopedic surgeries. The main causes of anesthesia-related mortality were problems with airway management and cardiocirculatory events related to anesthesia and drug administration. Our systematic review of the literature shows that perioperative mortality rates are higher in Brazil than in developed countries, while anesthesia-related mortality rates are similar in Brazil and in developed countries. Most cases of anesthesia-related mortality are associated with cardiocirculatory and airway events. These data may be useful in developing strategies to prevent anesthesia-related deaths.

Hip fracture in the elderly: does counting time from fracture to surgery or from hospital admission to surgery matter when studying in-hospital mortality?

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Anesthesia-related mortality in pediatric patients: a systematic review

This systematic review of the Brazilian and worldwide literature aimed to evaluate the incidence and causes of perioperative and anesthesia-related mortality in pediatric patients. Studies were identified by searching EMBASE (1951-2011), PubMed (1966-2011), LILACS (1986-2011), and SciElo (1995-2011). Each paper was revised to identify the author(s), the data source, the time period, the number of patients, the time of death, and the perioperative and anesthesia-related mortality rates. Twenty trials were assessed. Studies from Brazil and developed countries worldwide documented similar total anesthesia-related mortality rates (<1 death per 10,000 anesthetics) and declines in anesthesia-related mortality rates in the past decade. Higher anesthesia-related mortality rates (2.4-3.3 per 10,000 anesthetics) were found in studies from developing countries over the same time period. Interestingly, pediatric perioperative mortality rates have increased over the past decade, and the rates are higher in Brazil (9.8 per 10,000 anesthetics) and other developing countries (10.7-15.9 per 10,000 anesthetics) compared with developed countries (0.41-6.8 per 10,000 anesthetics), with the exception of Australia (13.4 per 10,000 anesthetics). The major risk factors are being newborn or less than 1 year old, ASA III or worse physical status, and undergoing emergency surgery, general anesthesia, or cardiac surgery. The main causes of mortality were problems with airway management and cardiocirculatory events. Our systematic review of the literature shows that the pediatric anesthesia-related mortality rates in Brazil and in developed countries are similar, whereas the pediatric perioperative mortality rates are higher in Brazil compared with developed countries. Most cases of anesthesiarelated mortality are associated with airway and cardiocirculatory events. The data regarding anesthesia-related and perioperative mortality rates may be useful in developing prevention strategies.