The presence of elevated cardiometabolic risk factors, such as obesity, high glucose or lipid levels, and smoking, in adolescents has been shown to be associated with earlier onset of chronic conditions, such as diabetes and heart disease.

Obesity, smoking, and elevated glucose increases the risk of dying before the age of 55 years. This is the first study to focus on risk factors and mortality among adolescents and young adults in a nationally representative US sample. (Read the full article)

Reductions in infant mortality in the 20th century have not continued. Racial and socioeconomic inequalities in both infant mortality and sudden infant death syndrome (SIDS) persist. Rates of infant mortality in English-speaking countries are higher than the Organisation for Economic Co-operation and Development average.

At least 16.4% of SIDS and 3.4% of infant deaths not classified as SIDS are attributable to maternal alcohol use. Maternal alcohol-use disorder increases the risk of infant mortality through direct effects on the fetus and indirectly through environmental risk factors. (Read the full article)

In Mexico, substantial declines in childhood diarrhea deaths have been documented since the introduction of the rotavirus vaccine in 2007. However, there is concern of lower vaccine effectiveness in less developed regions of Mexico with higher diarrhea-related mortality.

We documented significant and comparable declines across all 3 regions of Mexico with different levels of development, indicating equitable vaccine distribution to children with varying risk of mortality and reaffirming the beneficial effects of rotavirus vaccination against fatal diarrheal disease. (Read the full article)

Attention-deficit/hyperactivity disorder (ADHD) has been viewed as a neurodevelopmental disorder, adversely affecting behavior and school performance, with studies suggesting increased risk for poor adult outcomes. However, no prospective studies have examined long-term outcomes of childhood ADHD in an epidemiologic sample.

Our epidemiologic study indicates that adults with childhood ADHD are at increased risk for death from suicide. ADHD persists into adulthood in 29.3% of childhood ADHD cases, and 56.9% have ≥1 psychiatric disorder other than ADHD. (Read the full article)

Infant and neonatal mortality rates in the United States decreased markedly during the twentieth century but have not decreased notably during recent years. There has been an increase in preterm and low birth weight births in recent years.

The lack of decrease in infant and neonatal mortality rates in recent years is due in large part to the increasing proportion of preterm and low birth weight infants, particularly infants <500 g. (Read the full article)

Seizure-related death, including sudden death, is a frightening prospect. In part because risk and prevention are poorly understood, neurologists tend to avoid discussions of sudden death with families and young patients.

Most deaths in children with epilepsy are not seizure related. Relative to the population, however, sudden and seizure-related deaths alone double overall mortality. In uncomplicated epilepsy, such deaths occur at rates comparable to individual leading causes of death in young people. (Read the full article)

Significant variation in the mortality of preterm infants has been observed among NICUs. Factors explaining this variation have been difficult to identify.

Sizable center differences in mortality exist, even among similarly sized NICUs in academic centers. Patient characteristics and center treatment rates explain some of the center effect, especially for the youngest infants, but a significant portion of these differences remains unexplained. (Read the full article)

Tympanometry provides a measure of middle ear function. There has been no description of the relationship between measurements of middle ear function in the absence of gross anatomic defects and clinical outcome among children with acute nontraumatic coma.

This study reveals an unexpected association between abnormal middle ear function and death in childhood acute coma. These findings call for more investigations on the relationship between middle and inner ear anatomy and function and intracranial dynamics and clinical outcomes. (Read the full article)

Adult males are known to have a greater overall likelihood of death than female adults. Among children, excess male mortality is known for specific conditions but not as a general phenomenon.

Males are more likely to die during childhood and adolescence than their female peers from not only injuries but also from a wide variety of medical conditions, suggesting the existence of either a female robustness factor or a male vulnerability factor. (Read the full article)

Infants with trisomy 13 (T13) or trisomy 18 (T18) are known to have poor survival. Little is known about how very low birth weight (VLBW) impacts survival and morbidities among infants with T13 or T18.

We examined the risks of mortality and neonatal morbidities for VLBW infants with T13 or T18 compared with VLBW infants with trisomy 21 and VLBW infants without birth defects in a 16-year cohort from the Neonatal Research Network. (Read the full article)

Early referral of infants with critical congenital heart disease (CCHD) is recommended to reduce mortality. However, few population-based data have been published showing the relationship between CCHD neonatal mortality and timing of cardiac evaluation at a specialty center.

In neonates with CCHD, 35% were not evaluated at a cardiac center by 4 days of age. These cases accounted for a significant number of CCHD deaths. This information enhances the rationale for pulse oximetry screening of neonates for CCHD. (Read the full article)

Few studies have performed precise cardiovascular assessments and regular follow-up of congenital rubella syndrome (CRS) patients’ clinical courses. A few studies have reported mortalities among children who have CRS; however, the causes of death have not been precisely described.

A total of 38 CRS cases in Vietnam were studied after a rubella outbreak in 2011. The mortality associated with pulmonary hypertension was significantly high if untreated. Conducting careful cardiologic assessments and providing continuous follow-up for each patient is required. (Read the full article)

Admissions to the ICU during off-hours (nights and weekends) have been variably associated with increased mortality in both adults and children. Changes in staffing patterns, patient characteristics, or other factors may have influenced this relationship over time.

This study demonstrates in a large, current, multicenter database sample that off-hours admissions to PICUs are not associated with increased risk-adjusted mortality. Admissions in the morning from 6:00 am to 10:59 am are associated with increased mortality and warrant further attention. (Read the full article)

Sleeping on a sofa increases the risk of sudden and unexpected infant death.

Infant deaths on sofas are associated with nonsupine placement, being found in side position, surface sharing, changing sleep location, and experiencing prenatal tobacco exposure. These results may help explain why sofa sleeping is hazardous for infants. (Read the full article)

In developed countries, child health disparities across wealth gradients are commonly widening; at the same time, child mortality in low- and middle-income countries is declining. Whether these declines are associated with widening or narrowing disparities is unknown.

A systematic analysis of the evidence on child mortality gradients by wealth in less-developed countries shows that mortality is declining fastest among the poorest in most countries, leading to declining disparities in this important indicator of child health. (Read the full article)

Respiratory syncytial virus (RSV) infection is a common cause of pediatric hospitalizations. Mortality rates associated with RSV hospitalizations are based on estimates from studies conducted decades ago. Accurate understanding of mortality is required for identifying high-risk infants and children.

Mortality associated with RSV is uncommon in the 21st century, with annual deaths far lower than previous estimates. The majority of deaths occurred in infants with complex chronic conditions or in those with life-threatening conditions in addition to RSV infection. (Read the full article)

After the recent economic recession, policy interventions including austerity measures led to reductions in government spending on health care in many countries. However, there is limited research into the effects of changes in government health care spending on child health.

Reductions in government health care spending are associated with long-lasting adverse effects on child health globally, especially in low-income countries. Given pressures to diminish health expenditures, we caution that reduced spending should be achieved through increased efficiency of care delivery. (Read the full article)

Burns are a leading cause of pediatric emergency department visits and hospitalizations and are often associated with significant long-term physical and psychological consequences and long-term medical and nursing treatments. Little is known of the long-term impacts of burns on mortality.

Children with burns had a 1.6 times greater rate of long-term mortality than a matched population-based cohort of children with no injury. Total mortality burden based on in-hospital deaths alone underestimates the true burden from both minor and severe burns. (Read the full article)

Few studies have established the protective efficacy of 1 to 3 primary doses of diphtheria-tetanus-whole-cell pertussis (DTwP)/diphtheria-tetanus-acellular pertussis (DTaP) vaccines against pertussis, hospitalization, or pertussis complications in infants. However, vaccine effectiveness against infant pertussis death has not been previously reported.

This is the first study to report the protective role of ≥1 DTwP/DTaP doses among vaccine-eligible infants aged ≥6 weeks against death, hospitalization, and complications from pertussis. It describes risk markers for death among vaccine-ineligible infants aged <6 weeks. (Read the full article)

Medicaid made substantial investments in enhanced prenatal and postnatal care programs to address maternal and infant health, including infant mortality. Evaluations of population-based programs are few, and although some have reported reductions in infant mortality, they have methodological limitations.

A population-based home visitation program can be a successful approach to reduce infant mortality. The reduced risk of infant death is consistent with previous findings on the effects of the program on health care utilization and birth outcomes. (Read the full article)

Studies on the risk of mortality and morbidities of extremely preterm infants of multiple gestation births have shown inconsistent results. Perinatal antecedents, admission status and severity of illness after birth can adversely affect outcomes of the extremely premature infants.

Preterm multiple gestation infants have increased risk of mortality but similar risk of major morbidities compared with singletons. Outcomes improved over time and all adverse outcomes, including mortality, were comparable between multiples and singletons in the most recent 5-year epoch. (Read the full article)

Objectives: Carbapenemase-producing Enterobacterales and specifically KPC-producing Klebsiella pneumoniae (KPC-Kp) are rapidly spreading worldwide. The prognosis of ventilator-associated pneumonia (VAP) caused by KPC-producing Klebsiella pneumoniae (KPC-Kp) is not well known. Our study tries to assess whether ventilator-associated pneumonia caused by a KPC-Kp strain is associated with higher all-cause mortality than if caused by carbapenem-susceptible isolates.

Study design and methods: This is a retrospective cohort study of patients with VAP due to K. pneumoniae from a 35-bed polyvalent Intensive Care Unit in a university hospital (> 40,000 annual admissions) between January 2012 and December 2016. Adjusted multivariate analysis was used to study the association of KPC-Kp with 30-day all-cause mortality (Cox regression).

Results. We analyze 69 cases of K. pneumoniae VAP of which 39 were produced by a KPC-Kp strain with high-level resistance to meropenem (MIC > 16 mg/mL). All-cause mortality at 30 days was 41% in the KPC-Kp group (16/39) and 33.3% in the carbapenem-susceptible cases (10/30). KPC-Kp etiology was not associated with higher mortality when controlled for confounders (adjusted hazard ratio [lsqb]HR[rsqb] 1.25; 95% CI: 0.46–3.41). Adequate targeted therapy (HR 0.03; 95% CI: <0.01–0.23) was associated with all-cause mortality.

Conclussion. Assuming the limitations due to the available sample size, the prognosis of VAP caused by KPC-Kp is similar to VAPs caused by carbapenem-susceptible K. pneumoniae when appropriate treatment is used.

Introduction: This study was performed to evaluate the impacts of vanA-positivity of Enterococcus faecium (EFM) exhibiting diverse susceptibility phenotypes to glycopeptides on clinical outcomes in patients with a bloodstream infection (BSI) through a prospective, multicenter, observational study.

Methods: A total of 509 patients with an EFM BSI from eight sentinel hospitals in South Korea during a two-year period were enrolled in this study. Risk factors of the hosts and causative EFM isolates were assessed to determine associations with the 30-day mortality of EFM BSI patients via multivariable logistic regression analyses.

Results: The vanA gene was detected in 35.2% (179/509) of EFM isolates; 131 EFM isolates exhibited typical VanA phenotypes (group vanA-VanA), while the remaining 48 EFM isolates exhibited atypical phenotypes (group vanA-Atypical), including VanD (n = 43) and vancomycin-variable phenotypes (n = 5). A multivariable logistic regression indicated that vanA-positivity of causative pathogens was independently associated with the increased 30-day mortality rate in the patients with an EFM BSI; however, there was no significant difference in the survival rates between the patients of the vanA-VanA and vanA-Atypical groups (log-rank test, P = 0.904).

Conclusions: A high 30-day mortality rate was observed in patients with vanA-positive EFM BSIs, and vanA-positivity of causative EFM was an independent risk factor for early mortality irrespective of the susceptibility phenotypes to glycopeptides; thus, intensified antimicrobial stewardship is needed to improve clinical outcome of patients with vanA-positive EFM BSI.

BACKGROUND:

Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with a mortality of ~27%. The Congenital Diaphragmatic Hernia Study Group (CDHSG) developed a simple postnatal clinical prediction rule to predict mortality in newborns with CDH. Our aim for this study is to externally validate the CDHSG rule in the European population and to improve its prediction of mortality by adding prenatal variables.

Jeffrey D. Horbar
Jun 1, 2012; 129:1019-1026
ARTICLES

Jeffrey D. Horbar
Jul 1, 2002; 110:143-151
ARTICLES

Yong Y. Han
Dec 1, 2005; 116:1506-1512
ARTICLES

The Delaware State Housing Authority (DSHA) announced last month that it will be taking the lead in a new outreach project designed to expand the relief options available to homeowners who are struggling with their mortgages. The Making Home Affordable Outreach and Intake Project aims to help homeowners avoid mortgage default by seeking resolutions through the Making Home Affordable (MHA) Program, the cornerstone of President Obama’s plan to offer lasting relief to homeowners in financial distress.

Cancer screening and early detection efforts continue to drive down Delaware’s all-site cancer mortality rates, say Delaware public health officials. From 2000-2004 to 2010-2014, Delaware’s cancer death rate decreased 12 percent, an impressive improvement though slightly lower than the decline seen nationally (14 percent), according to the latest cancer data announced by the Division of Public Health (DPH).

DOVER – Cancer screening and early detection efforts continue to drive down Delaware’s cancer death rates, say state public health officials. In particular, officials are seeing dramatic improvements in the all-site mortality rate among non-Hispanic African-American men, which decreased by 30 percent between the five-year periods of 2001-2005 and 2011-2015, according to the latest cancer […]

WILMINGTON  – For the first time, the Delaware Division of Public Health (DPH) through the integration of 12 multi-agency datasets, has developed a demographic picture of the Delawareans who died from drug overdoses in 2017. DPH released the Drug Overdose Mortality Surveillance Report, Delaware, 2017, in Wilmington on Wednesday, Aug. 14, 2019. In addition to […]

To reduce disparate birth outcomes and save the lives of both infants and their mothers, the Division of Public Health (DPH) and the Delaware Healthy Mother and Infant Consortium (DHMIC) awarded mini-grants to six community organizations. The local grant recipients were announced Dec. 10, during the DHMIC’s quarterly meeting in Dover.

Part of the explanation can be higher co-morbidity in certain cities and also a shortage of critical equipment like ventilators.

While praising the state on some counts, including increasing daily testing from 400 to 2,410 per day between April 20 and May 2, it also flagged the non-cooperation of the state bureaucracy.

The state's TMC government has been drawing consistent criticism from the Centre and opposition parties over the way it has tackled the pandemic, and has been accused of under-reporting data about the number of COVID-19 cases and deaths.

IN BELGAVI, KARNATAKA STATE, BOUGHT AGRICULTURAL LAND OF 2.75 ACRES AFTER GETTING DC APPROVAL IN 2018 WITH A LOCK IN TRANSFER 5 YEARS. NOW CAN I TAKE LOAN FROM AN INDIVIDUAL FOR BUYING A TRACTOR AND CULTIVATION OF LAND BY MORTGAGING THIS AGRICULTURAL LAND

Reserve Bank revises Guidelines on Mortgage Guarantee Companies (MGCs)

Clive Briault, FSA Retail Managing Director, gave advice to the Council of Mortgage Lenders Annual Conference urging firms to assess their funding and liquidity positions in light of expected worsening of liquidity and credit risks. Mr Briault also...

Partly in an effort to counter the tide of mortgage fraud cases, the Land Registry has amended the Land Registration Rules 2003 with effect from 10 November 2008. The Land Registration (Amendment) Rules 2008 substantially amend many of the forms req...

Kavesseri Menon and Beena Menon –v- Nathan Pask and Rosalind Goode (as joint fixed charge Receivers) [2019] EWHC 2611(ch) Summary: The High Court recently provided much needed clarity on the previously unanswered question of whether Receivers ...

The Land Registry is changing its practice on the discharge of mortgages in cases where form DS1 is not available when the application is made to the Land Registry. On 3 August 2009, the Land Registry will implement an important change in practice ...

The mortgage pre-action protocol (MPAP) has been in force for a little over six months, long enough for the courts' approach to settle down and for patterns to emerge. This article looks at our experiences. The good news is that MPAP compliance has...

LSG Litigation regularly deal with cases involving mortgage fraud. The key to combating mortgage fraud is early detection, comprehensive and vigorous investigation and immediate recovery action. A Case Study In October 2008, we were instructed to...

Currently CPR 55.10 provides that where a mortgagee seeks possession of land which consists of or includes residential property the claimant must send a notice to the property addressed to 'the occupiers' within 5 days of receiving notification of t...

The Ondo State Government has given a month ultimatum for concern residents of the state to evacuate the corpses of their loved ones from morgues operated by the government for decent burial or risk being given mass burial. The state Commissioner for Health, Dr. Wahab Adegbenro, who disclosed this on Saturday, stated that the move […]

Mortuary congestion: Ondo threatens mass burial for corpses, gives 30-day ultimatum

La enseñanza bíblica en profundidad de John MacArthur lleva la verdad transformadora de la Palabra de Dios a millones de personas cada día.

La enseñanza bíblica en profundidad de John MacArthur lleva la verdad transformadora de la Palabra de Dios a millones de personas cada día.

La enseñanza bíblica en profundidad de John MacArthur lleva la verdad transformadora de la Palabra de Dios a millones de personas cada día.

The volume of home mortgage loans made out by commercial banks is falling at a rapid rate after the government's measure to keep the housing marketing from overheating on August 2. According to figures made public by the nation's top-five banks including Kookmin, Shinhan, Woori, KEB Hana, and Nonghyup on August 21, the balance of home mortgage loans as of August 18 was 368,370.2 billion won, up by 1,834.3 billion won from the end of July (366,535.9 billion won). In monthly rate, this is up ...