A Pitești-i Református Egyházközség első tíz évének demográfiai adatsorai a halálozási anyakönyvek tükrében

Demographic Data of the First Ten Years of Existence of the Pitești Reformed Church in the Light of the Official Death Registries. In the last three centuries, many Hungarians in Transylvania went to work and live in the southern part of the Carpathians. At first, they went just for seasonal work, but later they become permanent migrants. They founded new Reformed parishes and schools in the new locations. We have data on the population of Pitești from 1844, when Sándor Ürmösy described the ethnic and confessional composition of the town for the first time, and he mentions 1,500 Hungarians in Pitești. As result of the Reformed missionary work, the first Reformed churches were established in the most important towns of old Romania in the mid-19th century. The documents of those times reveal to us data on the demographic, confessional, and ethnic composition of the population. In this study, I attempted to find the most important data on the first ten years in the life of the Pitești Reformed community linked to its members’ age of death, cause of the death, and occupation. Keywords: mission, Pitești, Reformed Church, old Romania, official death registries

The Mortality of Adult Sickle Cell Patients at a Comprehensive Sickle Cell Center

Sickle cell disease (SCD) is the most common hemoglobinopathy affecting 100,000 people in the United States. Although without a national registry, the precise number remains an estimate and the mortality data remains unknown. The life expectancy of SCD has extended into adulthood with the advent of prophylactic penicillin use, antipneumococcal vaccines, newborn screenings, and use of hydroxyurea (HU). However as SCD patients age, comorbidities arise reducing the life expectancy. There is an evolving landscape regarding SCD therapies, with 3 FDA approved drugs since 2017 (L-glutamine, voxelotor, crizanlizumab) joining HU which was approved in 1998. It is paramount to understand the factors that lead to early mortality in SCD so that future therapies and cures can be accessible and benefit all SCD patients. We embarked a review of the mortality data in a healthcare system serving a significant number of SCD patients in Atlanta, GA. Methods: We conducted a retrospective chart review of the Georgia Comprehensive Sickle Cell Center at Grady Health system's electronic medical record for deceased sickle cell patients from 2013 to 2020. Patients were then grouped into 3 groups, those whom followed up at the Sickle Cell Center (defined as outpatient visit within 6 months prior to death-RF), those whom did not (defined as outpatient visit > 6 months-NF), and those with unknown status. Results: Overall, 72 patients were analyzed, with the following genotype distribution: SS n=49, SC n=14, Sbeta null thalassemia (Sβ0 thal) n=2, SBeta plus thalassemia (Sβ+ thal) n=7. Overall, the most common SCD complication was acute chest syndrome (ACS) (62.5%). The majority had hypertension (HTN) (52.8%), followed by reported heart failure (40.3%) and pulmonary HTN (pHTN) (40.3%), stroke (37.5%), and chronic kidney disease (CKD) (31.9%). 35% were current and/or former smokers. Median TR max velocity was 2.8 m/sec, median albumin/Cr ratio was 27.8 mg/g, and other characteristics are in Table 1. The median age of death was 44 (STD= 15.5) overall and by genotype it was: SS at age 38 (STD=14.6); Sβ0 thal at age 42.5 ( STD=2.12); Sβ+ thal at age 50 ( STD=14.7); SC at age 51 (STD=16.5). 46 patients had data of their final hospitalization available. 73.9% (n=34) received at least 1 simple transfusion with a only 17.4% (n=8) receiving an exchange transfusion. The majority were critically ill, with 84.8% in the ICU and 95.7% with multiorgan failure. 50 patients had routine follow up (RF) while 14 patients did not (NF), and 8 patients with unknown outpatient visit status. The median age of death for RF and NF were the same 43.5 (STD=15.53) & 43 (STD=15.71) years, respectively. The genotype distribution, and other characteristics are listed in Table 2. About 44% (n=22) of the RF group were prescribed HU, with 31.8% (n=7) were prescribed a dose > 15mg/kg/dose. This was not a significant difference from the NF group, where 50% (n=7) were prescribed HU, with 42.9% at > 15mg/kg/dose. The median MCV, percentage of HbF were similar. Significant majority in RF and NF groups were prescribed chronic opiates (86% and 78.6%, respectively) with 105 and 95 median MME per day. 42.9% of patients in the NF group had alloimmunization compared to 26% in the RF group. Discussion: Most of the patients had at least 1 severe complications from SCD, and most had other comorbidities (Table 1). This is commensurate with SCD literature showing that the manifestations of chronic end-organ damage increase as patients age which increases the likelihood of early mortality. In our analysis, the median age of death was similar for those in the RF and NF groups across genotypes. HU is a disease-modifying therapy that impacts survival and reduces complications and was FDA approved in 1998, however less than 50% of patients had a prescription. Median HbF and MCV were similar between the 2 groups, suggesting HU adherence was not a factor. This raises concern about accessibility of HU for patients which was not within the scope of this review. Improvement of access and education for patients and clinicians of these therapies is needed to see reduction in mortality. As more of the adult population starts to include those with access to HU since early childhood, future studies can examine what impact that will have on HU adherence, and life expectancy. With the advent of new therapies, it is imperative to study these agents on the patients with SCD complications to evaluate their efficacy in reducing mortality. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Deaths from ‘diseases of despair’ in Britain: comparing suicide, alcohol-related and drug-related mortality for birth cohorts in Scotland, England and Wales, and selected cities

BackgroundThe contribution of increasing numbers of deaths from suicide, alcohol-related and drug-related causes to changes in overall mortality rates has been highlighted in various countries. In Scotland, particular vulnerable cohorts have been shown to be most at risk; however, it is unclear to what extent this applies elsewhere in Britain. The aim here was to compare mortality rates for different birth cohorts between Scotland and England and Wales (E&W), including key cities.MethodsMortality and population data (1981–2017) for Scotland, E&W and 10 cities were obtained from national statistical agencies. Ten-year birth cohorts and cohort-specific mortality rates (by age of death, sex, cause) were derived and compared between countries and cities.ResultsSimilarities were observed between countries and cities in terms of peak ages of death, and the cohorts with the highest death rates. However, cohort-specific rates were notably higher in Scotland, particularly for alcohol-related and drug-related deaths. Across countries and cities, those born in 1965–1974 and 1975–1984 had the highest drug-related mortality rates (peak age at death: 30–34 years); the 1965–1974 birth cohort also had the highest male suicide rate (peak age: 40–44 years). For alcohol-related causes, the highest rates were among earlier cohorts (1935–1944, 1945–1954, 1955–1964)—peak age 60–64 years.ConclusionsThe overall similarities suggest common underlying influences across Britain; however, their effects have been greatest in Scotland, confirming greater vulnerability among that population. In addressing the socioeconomic drivers of deaths from these causes, the cohorts identified here as being at greatest risk require particular attention.

US Obesity Mortality Trends and Associated Noncommunicable Diseases Contributing Conditions Among White, Black, and Hispanic Individuals by Age from 1999 to 2017

This study aims to assess the effect of obesity as an underlying cause of death in association with four main noncommunicable diseases (NCDs) as contributing causes of mortality on the age of death in White, Black, and Hispanic individuals in the USA. To estimate mortality hazard ratios, we ran a Cox regression on the US National Center for Health Statistics mortality integrated datasets from 1999 to 2017, which included almost 48 million cases. The variable in the model was the age of death in years as a proxy for time to death. The cause-of-death variable allowed for the derivation of predictor variables of obesity and the four main NCDs. The overall highest obesity mortality HR when associated with NCD contributing conditions for the year 1999–2017 was diabetes (2.15; 95% CI: 2.11–2.18), while Whites had the highest HR (2.46; 95% CI: 2.41–2.51) when compared with Black (1.32; 95% CI: 1.27–1.38) and Hispanics (1.25; 95% CI: 1.18–1.33). Hispanics had lower mortality HR for CVD (1.21; 95% CI: 1.15–1.27) and diabetes (1.25; 95% CI: 1.18–1.33) of the three studied groups. The obesity death mean was 57.3 years for all groups. People who die from obesity are, on average, 15.4 years younger than those without obesity. Although Hispanics in the USA have a higher prevalence of diabetes and cardiovascular disease (CVD), they also have the lowest mortality HR for obesity as an underlying cause of death when associated with CVD and cancer. While there is no obvious solution for obesity and its complications, continued efforts to address obesity are needed.

Clinical and Epidemiological Features of Death with COVID-19 in Karnali Province of Nepal

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread to many countries and increased mortality worldwide. Most deaths were either elderly or have underlying medical problems and even relatively young individuals have died from COVID-19. This study aimed to analyze the epidemiological and clinical characteristics of COVID-19 related deaths in Karnali Province, Nepal. Materials and Methods: We studied COVID-19 deaths from 19 May 2020 to 25 December 2020. Information from all districts of Karnali Province were included in this study. Demographic characteristics and geographic distribution map of the death toll in each district over time was analyzed. Quantum GIS(QGIS) 3.16.2 version was used to plot the deaths on maps and IBM SPSS Statistics 25 to perform statistical analysis Results: As of December 25, 2020, a total of 25 deaths were reported. Mean age of death was 52 (SD 20.99) years. Most of the deaths were distributed in age group of 50 years and above. Additionally, the male to female ratio was 5:2. A total of 56% of the deaths in Karnali were with underlying diseases and was more pronounced among males. Most of the cases were centralized in Surkhet district with highest death rate in Birendranagar municipality. Conclusion: COVID-19 poses a greater threat to the elderly people with more devastating effects, particularly in the presence of underlying diseases. The geographical distributions show that the epidemic in the Surkhet district is more serious than that in the surrounding districts. Case investigation, Contract tracing and dedicated ICU ventilator service for critical cases are essential for response of Pandemic.

Four Decades of COPD Mortality Trends: Analysis of Trends and Multiple Causes of Death

There is little information on chronic obstructive pulmonary disease (COPD) mortality trends, age of death, or male:female ratio. This study therefore sought to analyze time trends in mortality with COPD recorded as the underlying cause of death from 1980 through 2017, and with COPD recorded other than as the underlying cause of death. We conducted an analysis of COPD deaths in Galicia (Spain) from 1980 through 2017, including those in which COPD was recorded other than as the underlying cause of death from 2015 through 2017. We calculated the crude and standardized rates, and analyzed mortality trends using joinpoint regression models. There were 43,234 COPD deaths, with a male:female ratio of 2.4. Median age of death was 82 years. A change point in the mortality trend was detected in 1996 with a significant decrease across the sexes, reflected by an annual percentage change of −3.8%. Taking deaths into account in which COPD participated or contributed without being the underlying cause led to an overall 42% increase in the mortality burden. The most frequent causes of death when COPD was not considered to be the underlying cause were bronchopulmonary neoplasms and cardiovascular diseases. COPD mortality has decreased steadily across the sexes in Galicia since 1996, and age of death has also gradually increased. Multiple-cause death analysis may help prevent the underestimation of COPD mortality.

Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study

(1) Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (2) Methods: We retrospectively examined the outcomes of 475 people experiencing homelessness with the available clinical and social data. Our sample was comprised of 84.4% men and 51.8% foreign-born people. Cox’s proportional hazard models were used to identify mortality risk factors between origin groups. (3) Results: 60 people died during the ten-year period. The average age of death was 49.1 years. After adjusting for demographic characteristics and the duration of homelessness, the risk factors for mortality were origin (people born in Spain) (HR = 4.34; 95% CI = 1.89–10.0), type 2 diabetes (HR = 2.9; 95% CI = 1.62–5.30), alcohol use disorder (HR = 1.9; 95% CI = 1.12–3.29), and infectious diseases (HR = 1.6; 95% CI = 1.09–2.39). Our results show a high prevalence of infectious and chronic diseases. Type 2 diabetes emerges as an important risk factor in homelessness. The average age of death of individuals experiencing homelessness was significantly lower than the average age of death in the general population (which is greater than 80 years). (4) Conclusions: Foreign-born homeless people were generally younger and healthier than Spanish-born homeless people. Chronic diseases were controlled better in Spanish-born people, but this group showed an increased risk of mortality.

“Like Father, Like Son”: The Importance of Fathers in Nineteenth- and Twentieth-century Rural Spain

This paper uses the links between children born between 1800 and 1919 and their parents in 12 rural Aragonese villages to analyze the role of fathers in the survival, health, and lifespan of children. The researchers compared the effect of being fatherless (or being motherless) to having both parents alive. The results show that being fatherless increased the probability of death during childhood. Moreover, fatherlessness reduced the average age of death as an adult, a child’s average height, the probability that a child is literate, the child’s socioeconomic status, and the individual’s age at marriage.

Cytomorphological changes of a cat’s cadaver’s parenchymal organs in the early postmortem period in the forensic veterinary examination aspect

The cytomorphological changes of a cat’s cadaver’s parenchymal organs in the early postmortem period in the aspect of forensic veterinary examination are established in the work. The aim of the work is to clarify the processes of necrobiosis at the cellular level under aerobic environment in the first day after the death of the animal as a cytomorphological criterion in terms of forensic veterinary examination in deciding the age of death in the early postmortem period. It is proved that the most dynamic cytomorphological changes are found in the spleen and pancreas tissue; cytoarchitectonics of liver, lung and heart tissue changes less intensively. Intense cytomorphological changes in kidney tissue and brain were not observed. It was found that parenchymal organs samples cytological research after the first day of the postmortem period to determine the cells histological topography is impossible. It was found that the cytoarchitectonics dynamics of kidney and brain tissue is uninformative to solve the problems of forensic veterinary examination, but the necrobiosis of liver, lung and heart cells is moderately informative. High informativeness of cytomorphological picture change in spleen and pancreas tissue has been established, as the intensity of cytomorphological changes dynamics and their informativeness to solve the question of the age of death are directly correlated. It is recommended to use the cytological rapid method as an additional in the practice of forensic veterinary examination to address the issue of animal death age in terms of its non-obviousness before the appearance of late cadaveric phenomena.

A statistical theory of the strength of epidemics: an application to the Italian COVID-19 case

The proposed theory defines a relative index of epidemic lethality that compares any two configurations in different observation periods, preferably one in the acute and the other in a mild epidemic phase. Raw mortality data represent the input, with no need to recognize the cause of death. Data are categorized according to the victims’ age, which must be renormalized because older people have a greater probability of developing a level of physical decay (human damage), favouring critical pathologies and co-morbidities. The probabilistic dependence of human damage on renormalized age is related to a death criterion considering a virus spread by contagion and our capacity to cure the disease. Remarkably, this is reminiscent of the Weibull theory of the strength of brittle structures containing a population of crack-like defects, in the correlation between the statistical distribution of cracks and the risk of fracture at a prescribed stress level. Age-of-death scaling laws are predicted in accordance with data collected in Italian regions and provinces during the first wave of COVID-19, taken as representative examples to validate the theory. For the prevention of spread and the management of the epidemic, the various parameters of the theory shall be informed on other existing epidemiological models.