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The Moment of Death: Is Hospice Making a Difference?
Published in Inge B. Corless, Zelda Foster, The Hospice Heritage: Celebrating Our Future, 2020
Today there are many who would hesitate to accept the moment of death as an unimpeachable reality. Concepts such as “clinical death” and “brain death” have become familiar to the general public as well as allied health professionals. We are aware of controversy regarding “cortical death” vs. “whole brain death” as criteria for determining the end of life. We are aware that questions regarding the criteria for determining death have escaped from the sphere of philosophy to the court room and the hospital ethics committee. We are aware of paranormal death reports that some people interpret as having experienced “temporary death,” if this oxymoron be allowed. And we are aware that advocates of cryonic suspension believe that some people certified as dead might be resuscitated in the future. The destabilization of the concepts of “death” and “dead” makes it more difficult to assume that there is an actual identifiable moment of passage.
Sociological Perspectives on Disposal and Ritual
Published in Gerry R. Cox, Neil Thompson, Death and Dying, 2020
Although not common, cryonics or freezing of the body or parts of it is also available. While controversial, the effectiveness of cryonics is quite debatable. Some argue that the person would need to be frozen before they experience clinical death to be able to be revived and cured of whatever is taking their life. The technology may someday be available, but it is debatable whether or not it could eventually become successful. Key PointAll these are examples of cultural variations in how different societies and different groups of people deal with the challenge of disposing of the body after death. It reflects the rich diversity of social practices. They highlight once again the importance of adopting a sociological perspective if we are to develop an adequate understanding.
Death: Process or Event?
Published in David Lamb, Death, Brain Death and Ethics, 2020
Scepticism regarding the event of death is often attributable to a failure to articulate clearly which concept of death is being employed in a given discussion or proposal. In fact, most of the confusion underlying the ‘event’ versus ‘process’ debate is generated by a failure to distinguish between clinical death – death of the organism as a whole – and biological death – death of the whole organism. Clinical death can be defined as an event which marks ‘the cessation of integrative action between all organ systems of the body’. (Collins, 1980, p. 3) Conversely, life has been said to entail the integrated function of at least nine organ systems. According to Angrist: (1958, p. 2150) Death may be defined as the cessation of integrated life functions. Life depends on integration of the following physiological functions: ingestion, digestion, absorption, respiration, distribution (circulation), integration (nervous system and endocrines), metabolism, excretion, and egestion (elimination). Death occurs if any one of these functions is much impaired or arrested. A long period of symptoms usually precedes death whilst impairment occurs in the three first and three last listed functions.
Clinical characteristics and prognosis of patients with idiopathic membranous nephropathy with kidney tubulointerstitial damage
Published in Renal Failure, 2023
Mengyao Sun, Ping Li, Jianwei Dong, Zhuo Li, Chaofan Li, Shasha Zhang, Bing Chen
According to the response criteria for IMN treatment, the clinical effect of treatment was assessed based on changes in 24-h urine protein and Scr levels. The CR rate was defined as urinary protein < 0.3 g/24 h or urinary protein/creatinine < 300 mg/g, normal kidney function, albumin > 35 g/L, and stable renal function. PR rate was defined as 24-h urine protein > 0.3 g/24 h; however, < 3.5 g/24 h or urinary protein/creatinine at 300–3500 mg/g or 24-h urine protein decreased 50% from baseline, and kidney function was normal. We defined worse kidney condition as a doubling of baseline Scr levels that persisted for more than 3 months after follow-up treatment. Recurrence was defined as the reachievement of the NS criteria 1 month after CR or PR. Serious complications included clinical death, severe lung infection, necrosis of the femoral head, and other diseases.
Clinical characteristics of coronavirus disease 2019 (COVID-19) patients with hypertension on renin–angiotensin system inhibitors
Published in Clinical and Experimental Hypertension, 2020
Xian Zhou, Jingkang Zhu, Tao Xu
The COVID-19 patients with a history of hypertension were divided into two groups according to whether to take ACEI or ARB drugs, of which 15 patients had previously taken ACEI or ARB were divided into ACEI or ARB group, and other patients were divided as control group. The patients in ACEI or ARB group were younger than that in the control group and the difference was statistically significant (average age, 58.5 vs 69.2). While there were no significant differences in lymphocyte counts, crude cure rate, crude mortality rate, onset time, and length of hospital stay between the two groups (Table 3). We classify patients transfer to high-level hospital and clinical death as a poor prognosis, and the prognosis between the two groups was examined by logistic regression analysis with adjustment for age, sex, hospitalization time, time from onset to hospital admission, and whether to take ACEI or ARB. As shown from Table 4, whether to take ACEI or ARB was not significantly associated with prognosis.
Outcomes and implications of diarrhea in patients with SARS-CoV-2 infection
Published in Scandinavian Journal of Gastroenterology, 2020
Haitao Shang, Tao Bai, Yuhua Chen, Chao Huang, Shengyan Zhang, Pengcheng Yang, Lei Zhang, Xiaohua Hou
Compared to the patients with diarrhea alone (group A), the subgroup patients with both diarrhea and respiratory symptoms (group B) had 3.2 (95% confidence interval (CI), 0.71–14.52) times higher odds ratio (OR) of clinical death with longer hospital stay but shorter time from onset to admission (Table 2, Figure 2(F)). It should be pointed out that there was no significant difference in the mortality rate between group A and group B with the p = .162, which may be due to the small number of deaths (only two cases) in group A. Moreover, compared to the patients with respiratory symptoms alone (group C), group B patients had 2.2 (95% CI, 1.16–4.02) times higher OR of clinical death with higher mortality (p = .013), longer hospital stays (p = .044, Table 2, Figure 2(F)) and longer total duration of disease (p = .048, Table 2, Figure 2(F)). In general, it seemed that combination of respiratory and gut symptoms presented worse outcome.