Medico-legal autopsies after sunset: Ethical issues

From the British era, regular medico-legal autopsies have never been done in India after sunset, except for those specially permitted by the law enforcement agencies. The Ministry of Health and Family Welfare, Government of India, issued a notification on November 15, 2021, regarding the “Conduct of post-mortem in hospitals after sunset”. This has given rise to much debate on whether post-mortems can be conducted after sunset in an ethical manner. Here, we briefly discuss the various issues related to the carrying out of post-mortems after sunset in India.

Mapping of SARS-CoV-2 in Waldeyer's lymphatic ring and visceral biopsies: the age and the illness duration's impact

Abstract Objective: To study the impact of age and the interval between disease diagnosis and death on the organotropism of SARS-CoV-2. Method: Patients underwent post-mortem biopsies from lungs, Waldeyer ring, heart, liver, kidneys and bone marrow between 2020-2021. SARS-CoV-2 organotropism was mapped by using molecular RT-PCR analyses for SARS-CoV2 targeting the Envelope gene (E), the RNA Polymerase Gene (RdRp), and the Nucleocapsid gene (N). Statistical and linear regression analysis was performed to study the impact of age and illness duration in SARS-CoV-2 organotropism. Results: We performed 158 postmortem biopsies in 21 patients, with a mean age of 76 years old. The mean interval between the diagnosis of the infection to the death was 23 days. The RNA of the SARS-CoV-2 was detected in 100% of lung biopsies, 76%-82% of Waldeyer's ring biopsies, 55% of heart biopsies, 40% of kidney biopsies, 33% of liver and 25% of bone marrow biopsies. Patients who died before the day 9, presented extensive visceral dissemination of SARS-CoV-2 RNA. Most of the patients older than 80 years (90%) presented visceral dissemination of SARS-CoV-2 RNA, while among younger patients, only 3/11 patients presented visceral dissemination of the virus. The relationship between "age" and "illness duration" and multitropism of the virus was statistically significant (p< 0.001). Conclusion: Disease interval and age were factors that were significantly associated with RT-PCR positive results in multiple organs. Critical COVID-19 patients have multiorganic viral dissemination in early stages. In the critical older patients, multiorganic viral dissemination is the rule. Level of evidence: 4. Case Series.

Tributo a la vida y obra de Juan Eloy Valenzuela y Mantilla, el primer médico de Bucaramanga

En este escrito se hace breve mención a la Real Expedición Botánica de la Nueva Granada como escuela de botánica de Eloy Valenzuela, a su mentor, el protomédico gaditano José Celestino Mutis, al protagonismo de Valenzuela en los aspectos sociales de los pobladores de la Villa de Bucaramanga en el siglo XVIII. También se muestran las enfermedades más frecuentes de la época y los remedios con que eran socorridos los pacientes.

This paper does a brief mention of the Royal Botanical Expedition of New Granada as Eloy Valenzuela's school of botany. Shows José Celestino Mutis, the Spanish protomedical mentor of Valenzuela, and describes the Valenzuela's leading role in the social aspects of the inhabitants of the Villa de Bucaramanga in the 18th century. The most frequent diseases of the time and the remedies with which patients were helped are shown.

Assessment of Post-mortem Processing Methods on Quality and Shelf Life of Mutton

This study was carried out to assess the influence of post-mortem processing methods on quality and shelf life of two breeds of sheep meat. A total of twelve sheep, six each from Balami and Ouda (two prominent breed of Sheep in Nigeria) were weighed, slaughtered and allotted to three processing methods which are scalding, singeing and skinning in a completely randomized experimental design in a 2 × 3 factorial arrangement (2 breeds and 3 post-mortem processing methods). The carcass characteristics, primal cuts, physico-chemical properties, sensory and microbial counts were assessed. The results showed that Ouda breed gave the highest (p<0.05) dressing % (36.43%), preferred (p<0.05) primal cuts in rounds (15.13%), Marbling score, lipid profile (Total cholesterol, LDL), and Lipid peroxidation, Balami sheep was however rated higher (p<0.05) in juiciness, tenderness and overall acceptability. The Scalded sheep had the highest dressing % (35.45%), with preferred marbling score (5.80), and microbial counts. The scalded samples were also the lowest (p<0.05) for crude Fiber, CF, total cholesterol (276.40 mg/dL) and LDL (183.89 mg/dL). Minimal exudate loses (cooking loss and drip loss) were recorded in singeing samples and was rated highest (p<0.05) with organoleptic properties. The microbial and fungi loads increased with the storage days. Conclusively, Ouda breed and Scalding method of post-mortem dressing gave the preferred values for optimum nutrients and shelf-life of sheep meat.

Estimation of Time Since Death of Bodies Above Soil Surface in A Guinea Forest-Savannah Vegetation of Nigeria Using Visible Post Mortem Changes

Background: Forensic taphonomy is the use of decomposition timeline estimation to unravel mystery behind time of death confirmation in homicide cases involving the law court. The Guinea forest-savannah vegetation is one of the vegetations in Nigeria characterized by short trees, grassland, very hot temperatures almost round the year, speedy wind, etc. It has two distinct seasons – rainy and dry seasons. This study aimed at investigating the visible post mortem changes of domestic pigs (Sus scrofa domestica) in a Guinea forest-savannah vegetation of Nigeria so that it can be used to estimate time since death of bodies on the soil surface. Methods: A stratified random sampling technique was used to select two male and two female matured domestic pigs from a private pig farm located close to the research facility. The visible post mortem changes were observed daily (morning, afternoon and evening) for 49 days. Results: Four stages of decomposition were identified namely fresh, bloat, active decay, and advanced decay stages. Mummification process started at the sixth day post mortem which slowed the rate of decomposition, and prevented the animals to completely skeletonize within the study period. Extreme atmospheric temperature was the major factor that aided the mummification of the animals. Conclusions: Decomposition of domestic pigs in this region accelerates at the early hours of post mortem, and subsequently slows down due to extreme climatic conditions. In addition, it takes carcasses on the soil surface more than 49 days to completely skeletonize due to its vegetative factors. This implies that most crime investigations carried out in this region must take into account the climatic conditions before estimating the time of death.

¿Es el "diente rosado" válido en el contexto forense actual? / Are "pink teeth" relevant to current forensics?

Introducción: El "diente rosado" es un fenómeno post mortem. Se caracteriza por una tonalidad rosa, rojiza y hasta púrpura, que puede observarse en los dientes. Su primera referencia se remite a 1829, cuando Thomas Bell lo describió, y genera polémica desde hace casi dos siglos. La temática plantea varias interrogantes: ¿sería más lógico nombrarlo "red teeth" o "purple teeth"?, ¿qué provoca esa tonalidad más intensa?, ¿la coloración rosada indica determinada causa de muerte?, ¿queda para siempre o puede desaparecer por diversos factores? Objetivo: Describir los indicadores de que el "diente rosado" o "pink teeth" pueda aún ser considerado un elemento importante para la investigación forense actual. Comentarios principales: Luego de la experiencia acumulada con los casos trabajados durante los últimos 20 años y la revisión bibliográfica realizada, se evidencia que el fenómeno aparece sobre todo en las piezas dentales anteriores y premolares monorradiculares. Además, puede verse tanto ante mortem como post mortem. Por causas diferentes el post mortem necesita de varios días para instaurarse y es un evento tafonómico, evidenciable tanto en muertes violentas como naturales, aunque la variación en su tonalidad depende de diversos factores. Consideraciones globales: Teniendo en cuenta la experiencia obtenida por los autores, y lo referido en la bibliografía sobre el tema, se evidencia que este signo, fenómeno o hallazgo (al aclararse las interrogantes planteadas) aún puede ser muy significativo y orientador en el contexto forense actual(AU)

Introduction: "Pink teeth" are a post-mortem phenomenon characterized by a rose, reddish and even purple shade of color which may be observed in teeth. Their first reference dates back to 1829, when Thomas Bell described them. They have been a topic of debate for almost two centuries. The subject poses several questions: Would it be more logical to name them "red teeth" or "purple teeth"? What causes the increase in color intensity? Does the pink shade signal a specific cause of death? Does it remain forever or may it disappear for a variety of reasons? Objective: Describe the indicators that "pink teeth" may still be considered an important element in current forensic research. Main remarks: Based on the experience gathered from the cases analyzed in the last 20 years and the bibliographic review conducted, it is evident that the phenomenon appears mainly in anterior teeth and single-rooted premolars. On the other hand, pink teeth may be observed ante mortem as well as post mortem. For a number of reasons, post mortem pink teeth take several days to form, and they are a taphonomic phenomenon, present in violent as well as natural deaths, though their change in tone depends on various factors. General considerations: Founded on the experience obtained by the authors and the bibliography about the topic, it is evident that this sign, phenomenon or finding (upon clarification of the questions posed) may still be very significant and enlightening in the current forensic context(AU)

Presence of Helicobacter spp. in dental tartar and gastric mucosa, and its relationship with EGUS in horses from a public slaughterhouse

Background: Despite the fact that Helicobacter spp. has been detected in equine gastric mucosa, no evidence exists about this infection in Colombian horses affected by equine ulcerative gastric syndrome (EGUS), nor in dental tartar. Objective: To detect Helicobacter spp. DNA in equine gastric mucosa and dental tartar and determine the relationship between the presence of Helicobacter spp. and gastric lesions. Methods: Samples of glandular gastric mucosa and dental tartar were collected from 30 equine slaughterhouses. Macroscopic lesions of the stomachs were classified and the total DNA in all samples was extracted using a commercial extraction kit. A final-point PCR was performed using primers for amplification of a segment of 251 bp of the gene encoding the 16s rRNA region; the amplified fragments were subjected to a second PCR to determine the presence of H. pylori, the VacA gene was typified. The resulting amplicons were sequenced. Results: It was possible to amplify 16s rRNA in several samples but there was no amplification of VacA. Fragments of the sequences were compatible with H. heilmannii. The 23.3 and 10% of gastric and tartar samples were positive for 16s rRNA of Helicobacter spp., respectively. Conclusion: Although genetic material of Helicobacter spp. was found in some animals, there was no relationship with gastric lesions. It is possible that helicobacteriosis has no bearing in EGUS etiology.

Antecedentes: A pesar de que se ha detectado Helicobacter spp. en mucosa gástrica equina, no existe evidencia de esta infección en caballos criollos colombianos afectados por síndrome ulcerativo gástrico (SUGE), ni tampoco reportes en sarro dental. Objetivo: Detectar ADN de Helicobacter spp. en sarro dental y mucosa gástrica de equinos, y determinar la relación entre la presencia de la bacteria y lesiones gástricas. Métodos: Las muestras de mucosa glandular gástrica y sarro dental fueron colectadas de 30 equinos que se encontraban en planta de beneficio. Las lesiones macroscópicas fueron clasificadas y el ADN total de las muestras fue extraído utilizando un kit comercial. Se desarrolló PCR convencional usando cebadores específicos para la amplificación de un segmento de 251 pb de un gen que codifica la región 16S del ARNr; los fragmentos amplificados fueron sometidos a una segunda PCR para determinar la presencia de H. pylori mediante la amplificación del gen VacA. Los amplificados resultantes fueron secuenciados. Resultados: Fue posible amplificar 16s ARNr en varias muestras, pero no hubo amplificación de VacA. Los fragmentos de las secuencias fueron compatibles con H. heilmannii. El 23,3 y 10% de las muestras gástricas y sarro fueron positivas para 16s ARNr de Helicobacter spp., respectivamente. Conclusión: Aunque el material genético de Helicobacter spp. se encontró en algunos animales, no hubo relación con las lesiones gástricas. Es posible que la helicobacteriosis no tenga incidencia en la etiología del EGUS.

Antecedentes: Apesar do Helicobacter spp. ter sido detectado na mucosa gástrica de equinos, não há evidências dessa infecção em cavalos crioulos colombianos afetados pela síndrome ulcerativa gástrica (SUGE), ou no sarro. Objetivo: Detectar ADN de Helicobacter spp. na mucosa gástrica e do sarro dental de equinos, e determinar a relação entre a presença de Helicobacter spp. e lesões gástricas. Métodos: Amostras de mucosa gástrica glandular e sarro dental foram coletadas de 30 equinos de abatedouro, as lesões macroscópicas dos estômagos foram classificadas. Se realizou extração de ADN total em todas as amostras através de kit comercial. Realizou-se PCR ponto final, amplificando o segmento de 251 pb do gene que codifica para a região 16s ARNr; os fragmentos amplificados foram sometidos novamente a PCR para determinar a presença de H. pylori, ao tipificar o gene VacA, e seguidamente foram sequenciados. Resultados: O houve amplificação do 16s ARNr em várias amostras, mas não amplificação de VacA. Fragmentos das sequencias foram compatíveis com H. heilmannii. O 23,3 e 10% das amostras gástricas e do sarro foram positivas para 16s ARNr de Helicobacter, respectivamente. Conclusão: Embora material genético de Helicobacter spp. encontrou-se em algumos animais não houve relação com lesões gástricas. Possivelmente a helicobacterioses não tem papel relevante na etiologia da SUGE.

Histopathological analysis of residual lens cells in capsular opacities after cataract surgery using objective software

Purpose: Remnant lens epithelial cells (LECs) within the capsular bag (CB) undergo epithelial?to?mesenchymal transition (EMT) and acquire a myofibroblast phenotype, depositing extracellular matrix (ECM) components, leading to posterior capsular opacification (PCO). This study histopathologically analyzes the LEC?to?myofibroblast transition and de novo ECM component deposition (i.e., smooth muscle actin (SMA) and fibronectin (FN) expression) and determines the intraocular lens (IOL) and patient factors associated with these changes. Methods: In total, 190 CBs with IOLs were removed from donor eyes. Digital images were obtained, and PCO was graded using published software (ADOS, Medical Parachute). Automated immunohistochemistry was performed using anti?SMA to detect EMT and anti?FN to document ECM remodeling. Slides were digitized and analyzed using the Positive Pixel Count v9 algorithm. Linear regression and Poisson regression were performed (P < 0.05). Results: SMA positive expression decreased as the time of IOL implantation increased (P < 0.0001). Positivity of SMA and FN demonstrated a positive correlation (P = 0.0002). Controlling for confounding factors in Poisson regression, hydrophobic and hydrophilic materials showed higher FN and SMA expression when compared to silicone material lenses (FN; P = 0.018; P < 0.0001, SMA; P = 0.001; P = 0.003, respectively). The square optic design had 29% higher SMA positivity compared to the opti?edge design (P = 0.042). One?piece haptic lenses had higher SMA expression compared to three?piece haptic (P = 0.042). A higher risk of expression of SMA and FN was seen in patients with a history of smoking, hypertension, and glaucoma (P < 0.05). Conclusion: This study demonstrated that SMA and FN expression is different according to IOL design and patient factors, thus indicating that LEC changes depend on lens biocompatibility. Therefore, by analyzing the histopathological composition of PCO by using LECs, further insight into the characteristics of IOLs that are important for biocompatibility can be ascertained.

Effects of Layered Clothing on the Post-mortem Decomposition of Rat Carcasses on Grass Bushes and Dead Leaves (Kesan Pakaian Berlapis Terhadap Penguraian Postmortem Bangkai Tikus di atas Dedaun Rumput yang Telah Mati) / Jurnal Sains Kesihatan Malaysia

@#A post-mortem decomposition is defined by the evaluation of the physical and chemical changes of a cadaver or a carcass in order to estimate the cause of death and the time of death. The purpose of this study is not to replicate a real crime scene but to enhance knowledge of the effects of clothing in a decomposition process, mainly, the effects of layered cotton clothing on the post-mortem decomposition of adult female rat carcasses. Fifteen rats were divided into three groups: control, one-layered and two-layered clothed. The control subjects were unclothed and used to compare the post-mortem changes with the clothed subjects, one-layered and two-layered rat carcasses. All subjects were placed outdoor, 2.5 meters away from each other on grass bushes and dead leaves. Ambient temperature and humidity were recorded to observe if it associates with the post-mortem changes of the rats. Insect activity on each subject was observed. Post-mortem changes were measured using the Total Body Score system. The results showed that the control group underwent a faster decomposition compared to the clothed groups. The different layers of clothing did not show a vast difference in post-mortem changes. The ambient temperature of 28°C influences the post-mortem decomposition. The decomposition was rapid under the dominance of maggots compared to ants as ant colonies delayed the decomposition process. The study gave the knowledge of the effect of clothing in decomposition of female rats in forensic science.

Causes of death and post-mortem testing for SARS-CoV-2 in a tertiary hospital during the COVID-19 pandemic in Ghana

Background: Causes of death during the coronavirus disease 2019 (COVID-19) pandemic ranhttp://crossmark.crossref.org/dialog/?doi=10.4102/ajlm.v11i1.1766=pdf&date_stamp=2022-11-23ge from direct consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to deaths unrelated to SARS-CoV-2. Another feature of the pandemic is the post-mortem testing for SARS-CoV-2. Understanding these aspects of COVID-19 are essential in planning and limiting the impact of SARS-CoV-2 virus on healthcare systems. Objective: This study investigated the underlying causes of death and the presence of SARS-CoV-2 in bodies received at the 37 Military Hospital, Accra, Ghana, during the COVID-19 pandemic. Methods: The study was conducted from 4­27 May 2020. Deceased patients that met the inclusion criteria were prospectively selected during the expanded surveillance period for SARS-CoV-2 testing, autopsy and determination of underlying and immediate cause of death. Results: A total of 161 deceased patients were analysed with 53 autopsies. The overall positive test rate for SARS-CoV-2 was 14.9% (24/161 patients), with a positive rate of 5.0% (8/161 patients) for nasopharyngeal samples and 30.2% (16/161 patients) for bronchopulmonary samples. The underlying causes of death were not related to SARS-CoV-2 infection in 85.1% (137/161) of patients, SARS-CoV-2-associated 12.4% (20/161) and SARS-CoV-2-induced in 2.5% (4/161). Cardiovascular complications formed the most common cause of death in patients with or without SARS-CoV-2. Conclusion: There was a high positive rate of SARS-CoV-2 in post-mortem cases. However, most deaths were not caused by SARS-CoV-2 but by cardiovascular complications. The high rate of bronchopulmonary positive results for SARS-CoV-2 requires that autopsies be done in suspicious cases with negative nasopharyngeal sampling.

Practical tips to using formalin-fixed paraffin-embedded tissue archives for molecular diagnostics in a South African setting

Background: Formalin-fixed paraffin-embedded (FFPE) tissue archives in hospitals, biobanks, and others offer a vast collection of extensive, readily available specimens for molecular testing. Unfortunately, the use of tissue samples for molecular diagnostic applications is challenging; thus, the forensic pathology FFPE tissue archives in Africa have been a largely unexploited genetic resource, with the usability of DNA obtainable from these samples being unknown.Intervention: The study, conducted from January 2015 to August 2016, determined the usefulness of FFPE tissue as a reliable source of genetic material for successful post-mortem molecular applications and diagnostics. Formalin-fixed paraffin-embedded tissue samples were collected and archived from autopsies conducted over 13 years in the forensic medicine department of the University of Pretoria (Pretoria, South Africa). Deoxyribonucleic acid from FFPE tissue samples and control blood samples was amplified by high-resolution melt real-time polymerase chain reaction before sequencing. The procurement parameters and fixation times were compared with the quantity and quality of the extracted DNA and the efficiency of its subsequent molecular applications.Lessons learnt: This study has shown that FFPE samples are still usable in molecular forensics, despite inadequate sample preparation, and offer immense value to forensic molecular diagnostics.Recommendations: FFPE samples fixed in formalin for more than 24 h should still be used in molecular diagnostics or research, as long as the primer design targets amplicons not exceeding 300 base pairs.

Análise retrospectiva das causas de condenações de carcaças e vísceras de bovinos abatidos em abatedouros frigoríficos na Região Norte da Amazônia Oriental / Análisis retrospectivo de causas de decomiso en canales y vísceras de bovinos sacrificados en mataderos en la Región Norte de la Amazonía Oriental / Retrospective analysis of the causes of condemnations of carcasses and viscera of cattle slaughtered in slaughterhouses in the Northern Region of the Eastern Amazon

Resumo Este trabalho buscou determinar as principais causas de condenação de carcaças e de órgãos diagnosticadas pelo serviço de inspeção oficial, nos frigoríficos sob inspeção federal que atendem o estado do Pará. A quantidade total de lesões encontradas em carcaças bovinas foi de 60.511, o que representou 0,78% do total de bovinos abatidos (7.706,638) durante o período estudado. A contusão foi a maior causa encontrada em carcaças bovinas com 21.270 achados (35,1%), seguida da contaminação com 17.865 ocorrências (29,5%). Os pulmões, os rins e o fígado foram as vísceras condenadas em maior quantidade abrangendo um quantitativo de 1.038.623, 468.540 e 231.318, respectivamente, sendo o enfisema pulmonar, o cisto urinário e a teleangiectasia hepática as principais causas de condenação. Nos demais órgãos inspecionados, a contaminação foi a primeira causa de descarte de cabeça, intestinos, coração, língua e cauda, culminando com elevados percentuais de 83,9%, 63,3%, 49,8%, 80,2% e 73,2%, respectivamente, evidenciando a necessidade de acentuar os treinamentos dos funcionários da indústria envolvidos no processo de abate e tecnologia da carne e a importância da realização das inspeções sanitárias pelo Médico Veterinário oficial nos matadouros frigoríficos para a preservação da saúde da população.

Abstract This work aimed to determine the main causes of condemnation of carcasses and organs diagnosed by the official inspection service in the slaughterhouses under federal inspection that serve the state of Pará. The total number of lesions found in bovine carcasses was 60.511, which represented 0,78% of the total number of cattle slaughtered (7.706,638) during the study period. The contusion was the largest cause found in bovine carcasses with 21.270 findings (35.1%), followed by contamination with 17.865 occurrences (29.5%). The lungs, kidneys and liver were the most condemned viscera, covering a quantity of 1.038,623, 468.540 and 231.318, respectively, with pulmonary emphysema, urinary cyst and hepatic "telangiectasia" being the main causes of condemnation. In the other inspected organs, contamination was the first cause of head, intestine, heart, tongue and tail discarding, culminating with high percentages of 83.9%, 63.3%, 49.8%, 80.2% and 73.2%, respectively, evidencing the need to emphasize the training of the employees of the industry involved in the process of slaughter and meat technology and the importance of carrying out the sanitary inspections by the official Veterinarian in slaughterhouses for the preservation of the health of the population.

Resumen Este trabajo buscó determinar las principales causas de decomiso de canales bovinas y órganos diagnosticados por el servicio de inspección oficial, en los mataderos bajo inspección federal que atienden el estado de Pará. El número total de lesiones encontradas en las canales de bovinos fue de 60.511, lo que representó 0,78 % del total de bovinos sacrificados (7.706.638) durante el período estudiado. La contusión fue la principal causa encontrada en los cadáveres de bovinos con 21.270 hallazgos (35,1%), seguida de la contaminación con 17.865 ocurrencias (29,5%). Los pulmones, los riñones y el hígado fueron las vísceras más decomisadas con un total de 1.038.623, 468.540 y 231.318, respectivamente, siendo el enfisema pulmonar, el quiste urinario y la teleangiectasia hepática las principales causas de condena. En los demás órganos inspeccionados, la contaminación fue la principal causa de disposición de la cabeza, intestinos, corazón, lengua y cola, culminando en altos porcentajes de 83,9%, 63,3%, 49,8%, 80,2% y 73,2%, respectivamente, mostrando la necesidad para potenciar la formación de los empleados de la industria involucrados en el proceso de sacrificio y tecnología cárnica y la importancia de realizar inspecciones sanitarias por parte del Veterinario oficial en los mataderos para la preservación de la salud de la población.

Medición funcional en el dominio de la ética empírica / Functional Measurement in the Field of Empirical Ethics / Medição funcional no domínio da ética empírica

El presente artículo propone un enfoque empírico de la ética derivado de la teoría psicológica del juicio humano propuesta por Norman Anderson. Muestra cómo la metodología de esta teoría ­denominada medición funcional­ puede utilizarse para caracterizar las diversas posiciones personales que existen en todas las sociedades respecto a los problemas de salud pública. Los principales resultados de tres estudios realizados en tres países diferentes (Guinea, Francia y Colombia) se presentan como ilustración de lo que puede aportar este enfoque. Dichos análisis se centraron en tres problemas deliberadamente muy diferentes: (a) el deber de atender a los pacientes infectados, en caso de una epidemia que ponga en peligro la vida de los cuidadores; (b) la aceptabilidad de la reproducción postmortem, en el caso de los soldados que mueren en combate, y (c) la aceptabilidad del suicidio asistido por un médico

This paper presents the proposal of an empirical ap-proach to ethics derived from a psychological theory of human judgment proposed by Norman Anderson. It shows how the methodology specific to this theory ­functional measurement­ makes it possible to char-acterize the various personal positions that exist in all societies regarding public health problems. The main results of three studies carried out in three different countries (Guinea, France, and Colombia) on various problems are presented as an illustration of what this approach can offer. These analyses focused on three deliberately very different problems: (a) the duty to care for infected patients in the event of a pandemic that puts at risk the lives of the health professionals, (b) the acceptability of postmortem reproduction in the specific context of fallen soldiers, and (c) the accept-ability of physicianassisted suicide

Este artigo propõe uma abordagem empírica da ética derivada da teoria psicológica do julgamento humano proposta por Norman Anderson. Mostra como a metodo-logia dessa teoria ­ denominada medição funcional­ pode ser utilizada para caracterizar as diversas posições pessoais que existem em todas as sociedades em relação aos problemas de saúde pública. Os principais resulta-dos de três estudos, realizados em três países diferentes (Guiné, França e Colômbia), são apresentados como uma ilustração do que esta abordagem pode contribuir. Esses estudos se concentraram em três problemas de-liberadamente muito diferentes: (a) o dever de cuidar de pacientes infectados no caso de uma epidemia que ponha em risco a vida dos cuidadores, (b) a aceitabilida-de da reprodução postmortem no caso de soldados que morrem em combate, e (c) a aceitabilidade do suicídio assistido por médicos

Presumed consent for organ donation: an incoherent justification / Presunción del consentimiento para la donación de órganos: una justificación incoherente / Consentimento presumido na dação de órgãos: uma justificação incoerente

Abstract: 15. The difference between supply and demand of transplantable organs is a global problem, and one of the most discussed measures aiming to solve it is the implementation of a presumed consent (opt-out) policy in cadaveric organ donation. This type of system is controversial when it comes to its direct effects on organ donation rates as well as its ethical base. We aim to present the latest perspectives concerning the ethical implications of the policy, especially regarding consent: its need, the coherence of presuming it and the policy's capacity to fulfill its requirements. From a community perspective, we advocate a default change in societies with an opt-out system, with a strong population education in that direction. The potential rights of family objection are also approached as well as the differences between theoretical discussion and concrete application of public policy.

Resumen: 19. El desfase entre la oferta y la demanda de órganos para trasplantes es un problema mundial, y una de las medidas más discutidas para solucionarlo es la aplicación de una política de consientimiento presumido (opt-out) de la donación de órganos de cadáveres. Este tipo de sistema es controvertido teniendo en cuenta sus efectos directos sobre las tasas de donación de órganos, así como su base ética. Nuestro objetivo es presentar las últimas perspectivas sobre las implicaciones éticas, especialmente en lo que respecta al consentimiento: su necesidad, la consistencia de su presunción y la capacidad de cumplir sus requisitos. Desde el punto de vista comunitario, abogamos por un cambio por defecto en las sociedades con un sistema de opt-out, con una fuerte educación de la población a tal efecto. También se abordan los posibles derechos de la objeción familiar, así como las diferencias entre el debate teórico y la aplicación concreta de las políticas públicas.

Resumo: 23. A diferença entre a oferta e a procura de órgãos para transplantação é um problema global, e uma das medidas mais discutidas com vista à sua resolução é a implementação de uma política de consentimento presumido (opt-out) na doação de órgãos de cadáver. Este tipo de sistema é controverso ponderando os seus efeitos diretos nas taxas de doação de órgãos, bem como da sua base ética. O nosso objetivo é apresentar as últimas perspetivas relativas às implicações éticas, especialmente no que diz respeito ao consentimento: a sua necessidade, a coerência da sua presunção e a capacidade em cumprir os seus requisitos. Numa perspetiva comunitária, defendemos uma mudança de default nas sociedades com um sistema opt-out, com uma forte educação da população nesse sentido. Os direitos potenciais da objeção familiar também são abordados, bem como as diferenças entre a discussão teórica e a aplicação concreta da política pública.

Asociación de polimorfismos en los genes CAPN y CAST con propiedades fisicoquímicas de la carne bovina: una revisión / Association of polymorphisms in CAPN and CAST genes with physicochemical properties of beef: a review / Associação de polimorfismos nos genes CAPN e CAST com propriedades físico-químicas da carne bovina: uma revisão

Resumen Las propiedades fisicoquímicas como terneza, color, jugosidad, sabor, marmoleo, pH y capacidad de retención de agua, son consideradas como los atributos que tienen mayor importancia en la calidad de la carne. El manejo post mortem influye en el funcionamiento del sistema proteolítico de las enzimas µ-calpaínas y calpastatinas, que están codificadas por los genes CAPN1 y CAST, respectivamente. Esta revisión muestra las asociaciones de los polimorfismos CAPN1 y CAST con el fin de explicar las propiedades fisicoquímicas antes mencionadas, que determinan las características relacionadas con la calidad de la carne. Existen polimorfismos de CAPN1 y CAST asociados a propiedades fisicoquímicas particulares de la carne, pero no todos los polimorfismos se asocian con las propiedades mencionadas. La actividad del sistema proteolítico de las enzimas varía según el manejo peri y post mortem. La presencia o ausencia de un polimorfismo varía entre razas. Por consiguiente, las asociaciones de polimorfismos de nucleótido simple con las propiedades fisicoquímicas de la carne mencionadas en esta revisión podrían ayudar a mejorar los indicadores de calidad de la carne bovina.

Abstract Physicochemical properties such as tenderness, color, juiciness, flavor, marbling, pH and water retention capacity, are considered the most important attributes in the meat quality. Posmortem management influences the functioning of the proteolytic system of the enzymes calpains and calpastatins, which are encoded by CAPN1 and CAST genes, respectively. This review displays the associations of CAPN1 and CAST polymorphisms in order to explain the aforementioned physicochemical properties, which determine the characteristics relate to the beef quality. There are CAPN1 and CAST polymorphisms associated with particular physicochemical properties of meat, but not all polymorphisms are associated with the mentioned properties. The activity of enzymes proteolytic system varies according to peri and posmortem management. The presence or absence of a polymorphism varies between races. Therefore, the associations of single nucleotide polymorphisms with the physicochemical properties of meat mentioned in this review could help to improve the quality indicators of beef.

Resumo Propriedades físico-químicas como maciez, cor, suculência, sabor, marmorização, pH e capacidade de retenção da água, são consideradas os atributos mais importantes na qualidade da carne. O manejo pós-morte influencia o funcionamento do sistema proteolítico das enzimas calpaína e calpastatina, que são codificadas pelos genes CAPN1 e CAST, respectivamente. Esta revisão mostra as associações dos polimorfismos CAPN1 e CAST para explicar as propriedades físico-químicas citadas, que determinam as características relacionadas à qualidade da carne. Existem polimorfismos CAPN1 e CAST associados a propriedades físico-químicas específicas da carne, mas nem todos os polimorfismos estão associados às propriedades mencionadas. A atividade das enzimas do sistema proteolítico varia de acordo com o manejo peri e pos-mortem. A presença ou ausência de um polimorfismo varia entre as raças. Portanto, as associações de polimorfismos de nucleotídeo único com as propriedades físico-químicas da carne mencionadas nesta revisão poderiam ajudar a melhorar os indicadores de qualidade da carne bovina.

Descripción de estudios de autopsias COVID-19: una revisión de alcance. Noviembre 2019 - Diciembre 2020 / Description of COVID-19 autopsy studies: a scoping review. November 2019 - December 2020

Antecedentes: las autopsias son esenciales para investigar las enfermedades emergentes ya que contribuyen a comprender su fisiopatología y fundamentar el tratamiento. Objetivo: Describir las publicaciones sobre autopsias de casos COVID-19 en el marco de la pandemia, 2019-2020. Metodología: Revisión de alcance. Periodo: publicaciones de noviembre 2019 a diciembre 2020. Términos utilizados: autopsia, cambios post mortem, hallazgos incidentales, infecciones por coronavirus, en sujetos humanos, en español e inglés; en bases de datos Research4Life, PubMed, LILACS, Researchgate. Se utilizó el estándar PRISMA. El protocolo fue aprobado por la Unidad de Investigación Científica de la Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras. Resultados: de un total de 320 artículos identificados, se seleccionaron 42, correspondientes a 582 autopsias, todos en el idioma inglés. De los 42 artículos, los dos países con más publicaciones fueron USA 16 y Alemania 5. En 27 el rango de autopsias reportadas fue 1-10. En 17 las medidas de bioseguridad implementadas no fueron consignadas y en 13 no fueron especificadas. En 19, no se describe si las autopsias fueron completas o parciales. Las autopsias completas se reportaron en 14 publicaciones, parciales en 5 y autopsias completas y parciales en 4. En 11 publicaciones no se describieron los hallazgos macroscópicos; en los 42 trabajos se examinaron los tejidos con microscopio óptico, en 28 se utilizaron marcadores inmunohistoquímicos y en 7 microscopio electrónico. El órgano descrito principalmente fue pulmón en 40 estudios. Conclusiones e implicaciones: son necesarias más publicaciones reportando series de autopsias completas, retomar la importancia del estudio de todos los órganos y la determinación de las causas de muerte por COVID-19. A diciembre de 2020, en América Latina no se había publicado estudios sobre autopsias. Las implicaciones para el manejo de casos y políticas públicas demuestran que se debe invertir en la realización de autopsias incluyendo los estudios histopatológicos que se requieran...(AU)

Epidemiological analysis of bovine tuberculosis in the southern region of Rio Grande do Sul from 2000 to 2015 / Análise epidemiológica da tuberculose bovina na região sul do Rio Grande do Sul no período de 2000 a 2015

Bovine tuberculosis (BTB) is an infectious and zoonotic disease with socioeconomic importance, responsible for economic losses in livestock due to the decrease in animal productivity, mortality, bovine carcass condemnation and restriction on exportations. The objective of the present study was to evaluate the epidemiological aspects of this disease through a descriptive analysis and time series of cases of bovine tuberculosis diagnosed at the Laboratório Regional de Diagnóstico (LRD) of the Faculdade de Medicina Veterinária, Universidade Federal de Pelotas (UFPel) from 2000 to 2015. A survey was carried out in the LRD database of cases diagnosed as tuberculosis in cattle during this period. The incidence rate of BTB ([cases/population] x 100000) was calculated. Qualitative variables (sex, age, race, origin, type of material and presumptive diagnosis) were analyzed in a descriptive way, aiming to establish the profile of affected animals, characterize the municipalities in which the disease is originated and also fix the main referral organs for diagnosis. The time series analysis was performed using the Gretl statistical software 1.9.12 (GNU Regression, Econometric and Time-series Library). To verify the existence of the stationary distribution, the test of Dickey-Fuller was used, considering a value of p<0.05. During this period, 331 cases of BTB were diagnosed in the LRD. The present study identified that the predominant profile of the bovines affected by tuberculosis was female bovine aged more than two years old and crossbreed; the main organ sent for histopathological examination was lymph nodes. The microregion of Pelotas presented the highest incidence of the disease. There was also a tendency of a decrease in the incidence rate of this disease over the years, absence of seasonal influence in the occurrence of the disease and no cases of epidemics occurred from 2002 to 2015 in the area covered by the LRD-UFPel.(AU)

Tuberculose bovina é uma enfermidade infectocontagiosa e zoonótica, de importância socioeconômica, responsável por prejuízos econômicos na pecuária em decorrência da diminuição na produtividade animal, mortalidades, condenações de carcaças e restrições nas exportações. O objetivo do presente estudo foi avaliar os aspectos epidemiológicos, por meio de uma análise descritiva e de séries temporais, dos casos de tuberculose bovina diagnosticados no Laboratório Regional de Diagnóstico da Faculdade de Veterinária, Universidade Federal de Pelotas (LRD-UFPel), no período de 2000 a 2015. Foi realizado um levantamento no banco de dados do LRD dos casos diagnosticados como tuberculose em bovinos, entre os anos de 2000 e 2015. Foi calculada a taxa de incidência da tuberculose bovina ([casos/população] x 100000). As variáveis qualitativas (sexo, idade, raça, procedência, tipo de material e diagnóstico presuntivo) foram analisadas de forma descritiva, tendo como finalidade estabelecer o perfil dos animais acometidos, caracterizar os municípios de origem, e estabelecer os principais órgãos remetidos para diagnóstico. A análise de série temporal foi feita através do software estatístico Gretl 1.9.12 (GNU Regression, Econometricand Time-series Library) e para verificar a existência da estacionariedade utilizou-se o teste de Dickey-Fuller aumentado, considerando um valor de p<0,05. Durante este período foram diagnosticados 331 casos de tuberculose bovina no LRD. O presente estudo permitiu concluir que o perfil predominante dos bovinos acometidos por tuberculose foi de fêmeas, com mais de dois anos de idade e mestiças; o principal órgão encaminhado para exame histopatológico foram linfonodos e a microrregião de Pelotas apresentou a maior incidência da doença. Foi constatada, ainda, uma tendência de queda na taxa de incidência da doença ao longo dos anos analisados, ausência de influência sazonal na ocorrência da enfermidade e, não foram registrados casos de epidemias nos anos de 2002 a 2015, na área de abrangência do LRD-UFPel.(AU)

Histomorphological Patterns in Myocarditis in Postmortem Specimens- A Descriptive Observational Study over a Period of 4 Years at a Tertiary Care Centre in Kerala.

In cases of sudden death, myocarditis is not an unusual finding especially when communicable diseases of viral origin are on the rise. Detection of myocarditis poises a diagnostic challenge to clinicians due to the absence of specific symptoms and there is a possibility of this being masqueraded as myocardial infarction. Examination of autopsy specimens are of utmost importance to detect the underlying etiology. For diagnosis of myocarditis histopathological examination of cardiac tissue is the gold standard. This is carried out based on Dallas criteria.Aim- This study was done to assess the, gross and histopathology findings in myocarditis in post mortem specimens in a tertiary care hospital in Kerala over a span of 4 years.METHODSThis is a descriptive observational study. All cases of Myocarditis diagnosed in the Department of Pathology, Medical College, Kottayam during the period of 4 years from January 2012 to December 2015 were included. Age distribution, gross and histopathologic findings were studied using the registers, post mortem specimens and histopathology slides in the department. Immunohistochemical studies were done in paraffin blocks of all newly diagnosed cases of myocarditis and some previously diagnosed cases the data was analyzed using SPSS.RESULTSWe received a total of 82 cases of myocarditis. The age distribution ranged from 75 days to 83 years. There was greater predilection for males accounting for 62% of cases. Inflammation was found in all cases and the predominant inflammatory cells were lymphocytes seen in 73% of cases. Myocyte necrosis was found in majority of the cases (98%).CONCLUSIONSMyocarditis was found to be an important cause of sudden death accounting for 0.15%.The age group affected was more in the 3rd and 4thdecade,which was comparable with other similar studies. Viral myocarditis constituted the majority of cases and mononuclear inflammation was seen in myocardium. Myocarditis was seen as part of systemic inflammation in 70% of cases. Application of Dallas criteria was helpful in diagnosis but correlation with clinical details and meticulous examination of coronaries are also needed to exclude conditions which may mimic myocarditis.

Decoding death by unknown causes using postmortem image-guided virtopsy: A review of recent literature and the Malaysian experience

@#Introduction: Autopsy is one of the most important approaches to identify clearly the exact cause of death, whether it was due to natural causes, sudden death, or traumatic. Various studies have been done in different countries regarding ways to improve the diagnosis during autopsy. The imaging approach is one of the methods that has been used to complement autopsy findings and to enhance the diagnosis for achieving the most accurate post-mortem diagnosis. The aim of this study is to identify the role of imaging modalities that complement routine autopsy and correlate the findings of diagnostic imaging that can help improve the accuracy of diagnosing the cause of death. Methods: We sourced articles from Scopus, Ovid and PubMed databases for journal publications related to post-mortem diagnostic imaging. We highlight the most relevant full articles in English that explain the type of modality that was utilised and the added value it provided for diagnosing the cause of death. Results: Minimally invasive autopsies assisted by imaging modalities added a great benefit to forensic medicine, and supported conventional autopsy. In particular the role of post mortem computed tomography (PMCT), post mortem computed tomography angiography (PMMR) and positron emission tomography computed tomography (PMCTA) that have incremental benefits in diagnosing traumatic death, fractures, tissue injuries, as well as the assessment of body height or weight for corpse identification. Conclusion: PMCT and PMMR, with particular emphasis on PMCTA, can provide higher accuracy than the other modalities. They can be regarded as indispensable methods that should be applied to the routine autopsy protocol, thus improving the findings and accuracy of diagnosing the cause of death.

The importance of the postmortem interval for the diagnosis of Waterhouse­Friderichsen syndrome by Neisseria meningitidis in a series of forensic cases

The effective value of microbiological post-mortem examinations stands as fundamental in forensic cases involving microbiology. We ran these analyses on five victims, who suddenly died after showing persistent fever. The examinations were conducted between 48 hours and 10 days after death, and adrenal gland apoplexy was detected in all the cases. Microbiological examinations identified Neisseria meningitidis, which was accountable for Waterhouse­Friderichsen syndrome. Diplococci were isolated from three cadavers that underwent forensic dissection between 2 and 3 days after death. The remaining two cadavers showed polymicrobial contamination, and a polymerase chain reaction technique was necessary to identify the pathogen. We assumed that the microbial overlap could lead to diagnostic mistakes and conceal the identification of the lethal pathogen. Therefore, we suggest using molecular techniques for a postmortem interval (PMI) longer than 72 hours. Classical microbiological examination should be performed for PMI within 72 hours.