Plano estadual de manejo de óbitos para enfrentamento da Covid-19: a experiência da Bahia / State Darth management plan for combating Covid-19: the Bahia experience / Plan estadual de manejo de muertes para enfrentar el Covid-19: la experiencia de Bahia

Os desafios impostos pela pandemia da Covid-19, relacionados a uma alta de letalidade e mortalidade pelo vírus SARS-CoV-2, alertou os gestores sobre a possibilidade de colapso da rede de serviços de manejo de óbitos no estado da Bahia. Este trabalho tem como objetivo descrever a experiência da equipe da vigilância em saúde da Bahia na formulação do Plano de Manejo do Óbito, direcionado a orientar as gestões estadual e municipais e serviços de saúde, públicos e privados, para a implementação de ações adequadas e oportunas frente à ocorrência de óbitos durante a pandemia. Para tanto, utilizou-se de revisão de literatura (em bases de dados internacionais), análise documental, questionários aplicados à gestão municipal e escuta de gestores e trabalhadores de serviços de saúde e afins por meio de webreuniões. O processo de formulação do plano partiu da classificação adotada pela Secretaria de Vigilância em Saúde do Ministério da Saúde para definir as fases da pandemia e estabelecer as ações e responsabilidades compartilhadas pelos entes federados. O documento foi aprovado pela Comissão Intergestores Bipartite (CIB) e publicado no site da Secretaria de Saúde do Estado da Bahia (Sesab), com vistas a atender os 417 municípios que compõem o território estadual.

The challenges imposed by the Covid-19 pandemic related to increased lethality and mortality from the SARS-CoV-2 virus alerted managers to the possibility of the collapse of the death management service network in the state of Bahia. Our study aims at describing the experience of the health surveillance team in Bahia in the formulation of the Death Management Plan, aimed at guiding state and municipal management, public and private health services for the implementation of appropriate and timely actions in the face of the occurrence deaths during the pandemic. For such purpose, we used literature review (in international databases), document analysis, questionnaires applied to municipal management and listening to managers and health service workers via web meetings. The process of formulating the Plan started from the classification adopted by the Health Surveillance Department of the Ministry of Health to define the phases of the pandemic and to establish the actions and responsibilities shared by the federated entities. The document was approved by the Bipartite Intergovernmental Commission (CIB) and published on the website of the Department of Health of the State of Bahia (Sesab), to serve the 417 municipalities that make up the state territory.

Los desafíos planteados por la pandemia del covid-19 relacionados con un aumento de la letalidad y mortalidad por el virus SARS-CoV-2 alertaron a los gerentes sobre la posibilidad del colapso de la red de servicios de gestión de muertes en el estado de Bahía. Este trabajo tiene como objetivo describir la experiencia del equipo de vigilancia en salud en Bahía en la formulación del Plan de Manejo de Muertes, destinado a orientar la gestión estadual y municipal, y los servicios de salud públicos y privados para la implementación de acciones adecuadas y oportunas ante las muertes ocurridas durante la pandemia. Para ello, se utilizaron revisión de la literatura (en bases de datos internacionales), análisis de documentos, cuestionarios aplicados a la gestión municipal y escucha a gerentes y trabajadores de servicios de salud y afines por medio de reuniones en línea. El proceso de formulación del Plan partió de la clasificación adoptada por la Secretaría de Vigilancia en Salud del Ministerio de Salud para definir las fases de la pandemia y establecer las acciones y responsabilidades compartidas por las entidades federativas. El documento fue aprobado por la Comisión Intergubernamental Bipartita (CIB) y publicado en el sitio web de la Secretaría de Salud del Estado de Bahía (Sesab), con el objetivo de atender a los 417 municipios que integran el territorio estadual.

Caracterización de fallecidos identificados e inhumados en cementerio humanitario: consideraciones respecto al no reclamo / Characterization of deceased identified and buried in a humanitarian cemetery: considerations regarding the non-claim

Justificación: la inhumación de cadáveres no reclamados, por los familiares directos o deudos de las morgues judiciales es una asignación de trabajo continua y periódica para los Centros de Ciencias Forenses no solo en Honduras, sino en varios países latinoamericanos. Objetivo: conocer las características sociodemográficas de los fallecidos identificados y no reclamados e inhumados en el cementerio humanitario por Medicina Forense de Tegucigalpa y San Pedro Sula, en el período 2010-2020 y la probable relación del fenómeno de la pérdida de los ritos mortuorios con el duelo. Metodología: se realizó un estudio descriptivo, retrospectivo, se analizaron 235 casos de inhumados identificados, 117 de la ciudad de Tegucigalpa y 118 de San Pedro Sula. Resultados: Los hondureños (97%) de sexo masculino, con manera de muerte homicida (43.40%), con un rango de edad entre 21 y 45 años (41.4%), procedentes de Tegucigalpa y San Pedro Sula (57%) predominantemente, representan los fallecidos identificados que nadie reclama. Conclusión: el no reclamo de cadáveres plenamente identificados es un proceso que necesita estudiarse de manera más exhaustiva e interdisciplinaria a fin de identificar factores que pudieran incidir, como: el temor a represalias en muertes asociadas a grupos criminales, la desvinculación afectiva entre el fallecido y el núcleo familiar, la migración, las condiciones económicas, igualmente, la desinformación ciudadana con respecto a los procedimientos institucionales; con la información actualmente disponible no es posible concluir cuales son estos factores...(AU)

Impasses entre dignidade e saúde no manejo de cadáveres da COVID-19: identificar ou reconhecer? / Stalemates between dignity and health in the handling of COVID-19 corpses: identify or recognize?

Com o aumento de mortos pela pandemia de COVID-19, surge o desafio relacionado aos serviços funerários, além da identificação de corpos. Municípios têm editado normas, limitando funerais e propondo sepultamentos coletivos. Quanto aos não identificados, procedimentos excepcionais foram estabelecidos pelo Conselho Nacional de Justiça e Ministério da Saúde. Por meio de pesquisa exploratória, este estudo analisou o dilema entre garantir a sanidade pública e a dignidade da pessoa humana. Propõe-se o uso de métodos primários de identificação e sepultamentos que permitam a individualização dos corpos.(AU)

With the increase in deaths due to the COVID-19 pandemic, the challengearises related to funeral services, in addition to the identification of bodies. Municipalities have been issuing regulations, limiting funerals and proposing collective burials. Brazilian National Council of Justice and the Ministry of Health establishedexceptional procedures for the unidentified patients. Through exploratory research, this article analyzed the dilemma between guaranteeing public health and the dignity of the human person. This study proposes to use primary methods of identification and burials that allow the individualization of bodies.(AU)

Gestion sécurisée des dépouilles de personnes décédées de la COVID-19 en Afrique sub-Saharienne: et si on laissait les familles enterrer leurs morts?

La pandémie à Coronavirus 2019 (COVID-19) touche les pays d´Afrique sub-Saharienne depuis le mois de mars 2020. Au-delà des désastres sanitaire et économique causés, se pose un problème psycho-socio-culturel en rapport avec la gestion des corps de personnes décédées de cette maladie; ce problème est susceptible d´entraver la bonne marche de la stratégie de riposte. Au Cameroun par exemple, la gestion actuelle de ces dépouilles ne fait pas l´unanimité. En effet, les restrictions appliquées à l´inhumation, bien que récemment assouplies proscrivent entre autres tout transfert interurbain des dépouilles. A la lumière des considérations culturelles africaines de la personne décédée, des dissensions créées entre les familles et le corps médical, de la législation et des données scientifiques disponibles, cet article analyse les risques et les bénéfices de l´inhumation des dépouilles par les familles. Il propose ensuite des solutions qui concilient la dignité (en laissant les familles enterrer leurs morts dans les domiciles), et la sécurité (en assurant une conservation hermétique et la surveillance d´un officier de police judiciaire). L´application de ces solutions pourraient améliorer la confiance de la population envers le système de santé et contribuer positivement aux stratégies de prévention, d´identification et de prise en charge des cas de COVID-19

Assessing the Parasitic Burden in a Late Antique Florentine Emergency Burial Site

Excavation (2008–2014) carried out under the Uffizi Gallery (Florence, Italy) led to the discovery of 75 individuals, mostly buried in multiple graves. Based on Roman minted coins, the graves were preliminarily dated between the second half of the 4th and the beginning of the 5th centuries CE. Taphonomy showed that this was an emergency burial site associated with a catastrophic event, possibly an epidemic of unknown etiology with high mortality rates. In this perspective, paleoparasitological investigations were performed on 18 individuals exhumed from 9 multiple graves to assess the burden of gastrointestinal parasitism. Five out of eighteen individuals (27.7%) tested positive for ascarid-type remains; these are considered as “decorticated” Ascaris eggs, which have lost their outer mammillated coat. Roundworms (genus Ascaris) commonly infest human populations under dire sanitary conditions. Archaeological and historical evidence indicates that Florentia suffered a period of economic crisis between the end of 4th and the beginning of the 5th centuries CE, and that the aqueduct was severely damaged at the beginning of the 4th century CE, possibly during the siege of the Goths (406 CE). It is more than plausible that the epidemic, possibly coupled with the disruption of the aqueduct, deeply affected the living conditions of these individuals. A 27.7% frequency suggests that ascariasis was widespread in this population. This investigation exemplifies how paleoparasitological information can be retrieved from the analysis of sediments sampled in cemeteries, thus allowing a better assessment of the varying frequency of parasitic infections among ancient populations.

Comparison of Helminth Infection among the Native Populations of the Arctic and Subarctic Areas in Western Siberia Throughout History: Parasitological Researches on Contemporary and the Archaeological Resources

The aim of this parasitological study is examining contemporary (the late 20th century) specimens of the arctic or subarctic areas in Western Siberia and comparing them with the information acquired from archaeological samples from the same area. In the contemporary specimens, we observed the parasite eggs of 3 different species: Opisthochis felineus, Ascaris lumbricoides, and Enterobius vermicularis. Meanwhile, in archaeoparasitological results of Vesakoyakha, Kikki-Akki, and Nyamboyto I burial grounds, the eggs of Diphyllobothrium and Taenia spp. were found while no nematode (soil-transmitted) eggs were observed in the same samples. In this study, we concluded helminth infection pattern among the arctic and subarctic peoples of Western Siberia throughout history as follows: the raw fish-eating tradition did not undergo radical change in the area at least since the 18th century; and A. lumbricoides or E. vermicularis did not infect the inhabitants of this area before 20th century. With respect to the Western Siberia, we caught glimpse of the parasite infection pattern prevalent therein via investigations on contemporary and archaeoparasitological specimens.

Confusing a Pollen Grain with a Parasite Egg: an Appraisal of “Paleoparasitological Evidence of Pinworm (Enterobius Vermicularis) Infection in a Female Adolescent Residing in Ancient Tehran”

There is often the risk of confusing pollen grains with helminth eggs from archaeological sites. Thousands to millions of pollen grains can be recovered from archaeological burial sediments that represent past ritual, medication and environment. Some pollen grain types can be similar to parasite eggs. Such a confusion is represented by the diagnosis of enterobiasis in ancient Iran. The authors of this study confused a joint-pine (Ephedra spp.) pollen grain with a pinworm egg. This paper describes the specific Ephedra pollen morphology that can be confused with pinworm eggs.

Treatment of livestock carcasses in soil using Corynebacterium glutamicum and lysosomal application to livestock burial

A method of rapidly decaying livestock carcasses is sought through Corine glutamicum, and furthermore, lysosomes are used to remove toxic microorganisms from livestock carcasses. The landfill was constructed on a laboratory scale. Optimized growth conditions of C. glutamicum that could quickly decay livestock carcasses were determined. Lysosomes were extracted from egg whites and used to treat contaminated soil to confirm their antimicrobial activities. Condition of C. glutamicum was activated, regardless both anaerobic and aerobic conditions, soil exists and, to be close to the optimum conditions as possible temperatures, moisture content was about 1/10 of the culture. Lysosomes were found to be effective in clearing soil contamination. C. glutamicum can accelerate the decay of livestock carcasses. A combination of C. glutamicum and lysomes could be used to treat soil contamination caused by decomposition of livestock.

Treatment of livestock carcasses in soil using Corynebacterium glutamicum and lysosomal application to livestock burial

A method of rapidly decaying livestock carcasses is sought through Corine glutamicum, and furthermore, lysosomes are used to remove toxic microorganisms from livestock carcasses. The landfill was constructed on a laboratory scale. Optimized growth conditions of C. glutamicum that could quickly decay livestock carcasses were determined. Lysosomes were extracted from egg whites and used to treat contaminated soil to confirm their antimicrobial activities. Condition of C. glutamicum was activated, regardless both anaerobic and aerobic conditions, soil exists and, to be close to the optimum conditions as possible temperatures, moisture content was about 1/10 of the culture. Lysosomes were found to be effective in clearing soil contamination. C. glutamicum can accelerate the decay of livestock carcasses. A combination of C. glutamicum and lysomes could be used to treat soil contamination caused by decomposition of livestock.

A young couple's grave found in the Rakhigarhi cemetery of the Harappan Civilization / 대한해부학회지

The Harappan Civilization, one of the earliest complex societies in the world, flourished on the Indian subcontinent. Although many additional Harappan settlements and cemeteries have been discovered and investigated, no coupled burials at Harappan cemeteries have been reported to date. In 2013–2016, we excavated the cemetery of the Rakhigarhi site (Haryana), the largest city of the Harappan Civilization. At the site, we found a grave that turned out to be a coupled (joint) burial of the primary type. This report is the first anthropologically confirmed case of coupled burial from a Harappan cemetery.

Taenia sp. in human burial from Kan River, East Siberia

We present an arhaeoparasitological analysis of a unique burial from the Neftprovod II burial ground in East Siberia, which dated from the Bronze Age. Analysis of a sediment sample from the sacral region of the pelvis revealed the presence of Taenia sp. eggs. Because uncooked animal tissue is the primary source of Taenia, this indicated that the individual was likely consuming raw or undercooked meat of roe deer, red deer, or elk infected with Taenia. This finding represents the oldest case of a human infected with Taenia sp. from Eastern Siberia and Russia.

Unusual Presentation of Traumatic Neuroma of the Medial Plantar Nerve after Deep Laceration Mimicking a Foreign Body Granuloma: A Case Report / 대한족부족관절학회지

Traumatic neuromas are rare benign tumors that are common after trauma or surgery and are usually accompanied by obvious symptoms of pain. Most reports show neuromas in the face, neck, and limbs, and the traumatic neuroma of the medial plantar nerve has rarely been reported. We encountered a traumatic neuroma of the medial plantar nerve after a deep laceration mimicking a foreign body granuloma. A small mass lesion was found around plantar aponeurosis with heterogeneous high signal intensity in the T2 fat suppression view and slightly enhanced intensity in the magnetic resonance imaging that suggested a foreign body granuloma. The lesion was diagnosed pathologically as a traumatic neuroma. A satisfactory clinical result was obtained after excision of the traumatic neuroma and burial of the proximal and distal stumps to the adjacent muscle at the secondary operation.

Ancient Human Parasites in Ethnic Chinese Populations

Whilst archaeological evidence for many aspects of life in ancient China is well studied, there has been much less interest in ancient infectious diseases, such as intestinal parasites in past Chinese populations. Here, we bring together evidence from mummies, ancient latrines, and pelvic soil from burials, dating from the Neolithic Period to the Qing Dynasty, in order to better understand the health of the past inhabitants of China and the diseases endemic in the region. Seven species of intestinal parasite have been identified, namely roundworm, whipworm, Chinese liver fluke, oriental schistosome, pinworm, Taenia sp. tapeworm, and the intestinal fluke Fasciolopsis buski. It was found that in the past, roundworm, whipworm, and Chinese liver fluke appear to have been much more common than the other species. While roundworm and whipworm remained common into the late 20th century, Chinese liver fluke seems to have undergone a marked decline in its prevalence over time. The iconic transport route known as the Silk Road has been shown to have acted as a vector for the transmission of ancient diseases, highlighted by the discovery of Chinese liver fluke in a 2,000 year-old relay station in northwest China, 1,500 km outside its endemic range.

Traditional Living Habits of the Taz Tundra Population: A Paleoparasitological Study

An excavation of the Vesakoyakha II–IV and Nyamboyto I burial grounds was conducted during the 2014 field season, and soil samples from intact burials dating from the 19th and 20th centuries, respectively, were analyzed to determine interactions between parasites and host/vectors. Considering the discovery of Diphyllobothrium sp. and Taenia sp. eggs in soil samples from the pelvic region, diphyllobothriasis was the most frequent helminthic infection among the Taz Nenets. The Nyamboyto Nenets mainly consumed uncooked fish, while the Vesakoyakha Nenets had a bigger variety in food choices, including reindeer meat. Nenets children were given raw fish from early childhood. The paleoparasitological results corroborate rare ethnographic records about the consumption of uncooked reindeer cerebrum which led to beef tapeworm helminthiases. This is the first parasitological report of helminthic diseases among the Taz Nenets, and, as such, it provides insight into their subsistence activities and food patterns and broadens our understanding of their health condition.

A First Case of Human Trichuriasis from a Roman Lead Coffin in France

A paleoparasitological study was carried out on 2 lead coffins recovered from the Roman site of Jaunay-Clan (near Poitiers, France). For the first time, this particular type of burial gave positive parasitological results, and eggs of the whipworm Trichuris trichiura were identified in 1 individual. In the present case, thanatomorphose associated with funerary practices may explain the scarcity of the recovered eggs. However, human whipworm has now been observed in 9 individuals dated to the Roman period. The very high frequency of Trichuris sp. eggs in Roman archaeological sites (up to 80%) suggests that fecal peril, hygiene, and waste management were problematic during this period. Finally, due to the fact that very few analyses have been conducted on human bodies dated to the Roman period, more analyses must be performed in the future to provide further information about diseases in the Roman world.

Human Skeletal Remains from Ancient Burial Sites in India: With Special Reference to Harappan Civilization / 체질인류학회지

Harappan Civilization is well known for highly sophisticated urban society, having been flourished in extensive regions of northwestern part of Pakistan and northeastern part of Afghanistan as its heyday around 4500 years ago. Most archaeologists agree on the periodization of this civilization as three different phases (Early, Mature and Late), which represent its cultural process of origin, development and decline. From the Harappan sites, one can note that there were about more than fifty burial sites discovered so far related with the civilization. In this article, we are trying to introduce the brief picture of the Harappan burials from the archaeological as well as anthropological perspectives.

Dental pulp fibroblast and sex determination in controlled burial conditions / Fibroblastos de la pulpa dental y la determinación del sexo en condiciones controladas de enterramiento

The need to identify bodies that are found as a result of disappearances with a diversity of causes, illegal burials and massive disasters, represent a wide percentage of dentistry practice on forensic research. The following study determined the performance of Barr Body Test, in fibroblasts of healthy teeth, under different conditions of burial (in vitro) with variations in pH, humidity and salinity in terms of general accuracy and sensitivity for men and women. Analyzed sample considered 47 dental pulps, taken from teeth under burial conditions during a period of a month. From dental pulps samples, 265 histological cuts valid for this study, were obtained, which were observed with an optical microscope under conventional H/E staining. Results showed a 98.9% of well-diagnosed cases, which correspond to the overall accuracy of the method. Sensitivity for men was 97.5% and 100% for women, over the analyzed sample. In low humidity conditions, 3 samples of badly diagnosed cases in men were observed, with a group accuracy of a 90%, with a sensitivity of 25% for men and 100% for women. The present study establishes that based on these results, the performance of Barr Body Test in fibroblasts, proposed for healthy pulp teeth, is not affected by burial conditions in terms of pH (acid-alkaline), salinity (high-low) and high humidity.

La necesidad de identificar cuerpos que resultan como consecuencia de desapariciones de causas variadas, inhumaciones ilegales y desastres masivos representa un porcentaje amplio en el quehacer odontológico en un escenario de investigación forense. El presente estudio determinó el rendimiento de la prueba diagnóstica de observación del cuerpo de Barr en células de la pulpa de dientes sanos, sometidos a distintas condiciones de enterramiento (in vitro) con variación de pH, humedad y salinidad en términos de exactitud general y sensibilidad para hombres y mujeres. La muestra analizada consideró 47 pulpas dentales, extraídas de dientes sometidos a condiciones de enterramiento durante un mes. De las pulpas dentarias se obtuvieron 265 cortes histológicos válidos para el estudio, los cuales mediante la tinción convencional H/E, fueron observados al microscopio óptico. Los resultados arrojaron un 98,9% de casos bien diagnosticados, que correspondió a la exactitud general del método. La sensibilidad para hombres fue de 97,5% y para mujeres de 100% sobre el total de la muestra analizada. Las condiciones de pH (ácido y alcalino), salinidad (alta y baja) y alta humedad presentaron una exactitud de grupo de 100%, con una sensibilidad para hombres y mujeres de 100%. En la condición de baja humedad se observaron 3 muestras de hombres mal diagnosticadas con una exactitud de grupo de 90% y sensibilidad para hombres de 25% y para mujeres de 100%. A la luz de los resultados, el presente estudio establece que el rendimiento de la prueba diagnóstica de observación del cuerpo de Barr en fibroblastos, propuesto para pulpas de dientes sanos, no se afecta con las condiciones de enterramiento propuestas bajo pH ácido ­ alcalino, salinidad alta ­ baja y humedad alta.

Especialistas em 'bem morrer': causa mortis, rituais e hierarquias em um mosteiro do Rio de Janeiro colonial / Experts in 'dying well': causa mortis, rituals, and hierarchies at a monastery in colonial Rio de Janeiro

Instalados na América portuguesa desde o final do século XVI, os monges beneditinos tinham como lema ter a morte sempre à vista. Neste artigo, são apresentados os diversos desdobramentos em torno da morte em um mosteiro no Rio de Janeiro setecentista. Com ênfase nas atuações performáticas, e fazendo uso de documentação depositada no próprio mosteiro, são analisadas as hierarquizações envolvidas, as formas de representação do tema e a sociabilidade gerada nas ocasiões de sepultamentos. Com enfoque nas relações estabelecidas, incluindo as reciprocidades inventadas e reinventadas ao longo dos rituais, demonstra-se que tais ocasiões forneciam subsídios para a distinção dos eclesiásticos em uma sociedade regida, em parte, por lógicas do Antigo Regime.

Benedictine monks, who settled in Portuguese America in the late sixteenth century, made it their tenet to always have death in mind. The article describes diverse aspects of the Benedictine approach towards death as displayed at an eighteenth-century monastery in Rio de Janeiro. Relying on documentation stored at the monastery and highlighting performance-like activities, the article analyzes hierarchical arrangements, the ways death was represented, and the forms of sociability manifested at the time of burials. Focusing on the relations that were established, including the reciprocities that were invented and re-invented throughout the rituals, it is demonstrated that these events provided a basis for the distinction earned by clerics in a society ruled in part by the logics of the Ancién Regime. .

Current State of Public Cemeteries in River State; Nigeria

Cemeteries or 'sleeping places' are where bodies or cremated remains are buried. Dead bodies are essentially 'wastes' and their improper disposal in the form of burial may come with health implications. This is particularly apt in Nigeria and indeed Rivers State where unsupervised burials are carried out in homes (houses); compounds and community-based cemeteries. A walk through survey of five functional public cemeteries in Rivers State appraised their current state and their possible health implications. This on-the-spot site visit revealed infrastructural; operational and maintenance challenges which have further stressed the need for better managed public cemeteries and more objective studies on the subject