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1.
Med. leg. Costa Rica ; 40(2)dic. 2023.
Article in Spanish | SaludCR, LILACS | ID: biblio-1514472

ABSTRACT

La muerte súbita es aquella que ocurre dentro de las 24 horas posteriores al inicio de los síntomas y se caracteriza por ser clínicamente inexplicable, inesperada y repentina. Debido a la naturaleza de la muerte súbita, no es posible llegar a un diagnóstico preciso sin una autopsia. En esta comunicación breve, evaluaremos el caso de un empleado de crucero de 33 años, sin historial médico/farmacológico previo, el cual falleció súbitamente mientras reposaba en su camarote. Debido a las sospechas iniciales de una posible muerte causada por una sobredosis de cocaína, se le realizó un panel toxicológico abarcador el cual resultó negativo. Empero, una tomografía computarizada (TC) craneal sin contraste revirtió la hipótesis inicial y la autopsia neuropatológica -sorpresivamente- confirmó que la verdadera causa de muerte fue la ruptura de un aneurisma sacular desconocido en el polígono de Willis.


Sudden death occurs within 24 hours after the onset of symptoms and is characterized by being clinically inexplicable, sudden, and unexpected. Due to the nature of sudden death, it is not possible an accurate diagnosis without performing an autopsy. In this brief communication, we will evaluate the case of a 33-year-old cruise employee, with no prior medical/pharmacological history, who suddenly died while resting in his cabin. Due to initial suspicions of a possible cocaine overdose death, a comprehensive toxicology panel was performed, although yielding a negative result. A cranial computed tomography without contrast reversed the initial hypothesis and the neuropathological autopsy -surprisingly- confirmed that the true cause of death was the rupture of an unknown saccular aneurysm in the Circle of Willis.


Subject(s)
Humans , Male , Adult , Circle of Willis/diagnostic imaging , Death, Sudden/pathology , Aneurysm/diagnostic imaging , Autopsy/methods
2.
Med. leg. Costa Rica ; 40(2)dic. 2023.
Article in Spanish | LILACS, SaludCR | ID: biblio-1514469

ABSTRACT

El monóxido de carbono (CO) es un gas que se produce durante la combustión incompleta de diferentes materiales orgánicos. Una vez que se inhala, se absorbe hacia la sangre, ejerciendo su efecto a nivel sistémico. Se une fuertemente a la hemoglobina, y forma la carboxihemoglobina lo que provoca una disminución del transporte de oxígeno a los tejidos y dependiendo de su concentración puede ser mortal. Los hallazgos comúnmente encontrados en la autopsia son color rojo cereza en la piel y órganos, así como edema pulmonar, entre otros. El diagnóstico de intoxicación por CO se basa en la medición post mortem de carboxihemoglobina en sangre, por lo que se deben tomar muestras para cuantificar estos niveles. Con respecto al manejo en estos casos, se presenta dos casos correspondientes a la autopsia médica legal en las que se estableció como causa de muerte la intoxicación por monóxido de carbono.


Carbon monoxide (CO) is a gas that is produced during the incomplete combustion of different organic materials. Once inhaled, it is absorbed into the blood, exerting its effect at the systemic level. It strongly binds to hemoglobin, and forms carboxyhemoglobin, which causes a decrease in oxygen transport to the tissues and, depending on its concentration, can be fatal. The findings commonly found in the autopsy are cherry red color in the skin and organs, as well as pulmonary edema, among others. The diagnosis of CO poisoning is based on the postmortem measurement of carboxyhemoglobin in the blood, so samples must be taken to quantify these levels. Regarding the handling of these cases, two cases corresponding to the legal medical autopsy are presented in which carbon monoxide poisoning was established as the cause of death.


Subject(s)
Humans , Male , Adult , Autopsy/methods , Carbon Monoxide Poisoning/diagnosis , Forensic Medicine , Costa Rica
3.
Arch. argent. pediatr ; 121(2): e202202593, abr. 2023. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1424937

ABSTRACT

Commotio cordis o conmoción cardíaca es un síndrome arritmogénico mecano-eléctrico raro y mortal. Es la segunda causa de muerte súbita en atletas jóvenes. Se asocia con una lesión que se produce durante la práctica deportiva, en la que un proyectil impacta a alta velocidad en el precordio y provoca una arritmia que conduce a la muerte inmediata del individuo sin una reanimación cardíaca. En las autopsias, los corazones son estructuralmente sanos. Con el conocimiento de este síndrome y las capacitaciones de reanimación cardiorrespiratoria a la comunidad, las tasas de supervivencia han mejorado. El objetivo de este trabajo es describir un paciente que llegó a nuestro hospital con conmotio cordis y su evolución, enfatizando la importancia de medidas de prevención y capacitación de la población en técnicas de reanimación cardiopulmonar y uso del desfibrilador externo automático para la supervivencia de los pacientes que sufren esta entidad.


Commotio cordis or cardiac concussion is a rare and fatal mechano-electric arrhythmogenic syndrome. It is the second most common cause of sudden cardiac death in young athletes. It is most commonly associated with a sports-related injury, wherein, there is a high-velocity impact between a projectile and the precordium, causing arrhythmia that leads to the immediate death of the individual without cardiac resuscitation. On autopsy, the heart is structurally normal. With increasing awareness of this condition and community training in cardiopulmonary resuscitation, survival rates have been improving. The objective of this study is to describe the case of a patient who arrived at our hospital with commotio cordis and his course, emphasizing the importance of prevention and training of the population in cardiopulmonary resuscitation techniques and the use of the automated external defibrillator for the survival of patients suffering from commotio cordis.


Subject(s)
Humans , Male , Child , Athletic Injuries/complications , Athletic Injuries/diagnosis , Athletic Injuries/therapy , Wounds, Nonpenetrating/complications , Cardiopulmonary Resuscitation/methods , Commotio Cordis/complications , Commotio Cordis/diagnosis , Autopsy , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/prevention & control
4.
Philippine Journal of Pathology ; (2): 49-52, 2023.
Article in English | WPRIM | ID: wpr-984548

Subject(s)
Autopsy , Workflow
5.
Journal of Forensic Medicine ; (6): 50-56, 2023.
Article in English | WPRIM | ID: wpr-984180

ABSTRACT

Estimation of postmortem interval (PMI) is one of the important research contents in forensic pathology, and it has always been the focus and hot spot of research work. In recent years, scholars at home and abroad have made some research progress in estimating PMI by using ocular tissue. After death, the changes of cornea, aqueous humor, iris, lens, vitreous humor and retina all show time sequence change rule highly related to PMI. This paper reviews the research progress of PMI estimation based on the morphological, biochemical, molecular and genetic material changes of different ocular tissue structures after death, and discusses the existing problems and development trends.


Subject(s)
Humans , Postmortem Changes , Time Factors , Autopsy , Vitreous Body , Forensic Pathology
6.
Journal of Forensic Medicine ; (6): 13-17, 2023.
Article in English | WPRIM | ID: wpr-984174

ABSTRACT

OBJECTIVES@#To investigate the concentration and change characteristics of 1, 5-anhydroglucitol (1, 5-AG) in the vitreous humor of rabbit cadavers with hyperglycemic metabolism, and to explore the value of 1, 5-AG in forensic pathology identification of death caused by hyperglycemic metabolism disorders.@*METHODS@#A diabetic hyperglycemic rabbit model was established by using alloxan. Eighteen rabbits with fasting glucose concentration ≥13.80 mmol/L (experimental group) and 18 healthy rabbits with fasting glucose concentration ≤6.10 mmol/L (control group) were selected. After death from air embolism. The blood samples were collected immediately, and vitreous humor samples were collected at 0 h, 12 h, 24 h and 36 h after death. The concentration of 1, 5-AG in the blood and vitreous humor of rabbits was determined.@*RESULTS@#The blood glucose concentration in the experimental group was (25.10±3.14) mmol/L. At the time of death, there was no significant difference in the concentration of 1, 5-AG in the blood [(0.94±0.20) μg/mL] and in the vitreous humor (0.99±0.05 μg/mL, P>0.05). The concentration of 1, 5-AG in the vitreous humor of the experimental group was lower than that of the corresponding control group at all time points (P<0.05), and there was no significant difference betwwen 1, 5-AG concentration in vitreous humor between earch time point in the experimental group and the control group (P>0.05). Correlation analysis showed that the concentration of 1,5-AG in blood was negatively correlated with blood glucose in both control group and experimental group (control group: r=-0.79, P<0.05; experimental group: r=-0.97, P<0.05).@*CONCLUSIONS@#Vitreous humor can replace blood as an effective test sample for 1,5-AG detection. The concentration of 1, 5-AG in rabbit vitreous humor remains stable within 36 hours after death and is not affected by the change of postmortem interval. If the concentration of 1, 5-AG decreases significantly, it indicates the existence of hyperglycemia in rabbits before death.


Subject(s)
Animals , Rabbits , Blood Glucose/metabolism , Postmortem Changes , Vitreous Body/metabolism , Cadaver , Autopsy
7.
Journal of Forensic Medicine ; (6): 7-12, 2023.
Article in English | WPRIM | ID: wpr-984173

ABSTRACT

OBJECTIVES@#To explore the difference in CT values between pulmonary thromboembolism and postmortem clot in postmortem CT pulmonary angiography (CTPA) to further improve the application value of virtual autopsy.@*METHODS@#Postmortem CTPA data with the definite cause of death from 2016 to 2019 were collected and divided into pulmonary thromboembolism group (n=4), postmortem clot group (n=5), and control group (n=5). CT values of pulmonary trunk and left and right pulmonary artery contents in each group were measured and analyzed statistically.@*RESULTS@#The average CT value in the pulmonary thromboembolism group and postmortem clot group were (168.4±53.8) Hu and (282.7±78.0) Hu, respectively, which were lower than those of the control group (1 193.0±82.9) Hu (P<0.05). The average CT value of the postmortem clot group was higher than that of the pulmonary thromboembolism group (P<0.05).@*CONCLUSIONS@#CT value is reliable and feasible as a relatively objective quantitative index to distinguish pulmonary thromboembolism and postmortem clot in postmortem CTPA. At the same time, it can provide a scientific basis to a certain extent for ruling out pulmonary thromboembolism deaths.


Subject(s)
Humans , Autopsy , Thrombosis , Pulmonary Embolism/diagnostic imaging , Tomography, X-Ray Computed , Angiography , Cadaver
8.
Journal of Forensic Medicine ; (6): 1-6, 2023.
Article in English | WPRIM | ID: wpr-984172

ABSTRACT

OBJECTIVES@#To analyze the gross pathological data of sudden cardiac death (SCD) with different causes, to provide data support for the identification of sudden cardiac death with unknown causes.@*METHODS@#A total of 167 adult SCD cases in the archive of the Forensic Expertise Institute of Nanjing Medical University from 2010 to 2020 were collected. The gross pathological data of SCD cases were summarized and the characteristics of different causes of death were statistically analyzed.@*RESULTS@#The ratio of male to female SCD cases was 3.4∶1. Coronary heart disease was the leading cause of SCD, and mainly distributed in people over 40 years old. SCD caused by myocarditis was mainly distributed in young people and the mean age of death was (34.00±9.55) years. By analyzing the differences in cardiac pathological parameters of SCD with different causes, it was found that the aortic valve circumference was significantly dilated in the SCD caused by aortic aneurysm or dissection (P<0.05). The heart weight of SCD caused by aortic aneurysm or dissection and combined factors was greater, and both pulmonary and tricuspid valvular rings were dilated in the SCD caused by combined factors in adult males (P<0.05).@*CONCLUSIONS@#Various gross pathological measures of SCD with different causes are different, which has reference value in the cause of death identification of SCD.


Subject(s)
Humans , Adult , Male , Female , Adolescent , Young Adult , Death, Sudden, Cardiac/pathology , Coronary Disease , Heart , Forensic Medicine , Autopsy
9.
Journal of Forensic Medicine ; (6): 186-192, 2023.
Article in English | WPRIM | ID: wpr-981853

ABSTRACT

OBJECTIVES@#To survey the development status and actual needs of virtual autopsy technology in China and to clarify the applicability of forensic virtual autopsy laboratory accreditation.@*METHODS@#The questionnaire was set up included three aspects:(1) the current status of virtual autopsy technology development; (2) the accreditation elements such as personnel, equipment, entrustment and acceptance, methods, environmental facilities; (3) the needs and suggestions of practicing institutions. A total of 130 forensic pathology institutions were surveyed by online participation through the Questionnaire Star platform.@*RESULTS@#Among the 130 institutions, 43.08% were familiar with the characteristics of virtual autopsy technology, 35.38% conducted or received training in virtual autopsy, and 70.77% have establishment needs (including maintenance). Relevant elements were suitable for laboratory accreditation.@*CONCLUSIONS@#Virtual autopsy identification has gained social recognition. There is a demand for accreditation of forensic virtual autopsy laboratory. After the preliminary assessment, considering the characteristics and current situation of this technology, China National Accreditation Service for Conformity Assessment (CNAS) can first carry out the accreditation pilot of virtual autopsy project at large comprehensive forensic institutions with higher identification capability, and then CNAS can popularize the accreditation in a wide range when the conditions are suitable.


Subject(s)
Autopsy , Forensic Medicine , Forensic Pathology , Accreditation , Surveys and Questionnaires
10.
Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 26(2cont): 324-335, 2023. ilus
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1518658

ABSTRACT

A insuficiência cardíaca congestiva é considerada, atualmente, a principal causa de óbitos em cães, sendo resultante da degeneração mixomatosa da válvula mitral, processo que inviabiliza o fechamento total da mesma durante a sístole. Apesar de se tratar de uma doença progressiva, os efeitos patológicos podem ser reduzidos significativamente e concomitantemente prolongar a vida do animal, desde que haja protocolos de tratamentos específicos e descritos por profissionais capacitados na área médica animal. Esse estudo teve como objetivo relatar um caso de insuficiência congestiva em um animal da espécie canina, sem raça definida, sexo masculino resgatado pela prefeitura do município de Botucatu, São Paulo, Brasil. Durante a necropsia foi observado os seguintes achados macroscópicos: neoplasias cutâneas aderidas ao tecido, tártaro dentário, pneumonia intersticial hemorrágica, companhias de fibrose e enfisema pulmonar hemorrágico, metástase calcificada circular em lobo pulmonar direito, necrose pulmonar, cardiomiopatia hipertrófica concêntrica, insuficiência cardíaca congestiva, aderência de pericárdio na cavidade torácica, fígado em aspecto de noz moscada, metástase hepática, hepatite, esplenomegalia, dilatação entérica multifocal, intussuscepção, necrose intestinal, hipertrofia de pelve renal e aderência de cápsula renal. Esses achados demonstram o comprometimento de todos os órgãos do animal, demonstrando que a causa mortis foi em decorrência de uma insuficiência respiratória de origem infecciosa que ocasionou a insuficiência cardíaca congestiva.(AU)


Congestive heart failure is currently considered the main cause of death in dogs, resulting from myxomatous degeneration of the mitral valve, a process that prevents its total closure during systole. Despite being a progressive disease, the pathological effects can be significantly reduced and, at the same time, prolong the animal's life, as long as there are specific treatment protocols described by trained professionals in the field of animal medicine. This study aimed to report a case of congestive insufficiency in an animal of the canine species, mixed breed, male, rescued by the municipality of Botucatu, Sao Paulo, Brazil. During the necropsy, the following macroscopic findings were observed: skin neoplasms adhered to the tissue, dental tartar, hemorrhagic interstitial pneumonia, fibrosis and hemorrhagic pulmonary emphysema, circular calcified metastasis in the right pulmonary lobe, pulmonary necrosis, concentric hypertrophic cardiomyopathy, congestive heart failure, adherence of pericardium in the thoracic cavity, nutmeg liver, liver metastasis, hepatitis, splenomegaly, multifocal enteric dilation, intussusception, intestinal necrosis, renal pelvis hypertrophy and renal capsule adherence. These findings showed the involvement of all tissues, demonstrating that the cause of death was due to respiratory failure of infectious origin that caused congestive heart failure.(AU)


Actualmente se considera la insuficiencia cardíaca congestiva como la principal causa de muerte en perros, resultante de la degeneración mixomatosa de la válvula mitral, proceso que impide su cierre total durante la sístole. A pesar de ser una enfermedad progresiva, los efectos patológicos pueden reducirse significativamente y, al mismo tiempo, prolongar la vida del animal, siempre y cuando existan protocolos de tratamiento específicos descritos por profesionales capacitados en el campo de la medicina animal. Este estudio tuvo como objetivo reportar un caso de insuficiencia congestiva en un animal canino, mestizo, macho, rescatado por el municipio de Botucatu, São Paulo, Brasil. Durante la necropsia se observaron los siguientes hallazgos macroscópicos: neoplasias cutáneas adheridas al tejido, sarro dental, neumonía intersticial hemorrágica, compañías de fibrosis y enfisema pulmonar hemorrágico, metástasis circular calcificada en lóbulo pulmonar derecho, necrosis pulmonar, miocardiopatía hipertrófica concéntrica, insuficiencia cardíaca, adherencia del pericardio en la cavidad torácica, hígado de nuez moscada, metástasis hepática, hepatitis, esplenomegalia, dilatación entérica multifocal, intususcepción, necrosis intestinal, hipertrofia de la pelvis renal y adherencia de la cápsula renal. Estos hallazgos demuestran la afectación de todos los órganos del animal, demostrando que la causa de la muerte se debió a una insuficiencia respiratoria de origen infeccioso que provocó una insuficiencia cardíaca congestiva.(AU)


Subject(s)
Animals , Male , Dogs , Autopsy/veterinary , Heart Failure/complications , Heart Failure/diagnosis , Brazil , Heart Failure/mortality , Infections/complications
12.
Rev. bras. ciênc. vet ; 29(3): 121-124, jul./set. 2022. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1411216

ABSTRACT

O aneurisma é uma dilatação anormal e permanente das artérias, resultante do enfraquecimento da parede do vaso adelgaçamento da camada média e enfraquecimento da camada elástica. Em animais, a maioria dos casos de aneurisma tem origem idiopática e são detectados acidentalmente durante a necropsia. O objetivo deste trabalho é relatar um caso de aneurisma aórtico com trombose associada em Bugio-preto(Alouatta caraya), bem como seus aspectos patológicos. O animal era adulto, macho, pertencente ao Centro Nacional de Primatas (CENP), na cidade de Ananindeua-PA, foi encaminhado para exame necroscópico para investigação da causa mortis. No histórico do animal, não constava qualquer enfermidade. O animal apresentava bom escore de condição corporal com preservação da topografia anatômica dos órgãos. Entretanto, observou-se presença de aumento de volume localizado em aorta torácica, a 1,4 cm da base do coração. Na abertura aórtica foi observado dilatações de tamanhos variados e, no interior da maior dilatação, notou-se uma estrutura de coloração vermelho escuro, aderida, de aspecto seco e superfície áspera, medindo 1,5 cm. Aneurismas aórticos em primatas não humanos não são comuns, porém já foram reportados na literatura. O diagnóstico precoce utilizando exames complementares é importante, porém, ainda há recursos não empregados na rotina veterinária tornando ainda mais difícil o diagnóstico e prevenção. Por isso, na medicina veterinária, os aneurismas são detectados acidentalmente durante a necropsia. Com base nos achados anatomopatológicos, concluiu-se que o animal veio a óbito por trombose associada a aneurisma aórtico.


An aneurysm is an abnormal and permanent dilation of the arteries, resulting from the weakening of the vessel wall.thinning of the middle layer and weakening of the elastic layer. In animals, most cases of aneurysm are idiopathic. This paper aimed to report a case of aortic aneurysm with associated thrombosis in a black-and-gold howler monkey(Alouatta caraya), as well as its pathological aspects. The animal was an adult, male, belonging to the National Primate Center (CENP), in the city of Ananindeua-PA, that was referred for necroscopic examination to investigate the causa mortis. In the animal's history, there was no disease. The animal had a good body condition score with preservation of the anatomical topography of the organs. However, there was an increase in volume located in the thoracic aorta, 1.4 cm from the base of the heart. In the aortic opening, dilations of different sizes were observed, and inside the largest dilatation, a structure of dark red color, adhered, with a dry appearance and rough surface, measuring 1.5 cm was noted in addition to dilations of different sizes. Inside the largest cavitation, a dark red structure was observed, adhered, with a dry appearance and rough surface, measuring 1.5 cm. Aortic aneurysms in non-human primates are incommon, but have been reported in the literature. Early diagnosis using complementary exams is important, however, there are still resources not used in the veterinary routine, making diagnosis and prevention even more difficult. Therefore, in veterinary medicine, aneurysms are accidentally detected during necropsy. Based on the anatomopathological findings, it was concluded that the animal died due to thrombosis associated with an aortic aneurysm.


Subject(s)
Animals , Aortic Diseases/veterinary , Primates/abnormalities , Autopsy/veterinary , Thrombosis/veterinary , Aortic Aneurysm, Thoracic/veterinary , Alouatta caraya/abnormalities
13.
Med. leg. Costa Rica ; 39(1)mar. 2022.
Article in Spanish | LILACS, SaludCR | ID: biblio-1386301

ABSTRACT

Resumen Este artículo describe la exposición a riesgos laborales en la actividad laboral de las salas de autopsia abarcan de manera general las condiciones en las cuales los trabajadores de las salas de autopsia se exponen a condiciones y situaciones durante la realización de una necropsia, con el objetivo de generar conciencia en la minimización de los riesgos por medio de la gestión de estos a través de medidas de mitigación, prevención y protección. Para estos efectos se define, clasifica, y se recomiendan tópicos al respecto de los riesgos laborales, así como propone la creación de protocolos y programas de prevención de enfermedades y accidentes laborales en las salas de autopsia.


Abstract This article describes the exposure to occupational risks in the work activity of the autopsy rooms, covering in a general way the conditions in which the workers of the autopsy rooms are exposed to conditions and situations during the performance of a necropsy, with the objective of generate awareness in minimizing risks by managing them through mitigation, prevention, and protection measures. For these purposes, it defines, classifies, and recommends topics regarding occupational risks, as well as proposing the creation of protocols and programs for the prevention of occupational diseases and accidents in autopsy rooms.


Subject(s)
Autopsy/methods , Occupational Risks , Occupational Health/education
14.
Int. j. med. surg. sci. (Print) ; 9(1): 1-9, Mar. 2022. tab
Article in Spanish | LILACS | ID: biblio-1512523

ABSTRACT

The primary function of the circle of Willis is to provide collateral blood flow between the anterior and posterior arterial systems of the brain. Its configuration can vary considering its vascular structures, this being considered an anatomical variant. Our study aims to determine the prevalence of these, discriminated by sex in corpses subjected to medicolegal autopsy at the National Institute of Legal Medicine and Forensic Sciences in 2019, in Cali-Colombia. Retrospective observational descriptive study, of photographic records, inspection records and expert reports, where variables of age, sex, anatomical variants, compromised vascular structures are differentiated. Univariate and bivariate analyzes were performed. The population consisted of 194 cases, with a median age of 33 years (interquartile range between 23-45). 24.4% corresponded to the male sex. A prevalence of 25.3% of cases with non-classic polygon was observed. The most frequent anatomical variant was hypoplasia 14.9%. The vascular structure that presented the most anatomical variants was the posterior communicating artery with 17%.


La función principal del polígono de Willis es proporcionar flujo sanguíneo colateral entre los sistemas arteriales anterior y posterior del cerebro. Su configuración puede variar teniendo en cuenta sus estructuras vasculares, considerándose esto una variante anatómica. En este estudio analizamos la prevalencia de las variaciones, discriminada por sexo en cadáveres sometidos a necropsia medicolegal en el Instituto Nacional de Medicina Legal y Ciencias Forenses en el año 2019, en Cali-Colombia. Estudio descriptivo observacional retrospectivo, de registros fotográficos, actas de inspección e informes periciales, donde se diferencia variables de edad, sexo, variantes anatómicas, estructuras vasculares comprometidas. Se realizaron análisis uni y bivariados. La población estuvo conformada por 194 casos, con una mediana de edad de 33 años (rango intercuartil entre 23-45). El 24.4% correspondieron al sexo masculino. Un 25,3% de casosse encontró un polígono no clásico. La variante anatómica más frecuente fue la hipoplasia 14.9%. La estructura vascular que más variantes anatómicas presentó fue la arteria comunicante posterior con un 17%.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Circle of Willis/pathology , Anatomic Variation , Forensic Medicine , Autopsy , Cadaver , Cerebral Arteries/pathology , Retrospective Studies , Analysis of Variance , Circle of Willis/anatomy & histology , Circle of Willis/abnormalities , Sex Distribution
15.
S. Afr. med. j ; 112(11): 879-881, 2022. tables
Article in English | AIM | ID: biblio-1399384

ABSTRACT

The anatomical pathology autopsy serves several purposes, notably as a quality management tool for evaluation of accuracy in clinical diagnosis. Despite its value, for various reasons there has been an international decline in autopsies conducted. In the modern medical era, with all its advances in technology, diagnostic techniques and interventions, there is still a high discrepancy between clinical diagnoses and postmortem findings.Objectives. To establish the discrepancies between clinical diagnoses and postmortem findings in anatomical pathology autopsies.Methods. A retrospective, descriptive study was conducted over the 4-year-period 2014 - 2017. The clinical diagnoses and postmortem findings of cases referred to the Department of Anatomical Pathology at the University of Pretoria, South Africa, were evaluated and compared using the modified Goldman criteria.Results. A total of 288 cases qualified for the study and were evaluated. The gender distribution was 155 (53.8%) male and 133 (48.2%) female, with the majority of cases in the age group 19 - 60 years (mean 36.4). The majority of the cases were referred by internal medicine, followed by paediatrics. The most common cause of death in major missed diagnoses was pulmonary conditions. Of the cases, 115 (39.3%) had a major discrepancy and 62 (21.5%) a minor discrepancy.Conclusion. This study showed that there is still a high discrepancy between clinical diagnoses and postmortem findings, similar to studies conducted globally. The current COVID-19 pandemic may be a driver for revival of the anatomical pathology autopsy, and future studies are recommended to evaluate whether the decline can be reversed


Subject(s)
Humans , Pulmonary Atelectasis , Clinical Laboratory Techniques , Pathology , Autopsy , Comparative Study
16.
Afr. j. lab. med. (Print) ; 11(1): 1-6, 2022. figures
Article in English | AIM | ID: biblio-1378851

ABSTRACT

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.


Subject(s)
DNA , Resolutions , Paraffin , Archives , Autopsy , Tissues , Pain Measurement , Genetic Testing , Polymerase Chain Reaction , Pathology, Molecular , Molecular Docking Simulation
17.
Afr. j. lab. med. (Online) ; 11(1): 1-8, 2022. figures, tables
Article in English | AIM | ID: biblio-1400558

ABSTRACT

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.


Subject(s)
Humans , Male , Female , Cause of Death , Delivery of Health Care , SARS-CoV-2 , COVID-19 , Hospitals, Military , Autopsy , Pandemics , Ghana , Methods
18.
Chinese Journal of Pathology ; (12): 431-436, 2022.
Article in Chinese | WPRIM | ID: wpr-935558

ABSTRACT

Objective: To summarize the clinicopathological factors related to perinatal fetal death and to evaluate importance of fetal autopsy and placental pathology. Methods: The clinicopathological data of 105 perinatal fetal deaths in Beijing Haidian Maternal and Child Health Hospital from November 2012 to December 2020 were retrospectively analyzed. Relevant literature was also reviewed. Results: The maternal age of the deceased fetuses ranged from 22 to 43 years with the average (31.35±4.04 years), and the gestational weeks were 28-40+6 weeks. Among them, 101 were singleton cases and 4 twin cases. 103 fetuses died in uterus and 2 died during delivery. Relevant factors analysis of the 105 perinatal fetal deaths showed that 86 cases (81.9%, 86/105) were related to umbilical cord/placental abnormality, 10 cases (9.5%, 10/105) uterine infection, 6 cases (5.7%, 6/105) fetal factors, 1 case was fetal maternal blood transfusion syndrome, 1 case twin blood transfusion syndrome, and 1 case died of complete uterine rupture. Among the 86 cases related to umbilical cord/placental abnormality, the diagnosis was most often based on the gross examination of placenta. The most common cause of death was umbilical cord torsion with thin root, followed by placental abruption, tight umbilical cord winding, vascular rupture and umbilical cord true knot. The morphology of placenta revealed mainly functional changes. Among the 10 cases related to intrauterine infections, the placenta generally showed lobular placental edema. The morphological characteristics of ascending infection were mainly acute chorioamnionitis, and the morphological characteristics of blood-borne infection were mainly acute or chronic villitis, as well as villous interstitial inflammation. Identification of viral inclusions suggested viral etiology, while the final diagnosis was relied on laboratory testing. Among the 6 cases related to fetal abnormality, the diagnostic value of placenta was limited and the diagnosis could be made with fetal autopsy. Conclusion: The causes of perinatal fetal death are complex, diverse, and often the synergistic result of multiple factors. Fetal autopsy and placental pathology are the key technical means to identify the cause of death and deserve more attention and utilization.


Subject(s)
Adult , Child , Female , Humans , Pregnancy , Young Adult , Autopsy , Fetal Death/etiology , Fetus/pathology , Gestational Age , Placenta/pathology , Retrospective Studies
19.
Journal of Forensic Medicine ; (6): 747-753, 2022.
Article in English | WPRIM | ID: wpr-984167

ABSTRACT

In criminal investigations, postmortem interval (PMI) is important information to be inferred in homicide investigations, as well as the focus and the difficulty in forensic pathology research. Because the DNA content in different tissues is relatively constant and shows changes regularly with the extension of PMI, it has become a research hotspot of PMI estimation. This paper reviews the recent progress of PMI estimation technologies including DNA-based single cell gel electrophoresis, image analysis, flow cytometry, real-time fluorescence quantitative PCR and high-throughput sequencing, hoping to provide references for forensic medicine practice and scientific research.


Subject(s)
Humans , Postmortem Changes , Autopsy/methods , DNA/genetics , Forensic Medicine , Forensic Pathology
20.
Journal of Forensic Medicine ; (6): 625-639, 2022.
Article in English | WPRIM | ID: wpr-984157

ABSTRACT

The succession of microbiota is closely associated with several essential factors, including race, sex, health condition, lifestyle, postmortem interval, etc., and it has great potential application value in forensic medicine. This paper summarizes recent studies on the forensic applications of the microbiome, including individual identification, geographical feature identification, origin identification of the tissue or body fluid, and postmortem interval estimation, and introduces the current machine learning algorithms for microbiology research based on next-generation sequencing data. In addition, the current problems facing forensic microbiomics such as the extraction and preservation of samples, construction of standardization and database, ethical review and practical applicability are discussed. Future multi-omics studies are expected to explore micro ecosystems from a comprehensive and dynamic perspective, to promote the development of forensic microbiomics application.


Subject(s)
Humans , Forensic Medicine , Autopsy , Microbiota/genetics , Algorithms , High-Throughput Nucleotide Sequencing , Postmortem Changes
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