WorldWideScience

Sample records for Autopsy

  1. Needle autopsy

    Directory of Open Access Journals (Sweden)

    Philip Davis Marsden

    1997-04-01

    Full Text Available Often in tropical practice there is not time or conditions to do a proper autopsy on a patient who has died. A needle biopsy technique is described for limited closed autopsy examination to clariffy organ histology. In this way the clinician may resolve puzzling fatal disease.Muitas vezes, em clínicas de países tropicais, não há tempo nem condições para se realizar uma necropsia adequada em um paciente que foi a óbito. Um técnica de biópsia por punção é descrita para fins de exame em necropsia limitadamente fechada, para esclarecimento da histologia do órgão. Dessa maneira, o clínico pode resolver enigmas de doenças fatais.

  2. Assessing the autopsy.

    OpenAIRE

    Nemetz, P. N.; J. Ludwig(Fakultät für Mathematik und Physik, Albert-Ludwigs-Universität, Freiburg, Germany); Kurland, L T

    1987-01-01

    This study outlines the role of autopsies in medical practice and health policy, details the nature and reason for declining rates, including those in Rochester, Minnesota, and suggests possible remedial measures to halt or reverse this trend. It is concluded that one of the principal impediments to reversing the declining rate of autopsies is what is referred to in Economics as "market failure." In particular, the nature of the spatial and temporal distribution of costs and benefits has prec...

  3. Touchless autopsy report

    OpenAIRE

    Rodrigues, César Augusto Cardoso

    2013-01-01

    This dissertation is a response to the most uncomfortable tasks in the medical examiners work, the tasks required to prepare an autopsy report. This is one of their biggest and most frequent limitations. The new technological tools of person-machine interface in the market motivated the realization of this project. This project is developed in Java, and allows a medical examiner to perform an autopsy report without requiring physical contact with the computer. Thus, this work has the followin...

  4. The maternal autopsy

    OpenAIRE

    Rushton, DI; Dawson, IMP

    1982-01-01

    Careful study of reports prepared for the Confidential Enquiries into Maternal Deaths in England and Wales has made it clear that many maternal autopsy reports are not as informative as they might be. This is, in part at least, because no pathologist who does not work in a maternity unit can expect to see more than a handful of such deaths in a working lifetime. This paper describes briefly the particular features to look for at autopsy, stresses the importance of taking adequate material for...

  5. The value of neonatal autopsy.

    LENUS (Irish Health Repository)

    Hickey, Leah

    2012-01-01

    Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals.

  6. Autopsias pediátricas / Pediatric autopsies

    Scientific Electronic Library Online (English)

    Fernando, Fernández Reverón; José, Hurtado de Mendoza Amat; Teresita de Jesús, Montero González; Clara, Santamaría Cuadrado; Ana E, Mera Fernández.

    2014-12-01

    Full Text Available Introducción: la autopsia es una herramienta útil que garantiza el estudio más completo del enfermo y la enfermedad, y evalúa la calidad del trabajo médico. El estudio de las autopsias pediátricas ofrece un importante volumen de información. Objetivo: demostrar la utilidad de la autopsia para la eva [...] luación de la calidad de la atención médica pediátrica. Métodos: estudio retrospectivo longitudinal. Se estudiaron 363 autopsias pediátricas realizadas en el Hospital Militar Central "Dr. Luis Díaz Soto", desde su inauguración en 1962 hasta el 2011, a través del empleo del Sistema Automatizado de Registro y Control en Anatomía Patológica. Resultados: predominó el sexo masculino (56,1 %) y el grupo etario más frecuente correspondió al de 28 días a un 1 año (70,8 %). Las principales causas básicas de muerte fueron por infecciones digestivas, respiratorias y cerebrales. La principal causa directa e intermedia de muerte fue el tromboembolismo pulmonar. La discrepancia clínico patológica fue de un 14,7 % en la causa básica y de 10,3 % en la causa directa de muerte. Conclusiones: el trabajo científico combinado en 50 años de las especialidades de pediatría y anatomía patológica, demostró la utilidad de la autopsia para evaluar la calidad del trabajo médico y el apoyo que brinda el Sistema Automatizado de Registro y Control de Anatomía Patológica. Abstract in english Introduction: autopsy is a useful tool to guarantee the most complete study of the sick person and of the disease, and to evaluate the quality of the physician's work. The study of pediatric autopsies provides a huge volume of information. Objective: to prove the usefulness of autopsy for the evalua [...] tion of the quality of pediatric medical care. Methods: retrospective longitudinal study of 363 pediatric autopsies conducted at "Luis Diaz Soto" central military hospital since its opening in 1962 through 2011. To this end, the Automated System of Registration and Control in Pathological Anatomy was used. Results: predominance of males (56.1 %) and of the group aged 28 days to one year (70.8 %). The main causes of death were digestive, respiratory and brain infections. The main direct and intermediate cause of death was pulmonary thromboembolism. The clinical and pathological discrepancy was 14.7% in the main cause and 10.3 % in the direct cause of death. Conclusions: the combined scientific work in 50 years by the pediatrics and pathological anatomy specialties proved the usefulness of autopsy to evaluate the quality of the physician's work and the support given by the Automated System of Registration and Control of Pathological Anatomy.

  7. Pneumatosis Intestinalis: Autopsy Finding

    Directory of Open Access Journals (Sweden)

    Bazmi Shabnam

    2009-10-01

    Full Text Available This is a case of a patient with bowel obstruction , imaging studies were suggestive for pneumatosis intestinalis. Clinically diagnosed as adhesion band and pnematosis intestinalis. She underwent laparatomy, enterolysis, obstructionolysis and enterorrhaphy. The patient developed respiratory distress and expired after 2 days. At autopsy we found gray-brown discoloration in the wall of some part of small bowel and flattening of mucus membrane. Grossly multiple gas-filled cysts were seen at the serosal surface. Microscopic evaluation of small intestine wall showed multiple cysts located in submucosal and serosal layers.

  8. Findings of autopsy imaging

    International Nuclear Information System (INIS)

    Described is the outline of autopsy imaging (Ai) by CT, MRI and ultrasonography (US) as the reading of the postmortem images is becoming important for radiologist on site. The present major Ai modality is CT, where the cause of death can be identified in most cases of injuries like that by traffic accident, and of intracranial hemorrhagic lesions. It is difficult for CT alone to determine the cause due to acute heart failure, for which Ai by enhanced CT (2-min heart massage during the intravenous infusion of a contrast agent) has been introduced. CT findings in Ai are varied according to the death cause, anabiotic treatment conducted and postmortem changes. The second item includes the gastrointestinal tract dilation, rib fracture, pneumo- or hemo-thorax, bruise or rupture, and intravascular gas, and the third, the blood hypostasis, which emphasizing the shadow at the gravity-loaded portions in Ai CT. MRI signals vary dependently on the temperature and the inversion time should be shortened to suppress the cerebrospinal signal at Ai of the cold body like that stored in a refrigerator. US can detect clear, macroscopic morphological changes and the portable machine has been in practice at autopsy onsite. As sound speed depends on the temperature in water, Ai US images are obscure relative to living body due to the low temperature. Authors think the problem to identify the cause of death will be mostly solved in Japan when radiological technologists more actively participate in Ai. (K.T.)

  9. Autopsy Tissue Program

    International Nuclear Information System (INIS)

    The Autopsy Tissue Program was begun in 1960. To date, tissues on 900 or more persons in 7 geographic regions have been collected and analyzed for plutonium content. The tissues generally consist of lung, liver, kidney, lymph, bone, and gonadal tissue for each individual. The original objective of the program was to determine the level of plutonium in human tissues due solely to fall-out from weapons testing. The baseline thus established was to be used to evaluate future changes. From the first, this program was beset with chemical and statistical difficulties. Many factors whose effects were not recognized and not planned for were found later to be important. Privacy and ethical considerations hindered the gathering of adequate data. Since the chemists were looking for amounts of plutonium very close to background, possible contamination was a very real problem. Widely used chemical techniques introduced a host of statistical problems. The difficulties encountered touch on areas common to large data sets, unusual outlier detection methods, minimum detection limits, problems with Aliquot sizes, and time-trends in the data. The conclusions point out areas to which the biologists will have to devote much more careful attention than was believed

  10. Congenital hyperthyroidism: autopsy report

    Directory of Open Access Journals (Sweden)

    Lima Marcus Aurelho de

    1999-01-01

    Full Text Available We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and hemorrhagic suffusions in the epicardium. The placenta had infarctions that involved at least 20% of its surface, and the vessels of the umbilical cord were fully exposed due to a decrease in Wharton 's jelly. Hyperthyroidism was confirmed by the maternal clinical data, the fetal findings of exophthalmia, craniosynostosis, and goiter with signs of follicular hyperactivity. Craniosynostosis is caused by the anabolic action of thyroid hormones in bone formation during the initial stages of development. The delayed initiation of treatment in the present case contributed to the severity of fetal hyperthyroidism and consequent fetal death.

  11. Maternal mortality: An autopsy audit

    OpenAIRE

    Jashnani K; Rupani A; Wani R

    2009-01-01

    Background: The process of audit standardizes protocols in departments and has long-term benefits. Maternal autopsies though routinely performed, deserve a special attention. Aims: This study was carried out to calculate the maternal mortality ratio (MMR) in a tertiary care hospital and to correlate final cause of death with the clinical diagnosis. An audit of maternal autopsies was carried out to evaluate current practices, identify fallacies and suggest corrective measures to rectify them....

  12. Maternal mortality: An autopsy audit

    Directory of Open Access Journals (Sweden)

    Jashnani K

    2009-01-01

    Full Text Available Background: The process of audit standardizes protocols in departments and has long-term benefits. Maternal autopsies though routinely performed, deserve a special attention. Aims: This study was carried out to calculate the maternal mortality ratio (MMR in a tertiary care hospital and to correlate final cause of death with the clinical diagnosis. An audit of maternal autopsies was carried out to evaluate current practices, identify fallacies and suggest corrective measures to rectify them. Materials and Methods: Eighty-nine autopsies of maternal deaths in the period 2003 to 2007 were studied in detail along with the clinical details. Results: There were 158 maternal deaths and 13940 live births in this five-year period. Maternal mortality rate was found to be very high (1133/ 100000 live births in our institution with a high number of complicated referral cases (68/89 cases, 76%. Of the 89 autopsies, acute fulminant viral hepatitis was the commonest cause of indirect maternal deaths (37 cases, 41.5%. This was followed by direct causes like pregnancy-induced hypertension (12 cases, 13.4% and puerperal sepsis (10 cases, 11.2%. Certain fallacies were noted during the audit process. Conclusion: During the audit it was realized that in maternal mortality autopsies, special emphasis should be given to clinicopathologic correlation, microbiological studies, identification of thromboembolic phenomenon and adequate sectioning of relevant organs. We found difficulty in identification of placental bed in the uterus in postpartum autopsies. A systematic approach can help us for better understanding of the pathophysiology of diseases occurring in pregnancy.

  13. The conventional autopsy in modern medicine

    OpenAIRE

    Ayoub, Tariq; Chow, Jade

    2008-01-01

    In many countries, including the UK, where relatives' consent is required, clinical autopsy rates (i.e. autopsies other than those required by law) have been declining since the 1950s. In the UK, even in teaching hospitals, the clinical autopsy rate has fallen to only 10% of deaths or less. At this rate of decline, clinical autopsies – and the pathologists who perform them – face extinction. The future practice of medicine will be blind to the many adverse consequences of clinical actions or ...

  14. Autopsy experience with a radioactive cadaver

    International Nuclear Information System (INIS)

    A patient who received a 200-mCi dose of 131I for widespread carcinoma died 10 days after treatment with 50 mCi remaining in the cadaver. An autopsy was required. The radiation levels were sufficiently high that personnel radiation protection was needed. An autopsy procedure was designed that prevented ingestion of radioactivity by the pathologist and his assistants, prevented excessive exposure of any involved personnel, and prevented contamination of the autopsy room or other hospital space. (author)

  15. Judicial autopsy of radiation accidents

    International Nuclear Information System (INIS)

    This paper discusses issues regarding the judicial autopsy of radiation accidents. In the litigation which follows a radiation accident, a claimant calls on the legal system to adjudicate a dispute. Scientific questions are thrust upon the court. The legal system (through attorneys for the parties) then invites scientists to assist the court in resolving such questions. The invitation, however, does not allow the scientist to bring along his full kit. Experimentation, such as repeating the accident with dosimeters to gather more accurate data, is generally not allowed. Also, the scientist must give up his practice of choosing which questions he will pursue

  16. [Cervical fractures in autopsy records].

    Science.gov (United States)

    Pankowski, Rafa?; Wilmanowska, Anita; Gos, Tomasz; Smoczy?ski, Andrzej

    2003-01-01

    We reviewed the autopsy records of 1872 cases of death because of politrauma, gunshot wounds and suicidal hanging. The analysis included causes and frequency of cervical spine fractures, their most common localisation, architecture of bone destruction and their influence on cervical cord. The most common cause of cervical spine injury was motor vehicle accidents. We examined 82 specimens with traumatic fractures of cervical spine obtained from accident victims. About half of the injuries occurred in upper cervical spine. The most common fracture localisation was C2 with dens fracture as the most frequent injury. The most common spinal cord lesion was complete rupture mainly at the upper cervical spine level. PMID:14564791

  17. Utah Youth Suicide Study: Psychological Autopsy

    Science.gov (United States)

    Moskos, Michelle; Olson, Lenora; Halbern, Sarah; Keller, Trisha; Gray, Doug

    2005-01-01

    We conducted a psychological autopsy study to further understand youth suicide in Utah. While traditional psychological autopsy studies primarily focus on the administration of psychometric measures to identify any underlying diagnosis of mental illness for the suicide decedent, we focused our interviews to identify which contacts in the…

  18. Cardiomegaly in Ghana: An Autopsy Study

    OpenAIRE

    Akosa, AB; Armah, H

    2005-01-01

    A three (3) year prospective macroscopic autopsy study of cardiomegaly, heart size ≥400grams, was conducted at the Korle Bu Teaching Hospital Mortuary between 1st January 1998 and 31st December 2000. Cardiomegaly constituted 12.2% of the autopsy series over the 3-year period. The causes of cardiomegaly were essential hypertension in 55% of cases and hypertension of renal origin in 23.4% of cases. Cardiomyopathies, cor pulmonale, chronic rheumatic heart diseases, ischaemic heart diseases, chro...

  19. Autopsy and medical education: a review.

    OpenAIRE

    Charlton, R.

    1994-01-01

    During the twentieth century there has been a decline in the rate of autopsies performed. A review of the literature reveals reasons for this decline which include: an improvement in the medical diagnostic technology available; inadequate training of doctors as to the importance of autopsy; and difficulties in obtaining consent from relatives and the present use of audit. Recommendations for changes in medical education are made which include: a greater appreciation of the procedure as a usef...

  20. Emotionally challenging learning situations: medical students' experiences of autopsies

    OpenAIRE

    Maria Weurlander; Max Scheja; Håkan Hult; Annika Wernerson

    2012-01-01

    Objectives: To explore medical students' experiences of an emotionally challenging learning situation: the autopsy. Methods: Qualitative data were collected by means of written accounts from seventeen students after their first and third autopsies and a group interview with seven students after their first autopsy. Data was interpreted using inductive thematic analysis. Results: Students experienced the autopsy in three ways: as an unnatural situation, as a practical exercise, and as a way to...

  1. Adult Hirschsprung's disease diagnosed during forensic autopsy.

    Science.gov (United States)

    Chatelain, Denis; Manaouil, Cécile; Marc, Bernard; Ricard, Jannick; Brevet, Marie; Montpellier, Dominique; Defouilloy, Christian; Jardé, Olivier

    2006-09-01

    We report a case of fatal Hirschsprung's disease (HD) discovered at autopsy. A 20-year-old man collapsed at home. Emergency medical personnel found him in cardiac arrest and all resuscitative efforts failed. He had a past history of chronic constipation since infancy. Forensic autopsy revealed a megacolon full of gas and stools. Microscopic examination showed absence of ganglion cells in a short segment of the rectum and enterocolitis in the left and transverse colon. HD is rarely described in adults. In many cases, patients complained of constipation since infancy but the affection remained misdiagnosed. The relative good tolerance of the disease is usually due to a short aganglionic bowel segment. Enterocolitis is a frequent and severe complication of HD in children but is rarely described in adults. This case suggests the importance of HD diagnosis in childhood in order to avoid fatal complications with forensic consequences. PMID:17018101

  2. Congenital hyperthyroidism: autopsy report Hipertireoidismo Congenital

    OpenAIRE

    Marcus Aurelho Lima; Lília Beatriz Oliveira; Neiva Paim; Maria de Fátima Borges

    1999-01-01

    We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and h...

  3. Verbal Autopsy Methods with Multiple Causes

    OpenAIRE

    King, Gary; Lu, Ying

    2008-01-01

    Verbal autopsy procedures are widely used for estimating cause- specific mortality in areas without medical death certification. Data on symp- toms reported by caregivers along with the cause of death are collected from a medical facility, and the cause-of-death distribution is estimated in the pop- ulation where only symptom data are available. Current approaches analyze only one cause at a time, involve assumptions judged difficult or impossible to satisfy, and require expensive, time-consu...

  4. The working procedure of human autopsy specimens

    International Nuclear Information System (INIS)

    In order to perform the Coordinated Research Program for the Reference Asian Man (phase 2): Ingestion and body content of trace elements of importance in Radiation Protection, study on elemental content in organs of normal Chinese has been worked by China Institute for Radiation Protection and Institute of Radiation Medicine - CAMS in recent two years. Sampling and sample collection of human tissues and the procedures of sample preparation of human autopsy specimens are enlisted

  5. Can postmortem fetal MR imaging replace autopsy?

    International Nuclear Information System (INIS)

    The purposes of this study were to compare postmortem fetal MRI findings with autopsy findings and to assess whether postmortem MRI can replace autopsy. The study group consisted of 13 stillborn fetuses, seven that died immediately after birth, and five terminated because of anomalies seen on prenatal sonograms. A total 17 were male, and eight were female, and their gestational ages were from 20 to 41 (average;28.2) weeks. Spin-echo T1-and T2-weighted axial, sagittal, and coronal MR images were obtained, and autopsy findings were divided into major and minor. A major finding was defined as an anomaly or syndrome which caused fetal death or termination of the pregnancy: minor findings were classified, on the basis of gross inspection, as internal or external. MR images were retrospectively analyzed by two radiologists unaware of the autopsy findings, and by comparison with these, the postmortem MRI detection rates for major and minor findings was then determined. In seven of 25 fetuses, MR imaging revealed major findings, a dietction rate of 100%. There were two cases of anencephaly, two of trisomy-18, and one each of hydrops fetalis with large cystic hygroma, diaphragmatic hernia, and Dandy-Walker malformation. Twenty-three of 60 minor findings (38.3%) were detected by MRI. The detection rates for external and internal findings were 29.6%(8/27) and 45.5%(15/33), respectively. Although a limitation of our study is the low detection rate for minor findings, postmortem fetal MRI may help diagnose the major cause of fetal death

  6. Can postmortem fetal MR imaging replace autopsy?

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jeong Yeon; Song, Mi Jin [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of); Kim, Seoung Hyup [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-02-01

    The purposes of this study were to compare postmortem fetal MRI findings with autopsy findings and to assess whether postmortem MRI can replace autopsy. The study group consisted of 13 stillborn fetuses, seven that died immediately after birth, and five terminated because of anomalies seen on prenatal sonograms. A total 17 were male, and eight were female, and their gestational ages were from 20 to 41 (average;28.2) weeks. Spin-echo T1-and T2-weighted axial, sagittal, and coronal MR images were obtained, and autopsy findings were divided into major and minor. A major finding was defined as an anomaly or syndrome which caused fetal death or termination of the pregnancy: minor findings were classified, on the basis of gross inspection, as internal or external. MR images were retrospectively analyzed by two radiologists unaware of the autopsy findings, and by comparison with these, the postmortem MRI detection rates for major and minor findings was then determined. In seven of 25 fetuses, MR imaging revealed major findings, a dietction rate of 100%. There were two cases of anencephaly, two of trisomy-18, and one each of hydrops fetalis with large cystic hygroma, diaphragmatic hernia, and Dandy-Walker malformation. Twenty-three of 60 minor findings (38.3%) were detected by MRI. The detection rates for external and internal findings were 29.6%(8/27) and 45.5%(15/33), respectively. Although a limitation of our study is the low detection rate for minor findings, postmortem fetal MRI may help diagnose the major cause of fetal death.

  7. Autopsy findings in severe malaria – a case report

    OpenAIRE

    Dedi Afandi; Budi Sampurna; Inge Sutanto; J. W. Marwoto; Nurjati Chairani; Sutisna Himawan; Rawina W; Ivan Riyanto

    2008-01-01

    Severe malaria, caused by Plasmodium falciparum infection, has a high mortality rate and is the main cause of death in malaria. Since clinical autopsy is unpopular in Indonesia, autopsy examination in malaria cases is rarely done. We reported a forty three year old woman from non endemic area that was dead because of severe malaria. Diagnosis was concluded from autopsy, histopathology, and toxicology. (Med J Indones 2008; 17: 210-5)Keywords: Plasmodium falciparum, cerebral malaria, black wate...

  8. Autopsy findings of fatal cryptogenic organizing pneumonia.

    Science.gov (United States)

    Terada, Tadashi

    2013-01-01

    Autopsy cases of cryptogenic organizing pneumonia (COP) have been rarely reported. A 73-year-old Japanese man consulted to a hospital because of flu-like sickness. He was diagnosed as pneumonia, and treated by antibiotics. He was referred to our hospital for further treatment. Chest X-P showed pneumonia involving the whole lungs. Blood laboratory test showed leukocytosis, increased CRP, and decreased PaO2. Despite of steroid therapy, he showed a downhill course and died one month after the first manifestation. The clinical diagnosis was acute pneumonia or ARDS. At autopsy, the both lungs were voluminous. The weight of lungs was 1050 g in the left lung and 1300 g in the right lung. The both lungs were entirely affected. The lungs were hard and little air was recognized. Microscopically, almost all alveolar spaces contained Masson's bodies. Bronchiolitis obliterans was not recognized. The alveolar walls were not affected. The Masson's bodies showed collagenization with lymphocytic infiltration. Hyalinization of Masson's bodies with little inflammatory infiltration was frequently seen. Cartilagenous metaplasia and ossification of Masson's bodies were seen in some places. The pulmonary arteries were affected by fibrosis, and occasionally showed thrombosis. The pathological diagnosis was COP. The heart weighted 500 g, and showed right ventricular hypertrophy (cor pulmonale). Other pathologic changes were pleural effusion (left, 800 ml: right, 1200 ml), acute liver congestion, prostatic hypertrophy, colon adenoma, and hypercellular bone marrow. The cause of death was respiratory failure due to COP and pleural effusion. In conclusion, the author reported an autopsy case of fatal COP. PMID:23696931

  9. Management and autopsy of a radioactive cadaver

    International Nuclear Information System (INIS)

    A 69 year old male was treated with an ablative dose of 3.7GBq (10 mCi) of I131 for carcinoma of the thyroid and died 10 days after administration. The requirement for an autopsy and the level of radiation still present in the body necessitated the intervention of radiation safety personnel to minimise support staff radiation exposure and area contamination. Preventative measures were taken in accordance with the ALARA principle and a detailed procedure is presented as a suggested model for any future occurrence

  10. Autopsy findings of fatal cryptogenic organizing pneumonia

    OpenAIRE

    Terada, Tadashi

    2013-01-01

    Autopsy cases of cryptogenic organizing pneumonia (COP) have been rarely reported. A 73-year-old Japanese man consulted to a hospital because of flu-like sickness. He was diagnosed as pneumonia, and treated by antibiotics. He was referred to our hospital for further treatment. Chest X-P showed pneumonia involving the whole lungs. Blood laboratory test showed leukocytosis, increased CRP, and decreased PaO2. Despite of steroid therapy, he showed a downhill course and died one month after the fi...

  11. Radiographic investigations during medico-legal autopsies

    International Nuclear Information System (INIS)

    During the last 13 years (1968-1980), 427 radiographic examinations were carried out during the course of medico-legal autopsies at the Institute of Forensic Medicine at the Free University of Berlin. Important problems were the demonstration of retained foreign bodies resulting from shooting, stabbing or blunt trauma, bone injuries, identification, and the question of life in neonates. An historical survey is given and 12 cases with special forensic problems are illustrated and discussed, and further means of investigations are described. (orig.)

  12. Psychological Autopsy: A Psychobiographical Exploration of Suicide

    Directory of Open Access Journals (Sweden)

    José Alonso Andrade Salazar

    2013-06-01

    Full Text Available The present work is a conceptual approach on psychosocial factors related to suicidal psychobiography from the exploration of the lives of people who self-eliminate, for which there will be a review of the literature, based on input from journal articles and books published in various sources of documentation. Autopsy psychology is a data collection method that provides light on the psychosocial motivations that drive and reinforce the act of suicide, and is currently used by professionals responsible for investigating the causes of suicide while contributing data produced in the developing programs to promote mental health and prevention of suicidal ideation and behavior.

  13. Autopsy issues in German Federal Republic transplantation legislation until 1997.

    Science.gov (United States)

    Schweikardt, Christoph

    2014-01-01

    This article analyzes the relevance of autopsy issues for German Federal Republic transplantation legislation until 1997 against the background of legal traditions and the distribution of constitutional legislative powers. It is based on Federal Ministry of Justice records and German Parliament documents on transplantation legislation. Transplantation and autopsy legislation started with close ties in the 1970s. Viewing transplantation legislation as relevant for future autopsy regulation contributed to the decision to stall transplantation legislation, because the interests of the federal government and the medical profession converged to avoid subsequent restrictions on the practice of conducting autopsies and procuring tissues for transplantation. Sublegal norms were insufficient for the prosecution of the organ trade and area-wide transplantation regulation after the reunification of Germany. In contrast to autopsy issues, legislative power for transplantation issues was extended to the federal level by an amendment to the constitution, allowing decision making for Germany as a whole. PMID:25557516

  14. Autopsy discoveries of death from malaria.

    Science.gov (United States)

    Menezes, Ritesh G; Pant, Sadip; Kharoshah, Magdy A; Senthilkumaran, Subramanian; Arun, M; Nagesh, K R; Bhat, Nishanth B; Mahadeshwara Prasad, D R; Karki, Raj Kumar; Subba, S H; Fazil, Abul

    2012-05-01

    Malaria inflicts a huge health care burden in terms of mortality and morbidity worldwide. There has been evidence in the literature where many unexpected/unexplained deaths turned out to be related to malaria on autopsy. The aim of this study is to review autopsy diagnosed malaria related deaths in the literature with due stress to its biologic and forensic aspects. A meticulous literature search was performed for "sudden malaria death", "malaria death postmortem diagnosis" and "unexplained death malaria" across PubMed, SCOPUS, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine, British Nursing Index, CINAHL, EMBASE, Ovid-MEDLINE and Google Scholar. All the literature was thoroughly reviewed and analyzed with reference to the type of study, location, travel history, age, gender, circumstance of death, method of diagnosis, species involved, chemoprophylaxis usage and take home message from the particular study. Plasmodium falciparum was responsible in most of the cases. The symptoms mimicked influenza in most of the case reports. Travel to endemic areas was common to most of the victims. The travelers were from all over the world including USA, France, Switzerland, Spain, Portugal, Germany and Asia (China and Japan). Vascular congestion with the presence of malarial pigment laden RBCs in capillaries of various organs was the major histopathology finding. Such lesions were found in the brains of all subjects (100%), liver of 78% of the cases, spleen in 67%, lungs in 56% and myocardium in 43% of the cases. Peripheral smear and rapid diagnostic test was of great aid to the autopsy in many cases. PCR was used for diagnosis as well as exclusion of possibility of co-infection with other species in case of Plasmodium knowlesi related death. The postmortem and histopathology findings in this case were similar to P. falciparum except for the fact that brain sections were negative for intracellular adhesion molecule-1. Chemoprophylaxis was not taken by the victims except for two in whom history of chloroquine based chemoprophylaxis was mentioned. Given the worldwide prevalence of the disease, increasing international travel and rapidly developing drug resistance, malaria will continue to be an important disease and should be considered in all cases of unexpected deaths particularly in malaria endemic regions or in presence of travel history to endemic regions. PMID:22369777

  15. Value of postmortem computed tomography in comparison to autopsy; Prospektive Untersuchung zur Wertigkeit der postmortalen Computertomographie im Vergleich zur Autopsie

    Energy Technology Data Exchange (ETDEWEB)

    Paperno, S.; Krug, B.; Lackner, L. [Klinik und Poliklinik fuer Radiologische Diagnostik, Univ. zu Koeln (Germany); Riepert, T.; Rothschild, M.A.; Schultes, A.; Staak, M. [Inst. fuer Rechtsmedizin des Klinikums der Univ. zu Koeln (Germany)

    2005-01-01

    Purpose: to assess the diagnostic value of postmortem computed tomography (CT) in comparison to autopsy. Materials and methods: twenty-seven cadavers were examined by sequential cranial CT and helical CT through the neck, thorax and abdomen and subsequently underwent an autopsy with histomorphologic examination of the pathologic specimens. The findings of CT, autopsy and histology were registered and compared by three radiologists and one specialist for forensic medicine, using a data entry form. Results: in 19 of 27 cases, the findings explaining the cause of death were concordant for CT and autopsy. Intracranial, intraspinal and intracardiac gas accumulations (n = 12) were registered by CT alone. The detection of skull fractures was equal for both methods (n = 3). CT showed diagnostic problems in the assessment of pneumonic infiltrations (n = 16) and pulmonary edema (n = 21). Conclusion: CT is a useful and complementary method to autopsy. (orig.)

  16. [Clinical autopsy--its role in modern medicine].

    Science.gov (United States)

    Diebold, J

    2007-10-24

    At the beginning of the 21st century, pathology is dominated by the advent of new molecular techniques. Presently pathology transforms into a clinical discipline at the interface of diagnosis and therapy. In this context many physicians feel that clinical autopsies are out-dated. However, the autopsy has developed into a highly effective and meaningful tool which uses the whole array of contemporary molecular techniques ("molecular autopsy"). For the future one can expect that the clinical autopsy will remain a pivotal instrument for quality management, student teaching and continuous education, epidemiology (e.g. cancer registries) and research (e.g. for neurodegenerative diseases). By endorsing autopsies physicians show that they are open for self-criticism and have an interdisciplinary view of their profession. Since autopsies often reveal unexpected findings, which can be important for both the lives of other patients and for family members of the deceased, relatives saying yes to an autopsy show true compassion and human solidarity. PMID:18019178

  17. Validity of verbal autopsy for ascertaining the causes of stillbirth

    Directory of Open Access Journals (Sweden)

    Arun K Aggarwal

    2011-01-01

    Full Text Available OBJECTIVE: To validate the verbal autopsy tool for stillbirths of the World Health Organization (WHO by using hospital diagnosis of the underlying cause of stillbirth (the gold standard and to compare the fraction of stillbirths attributed to various specific causes through hospital assessment versus verbal autopsy. METHODS: In a hospital in Chandigarh, we prospectively studied all stillbirths occurring from 15 April 2006 to 31 March 2008 whose cause was diagnosed within 2 days. All mothers had to be at least 24 weeks pregnant and live within 100 km of the hospital. For verbal autopsy, field workers visited mothers 4 to 6 weeks after the stillbirth. Autopsy results were reviewed by two independent obstetricians and disagreements were resolved by engaging a third expert. Causes of stillbirths as determined by hospital assessment and verbal autopsy were compared in frequency. FINDINGS: Hospital assessment and verbal autopsy yielded the same top five underlying causes of stillbirth: pregnancy-induced hypertension (30%, antepartum haemorrhage (16%, underlying maternal illness (12%, congenital malformations (12% and obstetric complications (10%. Overall diagnostic accuracy of verbal autopsy diagnosis versus hospital-based diagnosis for all five top causes of stillbirth was 64%. The areas under the receiver operator characteristic curve (ROC were, for congenital malformations, 0.91 (95% confidence interval, CI: 0.83-0.97; pre-gestational maternal illness, 0.75 (95% CI: 0.65-0.84; pregnancy-induced hypertension, 0.76 (95% CI: 0.69-0.81; antepartum haemorrhage, 0.76 (95% CI: 0.67-0.84 and obstetric complication, 0.82 (95% CI: 0.71-0.93. CONCLUSION: The WHO verbal autopsy tool for stillbirth can provide reasonably good estimates of common underlying causes of stillbirth in resource-limited settings where a medically certified cause of stillbirth may not be available.

  18. An autopsy study of maternal mortality: A tertiary healthcare perspective

    Directory of Open Access Journals (Sweden)

    Panchabhai T

    2009-01-01

    Full Text Available Background: An audit of autopsies of maternal deaths is important for the establishment of accurate cause of maternal deaths and to determine the contribution of various etiologies responsible in a given community. Aim: To study the causes of maternal deaths as determined by a pathological autopsy. Settings and Design: A retrospective study of all the cases of maternal deaths that underwent a pathological autopsy in a tertiary healthcare center from January 1998 to December 2006. Materials and Methods: The autopsy records with clinical notes were retrieved; gross and histopathology specimens and slides were studied to establish the accurate cause of maternal deaths. The variables like age (years, stay in the hospital, gravidity, trimester of pregnancy and method of delivery were used to classify and analyze the data from the autopsies. The causes of maternal deaths were divided in to direct and indirect; each being classified into subgroups based on the most evident pathology on autopsy. Results: The Maternal Mortality Rate (MMR over a nine-year period (1998-2006 was 827/100000 live births (471 maternal deaths against 56944 live births. An autopsy was performed in 277 cases (58.8%. In the autopsy group, the most common causes of maternal mortality were pre-ecclampsia/ecclampsia (40 of 277, 14.44% and hemorrhage (32 of 277; 11.55%; However, indirect causes like infectious diseases (27 of 277; 9.75% and cardiac (27 of 277; 9.75% disease also contributed to maternal deaths. Conclusion: Indirect causes like rheumatic heart disease and infections like tuberculosis, malaria or leptospirosis and nutritional anemia are still major causes of maternal mortality in developing countries like India. Intensive efforts need to be taken in these areas to reduce the maternal mortality in developing countries like India.

  19. The Molecular Autopsy: Should the Evaluation Continue After the Funeral?

    OpenAIRE

    Tester, David J.; Ackerman, Michael J.

    2012-01-01

    Sudden cardiac death (SCD) is one of the most common causes of death in developed countries, with most SCDs involving the elderly, and structural heart disease evident at autopsy. Each year, however, thousands of sudden deaths involving individuals younger than 35 years of age remain unexplained after a comprehensive medicolegal investigation that includes an autopsy. In fact, several epidemiologic studies have estimated that at least 3% and up to 53% of sudden deaths involving previously hea...

  20. Clinical diagnosis versus autopsy findings in polytrauma fatalities

    OpenAIRE

    Fakler Johannes K; Ertel Wolfgang; Tsokos Michael; Gahr Patrick; Buschmann Claas T

    2010-01-01

    Abstract Objectives The aim of the study was to determine if differences in clinical diagnosis versus autopsy findings concerning the cause of death in polytrauma fatalities would be detected in 19 cases of fatal polytrauma from a Level 1 trauma centre. Methods Clinical diagnoses determining the cause of death in 19 cases of fatal polytrauma (2007 - 2008) from a Level 1 trauma centre were correlated with autopsy findings. Results In 13 cases (68%), the clinical cause of death and the cause of...

  1. FETAL AUTOPSY STUDY OVER A TWO YEAR PERIOD

    Directory of Open Access Journals (Sweden)

    Shailaja

    2015-02-01

    Full Text Available INTRODUCTION: Perinatal death rate is declining in developed and developing countries and so are perinatal autopsies. In the present days due to wider availability and awareness of prenatal scanning more and more congenital malformations are picked up in e arlier weeks of gestation. This helps in counselling of the couple which usually leads to an informed decision on medical termination of pregnancy. Autopsy performed on such fetuses , yields additional information in many cases. AIMS: The study was carried out to determine how well the prenatal ultrasound findings correlate with autopsy findings and also to determine the cause of death where ultrasound was not performed in patients who had spontaneous intrauterine death and abortion. MATERIALS AND METHODS: T his was a prospective study carried out over a period of two years in the department of pathology at Kamineni Academy of Medical Sciences and Research Centre , Hyderabad , from January 2013 to December 2014. A total of 23 fetal autopsies were performed of wh ich one was a twin pregnancy. Brief maternal history , prenatal ultrasound scans , relevant biochemical markers and genetic studies wherever done , were noted. RESULTS : There were 14 male (60.86% and 8 female (34.78% fetuses , and in one case (4.34% gender could not be identified. Nineteen cases (82.60 % were less than 28 weeks of gestation. Medical termination of pregnancy was done in 13 cases (56.52 % whereas , 10 patients (43.47 % had spontaneous intrauterine death of the fetus. Ultrasound scanning was done in 15 cases (65.21 %. In 13 cases (86.66 % the ultrasound and autopsy findings were correlating whereas in two cases (13.33 % there were findings on imaging study which could not be identified on autopsy. Ultrasound was not done in 8 cases (34.78 % out of which 5 cases (62.5 % showed findings on autopsy which could have led to the fetal demise. Twelve cases (52.17 % were referral cases which had come from other hospitals. Genetic studies were done in 6 cases (26.08 % in the form of parental kary otyping and cord blood could be tested in only one case. CONCLUSIONS: There is a good correlation between prenatal ultrasound scanning and autopsy findings. However , functional heart defects , and minute ventricular septal defects cannot be identified on autopsy due to the small size of the organs. At the same time autopsy can demonstrate more accurately congenital malformations and unsuspected cord abnormalities. More awareness is required on the part of treating clinician s as to the appropriate sample collection , its timely transport to the laboratory in order to facilitate genetic testing.

  2. [Adult autopsies in a French university hospital (CHU Amiens) for the period 1975-2005].

    Science.gov (United States)

    Chatelain, Denis; Brevet, Marie; Guernou, Malika; Manaouil, Cécile; Leclercq, Fabienne; Bruniau, Alexis; Cordonnier, Carole; Sevestre, Henri

    2007-09-01

    We have reviewed the pathological reports of adult necropsies performed in Amiens hospital during the 1975-2005 period. 1,639 autopsies were performed in 1,049 men and 590 women. We distinguished three periods: 1975-1987 (period 1) with a high number of autopsies (86/year), 1988-1996 (period 2) with a huge decrease of autopsies performed (43/year) and 1997-2005 (period 3) with few autopsies performed (14/year). Patients were younger during period 3, 38% were less than 50 years old versus 26% and 29% during periods 1 and 2. The sex ratio M/F increased during period 3 (2.7 versus 1.7 and 1.9 during periods 1 and 2). Period 3 showed an increase of major diagnoses discovered during autopsies (36% versus 28% of autopsies performed during periods 1 and 2) and showed an increase of autopsies performed after iatrogenic events (20% versus 12% and 13% of autopsies of periods 1 and 2). Period 3 showed an increase of the delay between the death of patients and autopsy and a decrease of the delay of transmission of pathological reports. 2% of autopsies were never answered by the pathologists. In conclusion, our study confirms the major decline of autopsies during the last 30 years. Patients autopsied are currently young men and the autopsies are more frequently performed in potential forensic circumstances. Selection biases explain that major diagnoses are more frequently found at autopsies nowadays than 30 years ago. PMID:18185448

  3. Acquired immunedeficiency syndrome in forensic autopsies

    Scientific Electronic Library Online (English)

    Carlos Delmonte, Prints; José Antonio de, Mello; Ruggero Bernardo, Guidugli; Conceição Gonçalves Caldeira, Cury.

    1994-09-01

    Full Text Available No Instituto Médico Legal de São Paulo, de maio de 1985 a maio de 1989, foram realizadas 126 necrópsias de indivíduos portadores de AIDS cujo óbito foi motivo de investigações policiais. 119 eram do sexo masculino e 17 do sexo feminino e o pico de incidência etária foi dos 20 aos 30 anos. Foram obse [...] rvadas 54 mortes em estabelecimentos penais, 29 suicídios, 17 homicídios dolosos, 17 mortes suspeitas, 5 homicídios culposos e 4 corpos em putrefação. Os presidiários, à exceçáo de um que foi estrangulado, faleceram do curso natural da doença. Chamou atenção nas perícias a alta incidência de micobacteriose extra pulmonar. Os suicídios se procederam das mais diferentes formas e as vítimas, em sua maioria, apresentavam o quadro inicial da doença. As mortes suspeitas e os corpos encontrados em deterioração resultaram do abandono dos pacientes pelos familiares. Nos homicídios, a morte quase sempre ocorreu tardiamente nos hospitais e a doença contribuiu certamente para o agravamento das lesões. Os autores chamam atenção sobre os problemas jurídicos e sociais que envolvem as vítimas da AIDS e realçam esses últimos como um obstáculo a um controle efetivo da epidemia. Abstract in english From May 1985 to May 1989, 126 necropsies were performed at the São Paulo City Morgue on cadavers of individuals AIDS victims whose unnatural deaths had prompted police investigations. One hundred and nineteen males and 17 females were included. Ages were most commonly in the 20-to-30 year range. Fi [...] fty four deaths occurred in penal institutions, 29 deaths resulted from suicides, 17 deaths from manslaughter, 17 deaths were considered suspicious, 5 willful murders and 4 others also considered suspicious because corpses were found in advanced stages of putrefaction. Inmates, except one man who was strangled, died as a consequence of the disease. During all autopsies, special attention was paid to the high rate of extrapulmonary Mycobacterial infections. Suicides were committed in different ways and the majority of the victims were documented to be still in the initial stages of the disease. Suspicious deaths and deteriorated corpses were the result of negligence of the subject's families. Homicidal deaths occurred in subjects in the terminal stages of the disease inside the hospital where these subjects were assisted and the immunedeficiency certainly contributed to aggravate the injuries leading to death. Attention is drawn to both legal and social issues affecting AIDS victims. The authors believe these issues may pose a hindrance for efficient control of the AIDS epidemic.

  4. Congenital hyperthyroidism: autopsy report / Hipertireoidismo Congenital

    Scientific Electronic Library Online (English)

    Marcus Aurelho de, Lima; Lília Beatriz, Oliveira; Neiva, Paim; Maria de Fátima, Borges.

    1999-06-01

    Full Text Available Relata-se necropsia de natimorto com hipertireoidismo congênito, filho de mãe portadora de doença de Graves não tratada, que teve como causa de óbito insuficiência cardíaca congestiva. Os achados fundamentais foram vistos no crânio, tireóide coração e placenta. As suturas cranianas encontravam-se fe [...] chadas, com acavalgamento dos ossos cranianos. A tireóide apresentava aumento de volume e congestão sangüinea intensa e, histologicamente, os folículos mostravam hiperatividade. O coração estava aumentado de volume, amolecido, com cavidades dilatadas e sufusões hemorrágicas no epicárdio. A placenta apresentava infartos que acometiam menos de 20% da superfície placentária e os vasos do cordão umbilical encontravam-se completamente expostos por diminuição da geléia de Warton. O hipertireoidismo ficou comprovado pelos dados clínicos maternos, os achados fetais de exoftalmia, craniosinostose prematura e bócio com sinais de hiperatividade folicular. A craniosinostose é causada pela ação anabólica dos hormônios tireoidianos na formação óssea, nos estágios iniciais do desenvolvimento. O início tardio do tratamento no presente caso contribuiu para severidade do hipertireoidismo fetal e óbito. Abstract in english We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull [...] bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and hemorrhagic suffusions in the epicardium. The placenta had infarctions that involved at least 20% of its surface, and the vessels of the umbilical cord were fully exposed due to a decrease in Wharton 's jelly. Hyperthyroidism was confirmed by the maternal clinical data, the fetal findings of exophthalmia, craniosynostosis, and goiter with signs of follicular hyperactivity. Craniosynostosis is caused by the anabolic action of thyroid hormones in bone formation during the initial stages of development. The delayed initiation of treatment in the present case contributed to the severity of fetal hyperthyroidism and consequent fetal death.

  5. Clinical diagnosis versus autopsy findings in polytrauma fatalities

    Directory of Open Access Journals (Sweden)

    Fakler Johannes K

    2010-10-01

    Full Text Available Abstract Objectives The aim of the study was to determine if differences in clinical diagnosis versus autopsy findings concerning the cause of death in polytrauma fatalities would be detected in 19 cases of fatal polytrauma from a Level 1 trauma centre. Methods Clinical diagnoses determining the cause of death in 19 cases of fatal polytrauma (2007 - 2008 from a Level 1 trauma centre were correlated with autopsy findings. Results In 13 cases (68%, the clinical cause of death and the cause of death as determined by autopsy were congruent. Marginal differences occurred in three (16% patients while obvious differences in interpreting the cause of death were found in another three (16% cases. Five fatalities (three with obvious differences and two with marginal differences were remarked as early death (1-4 h after trauma and one fatality with marginal differences as late death (>1 week after trauma. Obvious and marginal discrepancies mostly occurred in the early phase of treatment, especially when severely injured patients were admitted to the emergency room undergoing continued cardiopulmonary resuscitation, i. e. limiting diagnostic procedures, and thus the clinical cause of death was essentially determined by basic emergency diagnostics. Conclusions Autopsy as golden standard to define the cause of death in fatal polytrauma varies from the clinical point of view, depending on the patient's pre-existing condition, mechanism of polytrauma, necessity of traumatic cardiopulmonary resuscitation, survival time, and thus the possibility to perform emergency diagnostics. An autopsy should be performed at least in cases of early fatal polytrauma to help establishing the definite cause of death. Moreover, autopsy data should be included in trauma registries as a quality assessment tool.

  6. A safer method for body restoration following autopsy.

    Science.gov (United States)

    Duflou, Johan; McNamara, Bradley; Cluney, Robert

    2014-01-01

    Restoration of autopsy incisions can result in inadvertent needle stick injury to the prosector, which can be difficult to prevent even with the use of personal protective equipment such as Kevlar cut resistant gloves. We present a new technique for closure of autopsy incisions using a commonly available commercial hardware tool, a hole punch with a lever enhanced action, combined with blunt probe sewing, which results in an esthetic and leak-proof means of restoring cadavers. This technique is especially useful in cases which may pose blood-borne infection risks to the prosector. PMID:24117624

  7. Pierre Robin sequence: case report, the relevance of autopsy

    Directory of Open Access Journals (Sweden)

    Cristiano C. Oliveira

    2015-10-01

    Full Text Available ABSTRACTPierre Robin sequence is a neonatal disorder characterized by micrognathism, glossoptosis and cleft palate. We reported an autopsy case of a child whose malformations of the oropharynx were identified only at birth. The child was extremely preterm with severe neonatal depression and poor recovery, and the orofacial alterations prevented the correct treatment. There was facial disorder characterized by micrognathia associated with cleft palate and posterior displacement of the tongue, compressing the vallecula, structurally compatible with glossoptosis. This autopsy surpassed the scientific and epidemiological relevance, allowing the family genetic counseling and close monitoring of a subsequent pregnancy.

  8. [Widespread mesenteric venous thrombosis and cirrhosis diagnosed with autopsy].

    Science.gov (United States)

    Kömür, ?lhami; Özdemirel, Rifat Özgür; Ba?p?nar, Bünyamin; ?am, Bülent; An?k Karayel, Ferah

    2015-09-01

    Mesenteric venous thrombosis is a rare disorder with a high mortality rate. Since patients remain asymptomatic, diagnosis of the disease is difficult. Diagnosis can be mainly made with either laparotomy or autopsy. Many factors are considered in the etiology of mesenteric venous thrombosis. Liver cirrhosis and chronic pyelonephritis, which we detected in the autopsy and histologic examination of our case, are considered as two of the factors. In our study, it was aimed to present a case with near-total intestinal necrosis caused by portal vein thrombosis which spread to the lineal vein, pancreatic vein and to the branches of superior mesenteric veins. PMID:26388282

  9. Renal arterial aneurysm--an incidental finding at autopsy.

    Directory of Open Access Journals (Sweden)

    Vaideeswar P

    1998-01-01

    Full Text Available Herein we describe a rare case of saccular renal artery aneurysm seen as an incidental autopsy finding in an elderly, hypertensive female. The aneurysm was seen as a small exophytic mass with calcified wall and lumen occluded by recanalized thrombus.

  10. An autopsied case of tuberculous meningitis showing interesting CT findings

    International Nuclear Information System (INIS)

    A 61-year-old female patient died of a neurological disorder of unknown origin one month after the first visit and was found to have had tuberculous meningitis at autopsy. CT revealed a low density area showing an enlargement of the cerebral ventricle but did not reveal contrast enhancement in the basal cistern peculiar to tuberculous meningitis. (Namekawa, K.)

  11. Autopsied case of tuberculous meningitis showing interesting CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Abiko, Takashi; Higuchi, Hiroshi; Imada, Ryuichi; Nagai, Kenichi (Iwate Prefectural Central Hospital (Japan))

    1983-11-01

    A 61-year-old female patient died of a neurological disorder of unknown origin one month after the first visit and was found to have had tuberculous meningitis at autopsy. CT revealed a low density area showing an enlargement of the cerebral ventricle but did not reveal contrast enhancement in the basal cistern peculiar to tuberculous meningitis.

  12. Mittelmeier hip prosthesis autopsy study 2 years after implantation.

    OpenAIRE

    Brach del Prever, Elena Maria

    1983-01-01

    A Mittelmeier hip prosthesis was removed at autopsy 2 years after implantation in a patient who was fatally injured. Macroscopic, histological, radiographic, and metrological studies revealed interesting new aspects on the remodelling of bone and the behaviour of the components of the prosthesis.

  13. Thoraco-pulmonary and hepatic actinomycosis: an autopsy report

    OpenAIRE

    Powell, George; Mangalika, Manel

    2011-01-01

    Actinomycosis is now a rare disease and death unheard of. Diagnosis is made challenging by its varied presentations and ability to be a ‘great pretender’. This report describes a rare autopsy case of thoraco-pulmonary and hepatic actinomycosis with the preceding clinical presentation.

  14. Autopsy of an Egyptian mummy (Nakht--ROM I)

    OpenAIRE

    1980-01-01

    Autopsy of a 3200-year-old Egyptian mummy by an international multidisciplinary team yielded much information about diseases of the ancient past. Major contributions were made by the disciplines of anatomy, dentistry, genetics, hematology, histology, microbiology, nuclear medicine, occupational medicine, orthopedic surgery, otolaryngology, pathology, pediatrics, plastic surgery, radiology and virology. Scientists from Toronto, Detroit, Philadelphia and Cardiff participated in the investigatio...

  15. 42 CFR 35.16 - Autopsies and other post-mortem operations.

    Science.gov (United States)

    2010-10-01

    ... Autopsies, or other post-mortem operations...autopsy or such other post-mortem operation under...circumstances of the particular death involved. Restrictions...of the autopsy or other post-mortem operation shall...be made a part of the clinical record. [25 FR...

  16. Forensic autopsy costs in the city of São Paulo

    Scientific Electronic Library Online (English)

    Fernando Augusto Mardiros, Herbella; Pedro Herbella, Fernandes; Carlos, Delmonte; José Carlos, Del Grande.

    Full Text Available CONTEXTO: A medicina moderna preocupa-se com análise de custos para os procedimentos diagnósticos e terapêuticos, não havendo trabalhos pertinentes a autópsias em nosso meio. OBJETIVO: Avaliar os custos diretos de uma necropsia forense. TIPO DE ESTUDO: Análise de custos. LOCAL: Instituto Médico Lega [...] l Sede de São Paulo. AMOSTRA: Movimento do ano de 2001. PROCEDIMENTOS: Autópsias forenses de rotina. VARIÁVEIS ESTUDADAS: Análise de despesas com recursos humanos e material consumível na realização de necropsias forenses. RESULTADOS: Os custos com recursos humanos corresponderam a US$ 93,46 ou 90,38% dos custos totais, cabendo às despesas materiais US$ 9,95 ou 9,62%. O custo total foi estimado em US$ 103,41 por procedimento. CONCLUSÕES: O exame necroscópico forense apresenta alto custo para o Estado devendo haver critério nos casos a serem necropsiados, corrigindo-se os custos de acordo com o volume de necropsias. Nossos resultados são semelhantes aos de trabalhos internacionais se os dados forem reorganizados com base no número anual de necropsias. Abstract in english CONTEXT: Modern medical practice involves cost analysis of therapeutic and diagnostic procedures. There are no papers dealing with this theme in relation to forensic autopsies in our country. OBJECTIVE: Analysis of direct costs of forensic autopsies. TYPE OF STUDY: Cost analysis. SETTING: São Paulo [...] Medical Examiner's Central Office. SAMPLE: Year 2001 activity. PROCEDURES: Routine forensic autopsies. MEAN MEASUREMENTS: Analysis of direct costs of personnel and material. RESULTS: Cost of personnel represents 90.38% or US$ 93.46. Material expenses comprised 9.62% or US$ 9.95. Total costs were calculated to be US$ 103.41. CONCLUSIONS: Forensic autopsies have a high cost. Cases to be autopsied should be judiciously selected. Our results are similar to international studies if data are rearranged based on the number of annual necropsies.

  17. The medical autopsy as quality assurance tool in clinical medicine: dreams and realities.

    Science.gov (United States)

    van den Tweel, Jan G; Wittekind, Christian

    2016-01-01

    The purpose of medical autopsy has changed to issues of quality assurance today. In addition, autopsies are considered valuable in medical education, e.g., delivering cases for problem-based learning for students. Many studies underscore the need for autopsies also in the era of technical progress emphasizing the continuing discrepancies between antemortem and post mortem diagnoses. Despite these important tasks, we face a decline of autopsy for several reasons with complex interactions. The role of all persons involved in this decline is evaluated and suggestions for changes are proposed. Last but not least, the future of the autopsy is in the hands of pathology itself. PMID:26316183

  18. Radioisotopes in tissues of patients studied at autopsy

    International Nuclear Information System (INIS)

    Following 67Ga scanning, a high dose of radioactivity was found in a gastric adenocarcinoma at autopsy. The amount of radioactivity in the adrenal glands, spleen, and bone marrow was also high. It was estimated that the pathologist received a whole-body dose of 100 to 200 mR which is considered to be an unacceptable risk. It is emphasized that medical personnel should be aware of patients who have had recent radionuclide scans

  19. Verbal Autopsy Methods with Multiple Causes of Death

    OpenAIRE

    King, Gary; Lu, Ying

    2008-01-01

    Verbal autopsy procedures are widely used for estimating cause-specific mortality in areas without medical death certification. Data on symptoms reported by caregivers along with the cause of death are collected from a medical facility, and the cause-of-death distribution is estimated in the population where only symptom data are available. Current approaches analyze only one cause at a time, involve assumptions judged difficult or impossible to satisfy, and require expensiv...

  20. Probabilistic Cause-of-death Assignment using Verbal Autopsies

    OpenAIRE

    McCormick, Tyler H.; Li, Zehang; Calvert, Clara; Crampin, Amelia C.; KAHN, KATHLEEN; Clark, Samuel J.

    2014-01-01

    In regions without complete-coverage civil registration and vital statistics systems there is uncertainty about even the most basic demographic indicators. In such areas the majority of deaths occur outside hospitals and are not recorded. Worldwide, fewer than one-third of deaths are assigned a cause, with the least information available from the most impoverished nations. In populations like this, verbal autopsy (VA) is a commonly used tool to assess cause of death and esti...

  1. Foetal Autopsy-Categories and Causes of Death

    OpenAIRE

    Fatima, Uroos; Sherwani, Rana; Khan, Tamkin; Zaheer, Sufian

    2014-01-01

    Introduction: Intrauterine death(IUD)/ Stillbirth forms a major part of perinatal mortality which thereby is a good indicator of pregnancy wastage as well as quality of healthcare available. The key objectives of autopsy examination are to know the cause(s) of death, elucidation of pathogenic mechanism and quality control of clinical management. The aim of this study was to identify the prevalent causes of IUD, thereby taking appropriate measures to prevent them and decrease the perinatal mor...

  2. Risk factors for suicide in Bali: a psychological autopsy study

    OpenAIRE

    Reverger Robert; Kato Motoichiro; Kurihara Toshiyuki; Tirta I Gusti

    2009-01-01

    Abstract Background The suicide rate in Bali has significantly increased in recent years. However, to date, there have been no case-control studies investigating risk factors for suicide. Methods A psychological autopsy study was conducted comparing 60 suicide cases and 120 living controls matched in age, sex, and area of residence. Results Multiple logistic regression analysis identified the following risk factors for suicide: at least one diagnosis of axis-I mental disorder (OR: 14.84 CI: 6...

  3. Clinicopathologic Findings of Hematological Malignancy: a Retrospective Autopsy Study.

    Science.gov (United States)

    Dierksen, Jennifer; Buja, L Maximilian; Chen, Lei

    2015-09-01

    Hematological malignancies exhibit many clinical presentations, from ambiguous systemic symptoms to rapid multi-organ failure. By identifying common clinical, laboratory, and autopsy findings in patients with a hematological malignancy, living patients may be diagnosed and treated earlier. We retrospectively reviewed our institution's 2003-2013 autopsy and respective medical records for patients with a hematological malignancy. Clinical, laboratory and autopsy findings were retrieved. 30 patients with hematological malignancy were identified, including 14 "new" cases, defined here as diagnosed either post-mortem (n=6) or within 4 weeks of death (n=8). 16 patients had a known prior diagnosis of greater than 4 weeks and/or received treatment. "New" patients most frequently presented with pain, dyspnea and gastrointestinal symptoms. Common laboratory findings for new lymphoma patients included elevated aspartate aminotransferase, prothrombin time (PT), lactate dehydrogenase (LDH), lactic acidosis, and cytopenia. New leukemia patients had peripheral smear findings, thrombocytopenia, elevated PT, lactic acidosis and elevated LDH. Patients with a prior diagnosis of hematological malignancy had similar findings to new patients with increased thrombocytopenia in prior lymphoma cases. Immediate causes of death were most frequently multi-organ failure through malignant organ infiltration and/or septic shock. With an increased awareness of hematological malignancy in a differential diagnosis, a timely diagnosis or clinical interventions can eventually save lives. PMID:26586710

  4. Suicides among Serbian war veterans: An autopsy study

    Directory of Open Access Journals (Sweden)

    Mihailovi? Zoran

    2015-01-01

    Full Text Available Introduction. The risk of suicide among war veterans is a controversial issue, where findings so far have been contradictory. Objective. This study focusses on suicide in Serbian veterans from the wars in former Yugoslavia in the 1990s in order to create appropriate preventive measures and reduce the number of these fatal cases. Methods. The autopsy protocols of all 44 suicides committed by war veterans in the Belgrade District population over a period between 1992 and 2000 were investigated. Data were obtained from autopsy records, results of toxicological investigations and psychological autopsy protocols. Results. Symptoms of posttraumatic stress disorder were present in 27.3%, major depression in 9.1% and schizophrenia in 6.8% of veterans. The majority of suicides (84.1% were committed by recruits in the Yugoslav National Army, spending between three and eight months in the zone of war operations. Six committed suicide during the first 30 days after their war activities, while the majority of suicides occurred between five and six years after combat. The most frequent manner of suicide was the use of handguns (56.8% and bombs (18.2%. Conclusion. The results of this research may give useful information about the individuals with the highest suicidal risk in order to alleviate the consequences of war psychotraumas in veterans and prevent their growth into a permanent handicap or suicide. [Projekat Ministarstva nauke Republike Srbije, br. OI 175093

  5. An autopsy study describing causes of death and comparing clinico-pathological findings among hospitalized patients in Kampala, Uganda

    OpenAIRE

    Cox, J. A.; Lukande, R. L.; Nelson, A. M.; Mayanja-Kizza, H; Colebunders, R; van Marck, E; Manabe, Y. C.

    2012-01-01

    BACKGROUND: Information on causes of death in HIV-infected patients in Sub-Saharan Africa is mainly derived from observational cohort and verbal autopsy studies. Autopsy is the gold standard to ascertain cause of death. We conducted an autopsy study to describe and compare the clinical and autopsy causes of death and contributory findings in hospitalized HIV-infected and HIV-uninfected patients in Uganda. METHODS: Between May and September 2009 a complete autopsy was performed on patients tha...

  6. Study of various congenital anomalies in fetal and neonatal autopsy

    Directory of Open Access Journals (Sweden)

    V. Siva Sankara Naik

    2015-05-01

    Full Text Available Background: The study of dead is to save the livings. The growing awareness that still births and infant mortalities are unable to reduction has led to a wide spread desire for more information regarding the cause of these deaths. Congenital malformations have become important cause of fetal and neonatal (perinatal mortality in developed countries and would very soon be increasingly important determinants of fetal and neonatal mortality in developing countries like India. In spite of antenatal diagnostic modality still the fetal autopsy plays the vital role in the conformation as well as identification of congenital anomalies and also for the counseling of the parents, to prevent the fetal congenital anomalies in further pregnancies. This study was undertaken with the purpose of finding out cause of death during the perinatal period at government maternity hospital and pediatric department S.V.R.R.G.G.H. and S.V. medical college Tirupati, and to study the clinical and pathological findings (Gross and microscopic in fetal and neonatal death. Methods: The present study of congenital anomalies in fetal and neonatal deaths was done at S.V. medical college, Tirupati, over a time period of 2 years from September 2008 to 2010 August. Consent for autopsy in requested compassionately, respectfully and fully informed. The present study included dead fetus and neonates with gestational age above 20 weeks of intra uterine life and within 7 days of post natal life. All fetuses of gestational age <20 weeks and all neonates above 7 days of age were excluded from the study. The study also obtained clearance from the ethical committee of the institution. Autopsy was performed by standard technique adopted by Edith L. Potter. External and internal findings followed by histopathological examination, and autopsy findings were compared with available ultrasound findings. Results: A total of 46 Autopsies performed, 40 (87% were fetal deaths, 6 (13% were early neonatal deaths. In a total of 46 fetuses, there were 13 male and 33 female babies. On external examination of 46 fetal and Neonatal (perinatal deaths, 8 (17.39% babies showed congenital malformation. On internal examination of the 46 fetal and Neonatal (perinatal deaths, 4 babies showed internal congenital anomalies. A total of 46 anatomical and histopathologic examinations were done among fetal and neonatal (perinatal deaths. Out of 13 autopsies on male babies, 2 had congenital malformation and 33 autopsies on female babies, 7 had congenital malformations. Congenital anomalies were commonest in the birth weight group of 1000-1500 grams accounting for 9 cases. Malformations of central nervous system (33.33% were most common followed by musculoskeletal system (16.66%, genitourinary and respiratory system (8.33% respectively. Conclusion: Most number of perinatal deaths occurred in low birth weight and preterm babies. Study of malformations greatly helpful in genetic counseling and prenatal diagnosis in successive pregnancies. [Int J Res Med Sci 2015; 3(5.000: 1114-1121

  7. Autopsy practice in forensic pathology - Evidence-based or experience-based?

    DEFF Research Database (Denmark)

    Colville-Ebeling, Bonnie; Freeman, Michael; Banner, Jytte; Lynnerup, Niels

    2014-01-01

    Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case...... reliance on experience and individual customary practices led to disparities between the autopsy reports as well as omissions of important information such as cardinal signs, and conclude that such reliance increases the potential for error in autopsy practice. We suggest that pre-autopsy data......-gathering and the use of check lists specific to certain injury causes are likely to result in less deviation from evidence-based practices in forensic pathology. Pre-autopsy data-gathering and check lists will help ensure a higher degree of standardization in autopsy reports thus enhancing the quality and...

  8. An exploratory study of the pattern of consent for autopsy in a regional hospital setting.

    LENUS (Irish Health Repository)

    Kaar, T K

    2012-02-03

    A prospective study of the pattern of responses to requests for autopsy in a general surgical unit was performed. Information on the characteristics of the deceased, of the requestee and of the requester was documented in the case of 66 patients who died while in hospital. Permission to perform autopsy was not requested in 39 out of 66 cases and this was the most frequent contributory factor to the low rate of autopsy. Once a decision to grant or refuse autopsy is made by relatives of the deceased, the decision is unlikely to be reversed. Permission to perform autopsy was more likely to be sought when the deceased was male than when deceased was female. The relatives of patients who had recently undergone surgery were more likely to refuse permission for autopsy than were those of patients who had not had recent surgery.

  9. Primary diffuse leptomeningeal gliomatosis: An autopsy case report

    Directory of Open Access Journals (Sweden)

    Shaik Afshan Jabeen

    2014-01-01

    Full Text Available Primary diffuse leptomeningeal gliomatosis (PDLG is a rare condition, characterized by infiltration of the meninges by glial cells without evidence of the primary tumor in the brain or spinal cord parenchyma. Glioma arising primarily from the leptomeninges is extremely rare and often diagnosed only in post mortem examination and the diagnosis may be missed in meningeal biopsy. We describe a young female who presented with symptoms of raised intracranial pressure with imaging evidence of diffuse leptomeningeal enhancement in whom autopsy confirmed the diagnosis of PDLG. Our case illustrates the diagnostic difficulties in making the pre-mortem diagnosis even with multiple cerebrospinal fluid cytologies and leptomeningeal biopsy.

  10. Bone-dust in autopsies: reduction of spreading.

    Science.gov (United States)

    Kernbach-Wighton, G; Kuhlencord, A; Rossbach, K; Fischer, G

    1996-12-01

    During autopsies, an open oscillating saw produces large quantities of respirable bone-dust, which is able to carry microbes over several metres. Experiments were done using a modified (open) undulation saw (spray tube to moisten the saw-blade with water). Saw-dust was asservated with culture media. Colonies were identified macroscopically. Microbes in the air were quantified (per unit of time). A remarkable reduction of saw-dust is done by an integrated spray tube using water. There remains a contamination at the head of the autopsy table in the level of the table top. We found a complete decontamination 150 cm above the floor. No spreading of particles carrying microbes was seen over distances of more than 1.5 m. The risk of an airborne infection is minimal when using a manual saw (absence of grinding-dust). The modified type of an 'oscillating saw with a spray-tube' may be considered a practicable compromise between a manual saw and an unprotected undulation saw. It is necessary to complete the precautions against airborne infections by breath masks and safety-goggles. PMID:9022272

  11. Investigations into distribution of lidocaine in human autopsy material.

    Science.gov (United States)

    Oertel, Reinhard; Arenz, Norman; Zeitz, Sten Gunnar; Pietsch, Jörg

    2015-08-01

    With screening methods in the legal medicine drugs were often detected in autopsy material. In this study the antiarrhythmic and the local anesthetic drug lidocaine could be proved in fifty-one cases and determined in different autopsy materials. For the first time the comparison of so many distribution patterns of lidocaine in human compartments was possible. A liquid-liquid extraction procedure, a standard addition method and LC/MS/MS were used for analytics. The measured concentrations in blood were in the therapeutic range or lower. The time between lidocaine application and death was given in twenty-nine cases. These data were very helpful to estimate and interpret the distribution process of lidocaine between application and death. This time exerted a crucial influence on the distribution of lidocaine in the compartments. Most of the intravenous applicated lidocaine was found in heart blood after a very short time of distribution. Afterwards the highest concentrations were measured in brain. Later the highest concentration was found in the kidney samples or in urine. If the time between lidocaine application and death is known, the results of this study can be used to deepen the knowledge of its pharmacokinetics. If this time is unknown, the circumstances and the causes of death can be better explained. PMID:25619956

  12. Anatomical Findings in Patients with Infective Endocarditis Diagnosed at Autopsy

    Directory of Open Access Journals (Sweden)

    Miguel Angel Serra Valdés

    2013-12-01

    Full Text Available Background: Infective endocarditis continues to challenge modern medicine despite its rare occurrence in the general population. Its incidence depends on risk groups. Correlation of anatomical and pathological findings with clinical and epidemiological elements may explain the current features of this condition. Objective: to describe the anatomical features of patients with infective endocarditis diagnosed at autopsy. Methods: A descriptive study including cases of infective endocarditis diagnosed at autopsy between 1986 and 2008 was conducted in the Provincial Clinical-Surgical Hospital Celia Sanchez, Granma. The variables analyzed were: age, sex, previous anatomical lesions, location of vegetations, multi-organ embolic infarcts and embolic abscesses, complications, culture of lesions and direct causes of death. Results: frequency of infective endocarditis diagnosed at necropsy ranged annually from 0.4 to 1.5%. Native valve endocarditis without previous damage was the most frequent. The anatomical findings were more common in the left side of the heart. Right-sided nosocomial endocarditis accounted for almost a third of the deceased patients and risk factors were identified. Embolic lesions affecting various organs, systemic complications and direct causes of death showed acute infectious endocarditis. The most common pathogen was Staphylococcus aureus. Conclusion: knowing the anatomical findings may contribute to the understanding of the clinical and epidemiological aspects of this condition. Correlation between anatomical and clinical findings was low; therefore difficulties in establishing the diagnosis during life are inferred.

  13. An autopsy case of fatal repellent air freshener poisoning.

    Science.gov (United States)

    Hitosugi, Masahito; Tsukada, Chie; Yamauchi, Shinobu; Matsushima, Kazumi; Furukawa, Satoshi; Morita, Satomu; Nagai, Toshiaki

    2015-09-01

    We describe a first fatal case of repellent air freshener ingestion. A 79-year-old Japanese man with Alzheimer-type senile dementia orally ingested repellent air freshener containing three surfactants: polyoxyethylene 9-lauryl ether, polyoxyethylene (40) hydrogenated castor oil, and lauric acid amidopropyl amine oxide (weight ratio of 1.3%). About 1h after the collapse, he was in cardiopulmonary arrest and subsequently died 10h after his arrival. The forensic autopsy performed 5.5h after death revealed the 380ml of stomach contents with a strong mint perfume identical to that of the repellent air freshener and the findings of acute death. Toxicologically, 9.1?g/ml and 558.2?g/ml of polyoxyethylene 9-lauryl ether were detected from the serum and stomach contents taken at autopsy. Generally, ingestion of anionic or non-ionic surfactants have been considered as safe. However, because the patient suffered from cardiac insufficiency with a low dose of repellent air freshener ingestion, medical staff members must evaluate the elderly patient for cardiac and circulatory problems regardless of the ingested dose. Not only medical and nursing staff members, but also families who are obliged to care for elderly persons must be vigilant to prevent accidental ingestion of toxic substances generally used in the household. PMID:25982958

  14. An autopsy case of pulmonary fissure induced by zygomycosis.

    Science.gov (United States)

    Imai, Yuichiro; Adachi, Yasushi; Kimura, Takashi; Nakano, Chikara; Shimizu, Toshiki; Shi, Ming; Okigaki, Mitsuhiko; Shimo, Tomohiko; Kaneko, Kazunari; Ikehara, Susumu

    2013-01-01

    For immunodeficient patients, fungi are life-threatening pathogens. In this paper, we present an autopsy case of combined zygomycosis and aspergillosis. A female in her 70s on chronic hemodialysis was admitted to a hospital suffering bloody sputum, dyspnea, and fever, probably due to perinuclear anti-neutrophil cytoplasmic antibody-related vasculitis. Antibiotics were administered and immunosuppressive therapy was started, resulting in an improvement in her condition. Pneumonia later developed, followed by pulmonary bleeding and intractable pneumothorax from which she ultimately died. On autopsy, the upper lobe of the left lung was found to have hemorrhagic necrosis and showed a large longitudinal fissure. Microscopically, Zygomycota were observed in both the lungs and heart, while Aspergillus was found in the middle lobe of the right lung. Zygomycosis, which usually has a poor prognosis, is assumed to have induced hemorrhagic infarction of the lungs, inducing pulmonary bleeding and necrosis, despite the use of lipid formulations of amphotericin B, which are effective medicines against Zygomycota. PMID:23874118

  15. [An Autopsy Case of Abnormal Behaviour Induced by Zolpidem].

    Science.gov (United States)

    Usumoto, Yosuke; Kudo, Keiko; Sameshima, Naomi; Sato, Kazuo; Tsuji, Akiko; Ikeda, Noriaki

    2015-06-01

    Zolpidem is a widely used ultrashort-acting non-benzodiazepine in clinical practice; compared with benzodiazepines, it does not have side effects such as daytime hangover, rebound insomnia, and development of tolerance. We report an autopsy case of abnormal behaviour induced by zolpidem. A man in his 60's had suffered from postherpetic neuralgia about 2 months ago and had been prescribed zolpidem for insomnia. According to his family, he had no memory of his actions such as striking a wall, taking his futon outside, and eating 5 times a day after he took zolpidem. Because his postherpetic neuralgia did not improve, he was hospitalized and treated with an epidural block. During hospitalization, he took off his clothes, removed the epidural block catheter by himself, and slept on others' beds. He disappeared from the hospital one day; the next day, he was found dead in a narrow water storage tank 10 km away from the hospital. He was thought to have driven a car by himself to reach the place. Forensic autopsy revealed that the cause of death was drowning. Zolpidem and several other drugs were detected by toxicological analysis of his blood; the concentrations of these drugs were within therapeutic range. There are several reports about somnambulism induced by zolpidem such as sleepwalking, sleep driving, and eating. Considering the strange episodes following zolpidem administration, his behaviour on the day of his death was considered abnormal behaviour induced by zolpidem. PMID:26306385

  16. The importance of autopsy examination in major disasters.

    Science.gov (United States)

    Mason, J K

    1984-01-01

    It is appreciated that there are national and jurisdictional variations in regard to post-mortem dissections following accidental death. The purpose of this paper is to plead that, since there will be nationals of many states involved in an aircraft disaster, there should be a uniform system of forensic investigation on a world wide basis. The justification for this recommendation is illustrated through the investigation of accident causes and through the solution of the many problems relating to the settlement of probate which arise in accidental death. The causes of accidents which may be discovered by autopsy include crew incapacitation and criminality of all types. The emergency status may also be revealed and the type of accident, particularly whether in a controlled or uncontrolled phase, may become clear. The medico-legal problems to be resolved include those concerning payment of insurance policies, including the degree of life expectancy, and especially the disposal of estates when members of a family apparently die together. The resulting payments to beneficiaries may be quite different depending on the quality of the autopsy. These investigations are complementary to, and do not interfere with, the identification process but they are time consuming and expensive. PMID:6517499

  17. An Autopsy of Nanofiltration Membrane Used for Landfill Leachate Treatment

    Science.gov (United States)

    Demir, Ibrahim; Koyuncu, Ismail; Guclu, Serkan; Yildiz, Senol; Balahorli, Vahit; Caglar, Suphi; Turken, Turker; Pasaoglu, Mehmet E.; Kaya, Recep; Sengur-Tasdemir, Reyhan

    2015-01-01

    Komurcuoda leachate treatment plant, Istanbul, which consists of membrane bioreactor (MBR) and nanofiltration (NF) system, faced rapid flux decline in membranes after 3-year successful operation. To compensate rapid flux decline in membranes, the fouled membranes were renewed but replacement of the membranes did not solve the problem. To find the reasons and make a comprehensive analysis, membrane autopsy was performed. Visual and physical inspection of the modules and some instrumental analysis were conducted for membrane autopsy. Membranes were found severely fouled with organic and inorganic foulants. Main foulant was iron which was deposited on surface. The main reason was found to be the changing of aerator type of MBR. When surface aerators were exchanged with bottom diffusers which led to increasing of dissolved oxygen (DO) level of the basin, iron particles were oxidized and they converted into particulate insoluble form. It was thought that probably this insoluble form of the iron particles was the main cause of decreased membrane performance. After the diagnosis, a new pretreatment alternative including a new iron antiscalant was suggested and system performance has been recovered. PMID:26137593

  18. Autopsy practice in forensic pathology - Evidence-based or experience-based? : A review of autopsies performed on victims of traumatic asphyxia in a mass disaster

    DEFF Research Database (Denmark)

    Colville-Ebeling, Bonnie; Freeman, Michael

    2014-01-01

    Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case series, we describe the variation observed in autopsy reports by five different pathologists of eight victims who died simultaneously from traumatic asphyxia due to compression during a human stampede. We observed that there was no mention of the availability of medical charts in five of the reports, of potentially confounding resuscitation efforts in three reports, of cardinal signs in seven reports and of associated injuries to a various degree in all reports. Further, there was mention of supplemental histological examination in two reports and of pre-autopsy radiograph in six reports. We inferred that reliance on experience and individual customary practices led to disparities between the autopsy reports as well as omissions of important information such as cardinal signs, and conclude that such reliance increases the potential for error in autopsy practice. We suggest that pre-autopsy data-gathering and the use of check lists specific to certain injury causes are likely to result in less deviation from evidence-based practices in forensic pathology. Pre-autopsy data-gathering and check lists will help ensure a higher degree of standardization in autopsy reports thus enhancing the quality and accuracy of the report as a legal document as well as rendering it more useful for data-gathering efforts.

  19. Correlation between prenatal diagnosis by ultrasound and fetal autopsy findings in second-trimester abortions

    DEFF Research Database (Denmark)

    Hauerberg, Laura; Skibsted, Lillian

    2012-01-01

    We evaluated the correlation between prenatal diagnosis by ultrasound and autopsy findings, based on 52 second-trimester pregnancies terminated due to fetal malformations or chromosome aberrations diagnosed at a gestational age of 12-25 weeks. In 24 pregnancies, there was full agreement between ultrasound and autopsy. In 23 fetuses, the main diagnosis was confirmed and additional or more specific findings were observed on autopsy. In five fetuses, there were considerable differences. Discrepancies between ultrasound and autopsy findings were mainly anomalies undetectable by ultrasound and thus expected; however, about one-third of the discrepancies were not expected, representing findings that were 'missed' at ultrasound. The main ultrasound diagnoses were confirmed in the majority of the pregnancies, but the additional information obtained at autopsy in more than half of the fetuses clearly shows the value and benefit of postmortem fetal examination following termination of a pregnancy.

  20. Autopsy rate in suicide is low among elderly in Denmark compared with Finland

    DEFF Research Database (Denmark)

    Ylijoki-Sørensen, Seija; Boel, Lene Warner Thorup; Boldsen, Jesper Lier; Bøggild, Henrik; Lalu, Kaisa; Sajantila, Annti

    2014-01-01

    National differences in the legislation on cause and manner of death investigation are reflected in a high autopsy rate in suicides in Finland and a low corresponding rate in Denmark. The consequences for mortality statistics of these different investigation practices on deaths classified as...... suicides in Denmark and Finland, respectively, are not known in detail. The aim of this article was to analyse autopsy rates in deaths classified as suicides, and to identify any differences in investigation practices in deaths with a comparable cause of death, but classified as unnatural deaths other than...... suicides was 99.8% in Finland and 13.2% in Denmark. Almost all of these autopsies were conducted as forensic autopsies. In the age group ?71 years, Danish suicides outnumbered Finnish suicides (410 versus 283). The total autopsy rate was lower in the more senior age group in Denmark (19.5%, 9.9%, 5...

  1. Correlated study of cerebral infarcts by CAT and autopsy

    International Nuclear Information System (INIS)

    The author aims to demonstrate the increased information which can be acquired from a correlated study of the computed tomogram and the pathomorphological patterns of the most common infarctions seen at autopsy. The discussion is divided into two sections: 1. A short bird's-eye view on the laws of distribution of flow in cases of cerebrovascular insufficiency, particularly all the deviations from simple hemodynamics in the process of infarction. 2. A systematic demonstration of the most frequent CT-patterns correlated with the corresponding pathomorphological specimens. This report is based on 6500 cerebral CTs, from which 590, i.e. 9%, showed infarcts. These include mainly cases seen in the neurological ward of the Merheim City Hospital. (Auth.)

  2. Rapidly aggravated Creutzfeldt-Jacob disease: autopsy-proven case

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seung Hyun; Kang, Hyun Koo; Yu, Hyeon; Lee, Sang Chun [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2005-11-15

    Creutzfeldt-Jakob disease (DJD) is one of the transmissible spongiform encephalopathies, which is mediated by what has been known as 'prion'. It is a rare and fatal progressive neurodegenerative disease that affects the middle and old aged. There are a number of subtypes of CJD, one of which is the sporadic type characterized by rapidly progressing clinical symptoms, including progressive dementia, myoclonic jerk, and pyramidal or extrapyramidal syndrome. Patients usually end up dying within 1 to 2 years of contacting the disease. We report an autopsy-proven case of sporadic CJD with clinical symptoms that progressed within several days, along with dramatic changes on diffusion weighted magnetic resonance images.

  3. Aflatoxins in autopsy kidney specimens from children in Nigeria.

    Science.gov (United States)

    Oyelami, O A; Maxwell, S M; Adelusola, K A; Aladekoma, T A; Oyelese, A O

    1998-11-13

    Autopsy kidney specimens from 24 children with kwashiorkor and 21 with other miscellaneous diseases, at the Obafemi Awolowo Teaching Hospital Complex, Ile-Ife, Nigeria, were analyzed for the presence of aflatoxins using high-performance liquid chromatography. Aflatoxins were detected in 14 children who died of kwashiorkor and in 13 of those who died from miscellaneous diseases. Aflatoxicol was detected in 10 specimens, 7 of which had severe gastroenteritis. Seven kidney specimens demonstrated the presence of more than one type of aflatoxin; four of these were kidneys of patients with kwashiorkor and the remaining three died from renal failure. No difference was found between the frequency of detection, type of aflatoxin detected, or mean concentrations of total aflatoxins in the kidney specimens of the kwashiorkor children when compared to the kidney specimens of children who died from miscellaneous diseases. These findings demonstrate that aflatoxins can be detected in the kidneys of children exposed to aflatoxins. PMID:9829555

  4. Autopsy pathology in the acquired immune deficiency syndrome.

    Science.gov (United States)

    Reichert, C M; O'Leary, T J; Levens, D L; Simrell, C R; Macher, A M

    1983-09-01

    The acquired immune deficiency syndrome (AIDS) is a devastating new illness which appears to be sexually and parenterally transmissible. AIDS was first described in the male homosexual community; however, the disease has more recently been described among intravenous drug abusers, Haitians, hemophiliacs, and others. The etiologic agent is unknown. AIDS may represent an infection by a previously undescribed organism, a mutant of a known microorganism, or a multifactorial combination of environmental, immunologic, and genetic factors. As a consequence of the disease's seemingly irreversible ablation of the cell-mediated immune system, AIDS victims succumb to a variety of infections and/or unusual neoplasms. In its fully developed form, mortality approaches 100%. At autopsy the gross and microscopic pathology of the syndrome can be divided into three general categories: 1) morphologic manifestations of profound lymphoid depletion; 2) infections, usually with mixed opportunistic pathogens; and 3) unusual neoplasms, most frequently Kaposi's sarcoma or high-grade lymphomas. PMID:6311021

  5. An autopsy case of pulmonary fissure induced by zygomycosis

    Directory of Open Access Journals (Sweden)

    Imai Y

    2013-07-01

    Full Text Available Yuichiro Imai,1 Yasushi Adachi,2,3 Takashi Kimura,4 Chikara Nakano,5 Toshiki Shimizu,4 Ming Shi,2 Mitsuhiko Okigaki,6 Tomohiko Shimo,1 Kazunari Kaneko,1 Susumu Ikehara2 1Department of Pediatrics, Kansai Medical University, Osaka, 2Department of Stem Cell Disorders, Kansai Medical University, Osaka, 3Division of Clinical Pathology, Toyooka Hospital, Hyogo, 4First Department of Internal Medicine, Kansai Medical University, Osaka, 5Second Department of Internal Medicine, Kansai Medical University, Osaka, 6Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto, Japan Abstract: For immunodeficient patients, fungi are life-threatening pathogens. In this paper, we present an autopsy case of combined zygomycosis and aspergillosis. A female in her 70s on chronic hemodialysis was admitted to a hospital suffering bloody sputum, dyspnea, and fever, probably due to perinuclear anti-neutrophil cytoplasmic antibody-related vasculitis. Antibiotics were administered and immunosuppressive therapy was started, resulting in an improvement in her condition. Pneumonia later developed, followed by pulmonary bleeding and intractable pneumothorax from which she ultimately died. On autopsy, the upper lobe of the left lung was found to have hemorrhagic necrosis and showed a large longitudinal fissure. Microscopically, Zygomycota were observed in both the lungs and heart, while Aspergillus was found in the middle lobe of the right lung. Zygomycosis, which usually has a poor prognosis, is assumed to have induced hemorrhagic infarction of the lungs, inducing pulmonary bleeding and necrosis, despite the use of lipid formulations of amphotericin B, which are effective medicines against Zygomycota. Keywords: pulmonary fissure, zygomycosis, aspergillosis, lung, immunosuppression

  6. Statistical analysis and dosimetry of Japanese Thorotrast-administered autopsy cases -1983-

    International Nuclear Information System (INIS)

    In 270 Throtrast-administered autopsy cases reported in Japan during the 1945-1983 period, 267 had been injected with Thorotrast intravascularly and the remaining 3 had been given by other routes, such as pyelography, etc. Of the 267 intravascularly Thorotrast-administered autopsy cases, 180 were malignant hepatic tumors, 20 liver cirrhosis, 16 leukemias, 5 aplastic anemias, 5 lung cancers, 3 sarcomas of Thorotrast injected site, 2 mesotheliomas, 1 hemangioendothelioma of the spleen, 1 malignant lymphoma, and 1 osteosarcoma. The dosimetry of 96 intravascularly Thorotrast-administered autopsy cases was performed for an estimate of the absorbed dose of critical organs, such as the liver, spleen, and bone marrow. (author)

  7. Utility of Postmortem Autopsy via Whole-Body Imaging: Initial Observations Comparing MDCT and 3.0T MRI Findings with Autopsy Findings

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Jang Gyu; Kim, Dong Hun; Paik, Sang Hyun [National Institute of Scientific Investigation, Seoul (Korea, Republic of)

    2010-08-15

    We prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings. Five cadavers were subjected to whole-body, 16- channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings. Most of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises. A postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations

  8. Chronic radium intoxication: clinical and autopsy findings in long-term New Jersey survivors

    International Nuclear Information System (INIS)

    Several cases of chronic radium intoxication are presented. The cases include clinical, radiological, and autopsy findings. All of the cases are characterized as long-term survivors. Case material is derived from New Jersey medical records

  9. Core Verbal Autopsy Procedures with Comparative Validation Results from Two Countries

    OpenAIRE

    Setel, Philip W; Rao, Chalapati; Hemed, Yusuf; Whiting, David R; Yang, Gonghuan; Chandramohan, Daniel; Alberti, K. G. M. M.; Lopez, Alan D

    2006-01-01

    A procedure for recording verbal autopsy information was tested in two countries and found to be capable of providing reasonable mortality data. The need to undertake validation studies was also demonstrated.

  10. An autopsy case with malignant liver tumor caused by thorotrast

    International Nuclear Information System (INIS)

    This paper reported the roentgenographic, laparoscopic and autopsy findings of a patient with thorotrast liver complicated with malignant liver tumor, which was considered to develop 35 years after the infusion of thorotrast. Laboratory findings of a 67-year-old man, who got a war wound before 35 years and received angiography by using thorotrast at that time, indicated marked symptoms of liver parenchymal disturbance, biliary occlusion and malignant liver tumor. X-ray examination revealed arborescent and reticular abnormal shadow in the liver and the spleen and spotted shadow at the liver hilus. Laparoscopic findings revealed reticulate grayish-yellow particles adhered to the recessus of the nodules in the surface of the liver. Liver biopsy showed deposition of thorotrast granules and necrosis and scar formation of the hepatic cells. Microautoradiography revealed ?-track from the region where thorotrast was deposited. Postmortem findings revealed thorotrast liver cirrhosis, primary liver tumor (reticulo-endothelial sarcoma), circular calcium deposit in the hepatic duct, the bile duct and the portal vein, and cholangitis, demonstrating delayed disturbance by thorotrast. (Kanao, N.)

  11. Cause of death among Ghanaian adolescents in Accra using autopsy data

    OpenAIRE

    Tettey Yao; Ohene Sally-Ann; Kumoji Robert

    2011-01-01

    Abstract Background There is limited data on adolescent mortality particularly from developing countries with unreliable death registration systems. This calls for the use of other sources of data to ascertain cause of adolescent mortality. The objective of this study was to describe the causes of death among Ghanaian adolescents 10 to 19 years in Accra, Ghana utilizing data from autopsies conducted in Korle Bu Teaching Hospital (KBTH). Findings Out of the 14,034 autopsies carried out from 20...

  12. Academic autopsies in Brazil - a national survey / Autópsias acadêmicas no Brasil - um inquérito nacional

    Scientific Electronic Library Online (English)

    Aloísio, Felipe-Silva; Márcia, Ishigai; Thaís, Mauad.

    Full Text Available Objetivo: Investigar o número e a taxa de autópsias acadêmicas, organização geral, ensino e pesquisa em serviços acadêmicos brasileiros. Métodos: Questionários padronizados enviados para escolas médicas brasileiras (n=177) e programas de residência em patologia ativos (n=53) de março a junho d [...] e 2009. Dados coletados referentes ao período de 2003 a 2008. Resultados: Trinta e dois serviços em 11 estados responderam à pesquisa. Vinte e um (65,6%) realizam menos de cem autópsias de causas naturais e menos de cinquenta autópsias fetais ou pediátricas/ano. Vinte e quatro (75%) realizam menos de cem autópsias de adultos/ano. Muitas instituições (46,9%) relataram queda no número de autópsias em seis anos. A contagem total e a taxa de autópsias em 2008 variaram, respectivamente, de 1 a 632 (mediana=80) e de 0 a 66% (média=10,6%). Foi observada uma redução contínua no total de autópsias em um grupo de 19 instituições (p Abstract in english Objective: To investigate the number and rate of academic autopsies, general organization, educational and research in Brazilian academic services. Methods: Standardized questionnaires were sent to Brazilian medical schools (n=177) and active pathology residency programs (n=53) from March to J [...] une 2009. Data were collected for years 2003 to 2008. Results: Thirty-two academic services in 11 Brazilian states answered the survey. Twenty-one (65.6%) perform less than a hundred autopsies for natural causes and less than fifty pediatric or fetal autopsies/year. Twenty-four (75%) perform less than a hundred adult autopsies/year. Many institutions (46.9%) reported a drop in the number of autopsies in a six-year period. The total autopsy count and autopsy rate in 2008 ranged 1-632 (median = 80), and 0-66% (mean = 10.6%), respectively. A steady decrease in the total count of autopsies in a pool of 19 institutions was observed (p

  13. Fungal infections as a contributing cause of death: An autopsy study

    Directory of Open Access Journals (Sweden)

    Megha S Uppin

    2011-01-01

    Full Text Available Context: With the continuing rise in the number of immunocompromised patients, the incidence of invasive mycoses has increased. Various studies have reported the trends of fungal infections in autopsies. Because of limitations in antemortem clinical diagnosis owing to lack of sensitive diagnostic tools, information regarding frequency and pathogenesis of fungal infections is largely dependent on autopsy studies. Aim: To study the prevalence of fungal infections at autopsy spanning a period of 20 years and to document recent trends, prevalence of various fungi over decades along with underlying predisposing factors and pathological findings. Settings and Design: Retrospective study. Materials and Methods:All autopsies between 1988 and 2007 were reviewed and all cases showing fungal infections were analyzed. The clinical details and demographic data were retrieved from medical records. Representative sections from all organs were stained with hematoxylin and eosin stain and special stains including Gomori?s silver methenamine (GMS and per-iodic acid Schiff (PAS. Culture details were noted, wherever available. Results: A total of 401 autopsies were performed during the study period. Fungal infections were identified in 35 (8.7% of these cases. Leukemia was the commonest risk factor. The commonest pathogen in the present study was Aspergillus sp. The commonest single organ involved was brain (n = 18. Culture positivity was seen in 23.8% cases. Conclusion: The study highlights various predisposing factors and organisms in autopsy series. Existing diagnostic modalities are not sensitive to ensure antemortem diagnosis of fungal infections.

  14. Post mortem magnetic resonance imaging in the fetus, infant and child: A comparative study with conventional autopsy (MaRIAS Protocol)

    OpenAIRE

    Thayyil Sudhin; Sebire Neil J; Chitty Lyn S; Wade Angie; Olsen Oystein; Gunny Roxana S; Offiah Amaka; Saunders Dawn E; Owens Catherine M; Chong WK 'Kling'; Robertson Nicola J; Taylor Andrew M.

    2011-01-01

    Abstract Background Minimally invasive autopsy by post mortem magnetic resonance (MR) imaging has been suggested as an alternative for conventional autopsy in view of the declining consented autopsy rates. However, large prospective studies rigorously evaluating the accuracy of such an approach are lacking. We intend to compare the accuracy of a minimally invasive autopsy approach using post mortem MR imaging with that of conventional autopsy in fetuses, newborns and children for detection of...

  15. Autopsy rate in suicide is low among elderly in Denmark compared with Finland

    DEFF Research Database (Denmark)

    Ylijoki-SØrensen, Seija; Boldsen, Jesper Lier

    2014-01-01

    National differences in the legislation on cause and manner of death investigation are reflected in a high autopsy rate in suicides in Finland and a low corresponding rate in Denmark. The consequences for mortality statistics of these different investigation practices on deaths classified as suicides in Denmark and Finland, respectively, are not known in detail. The aim of this article was to analyse autopsy rates in deaths classified as suicides, and to identify any differences in investigation practices in deaths with a comparable cause of death, but classified as unnatural deaths other than suicide. Data from the mortality registries were summarised for the years 2000, 2005 and 2010. Autopsy rates (total, forensic and medical) were analysed with regard to deaths classified as suicide, and they were compared for three age groups (1-50 years, 51-70 years and ?71 years) and for causes of death. Deaths classified as suicide were compared with other unnatural classifications, and comparable causes of death werecoded into six subgroups: poisonings, suffocations/strangulations, firearm discharges, drowning/submersions, explosions/flames and other/unspecified causes. The total autopsy rate for suicides was 99.8% in Finland and 13.2% in Denmark. Almost all of these autopsies were conducted as forensic autopsies. In the age group ?71 years, Danish suicides outnumbered Finnish suicides (410 versus 283). The total autopsy rate was lower in the more senior age group in Denmark (19.5%, 9.9%, 5.6%), whereas it was consistently high in Finland (99.8%, 99.9%, 99.6%). Among Danish deaths due to poisonings, the autopsy rate was 89.5% when these were classified as accidents, but only 20.7% for cases classified as suicides. The number of deaths in the two Danish subgroups was comparable (550 versus 553). In Denmark, the decision regarding the need, if any, for a forensic autopsy is made during the external forensic examination of the body. Our study showed that the limited use of forensic autopsy to confirm the cause of death in deaths classified as suicides raises doubts about the accuracy of the Danish suicide mortality statistics. Our finding is emphasised by those cases in which the cause of death was registered as intentional self-poisoning. The high number of suicides among the elderly in Denmark is striking and begs further investigation and research. Overall, our data from Finland and Denmark reveal striking differences between the two countries and warrant further comparative studies on the subject in other countries.

  16. Trauma cardíaco: estudo de necropsias Cardiac trauma: autopsy findings

    Directory of Open Access Journals (Sweden)

    Gustavo Pereira Fraga

    2004-12-01

    Full Text Available RESUMO OBJETIVO: Pacientes vítimas de trauma cardíaco morrem, na maioria das vezes, antes de receberem atendimento médico. Porém, são poucos os estudos epidemiológicos deste tipo de lesão descrevendo a porcentagem de pacientes que chegam a ser tratados. O objetivo do presente trabalho é avaliar as características das vítimas de trauma cardíaco através da interpretação de laudos de necropsia. MÉTODO: Foram revisados 1.976 casos de óbito por causas externas submetidos a necropsia no Instituto Médico Legal de Campinas, num período de dois anos. Os casos foram divididos em dois grupos: I, trauma penetrante; e II, trauma fechado. RESULTADOS: Houve predomínio dos traumas penetrantes (1.294 casos - 65,5%. Trauma cardíaco foi identificado em 359 laudos (18,2%, sendo 296 do grupo I e 63 do grupo II. No grupo I, 73,6% dos óbitos ocorreram no local do trauma e apenas 18 pacientes (6% foram atendidos em hospital e submetidos a toracotomia. No grupo II o tratamento cirúrgico foi indicado em dois dos 14 traumatizados (3,2% dos traumas fechados admitidos com presença de sinais vitais. A câmara cardíaca mais acometida no grupo I foi o ventrículo esquerdo (lesão isolada em 24,6% dos casos e no grupo II o ventrículo direito (25%. CONCLUSÕES: Conclui-se que as lesões cardíacas são eminentemente fatais e apenas 5,6% destes traumatizados que morreram chegaram a receber tratamento efetivo.ABSTRACT BACKGROUND: The vast majority of cardiac trauma victims die before receiving medical care. However, epidemiological studies are few about this injury, describing the patients whom treatment is provided. The objective of this study is to evaluate cardiac injuries victims' profile through the autopsy findings. METHODS: We have reviewed 1.976 external causes death cases, which were autopsied in the Campinas Medical Legal Institute, over a two-year period. The cases were assigned for two groups: I, penetrating trauma, and II, blunt trauma. RESULTS: Penetrating trauma was predominant (1.294 cases - 65.5%. Heart trauma was identified in 359 cases (18.2%, out of 296 in Group I and 63 in Group II. In Group I, 73.6% of the victims died at the scene and only 18 patients (6% were admitted at hospital and submitted to thoracotomy. In Group II, surgical care was offered for two out of 14 patients (3.2% of blunt trauma who were admitted with vital signs. The most affected heart chamber in Group I was the left ventricle (isolated injury in 24.6% and in Group II the was the right ventricle (25%. CONCLUSION: We conclude that heart injuries are eminently fatal and only 5.6% of this victims who died received effective medical care.

  17. Neuropathology and general autopsy findings in nondemented aged subjects.

    Science.gov (United States)

    Jellinger, Kurt A; Attems, Johannes

    2012-01-01

    A retrospective study of the essential general pathology and neuropathological features in 100 nondemented individuals aged 65 years or older (mean 81.23 ± 5.47 y) was performed using semiquantitative methods. 91% of the patients had a history of hypertension, 31% malignancies, 24% COPD, 18% myocardial infarction, and 4% stroke. Major causes of death were cardiovascular decompensation, pneumonia, acute myocardial infarction, and malignancies. General autopsy revealed severe systemic and coronary atherosclerosis in 86 and 90%, respectively, renal angioangiolosclerosis in 82%, acute or recurrent myocardial infarction in 65%, and other diseases. Neuropathology showed average brain weight of 1,163 ± 113 g, mild to moderate brain atrophy, absent to mild atherosclerosis of large cerebral arteries in 46%, mild, moderate and severe one in 31, 17, and 6%, respectively. There were considerable discrepancies in the severity between generalized/ aortic and intracranial atherosclerosis, only less than one-third being comparable. Negative Khachaturian criteria and CERAD Stage 0 were observed in 83 and 86%, respectively, only 13% with CERAD Stage A, and 1% Stage B. Braak neuritic stages ranged from 0 to II (53%), II - III (29%) to III - IV (18%), none scoring Grade V or VI. The average Braak score was 2.3 ± 0.8. Vascular pathologies were common; CAA was absent in 61%, mild or moderate in 36% and severe in 3%. Mild to severe lacunar state in basal ganglia and/or white matter was seen in 73%, hippocampal sclerosis in 3 cases, while only 9% were free of cerebrovascular lesions. Lewy bodies were observed in 5 brains involving substantia nigra (n = 3), cerebral cortex (n = 1) and medulla oblongata (n = 1), 1 case representing incidental Lewy body disease. ? pathology in brainstem was observed in 60 cases (60%). Mixed cerebral pathologies (cerebrovascular lesions and moderate neuritic Braak stages) were observed in 6 cases (mean age 89.6 y). The importance of mixed pathologies in nondemented elderly, being less frequent than in other studies, remains to be elucidated. PMID:22385790

  18. Coronary atherosclerosis in sudden cardiac death: An autopsy study

    Directory of Open Access Journals (Sweden)

    Sudha M

    2009-10-01

    Full Text Available Background: The incidence of ischemic heart disease (IHD has markedly increased in India over the past few years. Considering the variations in racial, dietary and lifestyle patterns in our population, it is essential to study the biology of coronary atherosclerosis in our patients. Vulnerable plaques have a large number of foam cells, extracellular lipid, thin fibrous caps and clusters of inflammatory cells and are more prone to rupture. These plaques are nourished by the microvessels arising from the vasa vasorum of the blood vessels and by lumen-derived microvessels through the fibrous cap. This autopsy study was designed to analyse the coronary arterial tree in cases of sudden cardiac death, classify coronary atherosclerotic plaques and to assess the factors contributing to vulnerability of the plaques including inflammation, calcification and microvascular density. Materials and Methods: Seven cases of sudden cardiac death were included in the study. The hearts were perfusion-fixed and the coronary arteries along with their main branches were dissected and studied. The location of the plaques, type of plaques, presence of inflammation and calcification were assessed. The cap thickness and microvessel density per 1000um 2 were assessed. The statistical significance was estimated. Results and Conclusions: Extensive high-grade coronary atherosclerotic disease was seen in all sudden cardiac death cases. Majority of the plaques were vulnerable. High-grade inflammation was seen in most of the vulnerable and ruptured plaques. All the ruptured plaques were uncalcified indicating that calcification probably stabilizes the plaques and protects against rupture. Increased microvessel density was noted in ruptured plaques compared to vulnerable plaques. However, it was not statistically significant.

  19. Different fatal toxicity of neuroleptics identified by autopsy.

    Science.gov (United States)

    Schreinzer, D; Frey, R; Stimpfl, T; Vycudilik, W; Berzlanovich, A; Kasper, S

    2001-04-01

    Autopsies and toxicological analyses at the Institute of Forensic Medicine revealed 85 fatal intoxications with neuroleptics in Vienna from 1991 to 1997. A total of 17 cases were linked to a single neuroleptic (NL) alone, while 68 deaths were attributed to a combination of NLs with other drugs. The most frequently detected agent was prothipendyl (n=41). During the study period the number of defined daily doses of high-potency NLs prescribed increased significantly (Ptoxicities of different NLs were calculated by dividing the number of deaths caused by this NL into the number of defined daily doses prescribed in the observation period (f-value). Single-substance intoxications and multiple-substance intoxications were distinguished. The highest f-values were associated with low-potency NLs, especially with prothipendyl, chlorprothixene and levomepromazine. Low f-values were found for the group of high-potency NLs, including flupentixol, fluphenazine, haloperidol and pimozide, as well as olanzapine. Compared to the f-values for all NLs prescribed, f-values for low-potency NLs were shown to be significantly higher concerning single-substance intoxications (P< or = 0.05) and multiple-substance intoxications (P < or = 0.001), while f-values for high-potency NLs were significantly lower (P< or = 0.05 and P< or = 0.001). We are not aware of the psychiatric diagnoses in our post-mortem sample. However, the present results indicate that careless use of low-potent NLs should be avoided in patients with a potential risk of accidental or suicidal overdose. PMID:11313157

  20. Tissue microchimerism is increased during pregnancy: a human autopsy study.

    Science.gov (United States)

    Rijnink, Emilie C; Penning, Marlies E; Wolterbeek, Ron; Wilhelmus, Suzanne; Zandbergen, Malu; van Duinen, Sjoerd G; Schutte, Joke; Bruijn, Jan A; Bajema, Ingeborg M

    2015-11-01

    Microchimerism is the occurrence of small populations of cells with a different genetic background within an individual. Tissue microchimerism is considered to be primarily pregnancy-derived and is often studied relative to female-dominant autoimmune diseases, pregnancy complications, malignancies, response to injury, and transplantation outcomes. A particular distribution pattern of chimeric cells across various organs was recently described in a model of murine pregnancies. Our aim was to determine the frequency and distribution of tissue microchimerism across organs during and after pregnancy in humans. We performed in situ hybridization of the Y chromosome on paraffin-embedded autopsy samples of kidneys, livers, spleens, lungs, hearts and brains that were collected from 26 women who died while pregnant or within 1 month after delivery of a son. Frequencies of chimeric cells in various tissues were compared with those of a control group of non-pregnant women who had delivered sons. Tissue microchimerism occurred significantly more frequently in the lungs, spleens, livers, kidneys and hearts of pregnant women compared with non-pregnant women (all P kidney (135 Y+/10(6) nuclei), brain (85 Y+/10(6) nuclei) and heart (40 Y+/10(6) nuclei). Data from this unique study group of women who died while pregnant or shortly after delivery provide information about the number and physiologic distribution of chimeric cells in organs of pregnant women. We demonstrate that during pregnancy, a boost of chimeric cells is observed in women, with a distribution across organs, that parallels findings in mouse models. PMID:26307194

  1. Utility of desmin and a Masson's trichrome method to detect early acute myocardial infarction in autopsy tissues

    OpenAIRE

    Ouyang, Jie; Guzman, Miguel; Desoto-Lapaix, Fidelina; Pincus, Matthew R.; Wieczorek, Rosemary

    2010-01-01

    Detection of early acute myocardial ischemia/infarction prior to neutrophilic infiltration in autopsy myocardium poses a diagnostic dilemma to the surgical pathologist. Morphological changes can be subtle or not identified at all on the hematoxylin and eosin stain. To evaluate the Masson's trichrome stain and immunohistochemical stains, desmin and myoglobin, in detecting acute myocardial ischemia/infarction in autopsy myocardium. We reviewed the autopsy files of the New York Harbor Healthcare...

  2. Verbal autopsy: current practices and challenges / Autopsie verbale: pratiques actuelles et défis à surmonter / Autopsias verbales: práctica y retos

    Scientific Electronic Library Online (English)

    Nadia, Soleman; Daniel, Chandramohan; Kenji, Shibuya.

    2006-03-01

    Full Text Available Los datos sobre causas de defunción obtenidos a partir de autopsias verbales (AV) son usados con creciente frecuencia con fines de planificación de la salud, establecimiento de prioridades, seguimiento y evaluación en los países con sistemas de registro civil incompletos o inexistentes. En algunas r [...] egiones del mundo es el único método disponible para poder estimar la distribución de las causas de mortalidad. Hoy día el método de las AV se utiliza sistemáticamente en más de 35 lugares, sobre todo en África y Asia. En este artículo presentamos un panorama general del sistema de las AV y los resultados de un análisis de los instrumentos de AV y los procedimientos operativos utilizados en los sitios de vigilancia demográfica y los sistemas de registro de estadísticas vitales por muestreo. Solicitamos información a 36 sitios sobre el terreno acerca de los procedimientos operativos y examinamos 18 cuestionarios de autopsia verbal y 10 listas de causas de defunción usadas en 13 países. El formato y el contenido de los cuestionarios de AV, los procedimientos operativos sobre el terreno, las listas de las causas de defunción y los procedimientos empleados para calcular las causas de mortalidad a partir de las AV diferían sustancialmente de un sitio a otro. Analizamos las consecuencias de utilizar distintos métodos y llegamos a la conclusión de que es necesario normalizar los instrumentos y los procedimientos de AV y hacerlos más fiables si se desea hacer comparaciones más precisas de los datos de AV en los planos nacional e internacional. Ponemos de relieve, además, las medidas adicionales que habría que adoptar para desarrollar un procedimiento de AV normalizado. Abstract in english Cause-of-death data derived from verbal autopsy (VA) are increasingly used for health planning, priority setting, monitoring and evaluation in countries with incomplete or no vital registration systems. In some regions of the world it is the only method available to obtain estimates on the distribut [...] ion of causes of death. Currently, the VA method is routinely used at over 35 sites, mainly in Africa and Asia. In this paper, we present an overview of the VA process and the results of a review of VA tools and operating procedures used at demographic surveillance sites and sample vital registration systems. We asked for information from 36 field sites about field-operating procedures and reviewed 18 verbal autopsy questionnaires and 10 cause-of-death lists used in 13 countries. The format and content of VA questionnaires, field-operating procedures, cause-of-death lists and the procedures to derive causes of death from VA process varied substantially among sites. We discuss the consequences of using varied methods and conclude that the VA tools and procedures must be standardized and reliable in order to make accurate national and international comparisons of VA data. We also highlight further steps needed in the development of a standard VA process.

  3. The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review

    International Nuclear Information System (INIS)

    The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases. Articles were eligible if they reported both PMCT as well as autopsy findings and included more than one trauma victim. Two reviewers independently assessed the eligibility and quality of the articles. The outcomes were described in terms of the percentage agreement on causes of death and amount of injuries detected. The data extraction and analysis were performed together. Fifteen studies were included describing 244 victims. The median sample size was 13 (range 5-52). The percentage agreement on the cause of death between PMCT and autopsy varied between 46 and 100%. The overall amount of injuries detected on CT ranged from 53 to 100% compared with autopsy. Several studies suggested that PMCT was capable of identifying injuries not detected during normal autopsy. This systematic review provides inconsistent evidence as to whether PMCT is a reliable alternative for autopsy in trauma victims. PMCT has promising features in postmortem examination suggesting PMCT is a good alternative for a refused autopsy or a good adjunct to autopsy because it detects extra injuries overseen during autopsies. To examine the value of PMCT in trauma victims there is a need for well-designed and larger prospective studies. (orig.)

  4. Radiography after unexpected death in infants and children compared to autopsy

    International Nuclear Information System (INIS)

    Postmortem radiography may reveal skeletal and soft-tissue abnormalities of importance for the diagnosis of cause of death. To review the radiographs of children under 3 years of age who had died suddenly and unexpectedly. To compare the radiological and autopsy findings evaluating possible differences in children dying of SIDS and of an explainable cause. A total of 110 consecutive skeletal surveys performed between 1998 and 2002 were reviewed. All but one were performed before autopsy and comprised AP views of the appendicular and axial skeleton and thorax/abdomen, lateral views of the axial skeleton and thorax, and two oblique views of the ribs. Radiography and autopsy findings were compared. Causes of death were classified as SIDS/borderline SIDS (n = 52) and non-SIDS (n = 58), with one case of abuse. In 102 infants there were 150 pathological findings, 88 involving the chest, 24 skeletal, and 38 miscellaneous findings. The radiological-pathological agreement was poor concerning pulmonary findings. Skeletal findings were sometimes important for the final diagnosis. Radiography revealed many skeletal and soft-tissue findings. Pulmonary pathology was most frequently found, but showed poor agreement with autopsy findings. Recognizing skeletal findings related to abuse is important, as these may escape recognition at autopsy. (orig.)

  5. Comparison of death certificate and autopsy diagnoses - Hiroshima. [Cause of death

    Energy Technology Data Exchange (ETDEWEB)

    Stone, R.S.; Anderson, P.S. Jr.

    1960-09-14

    In this report evaluation of the death certificates has been on the basis of comparison with recorded autopsy diagnoses without review of the latter. An attempt has been made to evaluate limitations inherent in this method. The cases analyzed here represent the ABCC Hiroshima autopsy series from 1949 through 1959. Post mortem examinations on stillbirths and neonatal deaths that were collected during the years 1948 through 1953 were excluded from consideration because such cases are not pertinent to the general problems under study. With this limitation 1304 cases were available for matching. In 139 of these cases the death certificates were not available through the mechanisms of the overall study, so 1165 cases remained. Before comparisons are made the most important questions that must be answered about the materials and methods of the present investigation are: (1) is the autopsy-death certificate series a representative sample of all deaths in the population; (2) are the autopsy diagnoses correct; (3) are the death certificates properly understood and coded; and (4) are biologically meaningful groupings chosen for comparison between autopsy cause of death and death certificate cause of death. Because it is not possible to provide exact answers to all of these questions the doubt that they raise must be admitted but evaluated in the perspective of that part of the answer which is known.

  6. Evaluating the Cause of Death in Obese Individuals: A Ten-Year Medical Autopsy Study

    Science.gov (United States)

    Saab, Jad; Salvatore, Steven P.

    2015-01-01

    Background. Obesity is a growing public health problem associated with increased morbidity and rate of death. Postmortem examination is imperative to determine the cause of death, to detect clinically unsuspected disease entities, and consequently to determine the actual impact of obesity on patient mortality. Methods. A total of 849 adult autopsies were retrospectively reviewed. Obese (BMI ? 30?kg/m2) and nonobese patients were separately studied. The primary cause of death in each group was categorized into malignancy, infection, stroke, ischemic and nonischemic heart disease, pulmonary embolism, hemorrhage, and primary nonneoplastic diseases of different organ systems. Results. Of 849 autopsies, 32.3% were obese. The leading causes of death in the obese population were malignancy (31.4%), infection (25.9%), ischemic heart disease (12.8%), and pulmonary embolism (6.2%). Obese individuals were statistically more likely to die from pulmonary embolism and liver disease and less likely to die from neurologic diseases and nonischemic heart disease. Conclusion. Autopsies on obese individuals constitute a third of all adult medical autopsies in our center. Increased death rates in the obese due to pulmonary embolism and liver disease should receive special clinical attention. Autopsy findings in the obese population should contribute to overall premortem disease detection, prevention, and management. PMID:25653872

  7. Autopsy in Islam: Considerations for Deceased Muslims and Their Families Currently and in the Future.

    Science.gov (United States)

    Sajid, Mohammed Imran

    2016-03-01

    Religious beliefs and cultures have influenced treatment of dead bodies in different ways by nations throughout history, and attitudes toward the deceased individuals have changed across time and so has the role and mechanism of autopsy. Islam has been a part of Europe for a long time; therefore, we would like to emphasize the important issues for Muslims and their families regarding death, autopsy, and funeral and to describe international perspectives of Muslim autopsies. Muslims have expressed their views on autopsy publically and internationally, and there have been claims of violation of the deceased, delays in burial, and nonconsideration of their religious beliefs. In this article, we aim to increase awareness and understanding of doctors about the religious and ethical issues important to Muslims and their families, so that appropriate considerations may be made where possible with regard to respectful treatment of deceased loved ones to decrease tensions presently being faced. Forensic medicine doctors could assist by undertaking autopsy without delay, in a private room by those of the same sex, and covering parts of the body not being worked on at that time. PMID:26505228

  8. Inventory of ABCC-RERF autopsies Hiroshima and Nagasaki, 1948-1980

    International Nuclear Information System (INIS)

    This is the fourth inventory of ABCC-RERF autopsies which covers those performed from 1948-80 (the other three inventories). For general information the introduction of the third inventory (1948-70) is included with some modification, and deaths and autopsy rates for 1971-80 are added. ABCC-RERF performed 10,096 autopsies (6,555 in Hiroshima and 3,541 in Nagasaki) from 1948 to 1980. Protocols, tissues, sections, smears, etc., assembled by the collaborating institutions were examined by members of the ABCC Department of Pathology who completed ABCC records for each case. Copies of all protocols, gross tissues, and histological sections were placed in a designated repository in the Medical School of each city where they are available to all qualified and interested investigators. (J.P.N.)

  9. [Soft tissue-cutting law, i.e. the career concept of an autopsy assistant].

    Science.gov (United States)

    Kormos, Timea; Csatai, Tamás; Jäckel, Márta

    2015-03-01

    Practical experience shows that the autopsy assistant society is fairly divided. There are some people who would have needed a thorough basic training, and there are those who - due to their diligence and the close cooperation with physician colleagues - would deserve an opportunity for further progress due to their extensive knowlegde. As regards the autopsy assistant profession the training, and the training system as well has changed significantly, and it requires further changes. Examining the issue in a wide spectrum, the aim of the authors is, as much as possible, to promote the formation of an "Autopsy assistant career," in which they want to create a predictable way for the members of the profession from the phase of becoming a student (competency, training, exams, vocational training, single note) to obtaining the master's degree. The authors would like to provide a summary about their experience and plans regarding this issue. PMID:25726768

  10. Sudden unexplained death in childhood. An audit of the quality of Autopsy reporting

    LENUS (Irish Health Repository)

    Treacy, A

    2013-03-01

    Cases of sudden unexplained death in childhood (SUDC) in Ireland in children aged >1year and <5 years were examined in order to assess the quality of autopsy reporting. All SUDC cases are notified to and documented by the National Sudden Infant Death Register (NSIDR) in Ireland along with all cases of sudden infant death syndrome (SIDS) referring to sudden infant deaths less than one year of age. The database of the NSIDR in Ireland was interrogated and cases of SIDS and SUDC were compared over a fifteen-year period (1995-2009). SIDS cases whose autopsies were conducted in the same hospital in the same year as the index SUDC case were used for comparison. The autopsy report for each case was examined and modified Rushton(MR) scores 1\\r\

  11. Verbal autopsy of 80,000 adult deaths in Tamilnadu, South India

    Directory of Open Access Journals (Sweden)

    Peto Richard

    2004-10-01

    Full Text Available Abstract Background Registration of the fact of death is almost complete in the city of Chennai and not so in the rural Villupuram district in Tamilnadu, India. The cause of death is often inadequately recorded on the death certificate in developing countries like India. A special verbal autopsy (VA study of 48 000 adult (aged ≥ 25 yrs deaths in the city of Chennai (urban during 1995–97 and 32 000 in rural Villupuram during 1997–98 was conducted to arrive at the probable underlying cause of death to estimate cause specific mortality. Methods A ten day training on writing verbal autopsy (VA report for adult deaths was given to non-medical graduates with at least 15 years of formal education. They interviewed surviving spouse/close associates of the deceased to write a verbal autopsy report in local language (Tamil on the complaints, symptoms, signs, duration and treatment details of illness prior to death. Each report was reviewed centrally by two physicians independently. Random re-interviewing of 5% of the VA reports was done to check the reliability and reproducibility of the VA report. The validity of VA diagnosis was assessed only for cancer deaths. Results Verbal autopsy reduced the proportion of deaths attributed to unspecified and unknown causes from 54% to 23% (p Conclusion A ten day training programme to write verbal autopsy report with adequate feed back sessions and random sampling of 5% of the verbal autopsy reports for re-interview worked very well in Tamilnadu, to arrive at the probable underlying cause of death reliably for deaths in early adult life or middle age (25–69 years and less reliably for older ages (70+. Thus VA is practicable for deaths in early adult life or middle age and is of more limited value in old age.

  12. An Autopsy Case of a Pregnant Woman With Severe Placental and Fetal Damage From Domestic Violence.

    Science.gov (United States)

    Kanawaku, Yoshimasa; Takahashi, Shirushi; Kanetake, Jun; Funayama, Masato

    2015-09-01

    We present an autopsy case of a pregnant woman who was a victim of domestic violence. The deceased showed injuries mainly to her head and abdomen. Postmortem examination revealed 1400 mL of abdominal hemorrhage, ablation of the perimetrium, placental avulsion, and intracranial hematoma. The cause of death was diagnosed as hemorrhagic shock. The uterus contained a fetus of 7 months' gestational age. Fetal autopsy revealed laceration of the lungs, laceration and avulsion of the liver, and 15 mL of hemoperitoneum. Both placental and fetal injuries suggested repeated severe attacks to the abdomen, such as those expected to result from kicking or hitting. PMID:25946087

  13. Confirmation of in vivo uranium-in-chest survey by analysis of autopsy specimens

    International Nuclear Information System (INIS)

    The results of radiochemical analyses of samples of lung, mediastinum, kidney, liver, sternum, rib and vertebrae taken at autopsy of a man who had worked for 22 months with UO2 powder and who subsequently died suddenly from a coronary thrombosis are here compared with the results of a routine in vivo uranium-in-chest count carried out on the same worker only three months before death and after which he carried out no work involving UO2. Methods of Whole Body Counting and radiochemical analysis employed are described. It is concluded that the results from organs taken at autopsy broadly confirm the in vivo chest survey result. (U.K.)

  14. Post-Mortem Echocardiography as a Guide to Cardiac Autopsy—A Worthwhile Concept?

    OpenAIRE

    J Ker; Du Toit-Prinsloo, L.; WFP. Van Heerden; G. Saayman

    2010-01-01

    Sudden and unexpected death in the young is a common and worldwide problem. Sudden, unexpected death in infancy (SUDI), clinically unexpected death in an infant between one week and one year of age, affects around 1 in 1000 infants. Autopsy will reveal a specific cause of death in only one third of cases. This has led to various ancillary examinations in an effort to increase the diagnostic yield of the autopsy. In this case report it is suggested that another diagnostic modality, that of the...

  15. Post-mortem echocardiography as a guide to cardiac autopsy : a worthwhile concept?

    OpenAIRE

    Ker, James; Du Toit-Prinsloo, L.; W.F.P. van Heerden; G. Saayman

    2010-01-01

    Sudden and unexpected death in the young is a common and worldwide problem. Sudden, unexpected death in infancy (SUDI), clinically unexpected death in an infant between one week and one year of age, affects around 1 in 1000 infants. Autopsy will reveal a specific cause of death in only one third of cases. This has led to various ancillary examinations in an effort to increase the diagnostic yield of the autopsy. In this case report it is suggested that another diagnostic modality, that of the...

  16. The lumbosacral ligament. An autopsy study of young black and white people.

    OpenAIRE

    Hanson, P; Sørensen, Henrik

    2008-01-01

    The lumbosacral ligament (LSL), situated between the L5-vertebra and the sacrum, was studied in autopsy material. Twenty-eight cadaveric specimens from 12 black and 16 white persons aged 17-30 years were studied during routine forensic autopsies. The ligaments were measured and determined in situ. Thereafter, the ligaments were removed for histologic preparation. The ligament in the black subjects was thicker compared with the white (7.5 +/- 1.4 vs. 5.7 +/- 1.2 mm), and wider (11.7 +/- 1.6 mm...

  17. The use of CT-scanning at the medicolegal external postmortem examination and at the forensic autopsy

    DEFF Research Database (Denmark)

    Leth, Peter Mygind

    2006-01-01

    Introduction: Can CT-scanning of deceased at the medico legal external examination improve the selection of cases to autopsy? Is CT-scanning a substitute or a supplement to the traditional forensic autopsy? Material: In 2006 60 deceased individuals from Southern Denmark (counties of Fyn and Sønde...

  18. Morphological changes in the digestive system of 93 human immunodeficiency virus positive patients: an autopsy study

    Directory of Open Access Journals (Sweden)

    Lucinda Calheiros Guimarães

    2012-04-01

    Full Text Available Involvement of the digestive system in patients with acquired immunodeficiency syndrome (AIDS is frequent and many changes in these patients are diagnosed only at autopsy. There are few studies of autopsy with detailed analysis of this system and only one was conducted in Brazil. We evaluated each segment of the digestive system in 93 consecutive autopsies of patients infected with human immunodeficiency virus (HIV and the importance of these lesions to death. Of these, 90 (96.8% patients had AIDS. We reviewed medical records, autopsy reports and histological sections from tongue to rectum stained with hematoxylin-eosin. When necessary, we analyzed special stains and immunohistochemistry to investigate infections. There was damage to the digestive system in 73 (78.5% cases. The most common infections were candidiasis (42%, cytomegalovirus (29%, histoplasmosis (11.8%, toxoplasmosis (9.7% and mycobacterial infection (9.7%. Malignancies were rare, present in four (4.3% cases (two Kaposi's sarcoma, one adenocarcinoma and one metastatic embryonal carcinoma. All segments showed lesions: tongue (48.6%, esophagus (44.8%, stomach (44.7%, colon (43.2% and small intestine (28.9%. The lesions found were immediate cause of death in five (5.4% cases. In another 36 (38.7% cases the basic disease was systemic and also compromised the digestive system.

  19. Anaerobiospirillum succiniciproducens sepsis in an autopsy patient: A troublesome diagnostic workup

    Directory of Open Access Journals (Sweden)

    Jason Koshy

    2014-01-01

    Full Text Available Anaerobiospirillum succiniciproducens is an uncommon yet potentially lethal gram-negative bacterium typically affecting patients with comorbidities. We report a case of A. succiniciproducens infection in an autopsy patient who had hepatitis C and type 2 diabetes and describe the difficulties in the laboratory identification of this pathogen.

  20. Correlation between prenatal diagnosis by ultrasound and fetal autopsy findings in second-trimester abortions

    DEFF Research Database (Denmark)

    Hauerberg, Laura; Skibsted, Lillian; Graem, Niels; Maroun, Lisa Leth

    2012-01-01

    Abstract? We evaluated the correlation between prenatal diagnosis by ultrasound and autopsy findings, based on 52 second-trimester pregnancies terminated due to fetal malformations or chromosome aberrations diagnosed at a gestational age of 12-25 weeks. In 24 pregnancies, there was full agreement...

  1. Correlation between prenatal diagnosis by ultrasound and fetal autopsy findings in second-trimester abortions

    DEFF Research Database (Denmark)

    Hauerberg, Laura; Skibsted, Lillian; Graem, Niels; Maroun, Lisa Leth

    2012-01-01

    We evaluated the correlation between prenatal diagnosis by ultrasound and autopsy findings, based on 52 second-trimester pregnancies terminated due to fetal malformations or chromosome aberrations diagnosed at a gestational age of 12-25 weeks. In 24 pregnancies, there was full agreement between...

  2. What Killed This Bank? Financial Autopsy as an Experiential Learning Tool

    Science.gov (United States)

    Hays, Fred H.; DeLurgio, Stephen A.

    2010-01-01

    Finance students today live in the midst of an enormous financial crisis. Institutions both large and small are failing or being rescued through government intervention. This environment presents a host of learning opportunities for instructors as well as students. This paper discusses financial autopsies as a form of experiential learning…

  3. [An autopsy case of pancreatic cancer with carcinoid tumor of the appendix].

    Science.gov (United States)

    Kawaura, Y; Ohike, E; Hirano, M; Iwa, T; Haratake, J

    1983-07-01

    A 78-year-old man with pancreatic carcinoma with carcinoid tumor of the appendix is reported. Upon autopsy, the tumor consisted of poorly differentiated adenocarcinoma with scirrhous-like spreading. In the appendix a carcinoid tumor, size measuring 2 mm X 1 mm, was seen; the carcinoid cells were argentaffin. PMID:6887529

  4. Hiding in Plain Sight: Clinically Unrecognized Fatal Tooth Asphyxia Revealed by the Forensic Autopsy.

    Science.gov (United States)

    Armstrong, Erica J

    2016-03-01

    Fatal asphyxia by choking whether by food or foreign material remains an uncommon occurrence affecting mainly those at the extremes of age and with variable and sometimes misleading clinical presentations. Prompt clinical recognition of impending airway obstruction afforded by complete physical examination and assessment is paramount for prevention of morbidity and mortality in these cases. In the elderly, a death initially presenting with sudden cardiorespiratory collapse may be erroneously certified as due to natural disease without performance of an autopsy. Fortunately, deaths subsequent to cardiorespiratory collapse, where results of the clinical work-up fail to identify an etiology and medical history is insufficient, are reportable, falling under the jurisdiction of the medical examiner/coroner. The performance of an autopsy in the evaluation of a sudden death arising after hospitalization in which the etiology remains unclear can provide valuable information to our clinical colleagues that they can apply to more timely diagnosis and treatment. Furthermore, the forensic autopsy offers clarification and answers to questions of medicolegal importance. This is particularly true for choking deaths.?Presented is a choking death after tooth aspiration whereby the forensic autopsy provided specific anatomic correlation to the clinical clues not recognized before death and provided the true cause of death. PMID:26726967

  5. Completed Suicide among Sinhalese in Sri Lanka: A Psychological Autopsy Study

    Science.gov (United States)

    Samaraweera, Sudath; Sumathipala, Athula; Siribaddana, Sisira; Sivayogan, S.; Bhugra, Dinesh

    2008-01-01

    Sri Lanka has the one of highest rates of suicide. Important factors associated with suicide were determined via the psychological autopsy approach (which had not been carried out previously in Sri Lanka). Over a 3-month period, in a catchment area, 31 suicides among Sinhalese were identified and 27 were investigated. Males were more likely to…

  6. Psychosocial and Psychiatric Factors Associated with Adolescent Suicide: A Case-Control Psychological Autopsy Study

    Science.gov (United States)

    Portzky, Gwendolyn; Audenaert, Kurt; van Heeringen, Kees

    2009-01-01

    This study aimed at the investigation of psychosocial and psychiatric risk factors of adolescent suicide by means of a case-control psychological autopsy study. Relatives and other informants of 19 suicide victims and 19 matched psychiatric controls were interviewed by means of a semi-structured interview schedule. Psychiatric controls included…

  7. The Missing Piece: A Sociological Autopsy of Firearm Suicide in the United States

    Science.gov (United States)

    Slater, Greta Yoder

    2011-01-01

    Social, economic, violence, political, and gun access predictors of suicide and gun suicide were examined via sociological autopsy. The model predicting suicide rates overall had the best results, X[superscript 2](9, N = 50) = 5.279 (CMIN, the goodness of fit statistic that represents the minimum discrepancy between the unrestricted sample…

  8. ¿Es útil realmente realizar autopsias? Is it really useful to perform autopsies?

    Directory of Open Access Journals (Sweden)

    José Hurtado de Mendoza Amat

    2008-03-01

    Full Text Available Motivados por la necesidad de exponer nuevas experiencias en el trabajo con las autopsias, luego de escribir el libro "La autopsia. Garantía de calidad en la Medicina" y concluir la investigación "Evaluación de la calidad de los diagnósticos premortem en autopsias realizadas en Cuba entre 1994 y 2003", se presenta este trabajo con el propósito de que pueda ser útil a los interesados en el tema y acercarse al objetivo final: lograr el máximo aprovechamiento de la autopsia. Se expone la situación de la autopsia en el mundo y en Cuba. Se enfatiza en los logros alcanzados en el país, donde se incluyen los hospitales militares, las dificultades atravesadas y se señala el camino a seguir para disminuir la morbilidad y mortalidad, y lograr el objetivo mayor: aumentar en cantidad y calidad la vida de la población.Motivated by the need to expose new experiences in the work with autopsies, alter writing the book "Autopsy. Guarantee of quality in Medicine" and after concluding the investigation "Evaluation of the quality of the premortem diagnoses in autopsies performed in Cuba between 1994 and 2003", this paper was presented aimed at being useful for those interested in the topic and at approaching the final aim: to take the maximum advantage of autopsy. It was exposed the situation of autopsy in the world and in Cuba. Emphasis was made on the advances attained in the country, including the military hospitals, the difficulties found, and the way to reduce morbidity and mortality and to achieve the major goal: to increase in quantity and quality the life of the population.

  9. Correlation of diagnostic imaging and autopsy findings of eight patients with acquired immune deficiency syndrome

    International Nuclear Information System (INIS)

    Objective: To investigate the imaging findings with pathologic correlation in patients with acquired immune deficiency syndrome (AIDS). Methods: Imaging findings, autopsy and pathological data were retrospectively analyzed in eight patients with AIDS. Routine CT scanning of different body parts was performed during their hospitalization. CT scanning was performed from the skull to the pelvis immediately following their death. After routine formalin fixing, 7 cadavers were cross sectioned for autopsy in freezing state and 1 for gross autopsy. Tissues were obtained from each sections and organs for pathological examinations. Results: The autopsy data showed parasitic infections (5 cases), bacterial infections (3 cases), fungal infections (2 cases), virus infections (2 cases), lymphoma (1 case) and cerebrovascular diseases (1 case)in eight patients with AIDS. The CT scanning demonstrated symmetrical ground glass liked shadows with pulmonary hilus as the center in 5 cases of pulmonary PCP infection; pulmonary patchy shadows, scattering distribution of nodular shadows, extensive military nodular shadows with even distribution and tuberculous pleurisy; cloudy shadows for 2 cases of fungi infection with multiple foci of chronic inflammation; pulmonary net-like parenchymal changes for 2 cases of pulmonary CMV infection; thickened intestinal wall and narrowed intestinal lumen for 1 case of intestinal tumor; low density shadows of brain tissue for 1 case of CMV encephalitis and MRI findings of high T1 and high T2 signals as well as MRA findings of broken vascular channels in liquefied areas of brain tissues; patchy low density areas inside a cyst of brain for one case of brain toxoplasmosis infection; multiple small patchy low density areas in cerebral basal ganglia for one case of brain cryptococcus infection. Conclusions: In AIDS patients, infection and tumor may occur in various organs resulting in complex symptoms, which makes it more complicated and difficult to make accurate diagnosis. A correlative study of imaging findings and pathological manifestation of AIDS patients at autopsy could be helpful for clinical diagnosis. (authors)

  10. Undetected patricide: Inaccuracy of cause of death determination without an autopsy.

    Science.gov (United States)

    Campobasso, Carlo P; Laviola, Domenica; Grattagliano, Ignazio; Strada, Luigi; Dell'Erba, Alessandro S

    2015-08-01

    Patricide (killing the father) is uncommon form of homicide. Usually the assaults occur at home in the absence of witnesses and adult sons are frequently involved. Homicides in a domestic context usually do not tend to recurrence, because the motivation for the crime ends with the death of the parent. However, this is not what was observed in the present case study dealing with the death of a 70 years old white man originally misclassified as accident and discovered three years later only after an additional homicide in a family context of a 60 years old white lady. Multiple stab wounds to the neck and thorax were misinterpreted at the external male body examination as blunt trauma falling down stairs. No forensic autopsy was requested and no comparison of medical findings with the results from the death scene, such as a bloodstain analysis was performed by the police officers nor required by the judicial authority. This was quite surprising because an additional but preliminary post-mortem external examination performed by a general practitioner on the male body already raised the suspicion that the external lesions were stab wounds thus requiring a forensic autopsy. Only the exhumation of the elderly body, performed years later, confirmed the diagnostic hypothesis raised by the first physician. The present case is quite representative of a death investigation not run professionally and performed by individuals with no specific training where most of the medico-legal investigations (especially for traumatic and violent deaths) are restricted to an external body examination without subsequent autopsy. Although misinterpretation of external lesions is inevitable and significant discrepancies between external body examination and forensic autopsy are not rare, in the case of contradictory results of post-mortem external examination or unclear/suspicious cause and manner of death, investigation should proceed necessarily with a forensic autopsy. PMID:26165662

  11. Let's talk about death: data collection for verbal autopsies in a demographic and health surveillance site in Malaysia

    Directory of Open Access Journals (Sweden)

    Pascale A. Allotey

    2015-07-01

    Full Text Available Background: Verbal autopsies have gained considerable ground as an acceptable alternative to medically determined cause of death. Unlike with clinical or more administrative settings for data collection, verbal autopsies require significant involvement of families and communities, which introduces important social and cultural considerations. However, there is very little clear guidance about the methodological issues in data collection. The objectives of this case study were: to explore the range of bereavement rituals within the multi-ethnic, multi-faith population of the district; to investigate the preparedness of communities to talk about death; to describe the verbal autopsy process; to assess the effects of collecting verbal autopsy data on data collectors; and to determine the most accurate sources of information about deaths in the community. Methods: A case study approach was used, using focus group discussions, indepth interviews and field notes. Thematic analyses were undertaken using NVivo. Results: Consideration of cultural bereavement practices is importance to acceptance and response rates to verbal autopsies. They are also important to the timing of verbal autopsy interviews. Well trained data collectors, regardless of health qualifications are able to collect good quality data, but debriefing is important to their health and well being. This article contributes to guidance on the data collection procedures for verbal autopsies within community settings.

  12. Post-mortem imaging as an alternative to autopsy in the diagnosis of adult deaths: A validation study

    OpenAIRE

    Roberts, ISD; Benamore, RE; Benbow, EW; Lee, SH; Harris, JN; Jackson, A; Mallett, S; Patankar, T; C. Peebles; Roobottom, C; Traill, ZC

    2012-01-01

    Background: Public objection to autopsy has led to a search for minimally invasive alternatives. Imaging has potential, but its accuracy is unknown. We aimed to identify the accuracy of post-mortem CT and MRI compared with full autopsy in a large series of adult deaths. Methods: This study was undertaken at two UK centres in Manchester and Oxford between April, 2006, and November, 2008. We used whole-body CT and MRI followed by full autopsy to investigate a series of adult deaths that were re...

  13. Post-mortem imaging as an alternative to autopsy in the diagnosis of adult deaths: a validation study.

    OpenAIRE

    Roberts, IS; Benamore, RE; Benbow, EW; Lee, SH; Harris, JN; Jackson, A; Mallett, S; Patankar, T; C. Peebles; Roobottom, C; Traill, ZC

    2012-01-01

    BACKGROUND: Public objection to autopsy has led to a search for minimally invasive alternatives. Imaging has potential, but its accuracy is unknown. We aimed to identify the accuracy of post-mortem CT and MRI compared with full autopsy in a large series of adult deaths. METHODS: This study was undertaken at two UK centres in Manchester and Oxford between April, 2006, and November, 2008. We used whole-body CT and MRI followed by full autopsy to investigate a series of adult deaths that were re...

  14. [An autopsy case of triple primary cancers consisting of glioblastoma multiforme of the pons, colon cancer and rectal carcinoid--a statistical analysis of cases of brain tumor combined with other primary cancers in Japan autopsy annuals].

    Science.gov (United States)

    Hayashi, K; Ohtsuki, Y; Sonobe, H; Takahashi, K; Wada, S; Yoshida, K

    1987-11-01

    An autopsy case of glioblastoma multiforms of the pons with a colon cancer, a rectal carcinoid, a renal adenoma and three gastric leiomyomas in a 81-year-old-woman is reported with a statistical analysis on multiple primary cancers associated with primary brain tumors as reported in the Japan autopsy annuals. Out of 329, 705 autopsy cases from 1975 to 1984 in the Japan autopsy registry, double cancers and triple cancers that included a primary brain tumor amounted to 123 cases (0.037%) and 12 cases (0.0036%), respectively. Other sites for primary cancers were the thyroid (23%), the stomach (15%), the lungs (12%), and the colon (10%) in that order of frequency. PMID:2826842

  15. Northern and Southern blot analysis of human RNA and DNA in autopsy material

    DEFF Research Database (Denmark)

    Larsen, S; Rygaard, K; Asnaes, S; Spang-Thomsen, M

    1992-01-01

    Fresh biopsy material for molecular biological investigations is not obtainable from all relevant normal human tissues. We studied the feasibility of using RNA and DNA from autopsies for Northern and Southern blot analysis. Tissue samples from seven organs were obtained from 10 autopsies performed...... 21-118 h postmortem. Extracted RNA and DNA were examined by Northern and Southern blot analysis using oligo-labelled human DNA probes recognizing gene transcripts of 2-5 kb. The results indicated that, in general, Northern blot analysis was feasible with the applied probes when the tissue was...... obtained less than two days postmortem. Histological examination showing slight or no autolysis and the presence of ribosomal bands after gel electrophoresis were both indicative parameters of RNA preservation. DNA was appropriate for Southern blotting when the tissue was obtained less than three to five...

  16. Amoebic cases at autopsy and factors that might have contributed to death at Ibadan.

    Science.gov (United States)

    Olubuyide, I O

    1990-09-01

    Twenty-one cases of amoebiasis seen at autopsy at the University College Hospital, Ibadan, over a 10-year period are reviewed. They constituted 0.59 percent of 3,556 autopsies performed during this period. Delay in seeking medical advice and in diagnosis and commencement of appropriate therapy were some of the factors contributing to the mortality in 16 (76pc) cases. Furthermore, Chronic renal failure, Cirrhosis, Lymphoma, Pregnancy and Sickle cell disease were also contributory factors to mortality in 7 (33pc) cases. With the progressive deterioration of the economics of Nigeria, urban migration and the increasing size of urban slums with crowded unhygienic conditions, the spread of this infection may accelerate and so result in greater mortality in the future. PMID:2285932

  17. Photogrammetric Documentation of Regions of Interest at Autopsy—A Pilot Study

    DEFF Research Database (Denmark)

    Slot, Liselott Kristina; Larsen, Peter Kastmand; Lynnerup, Niels

    2014-01-01

    method has a high accuracy. The precision of the markers' location on the models was somewhat less, although the method is still promising and potentially superior to the current procedures used for reconstructions. The possibility to measure any distance on a body, even after the autopsy is concluded......In this pilot study, the authors tested whether photogrammetry can replace or supplement physical measurements made during autopsies and, based on such measurements, whether virtual computer models may be applicable in forensic reconstructions. Photogrammetric and physical measurements of markers...... denoting wounds on five volunteers were compared. Virtual models of the volunteers were made, and the precision of the markers' locations on the models was tested. Twelve of 13 mean differences between photogrammetric and physical measurements were below 1 cm, which indicates that the photogrammetric...

  18. An autopsy case of thyroid cancer following radiotherapy for tongue cancer

    International Nuclear Information System (INIS)

    The patient was a 61 year old woman who was exposed to a-bomb (38 rad) at the age of 29. She had tongue cancer and received radiotherapy for it, and her thyroid cancer was found by autopsy. Besides Bleomycin, Maruyama vaccine, and so on, 6,000 R of radiation was given over lymph nodes of the neck, but she died 1 year and 8 months after the treatment without any effect. Besides squamous cell carcinoma of the tongue, multi-centric papillary adenocarcinoma in the left lobe and papillary adenocarcinoma scattering in the right lobe of the thyroid gland were found by autopsy. The metastases of cancer to lymph nodes of the neck were also detected. Thyroid cancer in this case seemed to be highly related with a-bomb exposure and radiotherapy for tongue cancer. Therefore, it is necessary to decide irradiation field carefully when radiotherapy is performed. (Tsunoda, M.)

  19. Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy-confirmed Alzheimer's disease.

    Science.gov (United States)

    Bangen, Katherine J; Nation, Daniel A; Delano-Wood, Lisa; Weissberger, Gali H; Hansen, Lawrence A; Galasko, Douglas R; Salmon, David P; Bondi, Mark W

    2015-04-01

    We examined the relationships of antemortem vascular risk factors to postmortem cerebrovascular and Alzheimer's disease (AD) pathologies. Eighty-four AD patients underwent an assessment of vascular risk (blood pressure, cholesterol, smoking, cardiovascular disease, diabetes, atrial fibrillation, transient ischemic attack [TIA], or stroke) and later underwent brain autopsy. Given our aim to examine mild cerebrovascular changes (CVCs), individuals were excluded if autopsy revealed large stroke. The most common forms of CVC were circle of Willis atherosclerosis followed by arteriosclerosis, lacunes, and microinfarcts. Excluding the history of TIA/clinical stroke, individual vascular risk factors were not associated with CVC. However, the presence of multiple vascular risk factors was associated with CVC. Furthermore, the presence of CVC was associated with lower Braak and Braak stage. These findings highlight the importance of aggregate risk in the vascular contribution to dementia. Interventions designed to maintain cerebrovascular health may represent important opportunities for preventing or delaying dementia, even when AD is the dominant pathology. PMID:25022538

  20. CASE REPORT: Papillary Adenoma of Kidney- An Incidental Autopsy Finding: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Bhakti D. Deshmukh

    2012-01-01

    Full Text Available Background: Renal papillary adenoma is usually an incidental finding at autopsy with an incidence of 7% to 23%. The frequency of small papillary tumours of kidney increases with age to approximately 40% of the population over the age of 65. These tumours occur morefrequently in scarred kidneys, acquired renal cystic disease and in children with von Hippel-Lindau syndrome. Case history: In this report we describe renal papillary adenoma incidentally detected during autopsies of two elderly males. Gross examination of kidneyshowed two tiny subcapsular yellowish nodules in one case and single nodule with similar morphology in the other. Microscopic examination in both the cases showed a well circumscribed tumour composed of densely packed tubules and papillae lined by small cuboidal to columnar cells with rounded uniform nuclei. However there was no nuclear atypia, mitosis or necrosis.

  1. Pseudoaneurysm originating from left ventricle aneurysm: an autopsy case and review of literature.

    Science.gov (United States)

    Dogan, Kamil Hakan; Demirci, Serafettin; Tavli, Lema; Buken, Bora

    2013-11-01

    Rupture of the free wall of the left ventricle is a catastrophic complication of acute myocardial infarction. Rarely, free wall rupture is contained by overlying adherent pericardium, producing a pseudoaneurysm of the left ventricle. In this report, a case of a left ventricular pseudoaneurysm due to a previous myocardial infarction is described. A 55-year-old woman had a severe chest pain 11 months prior to death. No cardiac investigation was performed. Three days prior to death, she suffered from fatigue and weakness, and had a witnessed sudden cardiac death. At autopsy, a 8.5 × 10 × 8 cm pseudoaneurysm of the left ventricle was found. There was severe coronary artery atherosclerosis. There were extensive adhesions between pericardium and pseudoaneurysm wall. The cause of death was attributed to heart failure and resulting arrhythmia. The case illustrates the rare event of left ventricular pseudoaneurysm first diagnosed at forensic autopsy. PMID:24237794

  2. Autopsy reenactment--a useful technique in the evaluation of adhesive tape asphyxia.

    Science.gov (United States)

    Herbst, Jonathon; Stanley, Wayne; Byard, Roger W

    2014-05-01

    A 19-year-old woman was found dead with her face and head wrapped in plastic adhesive tape in a cupboard beside an opened helium cylinder. Despite the alleged presence of a suicide message on a social networking website, the unusual circumstances raised the possibility at the time of autopsy of either accidental death from sexual asphyxia or homicide. A carefully monitored reenactment demonstrated, however, that the type of commercial adhesive tape that had been used did not cause complete airway obstruction and that it was possible to wrap a considerable length of tape around the head and neck with the breath held. All of the features at autopsy were, therefore, compatible with self-infliction. Asphyxial death was attributed to the combined effects of smothering from tape and anoxia from helium, an extremely rare combination in young females. PMID:24502562

  3. Relation of radiation to gastric carcinoma observed in autopsy cases in a fixed population, Hiroshima and nagasaki 1961 - 74

    International Nuclear Information System (INIS)

    A study was made of the relation to atomic bomb radiation of 535 cases of gastric carcinoma among 4,694 deaths occurring in a fixed population of Hiroshima and Nagasaki who were autopsied between 1961 and 1974. The proportion of all autopsies with gastric carcinoma as autopsy diagnosis tended to be high in the high dose group, but it could not be concluded with the present amount of information that there is a relation between gastric carcinoma and radiation in this autopsy study. Although no specific distribution of the histological types of gastric carcinoma was noted by radiation dose, the data indicated increases in the degree of extension of tumor cells in the gastric wall and the degree of metastasis to the lymph nodes seemed to be high in the high dose group. (author)

  4. Early Stage of Progressive Supranuclear Palsy: A Neuropathological Study of 324 Consecutive Autopsy Cases.

    Science.gov (United States)

    Nogami, Akane; Yamazaki, Mineo; Saito, Yuko; Hatsuta, Hiroyuki; Sakiyama, Yoshio; Takao, Masaki; Kimura, Kazumi; Murayama, Shigeo

    2015-01-01

    Diagnosing clinical progressive supranuclear palsy (PSP) is challenging. We hypothesize that there are more cases of pathological PSP than have been clinically identified, but its diagnosis is challenging because the initial lesions and progression of PSP have not yet been clarified. The purpose of our study was to clarify the incidence of PSP in consecutive autopsy cases and identify pathological characteristics of early PSP. We investigated 324 consecutive autopsy patients from a general geriatric hospital (age, mean±SD=82.5±8.7 years). Paraffin sections of the midbrain were immunostained with anti 4-repeat tau antibodies (RD4). We selected cases showing RD4-positive neurofibrillary tangles and tufted astrocytes in the midbrain sections. Then, we used anti-phosphorylated tau antibody to immunostain sections from the basal ganglia, subthalamic nucleus, midbrain, pons, medulla, and cerebellum. Of the 324 patients, 35 had RD4-positive structures in the midbrain. From these 35 cases, we excluded those for which autopsies confirmed definite PSP (n=5) and cases of corticobasal degeneration (n=1), Alzheimer's disease (n=11), dementia of grain (n=10), and neurofibrillary tangles predominant forms of senile dementia (n=2), leaving 8 cases. We diagnosed these 8 cases as pure PSP-type tauopathy. Pure PSP-type tauopathy was detected in 2.5% of the consecutive autopsy cases, and this incidence was 1.6 times greater than that of neuropathologically definite PSP. This pure PSP-type tauopathy likely indicates preclinical stages of PSP. Furthermore, the novel neuropathological finding, which we term "preclinical PSP," is unique and has not previously been reported. In order to elucidate the causes and pathological mechanisms of PSP, preclinical PSP should be investigated further. PMID:26823029

  5. Association of pulmonary histopathological findings with toxicological findings in forensic autopsies of illicit drug users

    Directory of Open Access Journals (Sweden)

    Todorovi? Miloš S.

    2011-01-01

    Full Text Available Background/Aim. Drug abuse remains a significant social problem in many countries. The aim of the study was to estimate association between pulmonary histopathological changes and results of toxicological analyses in forensic autopsies of illicit drug users. Methods. This investigation was performed in the Institute of Forensic Medicine, Belgrade, and in the Clinical Center, Department of Forensic Medicine, Kragujevac, from 2000 to 2004, and included 63 medicolegal autopsies of heroin or other drug consumers who suddenly died. Autopsies, postmortem toxicological examination of drugs and serological analyses of anti- HIV/HBV/HCV antibodies were performed. Results. The deceased persons were mostly male, 46/63 (73.01%, ranged in age from 19 to 49 years (mean 31 years and all were whites. Postmortem toxicological examination was performed on all of the deceased persons and drugs in the fatal range were identified in only eight of them (12.7%, in the toxic range in ten (15.87%, and in minimal concentrations in 35 (55.56% of the deceased persons. Drugs identified in the fatal, toxic or minimal range included heroin-morphine (38/53, cocaine (4/53, tramadol (3/53, and lorazepam (1/53. In the 7 remaining subjects, ethanol in combination with heroin was found in 4 cases, and diazepam in combination with heroin in 3 cases. Dominant pathomorphological changes were findings in the lung tissue. Most common histological changes observed in drug users were pulmonary edema - 55/63 (87.3%, acute alveolar hemorrhages - 49/63 (77.78%, hemosiderin-laden macrophages (siderophages - 52/63 (82,54%, and emphysematous changes - 51/63 (80,95%. Conclusion. Pulmonary edema is the frequent non-specific autopsy finding which is associated with virtually all routes of drug administration. The histopatological study is necessary to determinate a cause of death when a deceased person has the history of dependence or abouse of psychoactive drugs with negative toxicological results.

  6. Death due to sickle cell anaemia, an autopsy diagnosis: a study at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Hemali J. Tailor

    2015-04-01

    Full Text Available Background: Sickle cell disease (SCD is the generic term for the group of inherited haemoglobinopathies caused by the occurrence of Haemoglobin S (HbS in the homozygous or heterozygous form in combination of Hbs with another abnormal haemoglobin such as HbSC or beta-thalassaemias (HbS-thal. Sickle cell syndromes are remarkable for their clinical heterogeneity, including their presentations as sudden and unexpected deaths due to a sickle cell crisis. Less numbers of deaths are reported due to this cause because of ignorance of autopsy surgeon in considering this disease as a cause of death despite of its high prevalence. While doing autopsy in cases of deaths with no apparent cause and physical over activity medical officer must keep in mind the possibility of death due to vaso-occlusive crisis in sickle cell disease. Methods: The study covers a period of one year (January 2013 - December 2013 and it is a study of cases of autopsy carried out in a tertiary care hospital of South Gujarat. Results: A total of 607 cases examined, out of which sickled red blood cells were detected in 17 cases. The respective records were reviewed. Out of 17 cases, 13 cases were male and 4 cases were females. The youngest person was 15 years female and oldest was 70 years male. Conclusion: Sickle cell crisis is one of the causes of sudden unexplained deaths. The present study highlights the role of autopsy in such cases. Community awareness and marriage counseling programs are also helpful in preventing sickle cell disease. [Int J Res Med Sci 2015; 3(4.000: 944-947

  7. Thrombotic thrombocytopenic purpura in a patient with very early pregnancy: clinical presentation and autopsy findings.

    Science.gov (United States)

    Sharma, Aman; Radotra, Bishan; Wanchu, Ajay; Malhotra, Pankaj; Singh, Surjit; Varma, Subhash

    2008-10-01

    Thrombotic thrombocytopenic purpura is a thrombotic microangiopathy leading to microvascular occlusion resulting in ischemic dysfunction of various organs. Pregnancy has been thought to precipitate it during second and third trimester, but its reports in first trimester are extremely rare. We report the clinical protocol of a young lady with 5-week period of gestation, who presented with fever, seizures and altered sensorium, and succumbed to her illness during an episode of seizure. Complete autopsy findings are also presented in detail. PMID:18832919

  8. A STUDY OF LUNG PATHOLOGY IN PEDIATRICS AUTOPSIES: AN 8 YEAR STUDY

    Directory of Open Access Journals (Sweden)

    Majethia Nikhil

    2014-11-01

    Full Text Available BACKGROUND: Pneumonia remains the number one killer of children, taking the lives of 1.3 million in 2011 alone. More than 99% of all pneumonia deaths occur in developing countries. The majority of pneumonia cases are preventable and treatable, but clinical diagnosis is highly fallible in many cases and the frequency of morbid state is best assessed by post-mortem examination that may reveal diagnosis which may not be suspected clinically or may, in some way, discredit. AIMS: 1. To ascertain various pulmonary lesions in paediatric deaths. 2. To find incidence of pulmonary lesions. 3. To study the incidence of pulmonary tuberculosis, 4. To find incidence of pulmonary pathology directly and indirectly contributing to the death. SETTINGS: Lokmanya Tilak Municipal General Hospital, Sion, Mumbai. DESIGN: A retrospective observational study. METHODS AND MATERIAL: In this study pediatric age group of (0-15 years admitted in IPCU,NICU and Pediatric, Medicine and Surgery unit are included from the period of 2006-2013. The lung pathology in various diseases entities were studied and co-related with age, sex and clinical history. RESULTS: Of total 3606 autopsies, 642 were pediatric autopsies i.e. 17.8% of all autopsies, and 111 were neonatal autopsies. Of 642, 531(82.7% had primary lung pathology and 157(24.4% had secondary lung pathology. The common age group affected is < 5 years. Bronchopneumonia was the commonest pathology observed as primary lung pathology. Interstitial/viral pneumonia was 2nd most common of primary lung pathology Infective pathology was the most common lesions, of which bronchopneumonia was the most common pathology observed and tuberculosis contributed to 3%of primary lung pathologies. CONCLUSION: The most common lung lesion in pediatric age is infections, which are preventable and curative with appropriate measures. This study will help to improve mother child health services

  9. Effect of misclassification of causes of death in verbal autopsy: can it be adjusted?

    OpenAIRE

    Chandramohan, D; Setel, P.; Quigley, M

    2001-01-01

    BACKGROUND: Verbal autopsy (VA) is an indirect method of ascertaining cause of death from information about symptoms and signs obtained from bereaved relatives. This method has been used in several settings to assess cause-specific mortality. However, cause-specific mortality estimates obtained by VA are susceptible to bias due to misclassification of causes of death. One way of overcoming this limitation of VA is to adjust the crude VA estimate of cause-specific mortality fractions (CSMF) us...

  10. The importance of microbiological testing for establishing cause of death in 42 forensic autopsies

    DEFF Research Database (Denmark)

    Christoffersen, Søren

    2015-01-01

    Microorganisms have always been one of the great challenges of humankind, being responsible for both high morbidity and mortality throughout history. In a forensic setting microbiological information will always be difficult to interpret due to lack of antemortem information and changes in flora postmortem. With this study we aim to review the use of microbiological procedures at our forensic institute. In a retrospective study including 42 autopsies performed at our Institute, where microbiolog...

  11. Determination of americium and plutonium in autopsy tissue: methods and problems

    International Nuclear Information System (INIS)

    The current methods used by the tissue analysis program at LASL for the determination of americium and plutonium in autopsy tissue are described. Problems affecting radiochemical yield are discussed. Included are problems associated with sample preparation, separation of plutonium from large amounts of bone ash, and reagent contamination. The average 242Pu tracer yield for 1800 Pu determinations is 78 +- 12%. The average 242Am tracer yield is 85 +- 7% for 40 determinations

  12. Association between Cysticercosis and Neoplasia: A Study Based on Autopsy Findings

    OpenAIRE

    Camila Lourencini Cavellani; Aline Cristina Souza da Silva; Grace Kelly Naves de Aquino Ribeiro; Lívia Ferreira Oliveira; Mara Lúcia Fonseca Ferraz; Vicente De Paula Antunes Teixeira

    2013-01-01

    Chronic infections including the cysticercosis induce inflammatory cells to produce free radicals and synthesize carcinogenic toxins. The cells with genetic mutations proliferate in a disorganized manner, leading to the development of neoplasia. The aim of the present study was to demonstrate the relation between cysticercosis and neoplasia. Patients autopsied were divided into 4 groups: patients with neoplasia and cysticercosis (NC), patients with neoplasia only (NN), patients with cysticerc...

  13. Improving performance of the Tariff Method for assigning causes of death to verbal autopsies

    OpenAIRE

    Serina, Peter; Riley, Ian; Stewart, Andrea; James, Spencer L.; Flaxman, Abraham D; Lozano, Rafael; Hernandez, Bernardo; Mooney, Meghan D.; Luning, Richard; Black, Robert; Ahuja, Ramesh; Alam, Nurul; Alam, Sayed Saidul; Ali, Said Mohammed; Atkinson, Charles

    2015-01-01

    Background: Reliable data on the distribution of causes of death (COD) in a population are fundamental to good public health practice. In the absence of comprehensive medical certification of deaths, the only feasible way to collect essential mortality data is verbal autopsy (VA). The Tariff Method was developed by the Population Health Metrics Research Consortium (PHMRC) to ascertain COD from VA information. Given its potential for improving information about COD, there is interest in refini...

  14. Concordancia entre el diagnóstico clínico y el patológico por necropsias Clinico-pathological concordance at autopsies

    Directory of Open Access Journals (Sweden)

    EDITH VALDEZ-MARTÍNEZ

    1998-01-01

    Full Text Available Objetivo. Determinar la concordancia entre diagnósticos clínicos y patológicos con base en los resultados de necropsias. Material y métodos. Se revisaron 67 protocolos de necropsia y expedientes clínicos de niños y adultos del servicio de patología del Centro de Especialidades Médicas del Estado de Veracruz Doctor Rafael Lucio, durante 1995 y 1996. Se obtuvieron las frecuencias simples de las variables de estudio, y la concordancia se calculó con el estadístico kappa simple. Resultados. En general la cifra de necropsias fue de 10.5%. Correspondió a la población infantil la mayor frecuencia (17.5%. El 59% de diagnósticos clínicos en niños y el 57% en adultos presentaron algún tipo de error La concordancia del diagnóstico principal ante y postmortem fue de 26% (infantes y 41% (adultos. Conclusiones. La alta cifra de errores diagnósticos y la consecuente baja concordancia clínicopatológica apoyan el hecho de que, a pesar del avance tecnológico en los procedimientos diagnósticos, es necesario realizar necropsias con el fin de documentar de manera más definitiva el control de calidad del ejercicio de la medicina.Objective. To determine the degree of concordance between clinical and autopsy diagnosis. Material and methods. The records of 67 autopsies and clinical files of children and adults, comprising the years 1995 to 1996, from a third level hospital in the State of Veracruz, Mexico, were revised. The concordance score was calculated with the statistical kappa. Results. In general, the rate of autopsy was 10.5%, with higher frequency for children (17.5%. In children, 59% of clinical diagnoses revealed mistakes and in adults, 57%. The degree of agreement in the underlying cause ante and postmortem was 6% in children and 41% in adults. Conclusions The high rate of diagnostic error and low concordance score between clinical and autopsy diagnosis strongly suggests that, in spite of increased availability of modern diagnostic techniques, the necessity of postmortem studies to control the level of medical practice is evident.

  15. Ectopia cordis with endocardial cushion defect: Prenatal ultrasonographic diagnosis with autopsy correlation

    OpenAIRE

    Balakumar K; Misha K

    2010-01-01

    The prenatal ultrasonographic diagnosis of ectopia cordis associated with a complex intra-cardiac defect (common atrium, common atrioventricular valve with single ventricle) is illustrated in a 32-week gestation fetus. The fetus showed associated features of amniotic band disruption sequence. The cardiac autopsy findings correlated with the antenatal diagnosis. The association of ectopia cordis with amniotic band disruption is rare and infrequently reported in literature.

  16. Ectopia cordis with endocardial cushion defect: Prenatal ultrasonographic diagnosis with autopsy correlation

    Directory of Open Access Journals (Sweden)

    Balakumar K

    2010-01-01

    Full Text Available The prenatal ultrasonographic diagnosis of ectopia cordis associated with a complex intra-cardiac defect (common atrium, common atrioventricular valve with single ventricle is illustrated in a 32-week gestation fetus. The fetus showed associated features of amniotic band disruption sequence. The cardiac autopsy findings correlated with the antenatal diagnosis. The association of ectopia cordis with amniotic band disruption is rare and infrequently reported in literature.

  17. Psychological Autopsy and Necropsy of an Unusual Case of Suicide by Intravenous Toluene

    OpenAIRE

    Kulkarni, Ranganath R.; Hemanth Kumar, RG; Kulkarni, Pratibha R.; Kotabagi, Raghavendra B.

    2015-01-01

    Toluene (methylbenzene; volatile hydrocarbon) is an industrial solvent that causes major injury to the lungs; the organ being the first capillary bed encountered. We report an unusual case of suicide by a 24-year-old male, paramedical professional, with fatal outcome within 16 h of intentional, intravenous self-administration of toluene, with clinical presentation of acute respiratory distress syndrome. Psychological autopsy revealed severe depressive disorder and solvent (inhalant) abuse, wi...

  18. Memories of an Autopsy: The Effects of Stress Exposure on Suggestibility for a Stressful Event

    OpenAIRE

    Elisa Krackow; Vanessa M. Jacoby; Scotti, Joseph R.

    2013-01-01

    The current study examined the effects of stressful life events on memory for a stressful event. Two groups ofcollege students (N = 61) were formed for analysis based on the presence or absence of particular stressful lifeevents. Participants then viewed a graphic video depicting an autopsy, and received a memory interview fourdays later. Results showed similar group performance on correctly leading questions. However, participants inthe Specific Stressor-Exposed group were less suggestible t...

  19. The presence of enterovirus, adenovirus, and parvovirus B19 in myocardial tissue samples from autopsies

    DEFF Research Database (Denmark)

    Nielsen, Trine Skov; Hansen, Jakob; Nielsen, Lars Peter; Baandrup, Ulrik Thorngren; Banner, Jytte

    2014-01-01

    PURPOSE: Multiple viruses have been detected in cardiac tissue, but their role in causing myocarditis remains controversial. Viral diagnostics are increasingly used in forensic medicine, but the interpretation of the results can sometimes be challenging. In this study, we examined the prevalence of adenovirus, enterovirus, and parvovirus B19 (PVB) in myocardial autopsy samples from myocarditis related deaths and in non-inflamed control hearts in an effort to clarify their significance as the cau...

  20. Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring

    OpenAIRE

    Leitao, Jordana; Chandramohan, Daniel; Byass, Peter; Jakob, Robert; Bundhamcharoen, Kanitta; Choprapawon, Chanpen; de Savigny, Don; Fottrell, Edward; França, Elizabeth; Frøen, Frederik; Gewaifel, Gihan; Hodgson, Abraham; Hounton, Sennen; KAHN, KATHLEEN; Krishnan, Anand

    2013-01-01

    OBJECTIVE: Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems. METHODS: A literature revie...

  1. An analytical method for the determination of plutonium in autopsy samples

    International Nuclear Information System (INIS)

    A sensitive method for the determination of plutonium in autopsy samples is described. After a suitable chemical pretreatment of the samples the plutonium is separated by extraction chromatography with tri-n-octylphosphine oxide (TOPO) supported on microporus polyethylene. After electrodeposition of plutonium the activity is counted by alpha spectroscopy. The global yield was 75-80%. The reagent blank activity was such to allow the determination of some femtocuries of plutonium

  2. Evaluating the InterVA model for determining AIDS mortality from verbal autopsies in the adult population of Addis Ababa.

    OpenAIRE

    Tensou, B; Araya, T; Telake, DS; Byass, P; Berhane, Y; Kebebew, T; Sanders, EJ; Reniers, G

    2010-01-01

    OBJECTIVE: To evaluate the performance of a verbal autopsy (VA) expert algorithm (the InterVA model) for diagnosing AIDS mortality against a reference standard from hospital records that include HIV serostatus information in Addis Ababa, Ethiopia. METHODS: Verbal autopsies were conducted for 193 individuals who visited a hospital under surveillance during terminal illness. Decedent admission diagnosis and HIV serostatus information are used to construct two reference standards (AIDS vs. other...

  3. Changing patterns of infant death over the last 100 years: autopsy experience from a specialist children's hospital

    OpenAIRE

    Pryce, J. W.; Weber, M A; Ashworth, M. T.; Roberts, S; Malone, M.; Sebire, N J

    2012-01-01

    OBJECTIVES: Infant mortality has undergone a dramatic reduction in the UK over the past century because of improvements in public health policy and medical advances. Postmortem examinations have been performed at Great Ormond Street Hospital for over 100 years, and analysis of cases across this period has been performed to assess changing patterns of infant deaths undergoing autopsy. DESIGN: Autopsy reports from 1909 and 2009 were examined. Age, major pathology and cause of death was reviewed...

  4. Clinical manifestations and pulmonary histopathological analysis related to different diseases in patients with fatal pulmonary thromboembolism: an autopsy study

    OpenAIRE

    Ruppert ADP; Soeiro AM; Almeida MCF; Oliveira Jr MT; Serrano Jr CV; VL Capelozzi

    2014-01-01

    Aline Domingos Pinto Ruppert,1 Alexandre de Matos Soeiro,2 Maria Carolina Feres de Almeida,2 Múcio Tavares de Oliveira Jr,2 Carlos V Serrano Jr,2 Vera Luiza Capelozzi1 1Department of Pathology, 2Heart Institute, University of São Paulo Medical School, São Paulo, Brazil Background: To correlate underlying diseases, in autopsies of patients with pulmonary thromboembolism (PTE) to histological findings and manifestations reviewed in the medical records. Methods: The autopsy...

  5. Identifying factors associated with maternal deaths in Jharkhand, India: a verbal autopsy study.

    Science.gov (United States)

    Khan, Nizamuddin; Pradhan, Manas Ranjan

    2013-06-01

    Maternal mortality has been identified as a priority issue in health policy and research in India. The country, with an annual decrease of maternal mortality rate by 4.9% since 1990, now records 63,000 maternal deaths a year. India tops the list of countries with high maternal mortality. Based on a verbal autopsy study of 403 maternal deaths, conducted in 2008, this paper explores the missed opportunities to save maternal lives, besides probing into the socioeconomic factors contributing to maternal deaths in Jharkhand, India. This cross-sectional study was carried out in two phases, and a multistage sampling design was used in selecting deaths for verbal autopsy. Informed consent was taken into consideration before verbal autopsy. The analytical approach includes bivariate analysis using SPSS 15, besides triangulation of qualitative and quantitative findings. Most of the deceased were poor (89%), non-literates (85%), and housewives (74%). Again, 80% died in the community/at home, 28% died during pregnancy while another 26% died during delivery. Any antenatal care was received by merely 28% women, and only 20% of the deliveries were conducted by skilled birth attendants (doctors and midwives). Delays in decision-making, travel, and treatment compounded by ignorance of obstetric complications, inadequate use of maternal healthcare services, poor healthcare infrastructure, and harmful rituals are the major contributing factors of maternal deaths in India. PMID:23930345

  6. An Autopsy Case of Rapidly Progressing Spindle Cell Carcinoma of the Lung Accompanied with Intratumor Hemorrhage

    Science.gov (United States)

    Kida, Jun-ichiro; Kanaji, Nobuhiro; Kishi, Sosuke; Imaida, Katsumi; Bandoh, Shuji

    2015-01-01

    Patient: Male, 74 Final Diagnosis: Spindle cell carcinoma of the lung Symptoms: — Medication: Pemetrexed • carboplatin Clinical Procedure: Biopsy and autopsy Specialty: Oncology Objective: Rare disease Background: Spindle cell carcinoma (SPCC) of the lung is a subset of sarcomatoid carcinoma. Its clinical features are unclear because of its rarity. Here, we report an autopsy case of SPCC and review CT findings and chemotherapeutic regimens based on previous reports of this disease. To our knowledge, this is the first reported case of pemetrexed used to treat SPCC. Case Report: A 74-year-old Japanese male presented with dyspnea and contrast-enhanced computed tomography (CT) showed abundant left pleural effusion and a mass in lower lobe of the left lung. By the tumor biopsy, he was diagnosed for SPCC of the lung, cT3N0M1a, stage IV. The tumor was resistant to chemotherapy with carboplatin and pemetrexed, and rapidly progressed. Autopsy revealed abundant hemorrhage within the tumor, which apparently reflects a low-density area in CT. Conclusions: Present case and the accumulation of cases indicate that low-density areas in CT and rapid tumor progression may be common SPCC findings. PMID:26558362

  7. Pathogenesis of Morquio A syndrome: an autopsied case reveals systemic storage disorder.

    Science.gov (United States)

    Yasuda, Eriko; Fushimi, Kazunari; Suzuki, Yasuyuki; Shimizu, Katsuji; Takami, Tsuyoshi; Zustin, Jozef; Patel, Pravin; Ruhnke, Kristen; Shimada, Tsutomu; Boyce, Bobbie; Kokas, Terry; Barone, Carol; Theroux, Mary; Mackenzie, William; Nagel, Barbara; Ryerse, Jan S; Orii, Kenji E; Iida, Hiroki; Orii, Tadao; Tomatsu, Shunji

    2013-07-01

    Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is a lysosomal storage disorder caused by deficiency of N-acetylgalactosamine-6-sulfate sulfatase, which results in systemic accumulation of glycosaminoglycans (GAGs), keratan sulfate and chondroitin-6-sulfate. Accumulation of these GAGs causes characteristic features as disproportionate dwarfism associated with skeletal deformities, genu valgum, pigeon chest, joint laxity, and kyphoscoliosis. However, the pathological mechanism of systemic skeletal dysplasia and involvement of other tissues remain unanswered in the paucity of availability of an autopsied case and successive systemic analyses of multiple tissues. We report here a 20-year-old male autopsied case with MPS IVA, who developed characteristic skeletal features by the age of 1.5 years and died of acute respiratory distress syndrome five days later after occipito-C1-C2 cervical fusion. We pathohistologically analyzed postmortem tissues including trachea, lung, thyroid, humerus, aorta, heart, liver, spleen, kidney, testes, bone marrow, and lumbar vertebrae. The postmortem tissues relevant with clinical findings demonstrated 1) systemic storage materials in multiple tissues beyond cartilage, 2) severely vacuolated and ballooned chondrocytes in trachea, humerus, vertebrae, and thyroid cartilage with disorganized extracellular matrix and poor ossification, 3) appearance of foam cells and macrophages in lung, aorta, heart valves, heart muscle, trachea, visceral organs, and bone marrow, and 4) storage of chondrotin-6-sulfate in aorta. This is the first autopsied case with MPS IVA whose multiple tissues have been analyzed pathohistologically and these pathological findings should provide a new insight into pathogenesis of MPS IVA. PMID:23683769

  8. Investigation of a fatal airplane crash: autopsy, computed tomography, and injury pattern analysis used to determine who was steering the plane at time of accident. A case report

    DEFF Research Database (Denmark)

    Høyer, Christian Bjerre; Nielsen, Trine Skov; Nagel, Lise Loft; Uhrenholt, Lars; Boel, Lene Warner Thorup

    2012-01-01

    A fatal accident is reported in which a small single-engine light airplane crashed. The airplane carried two persons in the front seats, both of whom possessed valid pilot certificates. Both victims were subject to autopsy, including post-mortem computed tomography scanning (PMCT) prior to the autopsy. The autopsies showed massive destruction to the bodies of the two victims but did not identify any signs of acute or chronic medical conditions that could explain loss of control of the airplane. ...

  9. Using verbal autopsy to assess the prevalence of HIV infection among deaths in the ART period in rural Uganda: a prospective cohort study, 2006-2008

    OpenAIRE

    Mugisha Joseph O; Kibengo Freddie M; Nalweyiso Norah; Baisley Kathy; Mayanja Billy N; Van der Paal Lieve; Maher Dermot; Kaleebu Pontiano

    2011-01-01

    Abstract Background Verbal autopsy is important for detecting causes of death including HIV in areas with inadequate vital registration systems. Before antiretroviral therapy (ART) introduction, a verbal autopsy study in rural Uganda found that half of adult deaths assessed were in HIV-positive individuals. We used verbal autopsy to compare the proportion of HIV-positive adult deaths in the periods before and after ART introduction. Methods Between 2006 and 2008, all adult (? 13 years) deaths...

  10. Craniometric analysis for estimation of stature in Nepalese population--A study on an autopsy sample.

    Science.gov (United States)

    Shrestha, Rijen; Shrestha, Pramod Kumar; Wasti, Harihar; Kadel, Tulsi; Kanchan, Tanuj; Krishan, Kewal

    2015-03-01

    Establishing the identity of the deceased becomes essential when highly decomposed bodies, mutilated body parts or skeletal remains are recovered from mass fatality sites. In these situations, estimation of stature along with other parameters such as age, sex and race/ethnicity becomes important to establish the biological profile of the deceased. Following the Maoist insurgency in Nepal, there have been numerous discoveries of unidentified human remains in mass graves or otherwise. No systemic studies and anthropological data on the Nepalese population however, is available posing problems in anthropologic evaluation of the remains. The sample of the present study consisted of 200 autopsied cases (148 males and 52 female adult cadavers). During the autopsy, the scalp was reflected after giving a coronal incision extending from one mastoid to the other exposing the cranium in each case. Maximum cranial length (MCL), maximum cranial breadth (MCB), bi-zygomatic breadth (BZB), minimum frontal breadth (MFB) and length of parietal chord (PC) were then measured. Stature was measured as the length of the body from head to heel in centimeters with the heel, buttocks, back of the shoulders and the head in contact with the autopsy table. Linear and stepwise multiple regression models were derived for estimation of stature from cranial measurements. Univariate, bivariate and multivariate regression models show statistically significant correlation between stature and the cranial measurements. The present study opines that the stature estimation from cranial dimensions using multivariate linear regression models is more accurate than those of the univariate and bivariate regression models. This study presents a rare data from Nepalese population that show typical Asian features and thus, is significant from anthropologic and genetic point of view. The study observations further contribute a baseline data bank for forensic pathologists and specialists. PMID:25595547

  11. Agreement between death-certificate and autopsy diagnoses among atomic-bomb survivors

    International Nuclear Information System (INIS)

    Using the Atomic Bomb Casualty Commission/Radiation Effects Research Foundation series of over 5000 autopsies, we examined death-certificate accuracy for several disease categories and assessed the effect of potential modifying factors on this accuracy. For 12 cause-of-death categories, the overall percent agreement between death-certificate and autopsy diagnoses was only 52.5%. Although neoplasms had the highest detection rate (on the death certificate) in the study, still almost 25% of cancers diagnosed at autopsy were missed on the death certificate. Only for neoplasms and external causes of death were confirmation and detection rates above 70%. Confirmation rates were between 50% and 70% for infectious and parasitic diseases and heart and other vascular diseases. Detection rates reached a similar level for infectious and parasitic, cerebrovascular, and digestive diseases. Specificity rates were above 90% for all but the cerebrovascular disease category. Overall agreement decreased with increasing age of the decedents and was lower for deaths occurring outside of hospital vs those occurring in a hospital. There was some suggestion that agreement rates were higher for more-recent deaths but no indication that radiation dose, sex, city of residence, or inclusion in a biennial clinical-examination program influenced agreement. Because the inaccuracy of death-certificate diagnoses can have major implications for many aspects of health research and planning, it is important to be aware that death-certificate accuracy is low and can vary widely depending on the patient's age at death and the place of death. (J.P.N.)

  12. Postmortem heart weight modelled using piecewise linear regression in 27,645 medicolegal autopsy cases.

    Science.gov (United States)

    Wingren, Carl Johan; Ottosson, Anders

    2015-07-01

    The interpretation of postmortem heart weight is often difficult, and references for normal heart weight are important. However, to assess the cause of death at a medicolegal autopsy it is also important to have references based on an unselected population of medicolegal autopsy cases with non-natural causes of death (not due directly to disease). We aimed at studying and deriving references for adult heart weight by considering sex, age and body size in cases with an external cause of death. We identified all medicolegal autopsies in Sweden from 1999 to 2013 (n=79,778) and included 27,645 cases. We applied multivariate piecewise linear regression models in three strata of body mass-underweight, normal-/overweight and obesity. We observed that approximately 50% of the variation in heart weight was explained by age, sex and body size. These variables were slightly less important in explaining the variation in heart weight in the underweight and obese compared to in those normal or overweight. Based on the linear regression models we present equations to calculate the predicted heart weight with reference intervals using age, sex, body weight and height. We provide an online heart weight calculator (http://lundforensicmedicine.com) based on these equations. In the forensic interpretation of postmortem heart weights, we suggest that heart weight references derived in cases with an external cause of death is an important complement to references solely based on healthy and normal hearts. Furthermore, the heart weight references presented are derived from a large population, with sufficient numbers for separate models in underweight, normal-/overweight and obese populations. PMID:26004078

  13. Cause of death among Ghanaian adolescents in Accra using autopsy data

    Directory of Open Access Journals (Sweden)

    Tettey Yao

    2011-09-01

    Full Text Available Abstract Background There is limited data on adolescent mortality particularly from developing countries with unreliable death registration systems. This calls for the use of other sources of data to ascertain cause of adolescent mortality. The objective of this study was to describe the causes of death among Ghanaian adolescents 10 to 19 years in Accra, Ghana utilizing data from autopsies conducted in Korle Bu Teaching Hospital (KBTH. Findings Out of the 14,034 autopsies carried out from 2001 to 2003 in KBTH, 7% were among adolescents. Of the 882 deaths among adolescents analyzed, 402 (45.6% were females. There were 365 (41.4% deaths from communicable disease, pregnancy related conditions and nutritional disorders. Non-communicable diseases accounted for 362 (41% cases and the rest were attributable to injuries and external causes of morbidity and mortality. Intestinal infectious diseases and lower respiratory tract infections were the most common communicable causes of death collectively accounting for 20.5% of total deaths. Death from blood diseases was the largest (8.5% among the non-communicable conditions followed by neoplasms (7%. Males were more susceptible to injuries than females (?2 = 13.45, p = .000. At least five out of ten specific causes of death were as a result of infections with pneumonia and typhoid being the most common. Sickle cell disease was among the top three specific causes of death. Among the females, 27 deaths (6.7% were pregnancy related with most of them being as a result of abortion. Conclusions The autopsy data from the Korle-Bu Teaching Hospital can serve as a useful source of information on adolescent mortality. Both communicable and non-communicable diseases accounted for most deaths highlighting the need for health care providers to avoid complacency in their management of adolescents presenting with these diseases.

  14. Cause of Sudden Cardiac Deaths on Autopsy Findings; a Four-Year Report

    Directory of Open Access Journals (Sweden)

    Dinesh Rao

    2014-03-01

    Full Text Available Introduction: Incidence of sudden cardiac death (SCD has been steadily increasing all over the world. While knowing the cause of SCD is one of the favorites of the physicians involved with these cases, it is very difficult and challenging task for the forensic physician. The present report is a prospective study regarding cause of SCDs on autopsy examination in four-year period, Bangalore, India. Methods: The present prospective study is based on autopsy observations, carried out for four-year period from 2008 to 2011, and analyzed for cause of SCDs. The cases were chosen as per the definition of sudden death and autopsied. The material was divided into natural and unnatural groups. Finally, on histopathology, gross examination, hospital details, circumstantial, and police reports the cause of death was inferred. Results: A total of 2449 autopsy was conducted of which 204 cases were due to SCD. The highest SCDs were reported in 50-60 years age group (62.24%; n-127, followed closely by the age group 60-69 (28.43%; n-58. Male to female ratio was around 10:1. The maximum number of deaths (n=78 was within few hours (6 hours after the onset of signs and symptoms. In 24 (11.8% cases major narrowing was noted in both the main coronaries, in 87 (42.6% cases in the left anterior descending coronary artery (LAD, and in 18 (51.5% cases in the right coronary artery (RCA. The major cardiac pathology resulting in sudden death was coronary artery disease (n-116; 56.86% and myocardial infarction (n-104; 50.9%. most of the SCDs occurred in the place of residence (n-80; 39.2% followed closely by death in hospital (n-49; 24.01%. Conclusion: Coronary occlusion was the major contributory cause of sudden death with cardiac origin and the highest number of deaths were reported in the age 50-59 years with male to female ratio of 10:1. 

  15. Stillbirths and newborn deaths in slum settlements in Mumbai, India: a prospective verbal autopsy study

    OpenAIRE

    Bapat Ujwala; Alcock Glyn; More Neena; Das Sushmita; Joshi Wasundhara; Osrin David

    2012-01-01

    Abstract Background Three million babies are stillborn each year and 3.6 million die in the first month of life. In India, early neonatal deaths make up four-fifths of neonatal deaths and infant mortality three-quarters of under-five mortality. Information is scarce on cause-specific perinatal and neonatal mortality in urban settings in low-income countries. We conducted verbal autopsies for stillbirths and neonatal deaths in Mumbai slum settlements. Our objectives were to classify deaths acc...

  16. Random forests for verbal autopsy analysis: multisite validation study using clinical diagnostic gold standards

    Directory of Open Access Journals (Sweden)

    James Spencer L

    2011-08-01

    Full Text Available Abstract Background Computer-coded verbal autopsy (CCVA is a promising alternative to the standard approach of physician-certified verbal autopsy (PCVA, because of its high speed, low cost, and reliability. This study introduces a new CCVA technique and validates its performance using defined clinical diagnostic criteria as a gold standard for a multisite sample of 12,542 verbal autopsies (VAs. Methods The Random Forest (RF Method from machine learning (ML was adapted to predict cause of death by training random forests to distinguish between each pair of causes, and then combining the results through a novel ranking technique. We assessed quality of the new method at the individual level using chance-corrected concordance and at the population level using cause-specific mortality fraction (CSMF accuracy as well as linear regression. We also compared the quality of RF to PCVA for all of these metrics. We performed this analysis separately for adult, child, and neonatal VAs. We also assessed the variation in performance with and without household recall of health care experience (HCE. Results For all metrics, for all settings, RF was as good as or better than PCVA, with the exception of a nonsignificantly lower CSMF accuracy for neonates with HCE information. With HCE, the chance-corrected concordance of RF was 3.4 percentage points higher for adults, 3.2 percentage points higher for children, and 1.6 percentage points higher for neonates. The CSMF accuracy was 0.097 higher for adults, 0.097 higher for children, and 0.007 lower for neonates. Without HCE, the chance-corrected concordance of RF was 8.1 percentage points higher than PCVA for adults, 10.2 percentage points higher for children, and 5.9 percentage points higher for neonates. The CSMF accuracy was higher for RF by 0.102 for adults, 0.131 for children, and 0.025 for neonates. Conclusions We found that our RF Method outperformed the PCVA method in terms of chance-corrected concordance and CSMF accuracy for adult and child VA with and without HCE and for neonatal VA without HCE. It is also preferable to PCVA in terms of time and cost. Therefore, we recommend it as the technique of choice for analyzing past and current verbal autopsies.

  17. Reliability of death certifications for different types of cancer. An autopsy survey.

    OpenAIRE

    Cavallo, Franco

    1986-01-01

    A series of 1000 cases was selected, on the basis of a clinical and/or post-mortem diagnosis of cancer, out of 4927 autopsies performed at the Institute of Pathologic Anatomy and Histopathology of Turin University. The comparison between clinical and post-mortem diagnoses pointed to an overall concordance with regard to the correct identification of a malignancy as the underlying cause of death of 75%; if the correct identification of type and primary site of the tumor was also taken into acc...

  18. Verbal autopsy of 80,000 adult deaths in Tamilnadu, South India.

    OpenAIRE

    Peto Richard; Gajalakshmi Vendhan

    2004-01-01

    Abstract Background Registration of the fact of death is almost complete in the city of Chennai and not so in the rural Villupuram district in Tamilnadu, India. The cause of death is often inadequately recorded on the death certificate in developing countries like India. A special verbal autopsy (VA) study of 48 000 adult (aged ? 25 yrs) deaths in the city of Chennai (urban) during 1995–97 and 32 000 in rural Villupuram during 1997–98 was conducted to arrive at the probable underlying cause o...

  19. Organ distribution of radioactive cesium in autopsy material following the Chernobyl catastrophe

    International Nuclear Information System (INIS)

    Tissue specimens were obtained at autopsy, mechanically reduced to small pieces and filled into test tubes up to a height of 5 cm so that the measuring requirements were compatible with the maximum counting efficiency of the device used. Such tissue examinations were performed for the skeletal musculature of the calf, the liver, spleen, kidneys, heart muscle, thyroid, testicles, brain, fatty tissue from the abdominal wall as well as bone marrow from the femur. On separate quantitative analysis is was found that 67% of the cesium currently detected in tissue samples is Cs-137, while Cs-134 accounts for no more than 33%. (orig./DG)

  20. Efficacy of drug screening in forensic autopsy: retrospective investigation of routine toxicological findings.

    Science.gov (United States)

    Tominaga, Mariko; Michiue, Tomomi; Inamori-Kawamoto, Osamu; Hishmat, Asmaa Mohammed; Oritani, Shigeki; Takama, Masashi; Ishikawa, Takaki; Maeda, Hitoshi

    2015-05-01

    Toxicological analysis is indispensable in forensic autopsy laboratories, but often depends on the limitations of individual institutions. The present study reviewed routine drug screening data of forensic autopsy cases (n=2996) during an 18.5-year period (January 1996-June 2014) at our institute to examine the efficacy of the procedures and findings in autopsy diagnosis and interpretation. Drug screening was performed using on-site immunoassay screening devices and gas chromatography/mass spectrometry (GC/MS) in all cases, followed by re-examination using GC/MS and liquid chromatography/tandem mass spectrometry (LC/MS/MS) at a cooperating institute in specific cases in the last 4 years. GC/MS detected drugs in 486 cases (16.2%), including amphetamines (n=160), major tranquilizers (n=72), minor tranquilizers (n=294), antidepressants (n=21), cold remedies (n=77), and other drugs (n=19). Among these cases, fatal intoxication (n=123) involved amphetamines (n=73), major tranquilizers (n=37), minor tranquilizers (n=86), antidepressants (n=3), and cold remedies (n=9); most cases involved self-administration, alleged suicide and accidental overdose, while homicide was not included. These drugs were also identified in other manners of death, including homicide (n=40/372), suicide (n=34/226), accidental falls (n=27/129), and natural death (n=72/514). In these cases, on-site immunoassay screening of drugs of abuse showed negative findings in 2440 cases (81.4% in all cases), while GC/MS detected other drugs in 218 cases (7.3% in all cases), including several antipsychotic drugs, acetaminophen and salicylic acid. Further analysis using LC/MS/MS detected low concentrations of benzodiazepines in 32 cases, and also anti-diabetic and hypertensive drugs in a case of fatal abuse. These observations indicate the efficacy of systematic routine toxicological analysis to investigate not only the cause of death but also the background of fatalities in forensic autopsy. The provision of extensive drug screening is needed for forensic and social risk management, considering the marked diversity of medical and illicit drugs. PMID:25637163

  1. Birth attendants as perinatal verbal autopsy respondents in low-and middle-income countries: a viable alternative?

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    C Engmann

    2012-03-01

    Full Text Available OBJECTIVE: To assess the feasibility of using birth attendants instead of bereaved mothers as perinatal verbal autopsy respondents. METHODS: Verbal autopsy interviews for early neonatal deaths and stillbirths were conducted separately among mothers (reference standard and birth attendants in 38 communities in four developing countries. Concordance between maternal and attendant responses was calculated for all questions, for categories of questions and for individual questions. The sensitivity and specificity of individual questions with the birth attendant as respondent were assessed. FINDINGS: For early neonatal deaths, concordance across all questions was 94%. Concordance was at least 95% for more than half the questions on maternal medical history, birth attendance and neonate characteristics. Concordance on any given question was never less than 80%. Sensitivity and specificity varied across individual questions, more than 80% of which had a sensitivity of at least 80% and a specificity of at least 90%. For stillbirths, concordance across all questions was 93%. Concordance was 95% or greater more than half the time for questions on birth attendance, site of delivery and stillborn characteristics. Sensitivity and specificity varied across individual questions. Over 60% of the questions had a sensitivity of at least 80% and over 80% of them had a specificity of at least 90%. Overall, the causes of death established through verbal autopsy were similar, regardless of respondent. CONCLUSION: Birth attendants can substitute for bereaved mothers as verbal autopsy respondents. The questions in existing harmonized verbal autopsy questionnaires need further refinement, as their sensitivity and specificity differ widely.

  2. Signifance of Liver Ductal Plate Malformation in Differential Diagnosis of Autosomal Recessive Polycystic Kidney Disease: An Autopsy Case

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    Kivilcim Eren Erdogan

    2015-03-01

    Full Text Available Cystic renal diseases are a group of disorders that cause neonatal deaths. Autosomal recessive polycystic kidney disease (ARPKD is a rare entity which may be associated with liver disorders. Presenting autopsy case was stillbirth in 31 + 1 gestational week. In postmortem autopsy,viewed through the capsule, the renal surface was filled by innumerable miniature cysts about 1 mm in diameter. istopathological examination revealed multiple cysts of variable size in the renal medulla and tortuosity, elongation of ductal plate of liver. The autopsy was evaluated as ARPKD and ductal plate malformation. This disorder is not usually compatible with life. Some of the other cystic kidney diseases have better clinical outcome and must be distinguished from ARPKD. [Cukurova Med J 2015; 40(Suppl 1: 18-21

  3. DNA extraction and quantification from touch and scrape preparations obtained from autopsy liver cells

    Scientific Electronic Library Online (English)

    C.N.M., Ribeiro; L.C., Peres; J.M., Pina-Neto.

    2004-05-01

    Full Text Available The objective of the present study was to develop a simplified low cost method for the collection and fixation of pediatric autopsy cells and to determine the quantitative and qualitative adequacy of extracted DNA. Touch and scrape preparations of pediatric liver cells were obtained from 15 cadavers [...] at autopsy and fixed in 95% ethanol or 3:1 methanol:acetic acid. Material prepared by each fixation procedure was submitted to DNA extraction with the Wizard® genomic DNA purification kit for DNA quantification and five of the preparations were amplified by multiplex PCR (azoospermia factor genes). The amount of DNA extracted varied from 20 to 8,640 µg, with significant differences between fixation methods. Scrape preparation fixed in 95% ethanol provided larger amount of extracted DNA. However, the mean for all groups was higher than the quantity needed for PCR (50 ng) or Southern blot (500 ng). There were no qualitative differences among the different material and fixatives. The same results were also obtained for glass slides stored at room temperature for 6, 12, 18 and 24 months. We conclude that touch and scrape preparations fixed in 95% ethanol are a good source of DNA and present fewer limitations than cell culture, tissue paraffin embedding or freezing that require sterile material, culture medium, laboratory equipment and trained technicians. In addition, they are more practical and less labor intensive and can be obtained and stored for a long time at low cost.

  4. The burden of disease in Maputo City, Mozambique: registered and autopsied deaths in 1994

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    Dgedge Martinho

    2001-01-01

    Full Text Available OBJECTIVE: To classify the causes of death in Maputo City, Mozambique, using the methods of the Global Burden of Disease study, in order to provide information for health policy-makers and to obtain a baseline for future studies in Maputo City and provincial capitals. METHODS: Data were taken from the Maputo City death register and autopsy records for 1994. FINDINGS: A total of 9011 deaths were recorded in the death register, representing a coverage of approximately 86%. Of these, 8114 deaths (92% were classified by cause. Communicable, maternal, perinatal, and nutritional disorders accounted for 5319 deaths; noncommunicable diseases for 1834; and injuries for 961. The 10 leading causes of registered deaths were perinatal disorders (1643 deaths; malaria (928; diarrhoeal diseases (814; tuberculosis (456; lower respiratory infections (416; road-traffic accidents (371; anaemia (269; cerebrovascular diseases (269; homicide (188; and bacterial meningitis (178. CONCLUSIONS: Infectious diseases of all types, injuries, and cerebrovascular disease ranked as leading causes of death, according to both the autopsy records and the city death register. AIDS-related deaths were underreported. With HIV infection increasing rapidly, AIDS will add to the already high burden of infectious diseases and premature mortality in Maputo City. The results of the study indicate that cause of death is a useful outcome indicator for disease control programmes.

  5. SYSTEMIC AMYLOIDOSIS: FINDING ON AUTOPSY. REPORT OF TWO CASES (IN SPANISH

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    Martínez-Muñoz Elsa

    2014-01-01

    Full Text Available Introduction: amyloidosis is the extracellular accumulation of amyloid material, which causes damage in the functioning of organs and tissues. It is characterized by the presence of protein folding, which acquire the capacity of self-assembly creating unusual configurations. Case reports: the case reports of two female patients are presented. Both with 47 years of age, who died without clinical diagnosis. Due to not evident cause of the deaths, clinical autopsies were carried out. Massive presence of amyloid in different organs was found, which was confirmed with the Congo red staining method and the assessment in the polarized light microscopy. Multiple organ dysfunction syndromes secondary to the presence of systemic amyloidosis was diagnosed and in both patients was considered as the cause of death. Conclusion: the clinical symptoms of the amyloidosis are variable and nonspecific, depending of the extracellular deposits and its location in the body. It is a challenge to do a diagnosis. It is recommended to consider the diagnostic possibility of the amyloidosis in patients with suggestive symptoms of damage in the function of the organ and it is required the histological confirmation. Rev. cienc.biomed. 2014;5(1:123-129 KEYWORDS Amyloid, Amyloid beta-protein precursor, Amyloidosis, Autopsy.

  6. Histopathological change of the metastatic bone marrow. Response for radio- and combination chemotherapy at autopsy cases

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the histopathologic therapeutic effects in metastatic bone marrow for various therapy in cancer patients. Autopsy cases at Shikoku Cancer Center Hospital, mainly cancer of breast, stomach, lung and prostate examined radiotherapy (28-60 Gy) and chemotherapy and/or endocrine chemotherapy (medroxyprogesterone acetate, tamoxifen). Histological evaluation of effects for radio-and chemotherapy have been criteria of UICC and criteria for the evaluation of the clinical and pathological effects by Japan Society for Cancer Therapy. The precise effects for various therapy is difficult to measure objectively in metastatic bone. Histopathologic changes of metastatic bone marrow for radiotherapy revealed decrease and degeneration of tumor cells - swelling, vacuoles of cytoplasm and nuclei, bizarre and giant multinucleated giant cells etc. Stromal reaction was found postnecrotic fresh and/or old granulation-fibrosis and hyalinization, woven bone formation and fatty marrow. Systemic therapy of breast cancer revealed stromal fibrosis and chondroid ossification more than other tumors and therapy. Morphological features of metastatic bone marrow at autopsy cases may be necessary from viewpoint of therapeutic effects. (author)

  7. An autopsy case of cerebral radiation necrosis simulating recurrent malignant glioma

    International Nuclear Information System (INIS)

    The present case was a 60-year-old man. After removal of a malignant glioma (astrocytoma grade 3), radiation therapy was performed. From 1 year and 2 months after radiation therapy, disturbance of consciousness and right hemiparesis appeared. An abnormal shadow was noted on CT scan in the region from which the tumor had been extracted. Recurrence of the tumor was thus suspected. The symptoms were not relieved by steroid therapy or ACNU chemotherapy. The disturbance of consciousness gradually became aggravated and was complicated with respiration disorder. The patient died after a total course of 3 years and 6 months from the initial treatment. The findings of CT scans suggested a polymorphological tumor mass occupying the left frontal lobe with invasion to the right hemisphere via the corpus callosum. The gross and histological findings at autopsy mainly consisted of an extensive coagulation necrosis focus. There was also extensive vascular disturbance probably ascribable to radiation damage. Extensive investigations for residual tumor cells yielded negative results. The findings of CT scans were therefore considered to reflect changes in radiation necrosis with time. In the present case, autopsy findings, clinical course and image findings resembled those of recurrent malignant glioma but no residual tumor cells at the histological level. (author)

  8. Autopsy findings in carotid arterial rupture following radiotherapy of head and neck advanced carcinoma

    International Nuclear Information System (INIS)

    The influence of radiotherapy in advanced head and neck cancer was investigated by autopsy of head and neck patients who had had carotid artery rupture. Twenty-five cases of head and neck cancer revealed carotid artery rupture among the 255 head and neck cases autopsied from 1972 to 1985. The rate of carotid artery rupture in hypopharyngeal cancer was 8/32 (25%); in oral cancer 8/55 (14.5%), and in other cancers 9/165 (5.4%). In localization of ruptured arteries there were 9 cases of common carotid artery, 14 cases of external carotid artery, one case of internal carotid artery, and one unknown. These cases were irradiated using more than 70 Gy. The following reasons for carotid artery rupture were suspected: 1. There was a tumor with deep ulceration and necrosis near the vessel. 2. The wall of the artery had radiation angitis. 3. The artery wall was necrotic because of invasion by the tumor. 4. Thrombosis developed with ensuant rupture of the artery. Radiotherapy for advanced cancer of the head and neck is necessary to control pain and as palliative treatment, but to avoid rupture of the carotid artery, pain clinic techniques and chemotherapy as palliative treatment for this kinds of terminal condition should also be considered. (author)

  9. “CORONARY ARTERY DISEASE ON AUTOPSY”: A FIVE YEARS CLINICOPATHOLOGICAL STUDY (NOVEMBER-2007 TO OCTOBER-2012

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    Dr Amit H Agravat

    2013-02-01

    Full Text Available BackgroundThis study was done to investigate the cause of death due to coronary artery pathology found on autopsies received between November 2007 to October 2012. The study was conducted at the Histopathology laboratory, Pathology Department, P. D. U. Medical College, Rajkot, Gujarat, India.MethodsIn the present study, total 350 postmortem cases with coronary artery specimen received from Saurashtra region(formed by seven districts of Gujarat,India from November 2008 to October 2012 were considered. Histopathological sectioning of these specimens was done & slides were prepared & stained by Hematoxylin & Eosin stains, examined microscopically for coronary artery pathology. Each and every autopsy cases received irrespective of natural, unnatural or sudden death were considered for this study. Patients’ relatives were approached and detailed history about the life style, habit & clinical complains of the patient was noted for further evaluation.ResultsA direct relationship was observed between death due to coronary artery disease and personal history including risk factors like sedentary life style, smoking, alcohol, obesity, diabetes & also with particular age groups viz. 45-65 years.ConclusionsOur study confirms that coronary artery diseases are more common among the population with sedentary life style, habit of smoking, alcohol & obesity. Also relationships with diabetes & hypertension were observed. These signify, increasing incidence of coronary artery diseases with modernization & adaptation of western lifestyle in the developing countries as emphasized by this study in our study population. These informations are valuable in policy formation for the control of coronary as artery diseases.

  10. Cardiovascular Damage in Alzheimer Disease: Autopsy Findings From the Bryan ADRC

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    Corder Elizabeth H.

    2005-01-01

    Full Text Available Autopsy information on cardiovascular damage was investigated for pathologically confirmed Alzheimer disease (AD patients (n = 84 and non-AD control patients (n = 60 . The 51 relevant items were entered into a grade-of-membership model to describe vascular damage in AD. Five latent groups were identified “I: early-onset AD,” “II: controls, cancer,” “III: controls, extensive atherosclerosis,” “IV: late-onset AD, male,” and “V: late-onset AD, female.” Expectedly, Groups IV and V had elevated APOE ϵ 4 frequency. Unexpectedly, there was limited atherosclerosis and frequent myocardial valve and ventricular damage. The findings do not indicate a strong relationship between atherosclerosis and AD, although both are associated with the APOE ϵ 4 . Instead, autopsy findings of extensive atherosclerosis were associated with possible, not probable or definite AD, and premature death. They are consistent with the hypothesis that brain hypoperfusion contributes to dementia, possibly to AD pathogenesis, and raise the possibility that the APOE allele ϵ 4 contributes directly to heart valve and myocardial damage.

  11. Causes and Severity of Fatal Injuries in Autopsies of Victims of Fatal Traffic Accidents

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    F Panahi

    2010-03-01

    Full Text Available Introduction: In this retrospective study, we decided to determine the death causes and severity of injuries in traffic accidents according to reports of the forensic medical center of Yazd. Methods: A total of 251 fatalities due to traffic accidents that had undergone autopsy examinations at the Yazd forensic medicine center from2006 till 2008 were included in the study by census method. Data regarding gender, road user type, type of vehicle (car, motorcycle, autobus or minibus, consciousness level, and intensive care unit (ICU admission was gathered. For evaluation of injury severity, we used Injury Severity Score (ISS. Results: The population under study consisted of 202 men (80.5% and 49 women (19.5% with an average age of 34.1 years (range: 1-89 years. Motorcycle-pedestrian accidents were the most common type of injury (100, 39.8%. Head (220, 87.6% and face (169, 67.3% were the two most common sites of injuries. Mean (±SD of ISS was 23.2 (±10.4. According to autopsy records, the main cause of death was head trauma (146, 58.1%. Conclusion: Public awareness in terms of primary prevention of road accidents should be considered important. Also, regarding the high prevalence of brain injuries and complications associated with skull fractures, accessibility to neurosurgeons and availability of imaging devices have an important role in decreasing the mortality rate of traffic accidents.

  12. Alobar holoprosencephaly with cyclopia - autopsy-based observations from one medical center.

    Science.gov (United States)

    Swatek, Jaros?aw; Szumi?o, Justyna; Burdan, Franciszek

    2013-11-01

    Holoprosencephaly, a major congenital malformation of the brain, consists in a complete or partial failure of the prosencephalon to divide into separate hemispheres. Alobar holoprosencephaly with cyclopia was analyzed on the basis of autopsy reports performed for hospitals admitting patients from the Lublin Region in Eastern Poland in the period of 20 years (1981-2000). The malformation was found in seven newborns - five girls, one boy and one child with sex not established due to agenesia of the genital organs, all autopsied in the years 1990-1999. According to clinical data, none of the mothers (age 24-39 years) was exposed to any prescribed or over-the-counter (OTC) drugs during pregnancy, but one was exposed to paints in early pregnancy. The proboscis was present in four of seven cases. Six of seven children displayed additional congenital malformations. In two cases intrapancreatic accessory spleen suggesting trisomy 13 was found. Alobar holoprosencephaly with cyclopia is a rare lethal congenital anomaly frequently accompanied by other malformations and characterized by large variations in incidence. PMID:23791929

  13. Sudden cardiac death in the young: the molecular autopsy and a practical approach to surviving relatives.

    Science.gov (United States)

    Semsarian, Christopher; Ingles, Jodie; Wilde, Arthur A M

    2015-06-01

    The sudden death of a young, apparently fit and healthy person is amongst the most challenging scenarios in clinical medicine. Sudden cardiac death (SCD) is a devastating and tragic outcome of a number of underlying cardiovascular diseases. While coronary artery disease and acute myocardial infarction are the most common causes of SCD in older populations, genetic (inherited) cardiac disorders comprise a substantial proportion of SCD cases aged 40 years and less. This includes the primary arrhythmogenic disorders such as long QT syndromes and inherited cardiomyopathies, namely hypertrophic cardiomyopathy. In up to 30% of young SCD, no cause of death is identified at postmortem, so-called autopsy-negative or sudden arrhythmic death syndrome (SADS). Management of families following SCD begins with a concerted effort to identify the cause of death in the decedent, based on either premorbid clinical details or the pathological findings at postmortem. Where no cause of death is identified, genetic testing of deoxyribonucleic acid extracted from postmortem blood (the molecular autopsy) may identify a cause of death in up to 30% of SADS cases. Irrespective of the genetic testing considerations, all families in which a sudden unexplained death has occurred require targeted and standardized clinical testing in an attempt to identify relatives who may be at-risk of having the same inherited heart disease and therefore also predisposed to an increased risk of SCD. Optimal care of SCD families therefore requires dedicated and appropriately trained staff in the setting of a specialized multidisciplinary cardiac genetic clinic. PMID:25765769

  14. Problems in diagnosis and treatment of pancreatic cancer as seen in the autopsy findings

    International Nuclear Information System (INIS)

    The results obtained from a pathological study of the cancer spread, postoperative recurrence and intraoperative radiotherapy in 68 autopsy cases of pancreatic cancer were as follows: 1) The study of pancreatic cancer was conducted by classifying the cases according to the location of the cancer; uncus, head, body and tail. Difference was seen in the mode of cancer spread and also in the clinical symptoms among the pancreatic cancers in each location. Especially, it was maintained that cancer in the uncus should be treated independently from the cancer in the head. 2) There was no difference in the mode of cancer spread between postoperative recurrence or intraoperative radiotherapy cases and non-operated or non-intraoperative radiotherapy cases. Moreover, it suggested one side of difficulty of the surgical treatment, that is, all cases considered curative operation were performed through histological study of the resected specimen at operation have had retroperitoneal recurrence. 3) By histological study of autopsy cases of intraoperative radiotherapy, it was suggested that cancer cells remained or regrew in the periphery of the radiotherapy field, which is a meaningful finding for evaluating intraoperative radiotherapy in the future. (author)

  15. Neoplastic lesions in CADASIL syndrome: report of an autopsied Japanese case.

    Science.gov (United States)

    Hassan, Wael Abdo; Udaka, Naoka; Ueda, Akihiko; Ando, Yukio; Ito, Takaaki

    2015-01-01

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is one of the most common heritable causes of stroke and dementia in adults. The gene involved in the pathogenesis of CADASIL is Notch3; in which mutations affect the number of cysteine residues in its extracellular domain, causing its accumulation in small arteries and arterioles of the affected individuals. Besides the usual neurological and vascular findings that have been well-documented in CADASIL patients, this paper additionally reports multiple neoplastic lesions that were observed in an autopsy case of CADASIL patient; that could be related to Notch3 mutation. The patient was a 62 years old male, presented with a past history of neurological manifestations, including gait disturbance and frequent convulsive attacks. He was diagnosed as CADASIL syndrome with Notch3 Arg133Cys mutation. He eventually developed hemiplegia and died of systemic convulsions. Autopsy examination revealed-besides the vascular and neurological lesions characteristic of CADASIL- multiple neoplastic lesions in the body; carcinoid tumorlet and diffuse idiopathic pulmonary neuro-endocrine cell hyperplasia (DIPNECH) in the lungs, renal cell carcinoma (RCC), prostatic adenocarcinoma (ADC) and adenomatoid tumor of the epididymis. This report describes a spectrum of neoplastic lesions that were found in a case of CADASIL patient that could be related to Notch3 gene mutations. PMID:26261665

  16. Pattern of Suicide: A Review of Autopsies Conducted at Moi Teaching and Referral Hospital in Eldoret Kenya

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    B. N. Macharia

    2015-06-01

    Full Text Available Problem statement. Suicide is one of the ten leading causes of death in the world, accounting for more than 400,000 deaths annually. The pattern of suicide and the incidence of suicide vary from country to country. Cultural, religious and social values play some role in suicide. Currently, there is no data regarding the incidence of suicide in Kenya. Setting. Moi Teaching and Referral Hospital Mortuary. Study population. A seven-year retrospective study of all the autopsies performed at the Moi Teaching and Referral Hospital was analysed and the cases that were definitely determined as suicides were further studied. Objective. To characterize the pattern of suicide cases through autopsies conducted at MTRH mortuary between the years 2005 to 2012. Methodology. Retrospective descriptive cross-sectional study. Suicide cases were identified from the MTRH autopsy record books. From these record books, the autopsy number was used to retrieve the pathologists autopsy report. Data regarding age, gender and methods of suicide was retrieved and entered into a data collection form. Data analysis: Data collected was analysed using Stata version 10. Results. There were 213 autopsies performed. Majority were male 180(85%. The subjects had a median age of 29(IQR: 23–37 years. Organophosphate poisoning was the most preferred method followed by hanging. Organophosphate poisoning accounted for 195(91.54% and hanging for 17(7.98% of the subjects. Conclusion. The preferred methods of suicide were poisoning and hanging. The study may have missed some cases where the relatives could have declined for the postmortem procedure and hence the body released without postmortem examinations.

  17. Sharp Force Injuries at the University Hospital of the West Indies, Kingston, Jamaica: A Seventeen-year Autopsy Review

    Science.gov (United States)

    Neblett, A; Williams, NP

    2014-01-01

    ABSTRACT Objectives: This study aimed to ascertain the prevalence and patterns of fatal sharp force injuries, victims' demographics, cause of death and average survival time at the University Hospital of the West Indies (UHWI), Kingston, Jamaica. Methods: The autopsy records for 1990-2010 were searched for fatal cases of sharp force injuries. The records for 1998-2001were not located. A 17-year retrospective analysis was therefore performed and findings for the two periods, 1990-1997 and 2002-2010 were compared. All data were obtained from the provisional anatomical diagnoses (PAD) autopsy reports. Results: During the 17-year period, 57/4264 autopsies were performed for sharp force injuries, yielding an overall autopsy prevalence rate of 1.34%; 1.25%, 26/2086 (95% CI 0.77, 1.73) in Period 1 and 1.42%, 31/2178 (95% CI 0.92, 1.92) in Period 2. The majority were males (91.1%), in the age group 15-39 years (77%), mean age of 30.9 years (range = 17-65 years). Stab wounds predominated (91.3%) and the chest was the area most frequently stabbed (42.1%). In the 24 fatalities due to chest injuries only, eight (33.3%) had injuries to the heart alone. Forty-five patients (79.0%) died within 24 hours from exsanguination. Injury documentation at autopsy was deficient. Conclusion: Stabbing was the most common sharp force injury, mainly involving the chest, and young men were at greatest risk. Most patients died from exsanguination within 24 hours of admission. Introduction of synoptic-type reports for both clinical and autopsy examination may improve documentation. PMID:25781278

  18. Las autopsias en el hospital "Comandante Manuel Fajardo Rivero" / Autopsies in "Comandante Manuel Fajardo Rivero" hospital

    Scientific Electronic Library Online (English)

    Ygnacio, Ygualada Correa; José, Hurtado de Mendoza Amat; Teresita de J, Montero González.

    2013-03-01

    Full Text Available Objetivos: mostrar los principales resultados obtenidos de la autopsia y utilizarlos en la mejora continua de la calidad asistencial. Métodos: se realizó un estudio retrospectivo, longitudinal, de la base de datos de autopsias del SARCAP, realizadas en el Hospital Militar "Comandante Manuel Fajardo [...] Rivero" entre los años 1991-2011. Se analizaron el sexo, la edad, las especialidades de egreso, la estadía hospitalaria, las principales enfermedades, causas de muerte y evaluación de sus diagnósticos premortem. Resultados: se estudiaron 2 480 autopsias. Predominó el sexo masculino con el 51,7 % y las edades de 75-84 años con el 31 %. El 79,65 % de los casos fallecidos ocurrieron en el área de atención al grave y el 47,8 % de ellos fallecieron con una estadía de hasta 48 horas. La bronconeumonía y el infarto cardíaco fueron las principales causas directas de muerte, mientras en las básicas lo fueron la aterosclerosis coronaria, cerebral y generalizada. La hipertensión arterial y la diabetes mellitus fueron las principales causas contribuyentes. Las discrepancias para las causas directas y básicas de muerte fueron de una cada cuatro autopsias. Conclusiones: el estudio multicausal de la muerte permite caracterizar los principales problemas de salud. La aplicación del SARCAP y el diagnóstico del DMO han sido logros importantes de la especialidad alcanzados en esta institución. La metodología de trabajo obtenida en el estudio de la autopsia y su empleo en la mejora continua de la calidad de la asistencia médica en este centro constituye referencia para otros hospitales. Abstract in english Objectives: to show the main results of autopsy and to use tehm in the continuous improvement of care quality. Methods: a retrospective, longitudinal study was conducted in SARCAP autopsy database at "Comandante Manuel Fajardo Rivero" Military Hospital from 1991 to 2011. Different items were analyze [...] d such as sex, age, specialties of discharge, the hospital stay, major diseases, causes of death and its premortem diagnostic evaluation. Results: 2 480 autopsies were studied; most of them were male (51.7 %) and the mean age rate of 75-84 years (31 %). 79,65 % of the died cases happened in the area of attention to the serious patients and 47,8 % of the cases died with up to 48 hours of hospital stay. Bronchopneumonia and heart attacks were the main direct causes of death, while coronary, cerebral and generalized atherosclerosis were the basic causes of death. Hypertension and diabetes mellitus were the main contributing causes. Discrepancies for basic and direct causes of death were one in four autopsies. Conclusions: this multicausal-death study allowed characterizing those major health problems. Applying SARCAP and BMD diagnosis have been an important achievement in the specialty of this institution. The gained methodology during this autopsy study and its use in the continuous improvement of medical care quality in this center is a reference to other hospitals.

  19. Indication for resuscitative thoracotomy in thoracic injuries-Adherence to the ATLS guidelines. A forensic autopsy based evaluation

    DEFF Research Database (Denmark)

    Ohrt-Nissen, S; Colville-Ebeling, Bonnie; Kandler, K; Hornbech, K; Steinmetz, J; Ravn, J; Lehnert, P

    2016-01-01

    of deceased patients with potentially reversible thoracic lesions (PRTL). METHODS: The database at the Department of Forensic Medicine at Copenhagen University was queried for autopsy cases with thoracic lesions indicated by the SNOMED autopsy coding system. Patients were included if thoracic lesions......-agreement PRTL were found in 9 (82%) patients. CONCLUSIONS: Agreement with ATLS guidelines for RT was 63% for intervention and 100% for non-intervention in deceased patients with thoracic trauma. Agreement was higher for penetrating trauma than for blunt trauma. The adherence to guidelines did not improve the...

  20. Mortality patterns in Vietnam, 2006: Findings from a national verbal autopsy survey

    Directory of Open Access Journals (Sweden)

    Adair Timothy

    2010-03-01

    Full Text Available Abstract Background Accurate nationally representative statistics on total and cause-specific mortality in Vietnam are lacking due to incomplete capture in government reporting systems. This paper presents total and cause-specific mortality results from a national verbal autopsy survey conducted first time in Vietnam in conjunction with the annual population change survey and discusses methodological and logistical challenges associated with the implementation of a nation-wide assessment of mortality based on surveys. Verbal autopsy interviews, using the WHO standard questionnaire, were conducted with close relatives of the 6798 deaths identified in the 2007 population change survey in Vietnam. Data collectors were health staff recruited from the commune health station who undertook 3-day intensive training on VA interview. The Preston-Coale method assessed the level of completeness of mortality reporting from the population change survey. The number of deaths in each age-sex grouping is inflated according to the estimate of completeness to produce an adjusted number of deaths. Underlying causes of death were aggregated to the International Classification of Diseases Mortality Tabulation List 1. Leading causes of death were tabulated by sex for three broad age groups: 0-14 years; 15-59 years; and 60 years and above. Findings Completeness of mortality reporting was 69% for males and 54% for females with substantial regional variation. The use of VA has resulted in 10% of deaths being classified to ill-defined among males, and 15% among females. More ill-defined deaths were reported among the 60 year or above age group. Incomplete death reporting, wide geographical dispersal of deaths, extensive travel between households, and substantial variation in local responses to VA interviews challenged the implementation of a national mortality and cause of death assessment based on surveys. Conclusions Verbal autopsy can be a viable tool to identify cause of death in Vietnam. However logistical challenges limit its use in conjunction with the national sample survey. Sentinel population clusters for mortality surveillance should be tested to develop an effective and sustainable option for routine mortality and cause of death data collection in Vietnam.

  1. Post mortem magnetic resonance imaging in the fetus, infant and child: A comparative study with conventional autopsy (MaRIAS Protocol

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    Thayyil Sudhin

    2011-12-01

    Full Text Available Abstract Background Minimally invasive autopsy by post mortem magnetic resonance (MR imaging has been suggested as an alternative for conventional autopsy in view of the declining consented autopsy rates. However, large prospective studies rigorously evaluating the accuracy of such an approach are lacking. We intend to compare the accuracy of a minimally invasive autopsy approach using post mortem MR imaging with that of conventional autopsy in fetuses, newborns and children for detection of the major pathological abnormalities and/or determination of the cause of death. Methods/Design We recruited 400 consecutive fetuses, newborns and children referred for conventional autopsy to one of the two participating hospitals over a three-year period. We acquired whole body post mortem MR imaging using a 1.5 T MR scanner (Avanto, Siemens Medical Solutions, Enlargen, Germany prior to autopsy. The total scan time varied between 90 to 120 minutes. Each MR image was reported by a team of four specialist radiologists (paediatric neuroradiology, paediatric cardiology, paediatric chest & abdominal imaging and musculoskeletal imaging, blinded to the autopsy data. Conventional autopsy was performed according to the guidelines set down by the Royal College of Pathologists (UK by experienced paediatric or perinatal pathologists, blinded to the MR data. The MR and autopsy data were recorded using predefined categorical variables by an independent person. Discussion Using conventional post mortem as the gold standard comparator, the MR images will be assessed for accuracy of the anatomical morphology, associated lesions, clinical usefulness of information and determination of the cause of death. The sensitivities, specificities and predictive values of post mortem MR alone and MR imaging along with other minimally invasive post mortem investigations will be presented for the final diagnosis, broad diagnostic categories and for specific diagnosis of each system. Clinical Trial Registration NCT01417962 NIHR Portfolio Number: 6794

  2. Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth.

    LENUS (Irish Health Repository)

    2012-01-31

    INTRODUCTION: The number of parents agreeing to autopsy following stillbirth is declining, which has undermined clinicians\\' ability to assess causes of intrauterine death and can impact counselling regarding recurrence. Post-mortem radiological imaging is a potential alternative method of investigating perinatal loss. The aim of this study was to assess the role of multi-detector computed tomography (MDCT) in the investigation of stillbirth. STUDY DESIGN: Following ethical approval and written consent, parents were offered MDCT of the stillborn infant. MDCT was performed with 3D reconstruction, and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Body part and organ-specific measurements were performed; including head, chest and abdominal circumferences, and muscle and liver mass was also measured. Findings were correlated with obstetric history, post-mortem skeletal survey (plain radiography), and formal autopsy. RESULTS: Fourteen third-trimester stillborn infants were scanned. Image quality was moderate to excellent for most body structures. CT was better than plain radiography for imaging skeletal structures and large solid organs and demonstrated a range of pathologies including renal vein thrombosis, mesenteric calcification and skeletal hyperostosis that were not seen on plain radiographs. MDCT did not overlook autopsy findings and provided some additional information. CONCLUSION: This study confirms the feasibility of MDCT in the investigation of third trimester stillbirth. MDCT image quality is acceptable and the examination can demonstrate a range of anatomic and pathologic findings. Initially, its value may be as an important adjunct to conventional autopsy.

  3. Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth

    International Nuclear Information System (INIS)

    Introduction: The number of parents agreeing to autopsy following stillbirth is declining, which has undermined clinicians’ ability to assess causes of intrauterine death and can impact counselling regarding recurrence. Post-mortem radiological imaging is a potential alternative method of investigating perinatal loss. The aim of this study was to assess the role of multi-detector computed tomography (MDCT) in the investigation of stillbirth. Study design: Following ethical approval and written consent, parents were offered MDCT of the stillborn infant. MDCT was performed with 3D reconstruction, and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Body part and organ-specific measurements were performed; including head, chest and abdominal circumferences, and muscle and liver mass was also measured. Findings were correlated with obstetric history, post-mortem skeletal survey (plain radiography), and formal autopsy. Results: Fourteen third-trimester stillborn infants were scanned. Image quality was moderate to excellent for most body structures. CT was better than plain radiography for imaging skeletal structures and large solid organs and demonstrated a range of pathologies including renal vein thrombosis, mesenteric calcification and skeletal hyperostosis that were not seen on plain radiographs. MDCT did not overlook autopsy findings and provided some additional information. Conclusion: This study confirms the feasibility of MDCT in the investigation of third trimester stillbirth. MDCT image quality is acceptable and the examination can demonstrate a range of anatomic and pathologic findings. Initially, its value may be as an important adjunct to conventional autopsy.

  4. Industrial accidental deaths in the Niger delta region of Nigeria: a study of 32 autopsies in Port Harcourt.

    Science.gov (United States)

    Seleye-Fubara, D; Bob-Yellowe, E

    2006-10-01

    Accidents in the oil industry in the Niger delta region of Nigera raise concerns about safety measures and the management of industrial sites. A total of 32 autopsies were performed after coroners' inquest forms were served on the authors by the State, which serve as consent and request. Standard procedures were adopted in all the cases and the reports were appropriately issued. Death from industrial accidents accounted for 2.5% and 6.1% of total autopsies and accidental death autopsies respectively. The youngest victim was a 19 year old male while the oldest was a 55 year old male. The age group 30-39 years was the most vulnerable. There was a male dominance; (male:female ratio = 9.7:1). The commonest accidents in their order of frequency were: falling from a height, explosion/fire, motor vehicle accidents and falling objects. Multiple injuries, head and neck trauma and drowning were the commonest cause of death at autopsy. Accidental deaths were commoner in the small-scale industries (81%) than in the large-scale industries (19%). This is the first time such a study has been carried out locally. The proportion of accidental deaths in the small scale industries relative to that of the large ones may be attributed to the poor enforcement of safety measures in the smaller industries PMID:17191638

  5. Chronic radium intoxication: clinical and autopsy findings in long-term New Jersey survivors

    International Nuclear Information System (INIS)

    After briefly tracing the development of investigations into radium intoxication in the 1920s, the author presents detailed clinical and autopsy findings from each of the 42 people associated with the New Jersey radium industry during the second and third decades of this century who survived their initial occupational exposure to 226Ra and 228Ra for 25 years or longer. Preterminal 226Ra burdens are known for 31 cases. 24 of the 42 had malignant tumors or blood dyscrasias. Female, but not male, life spans were shortened and fertility possibly reduced. These and a variety of additional findings are discussed and deductions suggested. It was not possible to identify dose-response patterns and the study neither confirms nor challenges the current lifetime maximum permissible human 226Ra content of 0.1 ?Ci. Clinical and laboratory data are presented in 52 tables in an appendix

  6. Understanding Suicide in Socially Vulnerable Contexts: Psychological Autopsy in a Small Town in Mexico.

    Science.gov (United States)

    Chávez-Hernández, Ana-María; Macías-García, Luis-Fernando

    2016-02-01

    In Mexico, suicides are increasing in certain latitudes where local rates have grown to levels of alert; suicide is also the second most common cause of death for the group aged 15 to 19. The psychological autopsy method was utilized to uncover and analyze common factors in all of the registered suicides within 2011 and 2012 in a small town of the state of Guanajuato, located in the center of Mexico. A total of nine decedents were analyzed, and 22 interviews were conducted. The most salient factors were as follows: poverty, financial stress, substance abuse, low levels of education, conflictive relationships, and a poor handling of emotions. The concepts of social exclusion and vulnerability were employed to analyze suicides as symptoms of a much deeper problem of this country, suggesting that anomie and social malady are nowadays important suicidal factors, mostly for children and young people. PMID:25893954

  7. Membranoproliferative glomerulonephritis in a carcinoma with unknown primary: An autopsy study

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    Gupta Kirti

    2008-04-01

    Full Text Available Kidney disease frequently complicates malignancy and its treatment. Although many solid and hematologic cancers may involve the renal parenchyma, clinical sequelae are usually not prominent. Published reports cite membranous nephropathy as the most common malignancy-associated glomerulopathy, occurring with many carcinomas and occasionally with leukemia and lymphoma followed by minimal change disease. Rarely membranoproliferative glomerulonephritis (MPGN has been reported in patients with malignancy. The mechanism by which malignancy induces disease remains unproved, but may involve deposition of tumor antigen in the subepithelial space with in situ immune complex formation and subsequent complement activation. Treatment of the underlying malignancy may lead to resolution of nephrotic syndrome, lending indirect support to this theory. We report a rare autopsy case of a patient with metastatic carcinoma (with unknown primary associated with MPGN. The association between MPGN and metastatic carcinoma with unknown primary is uncommon and has not been previously reported in the literature.

  8. Effects of tracheal instillation of natural surfactant in premature lambs. I. Clinical and autopsy findings.

    Science.gov (United States)

    Adams, F H; Towers, B; Osher, A B; Ikegami, M; Fujiwara, T; Nozaki, M

    1978-08-01

    Ten pairs of twin lambs 118--122 days of gestation were given either natural surfactant or diluent endotracheally before the first breath. By using the premature twin lamb model, we have been able to show that instillation of natural surfactant produced 100% survival for the duration of the study period (2 hr); stable blood gases on room air; lungs that became increasingly compliant while on the respirator; generally well aerated lungs at autopsy; good lung pressure-volume relationships; normal lung surface tension measurements; and histologic evidence of good alveolar expansion with large amounts of free intraluminal phospholipid, no epithelial damage, and no hyaline membranes. It is concluded that tracheal instillation of natural surfactant into the premature lamb protects the lungs from developing many features characteristic of the respiratory distress syndrome. PMID:581094

  9. An autopsy case of peritoneal malignant mesothelioma in a radiation technologist

    Energy Technology Data Exchange (ETDEWEB)

    Horie, Akio; Hiraoka, Katsumi; Yamamoto, Osamu; Haratake, Joji; Tsuchiya, Takehiko (University of Occupational and Environmental Health, Kitakyushu, Fukuoka (Japan). School of Medicine); Sugimoto, Hidekatsu

    1990-01-01

    A case of peritoneal malignant mesothelioma in a radiation technologist, who had worked in this field for 34 years, is reported. Histopathologically, a biopsy specimen from the retroperitoneal tumor revealed a biphasic type of malignant mesothelioma. Electron microscopy disclosed that the tumor cells contained prominent microvilli, basal laminae adjacent to the stroma, junctional complexes, desmosomes, tonofilaments, clusters of glycogen granules, well developed rough endoplasmic reticulum (RER), confronting cisternae showing direct continuity with the RER and membrane-bound granules suggestive of secretory activity. No increased amount of asbestos was detected in autopsied lung material or the peritoneal mesothelioma. The estimated cumulative dose of occupational irradiation was calculated to be about 40 to 50 rad at most. Irradiation was discussed in relation to the etiology of the peritoneal mesothelioma. (author).

  10. Collecting duct renal cell carcinoma with the syndrome of inappropriate antidiuresis: An autopsy case report

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    Emi Yasuda

    2013-01-01

    Full Text Available A 57-year-old Japanese man visited our hospital with a moist cough. Chest radiographic imaging showed a left hilar shadow. Adenocarcinoma cells were found on cytologic screening of fresh sputum. Although multiple metastases including brain were detected, no tumor was observed in the kidneys. The patient underwent whole-brain irradiation and chemotherapy for advanced-stage lung cancer. One month before his death, carcinomatous meningitis was detected. Hyponatremia, hypo-osmolality, and hypertonic urine suggested the syndrome of inappropriate antidiuresis. Restricting water intake improved the hyponatremia; however, he developed fever and hematuria. Despite systemic administration of an antibacterial drug, he died. Primary tumor in the lung was absent, but adenocarcinoma of the right kidney was evident on autopsy. Lectin histochemical analysis of the carcinoma revealed its distal nephron origin, confirming collecting duct carcinoma. Severe carcinomatous meningitis, which is possibly caused the syndrome of inappropriate antidiuresis, was observed, with no cancer involvement of the pituitary gland and hypothalamus.

  11. Proton induced X-ray emission analysis of Pima Indian autopsy tissues

    International Nuclear Information System (INIS)

    Proton particle-induced X-ray emission (PIXE) analysis has been used to determine the concentrations of K, Ca, Ti, Mn, Fe, Co, Ni, Cu, Zn, Se, Br, Rb, Sr, Cd, Cs, and Pb in liver, spleen, aorta, kidney medulla, kidney cortex, abdominal fat, pancreas, and hair taken at autopsy from Southwest Indians, primarily of the Pima tribe. Samples were prepared by a low-temperature ashing procedure which is compared to other preparation methods. Data were analyzed by a computer program, ANALEX. The accuracy is tested with NBS standard reference materials and with flame atomic absorption spectrophotometric results. The precision allowed observation of element concentration differences between replicate, half-gram samples of the same tissue. The differences appeared to arise from tissue inhomogeneities. 5 figures, 4 tables

  12. Proton induced X-ray emission analysis of Pima Indian autopsy tissues

    Energy Technology Data Exchange (ETDEWEB)

    Mangelson, N.F.; Hill, M.W.; Neilson, K.K.; Eatough, D.J.; Christensen, J.J.; Izatt, R.M.; Richards, D.O.

    1979-07-01

    Proton particle-induced X-ray emission (PIXE) analysis has been used to determine the concentrations of K, Ca, Ti, Mn, Fe, Co, Ni, Cu, Zn, Se, Br, Rb, Sr, Cd, Cs, and Pb in liver, spleen, aorta, kidney medulla, kidney cortex, abdominal fat, pancreas, and hair taken at autopsy from Southwest Indians, primarily of the Pima tribe. Samples were prepared by a low-temperature ashing procedure which is compared to other preparation methods. Data were analyzed by a computer program, ANALEX. The accuracy is tested with NBS standard reference materials and with flame atomic absorption spectrophotometric results. The precision allowed observation of element concentration differences between replicate, half-gram samples of the same tissue. The differences appeared to arise from tissue inhomogeneities. 5 figures, 4 tables.

  13. Fetal Alcohol Syndrome in Sudden Unexpected Death in Infancy: A Case Report in Medicolegal Autopsy.

    Science.gov (United States)

    Tangsermkijsakul, Aphinan

    2016-03-01

    Fetal alcohol spectrum disorder is a range of birth defects associated with prenatal alcohol exposure. Fetal alcohol syndrome (FAS) is the most serious form of fetal alcohol spectrum disorder. Infants with FAS are prone to death because of various physical abnormalities. Consequently, infants with FAS may be presented in the medicolegal investigation as a form of sudden unexpected death in infancy. The author reported a 6-month-old male infant who was found dead at home. The history of maternal ethanol consumption during pregnancy was obtained. The infant was diagnosed with FAS at the autopsy because he was presented with postnatal growth retardation, multiple facial abnormalities, and abnormal brain structures, which met the criteria of FAS. The cause of death was severe aspiration pneumonia. The purposes of this case report are to show an uncommon manifestation of sudden unexpected death in infancy case for the forensic pathologists and to emphasize on the national healthcare problem. PMID:26730801

  14. Autopsy evaluation of coal mining deaths in the city of Zonguldak, Turkey

    Science.gov (United States)

    Ozer, Erdal; Yilmaz, Riza; Evcuman, Durmus; Yildirim, Ali; Cetin, Ilhan; Kocak, Ugur; Ergen, Kivanc

    2014-01-01

    Background In this study, our aim was to evaluate the fatal occupational accidents that occurred in Zonguldak coal mines between the years 2005–2008. Material/Methods We retrospectively evaluated 42 fatal coal mine occupational accidents in Zonguldak (Turkey) between the years 2005–2008. The forensic records of autopsies referred to the chief prosecutors’ office during 2005–2008 were reviewed retrospectively. There were 42 cases. The cases were evaluated with respect to age, mechanism of injury, body region of wound, cause of death, and legality of the mine. Results Ages of the deceased ranged between 17 and 52 (median: 32.9 yrs). Deaths were mostly in the 21–30 (35.8%), and 31–40 (30.9%) age groups. Only 1 case was younger than 18 years of age. Review of occupational fatalities has revealed that fatal accidents occurred mostly (76.2%) in the private, and fewer (23.8%) in the public mining enterprises. Crime scene investigation findings have demonstrated that of all occupational deaths (total n=42), 27 (64.3%) were due to subsidence, followed by methane gas poisoning (n=6, 14.2%), tram crash (n=3, 7.1%), log falls (n=2, 4.8%), electrocution (n=2, 4.8%), and methane explosion (n=2, 4.8%). Conclusions Despite laws and regulations concerning mining and because of problems in their implementation, Turkey leads the world in work-related accidents, occupational injuries, and deaths. Evaluation of autopsy findings of deaths in fatal occupational accidents occurring in coal mines is quite important in planning to decrease rates of occupational fatalities. PMID:24643126

  15. GSK3? Interactions with Amyloid Genes: An Autopsy Verification and Extension.

    Science.gov (United States)

    Hohman, Timothy J; Chibnik, Lori; Bush, William S; Jefferson, Angela L; De Jaeger, Phillip L; Thornton-Wells, Tricia A; Bennett, David A; Schneider, Julie A

    2015-10-01

    Glyocogen synthase kinase 3 (GSK3) plays an important role in the pathophysiology of Alzheimer's disease (AD) through the phosphorylation of tau. Recent work has suggested that GSK3? also plays a role in the amyloid pathway of AD through genetic interactions with APP and APBB2 on in vivo measures of amyloid. This project extends the previously identified genotype interactions to an autopsy measure of amyloid, while also testing the same interactions leveraging gene expression data quantified in the prefrontal cortex. 797 participants (251 cognitively normal, 196 mild cognitive impairment, and 350 Alzheimer's disease) were drawn from the Religious Orders Study and Rush Memory and Aging Project. A mean score of amyloid load was calculated across eight brain regions, gene expression levels from frozen sections of the dorsolateral prefrontal cortex were quantified using RNA amplification, and expression signals were generated using Beadstudio. Three SNPs previously identified in genetic interactions were genotyped using the Illumina 1M genotyping chip. Covariates included age, sex, education, and diagnosis. We were able to evaluate 2 of the 3 previously identified interactions, of which the interaction between GSK3? (rs334543) and APBB2 (rs2585590) was found in this autopsy sample (p = 0.04). We observed a comparable interaction between GSK3? and APBB2 when comparing the highest tertile of gene expression to the lowest tertile, t(1) = -2.03, p = 0.043. These results provide additional evidence of a genetic interaction between GSK3? and APBB2 and further suggest that GSK3? is involved in the pathophysiology of both of the primary neuropathologies of Alzheimer's disease. PMID:26194614

  16. Mobile education in autopsy conferences of pathology: presentation of complex cases

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    Kayser Klaus

    2006-11-01

    Full Text Available Abstract Background MeduMobile was a project to develop and evaluate learning scenarios for medical students and teachers by use of video communication and notebooks. Its core part was assigned to various medical routines, conferences or meetings such as doctor-patient bedside conversation. These were filmed by video teams and broadcasted live via the WLAN of the Charité campus to course participating students. One type of the learning arrangements was the autopsy conference as an on-call scenario. Materials and methods The MeduMobile project consisted of two main compartments: the regular seminar event which took place every week or month, and the on-call event. For an on-call event the students were informed two hours before the lesson's start. A mobile video team organised the video conference via a specific MeduMobile seminar system. This software offered the students to log. The MeduMobile seminar system is based on the Windows operating system and realises an extended video communication via WLAN. Thirteen access points were implemented at the Charité Campus Virchow Klinikum and Campus Mitte. A questionnaire was developed to investigate in the response and learning effect of the mobile seminar system. Results During the MeduMobile project 42 video conferences with (cumulative 145 participating students took place. Four autopsy conferences could be organised as on-call scenarios within this project. A prospective, not randomised follow-up study was included 25 students of the 1st – 6th clinical semester. According to the answers, professional reasoning, professional performance, sustainability, and the complexity were broadly accepted by the students. Discussion In principle, the MeduMobile realised an interdisciplinary case presentation using video conference and web page. The evaluation indicates a high acception of such complex case presentation with multidisciplinary settings. The use of the notebooks in mobile learning enables an interconnective training and promotes a complex learning.

  17. Sudden Cardiac Death in Brazil: A Community-Based Autopsy Series (2006-2010

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    Maria Fernanda Braggion-Santos

    2015-02-01

    Full Text Available Background: Sudden cardiac death (SCD is a sudden unexpected event, from a cardiac cause, that occurs in less than one hour after the symptoms onset, in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before found dead. Although it is a relatively frequent event, there are only few reliable data in underdeveloped countries. Objective: We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000 residents according to Coroners’ Office autopsy reports. Methods: We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to identify cases of SCD. Specific cause of death as well as demographic information, date, location and time of the event, comorbidities and whether cardiopulmonary resuscitation (CPR was attempted were collected. Results: We identified 899 cases of SCD (20%; the rate was 30/100000 residents per year. The vast majority of cases of SCD involved a coronary artery disease (CAD (64% and occurred in men (67%, between the 6th and the 7th decades of life. Most events occurred during the morning in the home setting (53.3% and CPR was attempted in almost half of victims (49.7%. The most prevalent comorbidity was systemic hypertension (57.3%. Chagas’ disease was present in 49 cases (5.5%. Conclusion: The majority of victims of SCD were men, in their sixties and seventies and the main cause of death was CAD. Chagas’ disease, an important public health problem in Latin America, was found in about 5.5% of the cases.

  18. Pulmonary tumor thrombotic microangiopathy induced by gastric carcinoma: Morphometric and immunohistochemical analysis of six autopsy cases

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    Shinozaki Minoru

    2011-03-01

    Full Text Available Abstract Background Pulmonary tumor thrombotic microangiopathy (PTTM has been known as a rare and serious cancer-related pulmonary complication. However, the pathogenesis and pathophysiology of this debilitating condition still remains obscure and no effective management was recommended. The present study aims to elucidate the pathophysiology of PTTM. Methods Autopsy records were searched to extract cases of pulmonary tumor embolism induced by metastasis of gastric carcinoma in the Toho University Omori Medical Center from 2000 to 2006. And then, tissue sections of extracted cases were prepared for not only light microscopic observation but morphometric analysis with the use of selected PTTM cases. Results Six autopsies involved PTTM and clinicopathological data of them were summarized. There was a significant negative association between pulmonary arterial diameter and stenosis rate in four cases. Although all cases showed an increase of stenosis rate to some degree, the degree of stenosis rate varied from case to case. Significant differences were found for average stenosis rate between the under 100 micrometer group or the 100 to 300 micrometer group and the 300 micrometer group in four cases. However, no significant differences were found for average stenosis rate between the under 100 micrometer group and the 100 to 300 micrometer group in all cases. Meanwhile, all cases showed positive reactivity for tissue factor (TF, five showed positive reactivity for vascular endothelial growth factor (VEGF, and three showed positive reactivity for osteopontin (OPN. Conclusions In the present study, we revealed that the degree of luminal narrowing of the pulmonary arteries varied from case to case, and our results suggested that pulmonary hypertension in PTTM occurs in selected cases which have a widespread pulmonary lesion with severe luminal narrowing in the smaller arteries. Furthermore, our immunohistochemical examination indicated that gastric carcinoma indicating PTTM shows a higher TF-positive rate than typical gastric carcinoma. However, it remains still obscuring whether gastric carcinoma indicating PTTM shows a higher VEGF or OPN-positive rate as determined by immunohistochemistry.

  19. Review of Handbook of Autopsy Practice, Brenda L. Waters (Ed.). 4th edition, Humana Press (2009). ISBN: 978-1-58829-841-6

    DEFF Research Database (Denmark)

    Leth, Peter Mygind

    2010-01-01

    for the family of the deceased and a quality assurance worksheet. The text is written in a well-formulated language, and is not too long. The illustrations and photos are of a high quality. All photos are black-and-white. The book covers a broad area of relevance to autopsy practice, including...... specialized techniques used for post-mortem investigation of the cardio-vascular system, the nervous system and eye and adnexa. Autopsy microbiology, chemistry and chromosome analysis and autopsies of bodies containing radioactive material are also among the topics that are addressed in this handbook, as well...

  20. An autopsy case of osteosarcoma of right mandibula developed after irradiation to the right cervical region for treatment of Hodgkin's disease

    International Nuclear Information System (INIS)

    An autopsy case of osteosarcoma derived from the right mandible was reported. The case was a 64 year-old-female who received radiotherapy (60Co) for Hodgkin's disease in the right neck 15 years prior to the development of her osteosarcoma. By autopsy findings, large nodular growths in the right facial region and the lung metastases of the osteosarcoma were remarkable. No recurrence of Hodgkin's disease was revealed by autopsy. The authors considered that right mandibular osteosarcoma were suspected to be radiation-induced according to the long latent interval and the development of the sarcoma derived from the same location of the irradiation field. (author)

  1. Situación actual y perspectiva de la autopsia en Cuba Present situation and prospects of autopsy in Cuba

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    José Hurtado de Mendoza Amat

    2013-03-01

    Full Text Available Se actualiza la situación de la autopsia en Cuba y se contrasta con la de otros países. El propósito de este trabajo es argumentar criterios y propuestas en el intento de lograr que la autopsia sea aprovechada al máximo y brinde todos los beneficios que puede y debe aportar. Se destaca que, a pesar de que el índice de autopsias ha descendido al 53,8 %, en fallecidos hospitalizados es mucho mayor que las de otros países. La aplicación de resultados de la investigación científica y de un Sistema Automatizado de Registro y Control en Anatomía Patológica, contribuyeron a mejorar la calidad de la autopsia. Se señala el bajo aprovechamiento de los beneficios que brinda la autopsia. Cuba, puede y debe hacer más para confirmar su supremacía en el trabajo con la autopsia, que es una fortaleza de su Sistema Nacional de Salud. Se exponen las perspectivas que permitiría lograr estos propósitos y el papel fundamental que tienen los patólogos en el intento de alcanzar la máxima eficiencia de la autopsia y su mayor aprovechamiento apoyándose en las reuniones sobre fallecidos y en estrecha relación con el resto de los participantes en el proceso. Conseguir estas metas significa contribuir a alargar y hacer más feliz la vida del hombre.This paper presented an update on the situation of autopsy in Cuba and a comparison with that of other countries. The objective was to substantiate criteria and proposals in an attempt to make a full use of autopsy so that it may provide all the benefits that it can and should contribute to medicine. It was underlined that, despite the decrease in the rate of autopsy to 53.8 %, the rate is much higher than that of other nations as far as hospitalized dead people are concerned. It analyzed the quality of autopsy and how some factors -the implementation of the scientific research results and of an automated system of registration and control in pathological anatomy- supported the rise of quality. There was pointed out the low utilization of the benefits of autopsy in the country. Cuba can and should do a lot more to confirm its supremacy in performing autopsy, which is one of the strengths of the Cuban national health care system. The perspectives that would allow attaining these objectives and the fundamental role of pathologists in achieving the highest efficiency and more utilization, supported on the meetings about the dead persons and in close relation with the rest of the participants in this process, were disclosed. Attainment of these goals means to extend the man's life and to make it happier.

  2. Effects on the estimated cause-specific mortality fraction of providing physician reviewers with different formats of verbal autopsy data

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    Chow Clara

    2011-08-01

    Full Text Available Abstract Background The process of data collection and the methods used to assign the cause of death vary significantly among different verbal autopsy protocols, but there are few data to describe the consequences of the choices made. The aim of this study was to objectively define the impact of the format of data presented to physician reviewers on the cause-specific mortality fractions defined by a verbal autopsy-based mortality-surveillance system. Methods Verbal autopsies were done by primary health care workers for all deaths between October 2006 and September 2007 in a community in rural Andhra Pradesh, India (total population about 180,162. Each questionnaire had a structured section, composed of a series of check boxes, and a free-text section, in which a narrative description of the events leading to death was recorded. For each death, a physician coder was presented first with one section and then the other in random order with a 20- to 40-day interval between. A cause of death was recorded for each data format at the level of ICD 10 chapter headings or else the death was documented as unclassified. After another 20- to 40-day interval, both the structured and free-text sections of the questionnaire were presented together and an index cause of death was assigned. Results In all, 1,407 verbal autopsies were available for analysis, representing 94% of all deaths recorded in the population that year. An index cause of death was assigned using the combined data for 1,190 with the other 217 remaining unclassified. The observed cause-specific mortality fractions were the same regardless of whether the structured, free-text or combined data sources were used. At the individual level, the assignments made using the structured format matched the index in 1,012 (72% of cases with a kappa statistic of 0.66. For the free-text format, the corresponding figures were 989 (70% and 0.64. Conclusions The format of the verbal autopsy data used to assign a cause of death did not substantively influence the pattern of mortality estimated. Substantially abbreviated and simplified verbal autopsy questionnaires might provide robust information about high-level mortality patterns.

  3. Situación actual y perspectiva de la autopsia en Cuba / Present situation and prospects of autopsy in Cuba

    Scientific Electronic Library Online (English)

    José Hurtado, de Mendoza Amat; Teresita de J, Montero González; Ignacio, Ygualada Correa.

    2013-03-01

    Full Text Available Se actualiza la situación de la autopsia en Cuba y se contrasta con la de otros países. El propósito de este trabajo es argumentar criterios y propuestas en el intento de lograr que la autopsia sea aprovechada al máximo y brinde todos los beneficios que puede y debe aportar. Se destaca que, a pesar [...] de que el índice de autopsias ha descendido al 53,8 %, en fallecidos hospitalizados es mucho mayor que las de otros países. La aplicación de resultados de la investigación científica y de un Sistema Automatizado de Registro y Control en Anatomía Patológica, contribuyeron a mejorar la calidad de la autopsia. Se señala el bajo aprovechamiento de los beneficios que brinda la autopsia. Cuba, puede y debe hacer más para confirmar su supremacía en el trabajo con la autopsia, que es una fortaleza de su Sistema Nacional de Salud. Se exponen las perspectivas que permitiría lograr estos propósitos y el papel fundamental que tienen los patólogos en el intento de alcanzar la máxima eficiencia de la autopsia y su mayor aprovechamiento apoyándose en las reuniones sobre fallecidos y en estrecha relación con el resto de los participantes en el proceso. Conseguir estas metas significa contribuir a alargar y hacer más feliz la vida del hombre. Abstract in english This paper presented an update on the situation of autopsy in Cuba and a comparison with that of other countries. The objective was to substantiate criteria and proposals in an attempt to make a full use of autopsy so that it may provide all the benefits that it can and should contribute to medicine [...] . It was underlined that, despite the decrease in the rate of autopsy to 53.8 %, the rate is much higher than that of other nations as far as hospitalized dead people are concerned. It analyzed the quality of autopsy and how some factors -the implementation of the scientific research results and of an automated system of registration and control in pathological anatomy- supported the rise of quality. There was pointed out the low utilization of the benefits of autopsy in the country. Cuba can and should do a lot more to confirm its supremacy in performing autopsy, which is one of the strengths of the Cuban national health care system. The perspectives that would allow attaining these objectives and the fundamental role of pathologists in achieving the highest efficiency and more utilization, supported on the meetings about the dead persons and in close relation with the rest of the participants in this process, were disclosed. Attainment of these goals means to extend the man's life and to make it happier.

  4. An Autopsy Study of Maternal Mortality in Mozambique: The Contribution of Infectious Diseases

    Science.gov (United States)

    Menéndez, Clara; Romagosa, Cleofé; Ismail, Mamudo R; Carrilho, Carla; Saute, Francisco; Osman, Nafissa; Machungo, Fernanda; Bardaji, Azucena; Quintó, Llorenç; Mayor, Alfredo; Naniche, Denise; Dobaño, Carlota; Alonso, Pedro L; Ordi, Jaume

    2008-01-01

    Background Maternal mortality is a major health problem concentrated in resource-poor regions. Accurate data on its causes using rigorous methods is lacking, but is essential to guide policy-makers and health professionals to reduce this intolerable burden. The aim of this study was to accurately describe the causes of maternal death in order to contribute to its reduction, in one of the regions of the world with the highest maternal mortality ratios. Methods and Findings We conducted a prospective study between October 2002 and December 2004 on the causes of maternal death in a tertiary-level referral hospital in Maputo, Mozambique, using complete autopsies with histological examination. HIV detection was done by virologic and serologic tests, and malaria was diagnosed by histological and parasitological examination. During 26 mo there were 179 maternal deaths, of which 139 (77.6%) had a complete autopsy and formed the basis of this analysis. Of those with test results, 65 women (52.8%) were HIV-positive. Obstetric complications accounted for 38.2% of deaths; haemorrhage was the most frequent cause (16.6%). Nonobstetric conditions accounted for 56.1% of deaths; HIV/AIDS, pyogenic bronchopneumonia, severe malaria, and pyogenic meningitis were the most common causes (12.9%, 12.2%, 10.1% and 7.2% respectively). Mycobacterial infection was found in 12 (8.6%) maternal deaths. Conclusions In this tertiary hospital in Mozambique, infectious diseases accounted for at least half of all maternal deaths, even though effective treatment is available for the four leading causes, HIV/AIDS, pyogenic bronchopneumonia, severe malaria, and pyogenic meningitis. These observations highlight the need to implement effective and available prevention tools, such as intermittent preventive treatment and insecticide-treated bed-nets for malaria, antiretroviral drugs for HIV/AIDS, or vaccines and effective antibiotics for pneumococcal and meningococcal diseases. Deaths due to obstetric causes represent a failure of health-care systems and require urgent improvement. PMID:18288887

  5. Stillbirths and newborn deaths in slum settlements in Mumbai, India: a prospective verbal autopsy study

    Directory of Open Access Journals (Sweden)

    Bapat Ujwala

    2012-05-01

    Full Text Available Abstract Background Three million babies are stillborn each year and 3.6 million die in the first month of life. In India, early neonatal deaths make up four-fifths of neonatal deaths and infant mortality three-quarters of under-five mortality. Information is scarce on cause-specific perinatal and neonatal mortality in urban settings in low-income countries. We conducted verbal autopsies for stillbirths and neonatal deaths in Mumbai slum settlements. Our objectives were to classify deaths according to international cause-specific criteria and to identify major causes of delay in seeking and receiving health care for maternal and newborn health problems. Methods Over two years, 2005–2007, births and newborn deaths in 48 slum areas were identified prospectively by local informants. Verbal autopsies were collected by trained field researchers, cause of death was classified by clinicians, and family narratives were analysed to investigate delays on the pathway to mortality. Results Of 105 stillbirths, 65 were fresh (62% and obstetric complications dominated the cause classification. Of 116 neonatal deaths, 87 were early and the major causes were intrapartum-related (28%, prematurity (23%, and severe infection (22%. Bereavement was associated with socioeconomic quintile, previous stillbirth, and number of antenatal care visits. We identified 201 individual delays in 121/187 birth narratives (65%. Overall, delays in receiving care after arrival at a health facility dominated and were mostly the result of referral from one institution to another. Most delays in seeking care were attributed to a failure to recognise symptoms of complications or their severity. Conclusions In Mumbai’s slum settlements, early neonatal deaths made up 75% of neonatal deaths and intrapartum-related complications were the greatest cause of mortality. Delays were identified in two-thirds of narratives, were predominantly related to the provision of care, and were often attributable to referrals between health providers. There is a need for clear protocols for care and transfer at each level of the health system, and an emphasis on rapid identification of problems and communication between health facilities. Trial registration ISRCTN96256793

  6. Medico-legal autopsies as a source of information to improve patient safety.

    Science.gov (United States)

    Madea, Burkhard

    2009-04-01

    Clear data on the epidemiology of medical malpractice are missing, at least for Germany. Especially data on the frequency of malpractice claims in penal and civil law are not available. However, from epidemiological and healthcare research some data on the frequency of adverse events (AE), preventable adverse events (PAE) and negligent adverse events (NAE) are available. According to a review of the German Alliance of Patient Safety adverse events can be expected in 5-10%, preventable adverse events in 2-4%, negligent adverse events in about 1% and lethal outcome in about 0.1% of hospitalized patients. However, these data are not compatible with figures from civil and penal law and there seems to be a great "litigation gap". Data on malpractice cases are available from the files of the arbitration committees on medical malpractice, files of liability insurance companies and files of the institutes of forensic medicine. However, these files are not complete and data sources may have some interferences. The arbitration committees are, however, mainly dealing with living patients. Lethal cases are a special subgroup and the best available data source are the files of the institutes of forensic medicine. This subgroup is of special importance since death is the most severe outcome of medical malpractice and the reproach to have caused the death of a patient by medical negligence is the most severe malpractice claim. From a retrospective multicentre study on autopsies performed in cases of medical malpractice claims (altogether 101.358 autopsies, 4450 due to medical malpractice claims) the most important data will be presented (disciplines concerned, cause of accusation, classification of accusation, causes of preliminary proceedings, occupational group and number of approved medical malpractice, outcome of medical malpractice proceedings). However, these data are not only of a descriptive value but have utmost importance also for risk analysis and to increase patient safety. A thorough evaluation of serious incidences, although less sophisticated than a root cause analysis, produces far more information than the usual hospital reporting system. Identification and evaluation of errors as well as reporting of errors may also contribute to the prevention of errors which is among other medical disciplines also a task of forensic medicine. PMID:19289305

  7. Relation of radiation to gastric carcinoma observed in autopsy cases in the life span study sample, Hiroshima and Nagasaki, 1961-74

    International Nuclear Information System (INIS)

    A study was made of the relation to atomic bomb radiation of 535 cases of gastric carcinoma among 4,694 deaths occurring in a fixed population of Hiroshima and Nagasaki who were autopsied between 1961 and 1974. The proportion of all autopsies with gastric carcinoma as autopsy diagnosis tended to be high in the high dose group, but it could not be concluded with the present amount of information that there is a relation between gastric carcinoma and radiation in this autopsy study. Although no specific distribution of the histological types of gastric carcinoma was noted by radiation dose, the data indicated increases in the degree of extension of tumor cells in the gastric wall and the degree of metastasis to the lymph nodes seemed to be high in the high dose group. (author)

  8. Current (1986) status of the Japanese follow-up study of the Thorotrast patients, and its relationships to the statistical analysis of the autopsy series

    International Nuclear Information System (INIS)

    Although the Japanese Thorotrast study was limited by the number of cases that could be followed or autopsied, (286 and 333) the following conclusions were made:- 1. Shortening of the lifespan occurred in the intravascular Thorotrast follow-up cases as compared with their controls. 2. The incidence of malignant hepatic tumours, liver cirrhosis, blood diseases and carcinoma of the gall-bladder was significantly higher in the intravascular Thorotrast cases than in their controls. 3. A chronological change occurred in the distribution of histological types of Thorotrast-induced malignant hepatic tumours during the 42-year period from 1945 to 1986. 4. A significantly higher rate of malignant peritoneal tumours was proved in the intravascular Thorotrast autopsy series as compared with the control autopsy series. 5. From the relationship between the follow-up study and the autopsy series, the authors estimated that 2000-3000 Japanese lived more than 3 years after intravascular injection of Thorotrast. (author)

  9. Alcohol and premature death in Estonian men: a study of forensic autopsies using novel biomarkers and proxy informants

    OpenAIRE

    Ringmets Inge; Tuusov Jana; Lang Katrin; Väli Marika; Pärna Kersti; Tõnisson Mailis; Helander Anders; McKee Martin; Leon David A

    2012-01-01

    Abstract Background Alcohol makes an important contribution to premature mortality in many countries in Eastern Europe, including Estonia. However, the full extent of its impact, and the mechanisms underlying it, are challenging issues to research. We describe the design and initial findings of a study aimed at investigating the association of alcohol with mortality in a large series of forensic autopsies of working-age men in Estonia. Methods 1299 male deaths aged 25-54 years were subject to...

  10. A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by computed tomography

    DEFF Research Database (Denmark)

    Jacobsen, Christina; Bech, Birthe H; Lynnerup, Niels

    2009-01-01

    BACKGROUND: Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechani...... reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis....

  11. A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by Computed Tomography

    Directory of Open Access Journals (Sweden)

    Lynnerup Niels

    2009-10-01

    Full Text Available Abstract Background Computed Tomography (CT has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fractures are captured by CT scan. The purpose of this study was to compare the diagnostic agreement between CT and autopsy regarding cranial fractures and especially the precision with which cranial fractures are recorded. Methods The autopsy fracture diagnosis was compared to the diagnosis of two CT readings (reconstructed with Multiplanar and Maximum Intensity Projection reconstructions by registering the fractures on schematic drawings. The extent of the fractures was quantified by merging 3-dimensional datasets from both the autopsy as input by 3D digitizer tracing and CT scan. Results The results showed a good diagnostic agreement regarding fractures localised in the posterior fossa, while the fracture diagnosis in the medial and anterior fossa was difficult at the first CT scan reading. The fracture diagnosis improved during the second CT scan reading. Thus using two different CT reconstructions improved diagnosis in the medial fossa and at the impact points in the cranial vault. However, fracture diagnosis in the anterior and medial fossa and of hairline fractures in general still remained difficult. Conclusion The study showed that the forensically important fracture systems to a large extent were diagnosed on CT images using Multiplanar and Maximum Intensity Projection reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis.

  12. A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by Computed Tomography

    OpenAIRE

    Lynnerup Niels; Bech Birthe H; Jacobsen Christina

    2009-01-01

    Abstract Background Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cr...

  13. Measurement of trends in childhood malaria mortality in Africa: an assessment of progress toward targets based on verbal autopsy.

    OpenAIRE

    Korenromp, EL; Williams, BG; Gouws, E.; Dye, C.; Snow, RW

    2003-01-01

    Reduction of deaths associated with malaria in children is a primary goal of malaria control programmes in Africa, but there has been little discussion about how changes in mortality will be measured. This paper assesses recent historical changes in the contribution of malaria to child survival in Africa by examining data from demographic surveillance systems (DSS) in 25 mainly rural settings. The data were adjusted for the varying sensitivity and specificity of verbal autopsies (VA) in diffe...

  14. A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by computed tomography

    DEFF Research Database (Denmark)

    Jacobsen, Christina; Bech, Birthe H; Lynnerup, Niels

    2009-01-01

    BACKGROUND: Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fract...

  15. Unique morphologic and clinical features of liver predominant/primary small cell carcinoma - autopsy and biopsy case series

    OpenAIRE

    Lo, Amy A.; Lo, Edward C.; Li, Haonan; Zhang, Wanying; Liao, Jie; Rao, M. Sambasivia; Miller, Frank; YANG, GUANG-YU

    2014-01-01

    Liver predominant small cell carcinoma is rare, but often presents as hyper-acute liver failure with unknown primary and is a medical emergency. We present 2 autopsy and 7 biopsy cases of liver predominant small cell carcinoma and demonstrate that these patients present with liver failure and identifiable hepatomegaly, but lack discrete lesions on imaging, as well as no mass lesions identified in other organs including lung. Compared to the multiple nodules of metastatic small cell carcinoma ...

  16. Sudden unexpected, unexplained death in epilepsy autopsied patients Morte súbita, inexplicada e inesperada em epilepsia: pacientes autopsiados

    OpenAIRE

    Sergio A. Antoniuk; Lubomira V. Oliva; Isac Bruck; Mariana Malucelli; Silvia Yabumoto; Jeferson Luis Castellano

    2001-01-01

    Sudden unexpected, unexplained death in epilepsy (SUDEP) has been reported to be responsible for 2 to 17% of all deaths in patients with epilepsy. This study was conducted to determine the circumstances of SUDEP and the autopsy findings in these patients. Fifty-three individuals whose cause of death was related to epilepsy were identified and in 30 cases relatives or friends were interviewed about the circumstances of death and other information which allowed to classify the patients as SUDEP...

  17. Pattern of Suicide: A Review of Autopsies Conducted at Moi Teaching and Referral Hospital in Eldoret Kenya

    OpenAIRE

    B. N. Macharia; Iddah, M. A.; F. M. Ndiangui; A. Keter

    2015-01-01

    Problem statement. Suicide is one of the ten leading causes of death in the world, accounting for more than 400,000 deaths annually. The pattern of suicide and the incidence of suicide vary from country to country. Cultural, religious and social values play some role in suicide. Currently, there is no data regarding the incidence of suicide in Kenya. Setting. Moi Teaching and Referral Hospital Mortuary. Study population. A seven-year retrospective study of all the autopsies performed at the M...

  18. A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by Computed Tomography

    International Nuclear Information System (INIS)

    Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fractures are captured by CT scan. The purpose of this study was to compare the diagnostic agreement between CT and autopsy regarding cranial fractures and especially the precision with which cranial fractures are recorded. The autopsy fracture diagnosis was compared to the diagnosis of two CT readings (reconstructed with Multiplanar and Maximum Intensity Projection reconstructions) by registering the fractures on schematic drawings. The extent of the fractures was quantified by merging 3-dimensional datasets from both the autopsy as input by 3D digitizer tracing and CT scan. The results showed a good diagnostic agreement regarding fractures localised in the posterior fossa, while the fracture diagnosis in the medial and anterior fossa was difficult at the first CT scan reading. The fracture diagnosis improved during the second CT scan reading. Thus using two different CT reconstructions improved diagnosis in the medial fossa and at the impact points in the cranial vault. However, fracture diagnosis in the anterior and medial fossa and of hairline fractures in general still remained difficult. The study showed that the forensically important fracture systems to a large extent were diagnosed on CT images using Multiplanar and Maximum Intensity Projection reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis

  19. Pathology of the heart in AIDS. A study of 60 consecutive autopsies.

    DEFF Research Database (Denmark)

    Hansen, B F

    1992-01-01

    Cardiac disease and cardiac death in AIDS patients is seldom reported. In recent years minor cardiac abnormalities have been demonstrated, especially by echocardiography. Cardiac pathology in AIDS patients is here reported from 60 consecutive autopsies where the heart was investigated either using single samples of ventricular myocardium (the first 21 cases) or by an examination of the whole heart (the last 39 cases). Myocarditis according to the Dallas criteria was seen in 25 of 60 cases (42%), and in seven of these cases a probable pathogen (Toxoplasma gondii, cytomegalovirus, fungi) was demonstrated. Diffuse myocardial fibrosis was seen in 40 of 60 cases (67%) and is considered to be partly due to repair after myocyte necrosis/myocarditis. A myocardium thus weakened might not be able to meet an increase in functional demand, and in 15 of the 39 cases (38%) where an examination of the whole heart was performed, there was dilation and/or hypertrophy of the right ventricle. This is in agreement with our knowledge that the main diseases and main causes of death in AIDS patients are pulmonary. Survival time in AIDS is increasing due to ever improving symptomatic treatment, and the results of this study indicate that the prevalence of especially right-sided heart failure will increase.

  20. A study of elderly unnatural deaths in medico-legal autopsies at Lucknow locality.

    Science.gov (United States)

    Kumar, S; Verma, A K

    2014-07-01

    The main aim of this study was to determine the causes and epidemiological aspects of unnatural deaths in the elderly. Data were collected on 4405 male and female victims of unnatural deaths aged 50 years or more from the total number of 21,235 autopsies performed in King George's Medical University, Lucknow, India over a 5-year period, from 2008 to 2012. There were 3165 male victims and 1240 female victims. Unnatural deaths were higher in rural (64%) than in urban (37%) areas. Accidental deaths were the most common manner of unnatural deaths (59%), followed by suicidal deaths (34%) and homicidal deaths (7%). Traumas were the most common cause of unnatural death (77.3%), followed by undetermined causes (16.6%) and toxicological causes (6.1%). The most common causes of traumatic deaths were blunt head injuries (34%) followed by stab in the chest (6%), burn (16%), blunt injuries in abdomen and chest (10%), firearm injuries in the head and trunk (9%), strangulation (3%), stab in the abdomen (4%), smothering (4%), cut throat (3%), throttling (1%) and hanging (10%). Carbamate poisoning was the most common cause of toxicological deaths (44%) followed by organophosphorous poisoning (33%), ethyl alcohol poisoning (12%), barbiturate poisoning (3%) and zinc phosphide poisoning (8%). PMID:24166690

  1. Infectious cause of death determination using minimally invasive autopsies in developing countries.

    Science.gov (United States)

    Martínez, Miguel J; Massora, Sergio; Mandomando, Inácio; Ussene, Esperança; Jordao, Dercio; Lovane, Lucilia; Muñoz-Almagro, Carmen; Castillo, Paola; Mayor, Alfredo; Rodriguez, Cristina; Lopez-Villanueva, Miriam; Ismail, Mamudo R; Carrilho, Carla; Lorenzoni, Cesaltina; Lacerda, Marcus V G; Bassat, Quique; Menéndez, Clara; Ordi, Jaume; Vila, Jordi

    2016-01-01

    In developing countries, the knowledge of the microorganisms causing fatal infections is critical and could help designing and implementing more effective preventive interventions and treatment guidelines. We aimed to develop and validate protocols for microbiological analysis in post-mortem samples obtained during minimally invasive autopsy (MIA) procedures and to assess their performance. Thirty MIAs performed in adults at Maputo Central Hospital in Southern Mozambique were included in the analysis. Microbiological tests included a universal screening for HIV, hepatitis B and C viruses, Plasmodium falciparum, and bacterial/fungal culture. In addition, a variety of molecular microbiology assays guided by the histological results were performed in blood, cerebrospinal fluid and a variety of tissue samples including liver, lung and central nervous system. The combination of culture-based methods together with molecular microbiological assays led to the identification of 17 out of 19 (89.5%) of the infectious deaths. Microorganisms identified included Mycobacterium tuberculosis, Toxoplasma gondii, Pneumocystis jiroveci, Cryptococcus neoformans, hepatitis B virus, human herpesvirus 8, cytomegalovirus, Streptococcus pneumoniae, Streptococcus dysgalactiae, Ryzopus oryzae, and Acinetobacter baumannii. The combination of classical cultures, serological tests and molecular assays performed in samples obtained through MIA allows the identification of most infectious agents causing death. PMID:26508103

  2. Ethyl glucuronide and ethyl sulfate in autopsy samples 27 years after death.

    Science.gov (United States)

    Politi, Lucia; Morini, Luca; Mari, Francesco; Groppi, Angelo; Bertol, Elisabetta

    2008-11-01

    The unique case of a 50-year-old known alcoholic whose corpse was exhumed 27 years after death is reported. The man apparently committed suicide by hanging, but many years later the case was questioned and homicide-linked to a long-lasting serial killer case-was suspected. Thus, the corpse was exhumed, and at the autopsy it was found to be naturally mummified. This fact permitted the analysis of body tissues with the aim to investigate the persistence of ethanol conjugates in the biological material 27 years after death. Fragments of liver and kidney, a blood clot, and a hair strand were collected and submitted to liquid chromatography tandem mass spectrometry analysis. Ethyl glucuronide (EtG) and ethyl sulfate (EtS) were identified and quantified in the liver, the kidney, and the blood clot. Hair analysis was found to be severely affected by ion suppression even after solid phase extraction. Consequently, EtG was identified in all hair segments (0-3 cm, 3-6 cm, and 6-10 cm), but no reliable quantification could be carried out. In summary, our findings demonstrate that, notwithstanding the expected conjugate degradation, EtG and EtS can be indicative of ante-mortem use of alcohol even many years after death. PMID:18661140

  3. Statistical studies on heart disease of the pathological autopsy cases in the Atomic Bomb Hospital

    International Nuclear Information System (INIS)

    Of 1230 autopsied cases in the Atomic Bomb Hospital and in the Red-Cross Hospital from 1956 to March, 1975, a statistical study was made on 118 cases in which primary or secondary heart disease had been found. The results are as follows. The incidence of myocardial infarction was 2.4 times higher in the group exposed to the atomic bomb within 2 km distance from the bombed area than that it was in the unexposed group. The incidence of acquired valvular disease was 4.1 times higher in the exposed group than in the unexposed group. From the standpoint of the incidence of myocardiosis, there was no difference between the groups. The incidence of pericarditis was 1.5 times higher in the exposed group than in the unexposed group. The incidence of cor pulmonale was 1.8 times higher in the exposed group than in the unexposed group. The incidence of other heart disease including congenital disease was, however, 1.6 times higher in the unexposed group than in the exposed group. The incidence of general heart disease was 1.7 times higher in the exposed group than in the unexposed group. The incidence of hypertrophy of the heart (more than 400 g) was 1.2 times higher in the exposed group than in the unexposed group. (Namekawa, K.)

  4. [A clinicopathological investigation of two autopsy cases of calpainopathy (LGMD2A)].

    Science.gov (United States)

    Hashiguchi, Shuji; Adachi, Katsuhito; Inui, Toshio; Arii, Yoshiharu; Kashiwagi, Setsuko; Saito, Miho; Kagawa, Noriko; Kawai, Hisaomi

    2014-09-01

    In this study, we compared the clinicopathological findings of two autopsy cases of patients with calpainopathy (LGMD2A) from different families. The patient in case 1 was a 72-year-old man with a history of type 2 diabetes mellitus. He exhibited recent memory impairments from the age of 70. ECG revealed an incomplete right bundle branch block. A homozygous frameshift mutation c.1796dupA was found in the CAPN3 gene. Cause of death was respiratory insufficiency and heart failure. The patient in case 2 was a 70-year-old man with a history of hypertension. ECG revealed an incomplete right bundle branch block. A homozygous missense mutation c.1080G>C (p.Trp360Cys) in CAPN3 gene was identified. Cause of death was ischemic cardiomyopathy and systemic circulatory failure. In both cases, muscle pathology revealed severe dystrophic changes. In case 2, cardiac hypertrophy and old myocardial infarcts with stenosis of coronary arteries were observed. Histological examination of the sinoatrial node showed fatty infiltration with ischemic changes in case 2. In both cases, the patients' brains showed cerebral atrophy and well preserved neurons. Calpain 3 abnormality was correlated with skeletal muscle involvement. It should be considered that LGMD2A might be complicated by dysfunction of the cardiac conduction system. PMID:25200581

  5. The importance of microbiological testing for establishing cause of death in 42 forensic autopsies.

    Science.gov (United States)

    Christoffersen, S

    2015-05-01

    Microorganisms have always been one of the great challenges of humankind, being responsible for both high morbidity and mortality throughout history. In a forensic setting microbiological information will always be difficult to interpret due to lack of antemortem information and changes in flora postmortem. With this study we aim to review the use of microbiological procedures at our forensic institute. In a retrospective study including 42 autopsies performed at our Institute, where microbiological test had been applied, analyses were made with regard to: type of microbiological tests performed, microorganisms found, histological findings, antemortem information, C-reactive protein measurement and cause of death. Fiftyone different microorganisms were found distributed among 37 cases, bacteria being the most abundant. Nineteen of the cases were classified as having a microbiological related cause of death. C-reactive protein levels were raised in 14 cases of the 19 cases, histological findings either supported or were a decisive factor for the classification of microbiologically related cause of death in 14 cases. As a multitude of abundant microorganisms are able to cause infection under the right circumstances, all findings should be compared to anamnestic antemortem information, before conclusions are drawn. A definite list of true pathogens is nearly impossible to compile. PMID:25769131

  6. Cerebromeningeal hemorrhage: analysis of autopsies performed over a 10-year period

    Directory of Open Access Journals (Sweden)

    Nelson Martelli

    1988-06-01

    Full Text Available A study was conducted on the medical records of 353 patients who died of a subarachnoid hemorrhage (SAH and who were submitted to autopsy over the last 10 years. SAH was associated with arterial hypertension in 180 (51% cases, with ruptured aneurysms in 102 (28.9%, and with other pathologies in 71 (20.1%. The patients with hemorrhage associated with arterial hypertension were mostly males, and those with hemorrhage due to aneurysms were mostly females. Of the patients with aneurysms, 36 (35.3% had aneurysms in the anterior communicating artery, 30 (29.4% in the internal carotid artery, and 23 (22.6% in the middle cerebral artery. Among the patients with aneurysms who suffered rebleeding and vasospasm, 59.1% and 61.5%, respectively, were classified as grade I and II upon admission, and all evolved toward grade IV after these complications, Vasospasm predominated from the 3rd to the 10th day after hemorrhage, and rebleedine from the 9 to 16th day and both were most frequent among patients with aneurysms of the anterior communicant artery. Sixty eight percent of the patients with aneurysms died during the first 9 days after hemorrhage. Because of our conduct was to operate systematically late, a considerable number of patients lost the oportunity to be treated surgically with possible favorable evolution due to vasospasm or rebleeding.

  7. The importance of microbiological testing for establishing cause of death in 42 forensic autopsies

    DEFF Research Database (Denmark)

    Christoffersen, SØren

    2015-01-01

    Microorganisms have always been one of the great challenges of humankind, being responsible for both high morbidity and mortality throughout history. In a forensic setting microbiological information will always be difficult to interpret due to lack of antemortem information and changes in flora postmortem. With this study we aim to review the use of microbiological procedures at our forensic institute. In a retrospective study including 42 autopsies performed at our Institute, where microbiological test had been applied, analyses were made with regard to: type of microbiological tests performed, microorganisms found, histological findings, antemortem information, C-reactive protein measurement and cause of death. Fiftyone different microorganisms were found distributed among 37 cases, bacteria being the most abundant. Nineteen of the cases were classified as having a microbiological related cause of death. C-reactive protein levels were raised in 14 cases of the 19 cases, histological findings either supported or were a decisive factor for the classification of microbiologically related cause of death in 14 cases. As a multitude of abundant microorganisms are able to cause infection under the right circumstances, all findings should be compared to anamnestic antemortem information, before conclusions are drawn. A definite list of true pathogens is nearly impossible to compile.

  8. Disseminated perivenous necrotizing encephalomyelitis in systemic lupus erythematosus: report of an autopsy case.

    Science.gov (United States)

    Shintaku, M; Matsumoto, R

    1998-03-01

    The patient, a 22-year-old woman who had been treated for systemic lupus erythematosus (SLE) for 10 years, was hospitalized for arthralgia, melena, and difficulty in walking. CT examination of the brain showed grain-like high-density lesions scattered throughout the cerebral white matter and basal ganglia. At autopsy, multiple perivenous, well-demarcated foci of brownish discoloration were seen scattered throughout the cerebral white matter and basal ganglia. Histopathologically these lesions consisted of foci of coagulation necrosis surrounding the veins. The veins in the foci showed fibrous thickening of the walls, but there were no indications of vasculitis. At the periphery of the lesions, the axons were better preserved than their myelin sheaths. The neuropathological findings in the present case closely resemble those of acute disseminated (perivenous) encephalomyelitis, although an inflammatory cell infiltration had apparently already subsided. Although its pathogenesis remains unclear, this finding should not be regarded as an incidental complication but rather as a rare subtype of central nervous system lesion occurring with SLE. PMID:9542599

  9. An Autopsy Case of Sudden Death Caused by Cerebral Malaria Infection.

    Science.gov (United States)

    Ya?mur, Gülhan; Gürler, A Selçuk; Karayel, Ferah; ?ahin, M Feyzi; Apayd?n, Nedim; Koç, Sermet

    2015-09-01

    Malaria is a lethal protozoan infection which is generally diagnosed antemortem and rarely diagnosed postmortem in a few cases. A fifty five year old, Turkish citizen male has been referred for autopsy. It has been found that he has gone abroad to work a month ago, however, quitted malaria prophylaxis before the intended end and brought into the emergecy department in an unconscious state.Following quinine and clindamycin treatment with the initial diagnosis of cerebral malaria, the case was reported to have died due to his general condition got worsened at the end of the third day of therapy.Histopathological evaluation of postmortem tissues was revealed haphazardly arranged minor bleedings and central vascular necrotic foci in the cerebrum, cerebelum and brain stem; light brown pigment containing cells around vasculature; and pigment containing cells in the spleen and bone marrow. Cerebral malaria has a rapid course and is rare but one of the lethal complications of infections with Plasmodium. Although domestic malaria cases has been decreasing in our country, it should be kept in mind that the malaria infection can be seen in persons travelling abroad to high endemic malarial regions and an appropriate antimalarial prophylaxis should be recommended to those overseas travellers. PMID:26470933

  10. Pathological and radiological correlation in an autopsy case of combined pulmonary fibrosis and emphysema

    Directory of Open Access Journals (Sweden)

    Karata H

    2015-07-01

    Full Text Available Hiroki Karata,1 Tomonori Tanaka,1 Ryoko Egashira,2 Kazuhiro Tabata,1 Kyoko Otani,3 Ryuji Hayashi,4 Takashi Hori,5 Junya Fukuoka1 1Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; 2Department of Radiology, Faculty of Medicine, Saga University, Saga, Japan; 3Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan; 4Department of Internal Medicine, University of Toyama, Faculty of Medicine, Toyama, Japan; 5Laboratory of Pathology, Toyama University Hospital, Toyama, Japan Abstract: We report an educational autopsy case of combined pulmonary fibrosis and emphysema. Radiological patterns of the upper lung were considered as mostly emphysema, but pathological observation revealed significant interstitial fibrosis of usual interstitial pneumonia as a major pathology. The patient eventually developed acute exacerbation of background interstitial pneumonia. Careful radiological and pathological correlation of the current case indicates that regions with distal acinar emphysema on computed tomography image may possess histologically marked dense fibrosis of lethal interstitial pneumonia. Keywords: interstitial pneumonia, CPFE, AEF, smoking, CT

  11. Non-atherosclerotic aorto-arterial thrombosis: A study of 30 cases at autopsy.

    Directory of Open Access Journals (Sweden)

    Vaideeswar P

    2001-01-01

    Full Text Available BACKGROUND: Aorto-arterial thrombosis is very often associated with atherosclerotic and/or aneurysmal changes. Thrombosis, unrelated to these changes is infrequent. AIMS: To evaluate the clinical presentation and aetiopathogenesis of aorto-arterial thrombosis, unrelated to atherosclerosis and aneurysms. SUBJECTS AND METHODS: A retrospective study of 30 autopsied cases of non-atherosclerotic and non-aneurysmal aorto-arterial thrombosis collected over a period of 14 years was carried out. RESULTS: There were 23 males and seven females and majority presented in the third to fourth decades of life with clinical features of acute abdomen or lower limb gangrene. Abdominal aorta as the site of thrombosis was observed in 46.5% cases. The causes were attributed to hypercoagulable states and changes in the aortic wall. No aetiology could be identified in 5 patients (16.6%. Associated tuberculosis was seen in six cases. CONCLUSIONS: Non-atherosclerotic aortic thrombosis is a heterogeneous group of disorders. Young and even elderly patients with symptoms related to abdominal ischaemia or peripheral vascular disease should be investigated thoroughly for hypercoagulable states and aortic pathology.

  12. A hospital based autopsy study of 50 cases at combined military hospital (cmh), sialkot

    International Nuclear Information System (INIS)

    To analyze the pattern of deaths on autopsy carried out on Armed Forces personnel in CMH Sialkot. Study Design: Retrospective analytical study Place and Duration of Study: Combined Military Hospital Sialkot (CMH), from 2009 to 2012 Materials and Methods: In a total of fifty (50) cases detailed postmortems were carried out and gross features on external examination and different systemic examinations were recorded. Histopathology of various organs was done in all cases. Chemical and toxicological examination of various abdominal viscera was carried out in all sudden and suspicious deaths. Results: Ischemic Heart Disease (IHD) was most common cause of death (38%) followed by road traffic accidents (14%) and electrocution (8%). Sudden adult death syndrome accounted for 4 cases of deaths. Other causes were drowning, cerebral malaria, heat stroke, gunshot wounds, myocarditis, brain hemorrhage, meningitis and diabetic ketoacidosis. Most of these cases were young soldiers (n=30) followed by Non-Commissioned Officers (n=17). Conclusion: A large number of our young soldiers dying of heart problems is an alarming situation. Awareness among the troops of various risk factors is most important. Precautionary measures against preventable causes should be taken. (author)

  13. Five years audit for presence of toxic agents/drug of abuse at autopsy

    International Nuclear Information System (INIS)

    Objective: To know the frequency of fatal poisoning in Peshawar regarding the toxic agents mostly involved and year wise percentage. To know the age group and the gender that is most vulnerable to fatal poisoning. Results: Poisoning was the cause of death in 1.48% of the total autopsies conducted during the five years. Males were more involved than the females, 90.38%. Suicidal poisoning was present in 17.30% of the total cases and accidental poisoning was found in 80.72% cases, while homicidal cases were 1.29% only. Diacetylmorphine (heroin) was the most commonly involved agent, 65.38%, of the total cases. The incidence of poisoning was more during the third and fourth decades of life. Conclusion: Diacetylmorphine (heroin) was the main causative agent involved in young males due to accidental over-dosage. Accidental and suicidal deaths should not be considered as inevitable. More elaborative studies are required in this area of recent research to adopt appropriate and adequate measures to save precious lives.(author)

  14. Understanding maternal deaths from the family's perspective: verbal autopsies in rural Tanzania.

    Science.gov (United States)

    Webber, Gail C; Chirangi, Bwire

    2014-09-01

    Maternal mortality rates in rural Tanzania are high. In preparation for the introduction of an intervention to reduce maternal deaths by distribution of misoprostol and erythromycin to women living in rural Rorya District, Mara Region, Tanzania, we conducted a limited verbal autopsy by surveying family members of women who died in childbirth in the previous five years. The purpose of this survey was to understand the circumstances surrounding these deaths. Thirty six family members were interviewed. The majority of the deaths occurred on the roadside as the women made their way to a health facility (23/36). Most of the women were delivered by a TBA (16/36) or family member (13/36). The majority of the family members attributed the death of their loved one to bleeding or retained placenta (32/36). Maternal deaths are common in this rural district of Tanzania because of long distances from the health facilities, difficulty finding transportation, costs of transport and hospital, and women's beliefs about being able to deliver at home and fear of medication. There is a need for increased education of women and their families about the benefits of childbirth in a healthcare facility attended by skilled providers. There is also a role for the community distribution of misoprostol to be used as an alternative uterotonic medication if a facility birth is not possible, as the rates of maternal death from hemorrhage are unacceptably high. PMID:25508048

  15. Hiperinfecção por Strongyloides stercoralis: relato de caso autopsiado / Strongyloides stercoralis hyperinfection: autopsy case report

    Scientific Electronic Library Online (English)

    Moema Gonçalves Pinheiro, Veloso; Anita Sperandio, Porto; Mário, Moraes.

    2008-08-01

    Full Text Available Infecção assintomática por Strongyloides stercoralis pode resultar em doença potencialmente fatal em pacientes imunodeprimidos. Os autores relatam caso de hiperinfecção por Strongyloides stercoralis descoberto à autópsia, enfatizando aspectos clinicopatológicos, em homem de 55 anos, em tratamento pa [...] ra mieloma múltiplo. Apresentava, havia um dia, cefaléia intensa, dor abdominal e oligúria desenvolvendo insuficiência respiratória aguda e choque séptico. Devido à dificuldade no diagnóstico, o tratamento empírico antes do início da terapia imunossupressora pode ser a melhor estratégia para prevenir a hiperinfecção pelo verme. Abstract in english Asymptomatic infection due to Strongyloides stercoralis may result in potentially fatal disease in immunodepressed patients. A case of Strongyloides stercoralis hyperinfection discovered at autopsy in a 55-year-old man who had been undergoing treatment for multiple myeloma is reported, emphasizing t [...] he clinical and pathological findings. One day earlier, he presented severe headache, abdominal pain and oliguria, from which he developed acute respiratory failure and septic shock. Because of difficulty in reaching this diagnosis, empirical treatment before starting immunosuppressive therapy may be the best strategy for preventing hyperinfection by this worm.

  16. Statistical analysis of a LASL study of plutonium in US autopsy tissue

    Energy Technology Data Exchange (ETDEWEB)

    Fox, T.; Tietjen, G.L.; McInroy, J.F.

    1979-01-01

    The Autopsy Tissue Program was begun in 1960. To date, tissues on 900 or more persons in 7 geographic regions have been collected and analyzed for plutonium content. The tissues generally consist of lung, liver, kidney, lymph, bone, and gonadal tissues for each individual. The original objective of the program was to determine the level of plutonium in human tissues due solely to fallout from weapons testing. The baseline thus established was to be used to evaluate future changes. From the first, this program was beset with chemical and statistical difficulties. Many factors whose effects were not recognized and not planned for were found later to be important. Privacy and ethical considerations hindered the gathering of adequate data. Since the chemists were looking for amounts of plutonium very close to background, possible contamination was a very real problem. Widely used chemical techniques introduced a host of statistical problems. The difficulties encountered touch on areas common to large data sets, unusual outlier detection methods minimum detection limits, problems with aliquot sizes, and time-trends in the data. The conclusions point out areas to which the biologists will have to devote much more careful attention than was believed.

  17. Statistical analysis of a LASL study of plutonium in US autopsy tissue

    International Nuclear Information System (INIS)

    The Autopsy Tissue Program was begun in 1960. To date, tissues on 900 or more persons in 7 geographic regions have been collected and analyzed for plutonium content. The tissues generally consist of lung, liver, kidney, lymph, bone, and gonadal tissues for each individual. The original objective of the program was to determine the level of plutonium in human tissues due solely to fallout from weapons testing. The baseline thus established was to be used to evaluate future changes. From the first, this program was beset with chemical and statistical difficulties. Many factors whose effects were not recognized and not planned for were found later to be important. Privacy and ethical considerations hindered the gathering of adequate data. Since the chemists were looking for amounts of plutonium very close to background, possible contamination was a very real problem. Widely used chemical techniques introduced a host of statistical problems. The difficulties encountered touch on areas common to large data sets, unusual outlier detection methods minimum detection limits, problems with aliquot sizes, and time-trends in the data. The conclusions point out areas to which the biologists will have to devote much more careful attention than was believed

  18. Renal tubular dysgenesis with hypocalvaria and ileocecal valve agenesis: an autopsy report

    Directory of Open Access Journals (Sweden)

    Ariel Barreto Nogueira

    2012-12-01

    Full Text Available Renal tubular dysgenesis (RTD is a rare, lethal, autosomal recessive disorder characterized by non-differentiation of the renal proximal convoluted tubules, resulting in oligohydramnios. It is usually diagnosed in the second trimester of pregnancy, following the oligohydramnios sequence, pulmonary hypoplasia and hypocalvaria. The prognosis is poor, and death usually occurs in utero or within the first few days of life. The pathogenesis of RTD is associated with the perinatal use of drugs, such as angiotensin- converting enzyme inhibitors, angiotensin II receptor antagonists, and anti- inflammatory drugs, as well as with fetal transfusion syndrome, genetic mutations in the pathway of the renin-angiotensin system pathway, cocaine snorting, or other pathological mechanisms that reduce renal blood flow. Here, we report the autopsy of a neonate born to consanguineous parents at 38 weeks of gestation, with RTD, decreased amniotic fluid, oligohydramnios sequence, hypocalvaria, pulmonary hypoplasia, and ileocecal valve agenesis. To our knowledge, the latter has never been reported associated with RTD.

  19. Autopsy findings of the first and second filial generations of atomic bomb survivors

    International Nuclear Information System (INIS)

    Autopsy findings of 652 fetuses whose parents or one parent were exposed to the Atomic Bomb (F1) and 115 fetuses which had one or two grandparents exposed (F2) were compared with that of 8570 fetuses whose parents were not exposed (control). The F1 fetuses have been collected since 1963 and F2 fetuses since 1971 voluntarily in Hiroshima. The findings were classified according to the types of delivery and to the distances away from the hypocenter where the parents and grandparents were exposed. Many normal cases in the group of artificial abortions and many malformations and pathological findings in the group of spontaneous abortions were found in both groups of F1 and F2. The malformations were cardiovascular, central nervous and urogenital system, quantitatively in that order, in both groups of F1 and F2. Although there were a few cases of cystic kidney and chondrodystrophy which belong to autosomal dominant and osteogenesis imperfecta which belong to autosomal recessive, these cases were not correlated with the distance. Most cases of malformation which belong to the multifactorial inheritance were found in each organ. No peculiar malformation was found in the groups of F1 and F2. (author)

  20. Autopsy findings of the first and second filial generations of atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Satow, Yukio (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology)

    1992-01-01

    Autopsy findings of 652 fetuses whose parents or one parent were exposed to the Atomic Bomb (F[sub 1]) and 115 fetuses which had one or two grandparents exposed (F[sub 2]) were compared with that of 8570 fetuses whose parents were not exposed (control). The F[sub 1] fetuses have been collected since 1963 and F[sub 2] fetuses since 1971 voluntarily in Hiroshima. The findings were classified according to the types of delivery and to the distances away from the hypocenter where the parents and grandparents were exposed. Many normal cases in the group of artificial abortions and many malformations and pathological findings in the group of spontaneous abortions were found in both groups of F[sub 1] and F[sub 2]. The malformations were cardiovascular, central nervous and urogenital system, quantitatively in that order, in both groups of F[sub 1] and F[sub 2]. Although there were a few cases of cystic kidney and chondrodystrophy which belong to autosomal dominant and osteogenesis imperfecta which belong to autosomal recessive, these cases were not correlated with the distance. Most cases of malformation which belong to the multifactorial inheritance were found in each organ. No peculiar malformation was found in the groups of F[sub 1] and F[sub 2]. (author).

  1. Statistical analysis on main cause of death among atomic bomb survivors. Study of autopsy cases

    Energy Technology Data Exchange (ETDEWEB)

    Hamada, Tadao; Kuramoto, Kiyoshi

    1986-11-01

    The purpose of this report is to present the patho-statistical analysis in 2306 autopsied patients (1237 exposed patients and 1069 non-exposed patients), focusing on the difference in the main cause of death between the exposed and non-exposed groups. The most common cause of death was malignancy in both exposed and non-exposed groups. The incidence of cardiovascular, respiratory tract, and hematologic diseases was higher in the exposed group than the non-exposed group. The incidence of various types of malignancy varied in the following order: lung cancer > stomach cancer > leukemia > liver cancer in patients exposed at less than or equal to 2,000 m from ground zero; stomach cancer > lung cancer > liver cancer > leukemia in those exposed at > 2,000 m or who were not in city; and liver cancer > stomach cancer > lung cancer > leukemia in non-exposed patients. Cancers of the lung and stomach were more frequently observed in the exposed group than the non-exposed group. The incidence of stomach cancer tended to increase with aging in the exposed group, as opposed to that of leukemia, although still observed in younger patients, decreasing with time. Older women tended to have liver cancer more frequently in the exposed group than the non-exposed group; however, this tendency was not seen in men. (Namekawa, K.).

  2. Molecular autopsy in young sudden cardiac death victims with suspected cardiomyopathy

    DEFF Research Database (Denmark)

    Larsen, Maiken Kudahl; Nissen, P H

    2011-01-01

    The aim of this investigation was to identify and characterise pathogenic mutations in a sudden cardiac death (SCD) cohort suspected of cardiomyopathy in persons aged 0-40 years. The study material for the genetic screening of cardiomyopathies consisted of 41 cases and was selected from the case database at the Institute of Forensic Medicine. Mutational screening by DNA sequencing was performed to detect mutations in DNA samples from deceased persons suspected of suffering from hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and arrhythmogenic right ventricle cardiomyopathy (ARVC). A total of 9 of the examined 41 cases had a rare sequence variant in the MYBPC3, MYH7, LMNA, PKP2 or TMEM43 genes, of which 4 cases (9.8%) were presumed to be pathogenic mutations. The presumed pathogenic mutations were distributed with one case of suspected HCM and DCM (MYH7; p.R442H), one case of suspected DCM (LMNA; p.R471H), and two cases of suspected ARVC (PKP2; p.R79X and LMNA; p.R644C). The presented data adds important information on the genetic elements of SCD in the young, and calls for expert pathological evaluation and molecular autopsy in the post-mortem examination of SCD victims with structural anomalies of the heart.

  3. Relationship of red splenic arteriolar hyaline with rapid death: a clinicopathological study of 82 autopsy cases

    Directory of Open Access Journals (Sweden)

    Kotani Hirokazu

    2012-12-01

    Full Text Available Abstract Background Little is known about the relationship between splenic arteriolar hyaline and cause of death. The purpose of this retrospective study was to evaluate the clinicopathological significance of splenic arteriolar hyaline in autopsy cases and estimate the applicability of hyaline for diagnosing the cause and rapidity of death. Methods Archival data and histological slides from 82 cases were reviewed retrospectively. One section of each spleen was evaluated microscopically. The tinctorial pattern of splenic arteriolar hyaline was examined with Heidenhain’s Azan trichrome stain, and the relationships between this pattern and age, cause of death, and rapidity of death were investigated. Results Fifty-four cases demonstrated hyaline change, with 3 different tinctorial patterns: red, blue, and a combination of red and blue. The 3 patterns coexisted in various proportions in each tissue section. Frequency of the blue pattern increased with age (P?P? Conclusions Estimation of splenic arteriolar hyaline with Heidenhain’s Azan trichrome stain is useful for assessment of the cause and rapidity of death. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1132441651796836

  4. Development of novel software to generate anthropometric norms at perinatal autopsy.

    Science.gov (United States)

    Cain, Matthew D; Siebert, Joseph R; Iriabho, Egiebade; Gruneberg, Alexander; Almeida, Jonas S; Faye-Petersen, Ona Marie

    2015-01-01

    Fetal and infant autopsy yields information regarding cause of death and the risk of recurrence, and it provides closure for parents. A significant number of perinatal evaluations are performed by general practice pathologists or trainees, who often find them time-consuming and/or intimidating. We sought to create a program that would enable pathologists to conduct these examinations with greater ease and to produce reliable, informative reports. We developed software that automatically generates a set of expected anthropometric and organ weight ranges by gestational age (GA)/postnatal age (PA) and a correlative table with the GA/PA that best matches the observed anthropometry. The program highlights measurement and organ weight discrepancies, enabling users to identify abnormalities. Furthermore, a Web page provides options for exporting and saving the data. Pathology residents utilized the program to determine ease of usage and benefits. The average time using conventional methods (ie, reference books and Internet sites) was compared to the average time using our Web page. Average time for novice and experienced residents using conventional methods was 26.7 minutes and 15 minutes, respectively. Using the Web page program, these times were reduced to an average of 3.2 minutes (P usage by both university and private practice groups is in progress. PMID:25634794

  5. Analysis of the scalp of women with AIDS subjected to autopsy: epithelial, follicular, and immunologic aspects.

    Science.gov (United States)

    Faria, Humberto Aparecido; Farnese, Mauricio; Rocha, Laura Penna; Olegário, Janaínna Grazielle Pacheco; Cavellani, Camila Lourencini; de Oliveira Guimarães, Camila Souza; dos Reis, Marlene Antônia; Miranda Corrêa, Rosana Rosa

    2013-02-01

    Hair keeps the scalp warmer and slightly moister than the rest of the skin, which contributes to a favorable environment for mycotic, bacterial, and parasitic infections. It is well established that AIDS makes the patient more susceptible to opportunistic infections and cutaneous manifestations. Because of this, the aim of this study was to analyze scalp fragments of autopsied women with AIDS. Twenty-eight scalp samples of women aged between 18 and 46 years were observed. These women were divided into 2 groups: with AIDS (n = 14) and without AIDS (n = 14). We conducted histochemical (hematoxylin-eosin, Picrosirius, and Verhoeff), morphometric (Image J; National Institutes of Health, Hamilton, ON, Canada and KS-300 Kontron-Zeiss; Kontron Elektronik, Carl-Zeiss, Germany), and immunohistochemical (S-100) analyses of the scalp. In patients with AIDS, epithelial thickness, number of epithelial cell layers, number of immature Langerhans cells in the epidermis, and percentages of elastic fibers in the dermis were significantly lower, whereas telogen hair follicles were significantly higher. The percentage of collagen fibers in the dermis and the diameter of the epithelial cells were smaller in patients with AIDS, without significant difference. AIDS possibly causes immunologic and morphologic alterations in the scalp. This study may establish parameters for better clinical and morphologic diagnostic in patients with AIDS. PMID:22921727

  6. A study on double cancer of the atomic-bomb survivors in Nagasaki, by autopsy cases

    International Nuclear Information System (INIS)

    Double cancer was observed in 49 of the 1,998 autopsy cases in Nagasaki Atomic-bomb Memorial Hospital for the past 25 years. It was the most frequent in atomic-bomb exposed groups in their sixties and seventies and in non-exposed group in their fifties and sixties. Males were more common than females with the ratio of 2 to 1 in the non-exposed group, while in exposed groups the ratio was 1 (males) to 2 (females). The frequency of malignant tumors was 3.1% in the non-exposed group, 4.6% in the exposed group over 2 km, and 6.7% in the exposed group within 2 km. Double cancer consisted mostly of epithelial tumors. Gastric cancer was the most frequent in both main and second primary cancer (18 cases). The incidence of latent thyroid cancer and prostatic cancer was also relatively high. Gastric cancer observed in many cases was Borrmann's II or III type. The incidence of poorly differentiated adenocarcinoma tended to be high as the histological type of gastric cancer in exposed groups. (Namekawa, K.)

  7. Classic form of hypoplastic left heart syndrome diagnosed post-natally: an autopsy report

    Directory of Open Access Journals (Sweden)

    Cristiane Rúbia Ferreira

    2014-09-01

    Full Text Available Hypoplastic left heart syndrome (HLHS is a congenital heart disease, which, despite the current improved knowledge about its management and surgical treatment, is still associated with high mortality, especially in the early neonatal period and before the second stage of reconstruction surgery. The low rate of prenatal diagnosis and delayed diagnostic suspicion results in unsuccessful therapeutic intervention, even though the real impact of early diagnosis and intervention on mortality and quality of life of patients is still uncertain. Fortunately, this syndrome of challenging treatment is not that frequent. It involves a spectrum of obstructions to the blood flow within the left heart and is characterized by an inappropriate size of the left ventricle associated with a wide variety of valvular dysfunctions. Treatment ranges from heart transplantation to palliative surgical procedures. The authors describe a case of a newborn with HLHS, whose diagnosis was made after birth because of early respiratory failure. Despite the use of prostaglandin the newborn died. An autopsy was performed and the anatomical findings were described.

  8. Hiperinfecção por Strongyloides stercoralis: relato de caso autopsiado Strongyloides stercoralis hyperinfection: autopsy case report

    Directory of Open Access Journals (Sweden)

    Moema Gonçalves Pinheiro Veloso

    2008-08-01

    Full Text Available Infecção assintomática por Strongyloides stercoralis pode resultar em doença potencialmente fatal em pacientes imunodeprimidos. Os autores relatam caso de hiperinfecção por Strongyloides stercoralis descoberto à autópsia, enfatizando aspectos clinicopatológicos, em homem de 55 anos, em tratamento para mieloma múltiplo. Apresentava, havia um dia, cefaléia intensa, dor abdominal e oligúria desenvolvendo insuficiência respiratória aguda e choque séptico. Devido à dificuldade no diagnóstico, o tratamento empírico antes do início da terapia imunossupressora pode ser a melhor estratégia para prevenir a hiperinfecção pelo verme.Asymptomatic infection due to Strongyloides stercoralis may result in potentially fatal disease in immunodepressed patients. A case of Strongyloides stercoralis hyperinfection discovered at autopsy in a 55-year-old man who had been undergoing treatment for multiple myeloma is reported, emphasizing the clinical and pathological findings. One day earlier, he presented severe headache, abdominal pain and oliguria, from which he developed acute respiratory failure and septic shock. Because of difficulty in reaching this diagnosis, empirical treatment before starting immunosuppressive therapy may be the best strategy for preventing hyperinfection by this worm.

  9. Medical neglect death due to acute lymphoblastic leukaemia: an autopsy case report.

    Science.gov (United States)

    Usumoto, Yosuke; Sameshima, Naomi; Tsuji, Akiko; Kudo, Keiko; Nishida, Naoki; Ikeda, Noriaki

    2014-12-01

    We report the case of 2-year-old girl who died of precursor B-cell acute lymphoblastic leukaemia (ALL), the most common cancer in children. She had no remarkable medical history. She was transferred to a hospital because of respiratory distress and died 4 hours after arrival. Two weeks before death, she had a fever of 39 degrees C, which subsided after the administration of a naturopathic herbal remedy. She developed jaundice 1 week before death, and her condition worsened on the day of death. Laboratory test results on admission showed a markedly elevated white blood cell count. Accordingly, the cause of death was suspected to be acute leukaemia. Forensic autopsy revealed the cause of death to be precursor B-cell ALL. With advancements in medical technology, the 5-year survival rate of children with ALL is nearly 90%. However, in this case, the deceased's parents preferred complementary and alternative medicine (i.e., naturopathy) to evidence-based medicine and had not taken her to a hospital for a medical check-up or immunisation since she was an infant. Thus, if she had received routine medical care, she would have a more than 60% chance of being alive 5 years after diagnosis. Therefore, we conclude that the parents should be accused of medical neglect regardless of their motives. PMID:25895240

  10. Review of Handbook of Autopsy Practice, Brenda L. Waters (Ed.). 4th edition, Humana Press (2009). ISBN: 978-1-58829-841-6

    DEFF Research Database (Denmark)

    Leth, Peter Mygind

    2010-01-01

    This 4th edition of Handbook of Autopsy Practice is a thoroughly updated version. Autopsy practice has undergone significant changes in recent time due to technological advancements such as molecular diagnostics, immunohistochemisty and the introduction of post-mortem imaging techniques. In the same period the autopsy rate in teaching hospitals has declined. A comprehensive and updated version is therefore most welcome. Part I have six completely new chapters, and contain an assortment of tools of great practical value for the forensic pathologist. There is for example a next-of-kin letter for the family of the deceased and a quality assurance worksheet. The text is written in a well-formulated language, and is not too long. The illustrations and photos are of a high quality. All photos are black-and-white. The book covers a broad area of relevance to autopsy practice, including specialized techniques used for post-mortem investigation of the cardio-vascular system, the nervous system and eye and adnexa. Autopsy microbiology, chemistry and chromosome analysis and autopsies of bodies containing radioactive material are also among the topics that are addressed in this handbook, as well as post-mortem imaging techniques. Part II begins with a list of special histologic stains, but the bulk is devoted to an alphabetic listing of major diseases with possible or expected findings and recommended procedures. This part has also been updated with new diseases and recent references. Part III provides a series of tables providing organ weights and body measurements for foetuses, children and adults. The Handbook of Autopsy Practice fulfils its purpose, and is a very worthwhile purchase for any autopsy facility.

  11. A semi-structured interview for psychological autopsy in suicide cases Entrevista semi-estruturada para autópsia psicológica em casos de suicídio

    OpenAIRE

    Blanca Guevara Werlang; Neury José Botega

    2003-01-01

    OBJECTIVE: To investigate the applicability and the interrater reliability of a Semi-Structured Interview for psychological autopsy in cases of suicide. METHOD: The Semi-Structured Interview for Psychological Autopsy (SSIPA) proposed in this paper consists of four modules which evaluate key-topics associated to suicide. In order to evaluate the instrument's applicability, a sample formed by 42 subjects related to 21 suicide cases was used. The interviews were tape-recorded first and then tran...

  12. Molecular autopsy in sudden cardiac death and its implication for families: discussion of the practical, legal and ethical aspects of the multidisciplinary collaboration

    OpenAIRE

    Michaud, Katarzyna; Fellmann, Florence; Abriel, Hugues; Beckmann, Jacques S.; Mangin, Patrice; Elger, Bernice Simone

    2009-01-01

    Sudden cardiac death (SCD) is a major cause of premature death in young adults and children in developed countries. Standard forensic autopsy procedures are often unsuccessful in determining the cause of SCD. Post-mortem genetic testing, also called molecular autopsy, has revealed that a non-negligible number of these deaths are a result of inherited cardiac diseases, including arrhythmic disorders such as congenital long QT syndrome and Brugada syndrome. Due to the heritability of these dise...

  13. Biodistribution Analysis of Oncolytic Adenoviruses in Patient Autopsy Samples Reveals Vascular Transduction of Noninjected Tumors and Tissues.

    Science.gov (United States)

    Koski, Anniina; Bramante, Simona; Kipar, Anja; Oksanen, Minna; Juhila, Juuso; Vassilev, Lotta; Joensuu, Timo; Kanerva, Anna; Hemminki, Akseli

    2015-10-01

    In clinical trials with oncolytic adenoviruses, there has been no mortality associated with treatment vectors. Likewise, in the Advanced Therapy Access Program (ATAP), where 290 patients were treated with 10 different viruses, no vector-related mortality was observed. However, as the patient population who received adenovirus treatments in ATAP represented heavily pretreated patients, often with very advanced disease, some patients died relatively soon after receiving their virus treatment mandating autopsy to investigate cause of death. Eleven such autopsies were performed and confirmed disease progression as the cause of death in each case. The regulatory requirement for investigating the safety of advanced therapy medical products presented a unique opportunity to study tissue samples collected as a routine part of the autopsies. Oncolytic adenoviral DNA was recovered in a wide range of tissues, including injected and noninjected tumors and various normal tissues, demonstrating the ability of the vector to disseminate through the vascular route. Furthermore, we recovered and cultured viable virus from samples of noninjected brain metastases of an intravenously treated patient, confirming that oncolytic adenovirus can reach tumors through the intravascular route. Data presented here give mechanistic insight into mode of action and biodistribution of oncolytic adenoviruses in cancer patients. PMID:26156245

  14. Prevalence rate of thyroid diseases among autopsy cases of the atomic bomb survivors in Hiroshima, 1951-1985

    International Nuclear Information System (INIS)

    To examine the radiogenic risk of latent thyroid cancer, thyroid adenoma, colloid/adenomatous goiter and chronic thyroiditis, the date for 3821 subjects collected in the course of autopsies of atomic bomb survivors in Hiroshima from 1951 to 1985 by the Radiation Effects Research Foundation (RERF) were analyzed using a logistic model. About 80% of the autopsies were performed at RERF and the remainder at local hospitals. The frequencies of the above diseases were not associated with whether the underlying cause of death was cancer. However, note that our results may be influenced by potentially biasing factors associated with autopsy selection. The relative frequency of latent thyroid cancer (greatest dimension ?1.5 cm but detectable on a routine microscopic slide of the thyroid gland) increased as the radiation dose increased and was about 1.4-fold greater at 1 Gy than in the 0-Gy dose group. The relative occurrence of thyroid adenoma also increased as radiation dose increased, and was about 1.5-fold greater at 1 Gy than in the 0-Gy dose group. Sex, age at the time of the bombing or period of observation did not significantly modify the radiogenic risks for thyroid adenoma or latent thyroid cancer. No statistically significant association was found between radiation exposure and the rates of colloid/adenomatous goiter and chronic thyroiditis. The possible late effect of atomic bomb radiation on the frequency of benign thyroid diseases is discussed on the basis of these data. 38 refs., 2 figs., 5 tabs

  15. Truncus arteriosus communis in a midtrimester fetus: Comparison of prenatal ultrasound and MRI with postmortem MRI and autopsy

    International Nuclear Information System (INIS)

    Different techniques are used in fetal cardiology, and their accuracy has been demonstrated on several occasions. Color Doppler US has proved to be a reliable and valuable tool in the diagnosis of fetal cardiac abnormalities. Magnetic resonance imaging (MRI) of the fetal heart has, so far, played no role in prenatal diagnostics. We report on a truncus arteriosus communis diagnosed prenatally during a screening ultrasound at 22 weeks of gestation. In addition to real-time ultrasound and color Doppler echocardiography, fetal MRI was performed. Fetal echocardiography arose suspicion of a type I common trunk. Fetal MR showed solely a widened vessel coursing retrocardially and additionally an inhomogeneous fluid distribution of the lung not shown on prenatal US. After termination of pregnancy at 23 weeks of gestation, MR fetography and autopsy were performed, and both found a type II common trunk. MR autopsy of the heart was very reliable in this case and could be an alternative when fetal pathology is not available for different reasons. Postmortem MRI was also able to demonstrate the inhomogeneous fluid distribution in the lung, which was confirmed by autopsy. Fetal and postmortem MR was reliable in the detection of an inhomogeneous fluid distribution in the lung not shown on prenatal US, providing a relevant additional finding to US. Therefore, MRI should be used more often in fetal cardiology, although it still must be further developed. (orig.)

  16. Truncus arteriosus communis in a midtrimester fetus: Comparison of prenatal ultrasound and MRI with postmortem MRI and autopsy

    Energy Technology Data Exchange (ETDEWEB)

    Muehler, Matthias R.; Lembcke, Alexander; Fischer, Thomas; Kivelitz, Dietmar [CCM, Department of Radiology, Charite, Berlin (Germany); Rake, Anett; Chaoui, Rabih; Heling, Kay-Sven [CCM, Section for Prenatal Medicine, Department of Gynecology and Obstetrics, Charite, Berlin (Germany); Schwabe, Michael [CCM, Department of Pathology, Charite, Berlin (Germany); Planke, Christiane [Carl-Thiem-Klinikum Cottbus, Department of Pediatrics and Juvenile Medicine, Cottbus (Germany)

    2004-11-01

    Different techniques are used in fetal cardiology, and their accuracy has been demonstrated on several occasions. Color Doppler US has proved to be a reliable and valuable tool in the diagnosis of fetal cardiac abnormalities. Magnetic resonance imaging (MRI) of the fetal heart has, so far, played no role in prenatal diagnostics. We report on a truncus arteriosus communis diagnosed prenatally during a screening ultrasound at 22 weeks of gestation. In addition to real-time ultrasound and color Doppler echocardiography, fetal MRI was performed. Fetal echocardiography arose suspicion of a type I common trunk. Fetal MR showed solely a widened vessel coursing retrocardially and additionally an inhomogeneous fluid distribution of the lung not shown on prenatal US. After termination of pregnancy at 23 weeks of gestation, MR fetography and autopsy were performed, and both found a type II common trunk. MR autopsy of the heart was very reliable in this case and could be an alternative when fetal pathology is not available for different reasons. Postmortem MRI was also able to demonstrate the inhomogeneous fluid distribution in the lung, which was confirmed by autopsy. Fetal and postmortem MR was reliable in the detection of an inhomogeneous fluid distribution in the lung not shown on prenatal US, providing a relevant additional finding to US. Therefore, MRI should be used more often in fetal cardiology, although it still must be further developed. (orig.)

  17. Validity of verbal autopsy for ascertaining the causes of stillbirth / Validité de l'autopsie verbale dans la détermination des causes de mortinaissance / Validez de las investigaciones verbales para determinar las causas de la mortinatalidad

    Scientific Electronic Library Online (English)

    Arun K, Aggarwal; Vanita, Jain; Rajesh, Kumar.

    2011-01-01

    Full Text Available OBJETIVO: Validar las entrevistas verbales a parientes y allegados para determinar las causas de la mortinatalidad que utiliza la Organización Mundial de la Salud (OMS), empleando el diagnóstico hospitalario de las causas subyacentes a la mortinatalidad («criterio de referencia») y comparar la propo [...] rción de mortinatos atribuidos a determinadas causas específicas, a través de la valoración del hospital, en comparación con los resultados de las investigaciones verbales. MÉTODOS: Realizamos un estudio prospectivo de todos los mortinatos que nacieron en un hospital de Chandigarh (India) entre el 15 de abril de 2006 y el 31 de marzo de 2008 y cuya causa de defunción se diagnosticó dentro de un plazo de 2 días. Todas las madres debían encontrarse como mínimo en la semana 24 de gestación y vivir dentro de un radio de 100 km del hospital. Para las entrevistas verbales, los trabajadores en el terreno visitaron a las madres entre las 4 y las 6 semanas posteriores a la mortinatalidad. Dos obstetras independientes revisaron los resultados de las autopsias y, en caso de desacuerdo, se solicitó la participación de un tercer experto. Se comparó la frecuencia de las causas de la mortinatalidad, según lo establecido por la valoración hospitalaria y por las investigaciones verbales. RESULTADOS: Tanto la valoración hospitalaria como la entrevista verbal coincidieron en cuáles eran las cinco causas de mortinatalidad más frecuentes: preeclampsia (30%), hemorragia prenatal (16%), enfermedad subyacente de la madre (12%), malformaciones congénitas (12%) y complicaciones obstétricas (10%). La precisión general del diagnóstico mediante investigación verbal, en comparación con el diagnóstico basado en la información hospitalaria para las cinco causas más frecuentes de mortinatalidad, fue del 64%. Las áreas bajo la curva de eficacia diagnóstica (ROC) fueron: para las malformaciones congénitas, 0,91 (intervalo de confianza del 95%, IC: 0,83-0,97); enfermedad pre-gestacional de la madre, 0,75 (95%, IC: 0,65-0,84); preeclampsia, 0,76 (95%, IC: 0,69-0,81); hemorragia prenatal, 0,76 (95%, IC: 0,67-0,84) y complicaciones obstétricas, 0,82 (95%, CI: 0,71-0,93). CONCLUSION: La herramienta de investigación verbal de la mortinatalidad que emplea la OMS puede ofrecer unas estimaciones razonablemente aceptables de las causas subyacentes más frecuentes a la mortinatalidad en los ámbitos con recursos limitados, en los que la causa de mortinatalidad pueda no estar certificada por un médico. Abstract in english OBJECTIVE: To validate the verbal autopsy tool for stillbirths of the World Health Organization (WHO) by using hospital diagnosis of the underlying cause of stillbirth (the gold standard) and to compare the fraction of stillbirths attributed to various specific causes through hospital assessment ver [...] sus verbal autopsy. METHODS: In a hospital in Chandigarh, we prospectively studied all stillbirths occurring from 15 April 2006 to 31 March 2008 whose cause was diagnosed within 2 days. All mothers had to be at least 24 weeks pregnant and live within 100 km of the hospital. For verbal autopsy, field workers visited mothers 4 to 6 weeks after the stillbirth. Autopsy results were reviewed by two independent obstetricians and disagreements were resolved by engaging a third expert. Causes of stillbirths as determined by hospital assessment and verbal autopsy were compared in frequency. FINDINGS: Hospital assessment and verbal autopsy yielded the same top five underlying causes of stillbirth: pregnancy-induced hypertension (30%), antepartum haemorrhage (16%), underlying maternal illness (12%), congenital malformations (12%) and obstetric complications (10%). Overall diagnostic accuracy of verbal autopsy diagnosis versus hospital-based diagnosis for all five top causes of stillbirth was 64%. The areas under the receiver operator characteristic curve (ROC) were, for congenital malformations, 0.91 (95% confidence interval, CI: 0.83-0.97); pre-gestational maternal illness, 0.75 (95% CI: 0.65-0.84);

  18. Alcohol and premature death in Estonian men: a study of forensic autopsies using novel biomarkers and proxy informants

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    Ringmets Inge

    2012-02-01

    Full Text Available Abstract Background Alcohol makes an important contribution to premature mortality in many countries in Eastern Europe, including Estonia. However, the full extent of its impact, and the mechanisms underlying it, are challenging issues to research. We describe the design and initial findings of a study aimed at investigating the association of alcohol with mortality in a large series of forensic autopsies of working-age men in Estonia. Methods 1299 male deaths aged 25-54 years were subject to forensic autopsy in 2008-2009. The routine autopsy protocol was augmented by a more systematic inspection of organs, drug testing, assay of liver enzymes and novel biomarkers of alcohol consumption (EtG, EtS and PEth, together with proxy interviews with next of kin for deaths among men who lived in or close to a major town. Results 595 augmented autopsies were performed. Of these, 66% were from external causes (26% suicide, 25% poisoning. 17% were attributed to circulatory system diseases and 7% to alcoholic liver disease. Blood alcohol concentrations (BAC of ? 0.2 mg/g were found for 55% of deaths. Interviews were conducted with proxy informants for 61% of the subjects who had resided in towns. Of these, 28% were reported in the previous year to have been daily or almost daily drinkers and 10% had drunk non-beverage alcohols. Blood ethanol and the liver enzyme GGT were only associated with daily drinking. However, the novel biomarkers showed a more graded response with recent consumption. In contrast, the liver enzymes AST and ALT were largely uninformative because of post-mortem changes. The presence of extremely high PEth concentrations in some samples also suggested post-mortem formation. Conclusion We have shown the feasibility of deploying an extended research protocol within the setting of routine forensic autopsies that offer scope to deepen our understanding of the alcohol-related burden of premature mortality. The most unique feature of the study is the information on a wide range of informative alcohol biomarkers, several of which have not been used previously in this sort of post-mortem research study. We have demonstrated, for the first time, the epidemiological value and validity of these novel alcohol biomarkers in post-mortem samples.

  19. Analysis of the symmetric configuration of the circle of Willis in a series of autopsied corpses

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    Stojanovi? Nebojša

    2015-01-01

    Full Text Available Introduction. The forming of the blood vessels network configuration at the base of the brain and interconnecting of blood vessels during the embryogenesis is directly related to the phylogenetic development of the brain and brain structures. A blood vessel configuration at the brain base, in the form of a ring or a hexagon, stands in direct relation to the perfusion needs of certain parts of the brain during its primary differentiation. The aim of this paper was to determine the incidence of certain blood vessel configurations at the base of the brain and understanding their symmetry or asymmetry. Methods. Analysis of the blood vessels at the base of the brain was performed on the autopsied subjects. The object of observation was the anterior segment of the circle of Willis consisting of C1- a. carotis interna (ICA, above a. communicaus posterior (PcoA, the segment A1 a. cerebri anterior (ACA from a. carotis interna bifurcation to the a. communicans anterior (AcoA and a. communicans anterior itself, as well as the posterior segment consisting of PcoA and the segment P1 - a. cerebri posterior (PCA from the a. basilaris bifurcation to the PcoA. For the purpose of grouping the findings, the four basic configuration types of the circle of Willis were identified based on its symmetry or asymmetry. Type-A (symmetric circle of Willis, type-B (asymmetric circle of Willis' due to the unilateral hypoplastic A1-ACA; type-C (symmetric circle of Willis with bilateral symmetric changes on PcoA and type-D (asymmetric circle of Willis due to the asymmetric changes on PcoA. Results. Autopsy was performed on 56 corpses. A total of 41 (73.2% subjects were recorded with a symmetric configuration of the circle of Willis', of which 27 (48.2% subjects had type A and 14 (25% type C. The asymmetric configuration was present in 15 (26.8% subjects, of whom 9 (16% had type B and 6 (10.8% type D. The symmetric Willis group (73.2% did not have a homogeneous finding that would fit into the schematic presentation of the symmetric type A and type C. A total of 17 (30.4% findings were classified in this group of the so-called conditionally symmetric configurations. In all the cases, type B (16% had unilaterally reduced diameter A1 and hyperplastic AcoA. Conclusion. The presence of asymmetric Willis configuration in 26.8% of the cases, which makes up more than one fourth, indicates that the asymmetric configurations do not represent a pathological form of connecting the blood vessels at the base of the brain, but rather one aspect of its adaptation. The forming of the basic types of configurations of the circle of Willis is associated with a tendency toward certain types of hemodynamic disorders and more frequent pathological changes in places of reduced resistance.

  20. Fatal alcohol intoxication in women: A forensic autopsy study from Slovakia

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    Straka Lubomir

    2011-12-01

    Full Text Available Abstract Background Plenty of information related to alcoholism can be found in the literature, however, the studies have mostly dealt with the predominance of male alcoholism and data related to addiction in women are desperately scarce and difficult to find. Basic demographic data focusing on the impact of acute alcohol intoxication on the circumstances of death and social behaviour in the alcohol addicted female population are needed especially in the prevention of alcohol related mortality. Methods A retrospective forensic autopsy study of all accidental deaths due to alcohol intoxication over a 12-year period was performed in order to evaluate the locations, circumstances, mechanisms and causes of death. Results A sample of 171 cases of intoxicated women who died due to blood alcohol concentration (BAC equal to or higher than 2 g/kg was selected. Among them 36.26% (62/171 of women died due to acute alcohol intoxication (AAI. We noted an increase in the number of deaths in women due to AAI from 2 in 1994 up to 5 in 2005 (an elevation of 150% between the years 1994-2005. The age structure of deaths in women due to BAC and AAI followed the Gaussian distribution with a dominant group of women aged 41-50 years (45.16% and 35.09% respectively. The most frequent place of death (98% among women intoxicated by alcohol was their own home. The study suggests a close connection between AAI and violence against women. Conclusions The increasing number of cases of death of women suffering from AAI has drawn attention to the serious problem of alcoholism in women in the Slovak Republic during the process of integration into "western" lifestyle and culture.

  1. Plaque in superficial femoral arteries indicates generalized atherosclerosis and vulnerability to coronary death : an autopsy study

    DEFF Research Database (Denmark)

    Dalager, SØren; Falk, Erling

    2008-01-01

    OBJECTIVES: Risk factors for atherosclerosis have limited ability to identify persons at high risk of coronary heart disease. Assessment of subclinical atherosclerosis in peripheral arteries might improve this limitation. We studied the relationship between atherosclerotic plaques in peripheral arteries, coronary plaques, and coronary death. METHODS: Predefined segments from the left anterior descending coronary artery, the right coronary artery, bilateral carotid, and superficial femoral arteries (SFA) were obtained from 100 autopsies (20-82 years, 30 females, 27 coronary deaths). Based on microscopic examination of 4756 sections, the extension of atherosclerosis (plaque burden) and the largest plaque area in each segment were quantified. RESULTS: Plaque burden in all arteries increased with age and was larger in coronary death (P < .05). SFA plaques occurred later than coronary and carotid plaques. When SFA plaque had developed, coronary plaque was also present. SFA plaque (odds ratio, 95% confidence interval: 7.07 [2.40-20.81]), but not carotid plaque, was significantly associated with coronary death, also after age and gender adjustment (21.25 [5.02-89.97]). The area under the receiver operating characteristic curves for the identification of coronary death individuals was 0.72 (95% confidence interval: 0.62-0.83) for coronary plaque, and 0.80 (0.72-0.89) for SFA plaque (age and gender adjusted). CONCLUSIONS: Atherosclerosis develops slower in SFA compared with coronary and carotid arteries. In persons with plaque in the SFA, plaque is always present in the coronary arteries. In younger persons, the presence of SFA plaque indicates a generalized susceptibility to atherosclerosis and vulnerability to coronary death.

  2. An autopsy case of a giant aneurysm of the anterior communicating artery

    International Nuclear Information System (INIS)

    A 64-year-old female was admitted to our hospital on 8, July, 1980 with a history of three previous subarachnoid hemorrhages. Neurological examinations revealed incontinentia urinae, gait disturbance, recent memory disturbance and motor weakness on the left side. The results of the neuroradiological examinations were as follows. Plain X-ray films showed a ring-like calcification in the right frontal region. A plain CT scan showed a ring-shaped iso- and high-density area in the intra hemispheric region, the intra bilateral anterior horn of the lateral ventricle, the intra septum pellucidum, and the intra anterior part of the third ventricle. A small high-density region was enhanced as an island within it by means of a Conray infusion. Left carotid angiography showed a large aneurysmal shadow arising from the anterior communicating artery and another from the left middle cerebral artery. In the venous phase the venous angle was supero-posteriorly shifted, and the septal vein was elevated. She died unexpectedly with a status epilepticus of unknown origin. Clinically, rerupture was not verified. An autopsy specimen revealed that a giant aneurysm (6 x 5 x 4 cm in size) arising from the anterior communicating artery occupied the intra ventricular space, the anterior horn of the lateral ventricle, and the right thalamic region. Also, there was a large berry aneurysm (2 x 1.7 x 1.5 cm in size) arising from the middle cerebral artery. A coronary section through the giant aneurysm showed a markedly compressed left lateral ventricle, right thalamus, and hypothalamus, while the third ventricle had shifted toward the left side. (J.P.N.)

  3. Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring

    Science.gov (United States)

    Leitao, Jordana; Chandramohan, Daniel; Byass, Peter; Jakob, Robert; Bundhamcharoen, Kanitta; Choprapawon, Chanpen; de Savigny, Don; Fottrell, Edward; França, Elizabeth; Frøen, Frederik; Gewaifel, Gihan; Hodgson, Abraham; Hounton, Sennen; Kahn, Kathleen; Krishnan, Anand; Kumar, Vishwajeet; Masanja, Honorati; Nichols, Erin; Notzon, Francis; Rasooly, Mohammad Hafiz; Sankoh, Osman; Spiegel, Paul; AbouZahr, Carla; Amexo, Marc; Kebede, Derege; Alley, William Soumbey; Marinho, Fatima; Ali, Mohamed; Loyola, Enrique; Chikersal, Jyotsna; Gao, Jun; Annunziata, Giuseppe; Bahl, Rajiv; Bartolomeus, Kidist; Boerma, Ties; Ustun, Bedirhan; Chou, Doris; Muhe, Lulu; Mathai, Matthews

    2013-01-01

    Objective Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems. Methods A literature review of existing VA instruments was undertaken. The World Health Organization (WHO) then facilitated an international consultation process to review experiences with existing VA instruments, including those from WHO, the Demographic Evaluation of Populations and their Health in Developing Countries (INDEPTH) Network, InterVA, and the Population Health Metrics Research Consortium (PHMRC). In an expert meeting, consideration was given to formulating a workable VA CoD list [with mapping to the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) CoD] and to the viability and utility of existing VA interview questions, with a view to undertaking systematic simplification. Findings A revised VA CoD list was compiled enabling mapping of all ICD-10 CoD onto 62 VA cause categories, chosen on the grounds of public health significance as well as potential for ascertainment from VA. A set of 221 indicators for inclusion in the revised VA instrument was developed on the basis of accumulated experience, with appropriate skip patterns for various population sub-groups. The duration of a VA interview was reduced by about 40% with this new approach. Conclusions The revised VA instrument resulting from this consultation process is presented here as a means of making it available for widespread use and evaluation. It is envisaged that this will be used in conjunction with automated models for assigning CoD from VA data, rather than involving physicians. PMID:24041439

  4. Recognition memory span in autopsy-confirmed Dementia with Lewy Bodies and Alzheimer's Disease.

    Science.gov (United States)

    Salmon, David P; Heindel, William C; Hamilton, Joanne M; Vincent Filoteo, J; Cidambi, Varun; Hansen, Lawrence A; Masliah, Eliezer; Galasko, Douglas

    2015-08-01

    Evidence from patients with amnesia suggests that recognition memory span tasks engage both long-term memory (i.e., secondary memory) processes mediated by the diencephalic-medial temporal lobe memory system and working memory processes mediated by fronto-striatal systems. Thus, the recognition memory span task may be particularly effective for detecting memory deficits in disorders that disrupt both memory systems. The presence of unique pathology in fronto-striatal circuits in Dementia with Lewy Bodies (DLB) compared to AD suggests that performance on the recognition memory span task might be differentially affected in the two disorders even though they have quantitatively similar deficits in secondary memory. In the present study, patients with autopsy-confirmed DLB or AD, and Normal Control (NC) participants, were tested on separate recognition memory span tasks that required them to retain increasing amounts of verbal, spatial, or visual object (i.e., faces) information across trials. Results showed that recognition memory spans for verbal and spatial stimuli, but not face stimuli, were lower in patients with DLB than in those with AD, and more impaired relative to NC performance. This was despite similar deficits in the two patient groups on independent measures of secondary memory such as the total number of words recalled from long-term storage on the Buschke Selective Reminding Test. The disproportionate vulnerability of recognition memory span task performance in DLB compared to AD may be due to greater fronto-striatal involvement in DLB and a corresponding decrement in cooperative interaction between working memory and secondary memory processes. Assessment of recognition memory span may contribute to the ability to distinguish between DLB and AD relatively early in the course of disease. PMID:26184443

  5. Morphological changes in the digestive system of 93 human immunodeficiency virus positive patients: an autopsy study Alterações morfológicas no sistema digestivo de 93 pacientes infectados pelo vírus da imunodeficiência humana: um estudo de autopsias

    OpenAIRE

    Lucinda Calheiros Guimarães; Ana Cristina Araujo Lemos Silva; Adilha Misson Rua Micheletti; Everton Nunes Melo Moura; Mario Leon de Silva-Vergara; Sheila Jorge Adad

    2012-01-01

    Involvement of the digestive system in patients with acquired immunodeficiency syndrome (AIDS) is frequent and many changes in these patients are diagnosed only at autopsy. There are few studies of autopsy with detailed analysis of this system and only one was conducted in Brazil. We evaluated each segment of the digestive system in 93 consecutive autopsies of patients infected with human immunodeficiency virus (HIV) and the importance of these lesions to death. Of these, 90 (96.8%) patients ...

  6. Demographic, etiological, and histological pulmonary analysis of patients with acute respiratory failure: a study of 19 years of autopsies

    Scientific Electronic Library Online (English)

    Alexandre de Matos, Soeiro; Aline D., Ruppert; Mauro, Canzian; Edwin R., Parra; Cecília, Farhat; Vera L., Capelozzi.

    Full Text Available INTRODUCTION: Acute respiratory failure has been one of the most important causes of death in intensive care units, and certain aspects of its pulmonary pathology are currently unknown. OBJECTIVES: The objective was to describe the demographic data, etiology, and pulmonary histopathological findings [...] of different diseases in the autopsies of patients with acute respiratory failure. METHOD: Autopsies of 4,710 patients with acute respiratory failure from 1990 to 2008 were reviewed, and the following data were obtained: age, sex, and major associated diseases. The pulmonary histopathology was categorized as diffuse alveolar damage, pulmonary edema, alveolar hemorrhage, and lymphoplasmacytic interstitial pneumonia. The odds ratio of the concordance between the major associated diseases and specific autopsy findings was calculated using logistic regression. RESULTS: Bacterial bronchopneumonia was present in 33.9% of the cases and cancer in 28.1%. The pulmonary histopathology showed diffuse alveolar damage in 40.7% (1,917) of the cases. A multivariate analysis showed a significant and powerful association between diffuse alveolar damage and bronchopneumonia, HIV/AIDS, sepsis, and septic shock, between liver cirrhosis and pulmonary embolism, between pulmonary edema and acute myocardial infarction, between dilated cardiomyopathy and cancer, between alveolar hemorrhage and bronchopneumonia and pulmonary embolism, and between lymphoplasmacytic interstitial pneumonia and HIV/ AIDS and liver cirrhosis. CONCLUSIONS: Bronchopneumonia was the most common diagnosis in these cases. The most prevalent pulmonary histopathological pattern was diffuse alveolar damage, which was associated with different inflammatory conditions. Further studies are necessary to elucidate the complete pathophysiological mechanisms involved with each disease and the development of acute respiratory failure.

  7. Demographic, etiological, and histological pulmonary analysis of patients with acute respiratory failure: a study of 19 years of autopsies

    Directory of Open Access Journals (Sweden)

    Alexandre de Matos Soeiro

    2011-01-01

    Full Text Available INTRODUCTION: Acute respiratory failure has been one of the most important causes of death in intensive care units, and certain aspects of its pulmonary pathology are currently unknown. OBJECTIVES: The objective was to describe the demographic data, etiology, and pulmonary histopathological findings of different diseases in the autopsies of patients with acute respiratory failure. METHOD: Autopsies of 4,710 patients with acute respiratory failure from 1990 to 2008 were reviewed, and the following data were obtained: age, sex, and major associated diseases. The pulmonary histopathology was categorized as diffuse alveolar damage, pulmonary edema, alveolar hemorrhage, and lymphoplasmacytic interstitial pneumonia. The odds ratio of the concordance between the major associated diseases and specific autopsy findings was calculated using logistic regression. RESULTS: Bacterial bronchopneumonia was present in 33.9% of the cases and cancer in 28.1%. The pulmonary histopathology showed diffuse alveolar damage in 40.7% (1,917 of the cases. A multivariate analysis showed a significant and powerful association between diffuse alveolar damage and bronchopneumonia, HIV/AIDS, sepsis, and septic shock, between liver cirrhosis and pulmonary embolism, between pulmonary edema and acute myocardial infarction, between dilated cardiomyopathy and cancer, between alveolar hemorrhage and bronchopneumonia and pulmonary embolism, and between lymphoplasmacytic interstitial pneumonia and HIV/ AIDS and liver cirrhosis. CONCLUSIONS: Bronchopneumonia was the most common diagnosis in these cases. The most prevalent pulmonary histopathological pattern was diffuse alveolar damage, which was associated with different inflammatory conditions. Further studies are necessary to elucidate the complete pathophysiological mechanisms involved with each disease and the development of acute respiratory failure.

  8. Is necropsy obsolete - An audit of the clinical autopsy over six decades: A study from Indian sub continent

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    Nikhil Moorchung

    2013-01-01

    Full Text Available Introduction: Several studies have documented a decrease in the autopsy rate. This study was taken up to analyse the cause of mortality, the discrepancies between the ante mortem and post mortem diagnosis and the discrepancies between diagnoses according to the type of the disease over a period of six decades. Materials and Methods: Autopsy reports and medical records were retrospectively analyzed over a 63 year period from 1947 to 2010. Results: In our study, there was a steady increase in the percentage of neoplastic cases from 1947 to 1994 after which there has been a significant drop. The cases dying due to infection has also shown a steady decline over the years until 1994. After 1994, there has been a significant increase in the deaths until 2010 (p < 0.05. Death due to cardiac causes has shown an increase until 1962 which has been followed by a steady decline. There has been a sudden rise in the number of cases dying due to renal causes between 1994 and 2000 (p < 0.05. There has been a statistically significant decrease in the discrepancies between the ante mortem and the post mortem diagnosis over the years. Discussion: This study shows that therapeutic and preventive measures correctly instituted have significantly reduce the mortality, particularly with reference to cardiac and infectious causes. The discrepancy between antemortem and post-mortem diagnosis in 2010 is still very high at 9.30 percent. The autopsy will continue to remain relevant especially in elucidating the molecular cause of disease.

  9. [Tumors of the central nervous system in biopsy and autopsy material. 7th communication: neurinomas and neurofibromatoses with CNS involvement].

    Science.gov (United States)

    Schneider, J; Warzok, R; Schreiber, D; Güthert, H

    1983-01-01

    In 1,491 autopsy cases with CNS tumors observed at the Pathological Institute of the Medical Academy of Erfurt in the period from 1953 to 1976 (54,946 autopsies) 72 cases (4.8%) with neurinomas were found. They comprise 67 solitary neurinomas, 1 bilateral acoustic neurinoma without other signs of neurofibromatosis, and 4 cases of neurofibromatosis with neurinomas of the CNS. Among the 68 cases with CNS neurinomas (neurofibromatoses excluded) 87% were acoustic neurinomas, 12% spinal tumors, and 1 case was located in the trigeminal nerve. In 60 (88%) of these 68 cases, the neurinoma was operated upon or clinically diagnosed, resp. The diameter of 18 (26%) neurinomas of the autopsy material was larger than 5 cm. Patients in the 6th decennium predominated in this series. The sex distribution revealed a preponderance of females over males (3:1). In 3 cases further CNS tumors (ependymoma, glioblastoma, meningioma) were found. Additionally, 3 cases had carcinomas of different localization (Table 5). Following tumors were seen in 9 cases of Morbus Recklinghausen with CNS involvement: 4 cases with multiple neurinomas, 3 meningiomas, 1 astrocytoma, 2 glioses and 1 angiomatous malformation (Table 6). Among 1,670 CNS tumors in biopsy material, 144 (8.6%) were neurinomas. 60% of them were located in the nervus acusticus, 40% spinally, mainly in the thoracic region. The 6th decennium was most affected, and females were more frequent than males (2:1) in our material. Nearly all CNS neurinomas were benign. Only 1 spinal tumors was classified as a malignant neurinoma. 2 of the 9 cases with Morbus Recklinghausen had malignant neurogenic tumors (neurofibrosarcomas). PMID:6410615

  10. Risk factors, organ weight deviation and associated anomalies in neural tube defects: A prospective fetal and perinatal autopsy series

    Directory of Open Access Journals (Sweden)

    Asaranti Kar

    2015-01-01

    Full Text Available Introduction: Neural tube defects (NTD are a group of serious birth defects occurring due to defective closure of neural tube during embryonic development. It comprises of anencephaly, encephalocele and spina bifida. We conducted this prospective fetal autopsy series to study the rate and distribution of NTD, analyze the reproductive factors and risk factors, note any associated anomalies and evaluate the organ weights and their deviation from normal. Materials and Methods: This was a prospective study done over a period of 6 years from August, 2007 to July, 2013. All cases of NTDs delivered as abortion, still born and live born were included. The reproductive and risk factors like age, parity, multiple births, previous miscarriage, obesity, diabetes mellitus, socioeconomic status and use of folic acid during pregnancy were collected.Autopsy was performed according to Virchow?s technique. Detail external and internal examination were carried out to detect any associated anomalies. Gross and microscopic examination of organs were done. Results: Out of 210 cases of fetal and perinatal autopsy done, 72 (34.28% had NTD constituting 49 cases of anencephaly, 16 spina bifida and 7 cases of encephalocele. The mothers in these cases predominantly were within 25-29 years (P = 0.02 and primy (P = 0.01. Female sex was more commonly affected than males (M:F = 25:47, P = 0.0005 There was no history of folate use in majority of cases. Organ weight deviations were >2 standard deviation low in most of the cases. Most common associated anomalies were adrenal hypoplasia and thymic hyperplasia. Conclusion: The authors have made an attempt to study NTD cases in respect to maternal reproductive and risk factors and their association with NTD along with the organ weight deviation and associated anomalies. This so far in our knowledge is an innovative study which was not found in literature even after extensive search.

  11. Cause-of-death ascertainment for deaths that occur outside hospitals in Thailand: application of verbal autopsy methods

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    Pattaraarchachai Junya

    2010-05-01

    Full Text Available Abstract Background Ascertainment of cause for deaths that occur in the absence of medical attention is a significant problem in many countries, including Thailand, where more than 50% of such deaths are registered with ill-defined causes. Routine implementation of standardized, rigorous verbal autopsy methods is a potential solution. This paper reports findings from field research conducted to develop, test, and validate the use of verbal autopsy (VA methods in Thailand. Methods International verbal autopsy methods were first adapted to the Thai context and then implemented to ascertain causes of death for a nationally representative sample of 11,984 deaths that occurred in Thailand in 2005. Causes of death were derived from completed VA questionnaires by physicians trained in ICD-based cause-of-death certification. VA diagnoses were validated in the sample of hospital deaths for which reference diagnoses were available from medical record review. Validated study findings were used to adjust VA-based causes of death derived for deaths in the study sample that had occurred outside hospitals. Results were used to estimate cause-specific mortality patterns for deaths outside hospitals in Thailand in 2005. Results VA-based causes of death were derived for 6,328 out of 7,340 deaths in the study sample that had occurred outside hospitals, constituting the verification arm of the study. The use of VA resulted in large-scale reassignment of deaths from ill-defined categories to specific causes of death. The validation study identified that VA tends to overdiagnose important causes such as diabetes, liver cancer, and tuberculosis, while undercounting deaths from HIV/AIDS, liver diseases, genitourinary (essential renal, and digestive system disorders. Conclusions The use of standard VA methods adapted to Thailand enabled a plausible assessment of cause-specific mortality patterns and a substantial reduction of ill-defined diagnoses. Validation studies enhance the utility of findings from the application of verbal autopsy. Regular implementation of VA in Thailand could accelerate development of the quality and utility of vital registration data for deaths outside hospitals.

  12. Cardiac-related findings at autopsy in people with severe mental illness treated with clozapine or risperidone

    OpenAIRE

    Deanna L. Kelly; Wehring, Heidi J.; Linthicum, Jared; Feldman, Stephanie; Robert P. McMahon; Love, Raymond C.; Wagner, Tara; Shim, Joo Cheol; Fowler, David R.

    2008-01-01

    Clozapine is a superior agent for treatment-refractory patients with schizophrenia, but is underutilized in the US, likely due to the risk of side effects. This study examined all available autopsy data on cardiac disease and risk factors in people with schizophrenia in a sample of deceased persons with severe mental illness who had received clozapine (N = 62) or risperidone (N = 42). The mean body mass index (BMI) at the time of death was 31.4 ± 8.8 kg/m2 and 27.1 ± 8.2 kg/m2 in the clozapin...

  13. The unexpected finding of a benign mature teratoma in a forensic pathology autopsy : a rare cause for sudden, unexpected death

    DEFF Research Database (Denmark)

    HØyer, Christian Bjerre; UlhØi, Benedicte Parm

    2013-01-01

    Intracranial teratomas are rare tumors that are usually discovered in infancy due to progressive symptoms. We describe a case of a 38-year-old man who was found dead 9 hours after the last sign of life. The deceased's medical history could not explain the sudden, unexpected death. A forensic autopsy revealed an asymptomatic, mature teratoma in the left frontal and temporal lobes. We concluded that the cause of death must have been a generalized epileptiform seizure originating in the tumor site(s) leading to aspiration of the stomach contents and unfavorable positioning, resulting in asphyxia.

  14. Cultural imperatives and the ethics of verbal autopsies in rural Ghana

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    Raymond A. Aborigo

    2013-09-01

    Full Text Available Background: Due to a paucity of statistics from vital registration systems in developing countries, the verbal autopsy (VA approach has been used to obtain cause-specific mortality data by interviewing lay respondents on the signs and symptoms experienced by the deceased prior to death. In societies where the culture of mourning is adhered to, the use of VA could clash with traditional norms, thus warranting ethical consideration by researchers. Objective: The study was designed to explore the ethics and cultural context of collecting VA information through a demographic and health surveillance system in the Kassena-Nankana District (KND of Ghana. Study Design: Data were collected through qualitative in-depth interviews (IDIs with four field staff involved in the routine conduct of VAs, four physicians who code VAs, 20 selected respondents to the VA tool, and eight opinion leaders in the KND. The interviews were supplemented with observation by the researchers and with the field notes of field workers. Interviews were audio-recorded, and local language versions transcribed into English. Thematic analysis was performed using QSR NVivo 8 software. Results: The data indicate that cultural sensitivities in VA procedures at both the individual and family levels need greater consideration not only for ethical reasons but also to ensure the quality of the data. Discussions of some deaths are culturally prohibited and therefore lead to refusal of interviews. Families were also concerned about the confidentiality of information because of the potential of blame for the death. VA teams do not necessarily engage in culturally appropriate bereavement practices such as the presentation of tokens. The desire by families for feedback on the cause of death, which is currently not provided by researchers, was frequently expressed. Finally, no standard exists on the culturally acceptable time interval between death and VA interviews. Conclusion: Ethical issues need to be given greater consideration in the collection of cause of death data, and this can be achieved through the establishment of processes that allow active engagement with communities, authorities of civil registrations, and Institutional Review Boards to take greater account of local contexts.

  15. Medición del panículo adiposo abdominal en autopsias / Measument of the panniculus adiposus abdominis in autopsies

    Scientific Electronic Library Online (English)

    José, Hurtado de Mendoza Amat; Teresita de J, Montero González; Justo, Hurtado de Mendoza Amat.

    2014-09-01

    Full Text Available Objetivo: evaluar la relación de la medida del panículo adiposo abdominal con la edad y el sexo, los parámetros hospitalarios, las causas de muerte y otras enfermedades diagnosticadas. Métodos: se procesaron por el Sistema Automatizado de Registro y Control de Anatomía Patológica 591 autopsias, en l [...] as que se midió el panículo adiposo abdominal a nivel del ombligo. Se crearon tres grupos de estudio según el grosor, con un número similar de casos: 0,1-1,6 cm; 1,7-2,6 cm y 2,7-9,2 cm. Resultados: en el grupo de mayor grosor el promedio de edad fue de 65 años; el 33,3 % correspondió al sexo masculino y el 62,6 % al femenino. Entre las causas de muerte aumentó el infarto agudo del miocardio y disminuyó la enfermedad cerebrovascular. Los tumores malignos se incrementaron en correspondencia con el aumento del grosor del panículo adiposo. Como causas contribuyentes se encontraron la elevación de la hipertensión arterial y la diabetes mellitus. En los trastornos relacionados con el síndrome metabólico, los órganos más afectados fueron las arterias, el páncreas, el hígado, el corazón y la vesícula biliar. Conclusiones: el grosor del panículo adiposo abdominal resulta un indicador apropiado para precisar la grasa abdominal y su importancia; así como su relación con la edad y el sexo, parámetros hospitalarios, causas de muerte y otras enfermedades diagnosticadas, principalmente aquellas que forman parte del síndrome metabólico. Abstract in english Objective: to evaluate the relationship among the size of panniculus adiposus abdominis , age, sex, hospital parameters, causes of death and other diagnosed diseases Methods: using the automated system of registry and control of pathological anatomy, 591 autopsies were processed in which the abdomin [...] al fatty panniculus adiposus abdominis around the navel. Three study groups were created according to thickness, with a similar number of cases: 0.1-1.6 cm: 1.7-2.6 cm and 2.7-9.2 cm. Results: the average age in the group with the thickest panniculus adiposus abdominis was 65 years: 33.3 % in males and 62.6 % in females. Acute myocardial infarction increased whereas the cerebrovascular disease decreased. The number of malignant tumors increased as the panniculus adiposus thickness increases too. The contributing causes were high blood pressure and diabetes mellitus. Regarding the metabolic syndrome related disorders, the most affected organs were arteries, pancreas, liver, heart and gallbladder. Conclusions: the panniculus adiposus abdominis thickness is an adequate indicator to measure abdominal adiposity and its importance, as well as its relationship with age and sex, hospital parameters, causes of death and other diagnosed diseases, mainly those related to the metabolic syndrome.

  16. Mercury in human brain, blood, muscle and toenails in relation to exposure: an autopsy study

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    Morild Inge

    2007-10-01

    Full Text Available Abstract Background The main forms of mercury (Hg exposure in the general population are methylmercury (MeHg from seafood, inorganic mercury (I-Hg from food, and mercury vapor (Hg0 from dental amalgam restorations. While the distribution of MeHg in the body is described by a one compartment model, the distribution of I-Hg after exposure to elemental mercury is more complex, and there is no biomarker for I-Hg in the brain. The aim of this study was to elucidate the relationships between on the one hand MeHg and I-Hg in human brain and other tissues, including blood, and on the other Hg exposure via dental amalgam in a fish-eating population. In addition, the use of blood and toenails as biological indicator media for inorganic and organic mercury (MeHg in the tissues was evaluated. Methods Samples of blood, brain (occipital lobe cortex, pituitary, thyroid, abdominal muscle and toenails were collected at autopsy of 30 deceased individuals, age from 47 to 91 years of age. Concentrations of total-Hg and I-Hg in blood and brain cortex were determined by cold vapor atomic fluorescence spectrometry and total-Hg in other tissues by sector field inductively coupled plasma-mass spectrometry (ICP-SFMS. Results The median concentrations of MeHg (total-Hg minus I-Hg and I-Hg in blood were 2.2 and 1.0 ?g/L, and in occipital lobe cortex 4 and 5 ?g/kg, respectively. There was a significant correlation between MeHg in blood and occipital cortex. Also, total-Hg in toenails correlated with MeHg in both blood and occipital lobe. I-Hg in both blood and occipital cortex, as well as total-Hg in pituitary and thyroid were strongly associated with the number of dental amalgam surfaces at the time of death. Conclusion In a fish-eating population, intake of MeHg via the diet has a marked impact on the MeHg concentration in the brain, while exposure to dental amalgam restorations increases the I-Hg concentrations in the brain. Discrimination between mercury species is necessary to evaluate the impact on Hg in the brain of various sources of exposure, in particular, dental amalgam exposure.

  17. Investigation of a fatal airplane crash: autopsy, computed tomography, and injury pattern analysis used to determine who was steering the plane at time of accident. A case report

    DEFF Research Database (Denmark)

    Høyer, Christian Bjerre; Nielsen, Trine Skov; Nagel, Lise Loft; Uhrenholt, Lars; Boel, Lene Warner Thorup

    2012-01-01

    A fatal accident is reported in which a small single-engine light airplane crashed. The airplane carried two persons in the front seats, both of whom possessed valid pilot certificates. Both victims were subject to autopsy, including post-mortem computed tomography scanning (PMCT) prior to the...... autopsy. The autopsies showed massive destruction to the bodies of the two victims but did not identify any signs of acute or chronic medical conditions that could explain loss of control of the airplane. PMCT, histological examination, and forensic chemical analysis also failed to identify an explanation...... for the crash. A detailed review of an airplane identical to the crashed airplane was performed in collaboration with the Danish Accident Investigation Board and the Danish National Police, National Centre of Forensic Services. The injuries were described using the abbreviated injury scale, the injury...

  18. The problem with medical research on tissue and organ samples taken in connection with forensic autopsies in France.

    Science.gov (United States)

    Rougé-Maillart, C; Dupont, V; Jousset, N

    2016-02-01

    Currently, in France, it is legally impossible to conduct scientific research on tissue and organ samples taken from forensic autopsies. In fact, the law schedules the destruction of such samples at the end of the judicial investigation, and the common law rules governing cadaver research cannot be applied to the forensic context. However, nothing seems in itself to stand in the way of such research since, despite their specific nature, these samples from forensic autopsies could be subject, following legislative amendments, to common law relating to medical research on samples taken from deceased persons. But an essential legislative amendment, firstly to allow the Biomedicine Agency to become authorized to issue a research permit and secondly, to change the research conditions in terms of the non-opposition of the deceased to said research. Such an amendment would be a true breakthrough because it would allow teams to continue to move forward calmly in research, and allow this research to be placed within a legal framework, which would promote international exchanges. PMID:26694871

  19. Forensic aspects of carbon monoxide poisoning by charcoal burning in Denmark, 2008-2012 : an autopsy based study

    DEFF Research Database (Denmark)

    Nielsen, Pia Rude; Gheorghe, Alexandra

    2014-01-01

    Carbon monoxide (CO) inhalation is a well-known method of committing suicide. There has been a drastic increase in suicide by inhalation of CO, produced from burning charcoal, in some parts of Asia, and a few studies have reported an increased number of these deaths in Europe. CO-related deaths caused by charcoal burning have, to our knowledge, not been recorded in the Danish population before. In this retrospective study we present all autopsied cases of CO poisoning caused by charcoal burning in the period 2008-2012. 19 autopsied cases were identified, comprising 11 suicides, 4 accidents, and 2 cases of maternal/paternal filicide-suicide. The mean age of decedents was 38.2 years and the majority of the decedents were men. In 16 cases carboxyhemoglobin levels were above 50 % and in 14 cases we found distinctive cherry red livor mortis. Various concentrations of ethanol and drugs were found in 9 cases. Data suggest that this method of death has increased significantly in Denmark. Therefore, it is highly relevant to draw attention to the subject, to increase awareness as well as prevent future escalation.

  20. Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

    Energy Technology Data Exchange (ETDEWEB)

    Winklhofer, Sebastian; Stolzmann, Paul [University of Zurich, Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, Zurich (Switzerland); University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Surer, Eddie; Ampanozi, Garyfalia; Thali, Michael; Schweitzer, Wolf [University of Zurich, Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, Zurich (Switzerland); Ruder, Thomas [University of Zurich, Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, Zurich (Switzerland); University Hospital Bern, Institute of Diagnostic, Interventional and Pediatric Radiology, Bern (Switzerland); Elliott, Marina [Simon Fraser University, Department of Archaeology, Burnaby, BC (Canada); Oestreich, Andrea; Kraemer, Thomas [University of Zurich, Department of Forensic Pharmacology and Toxicology, Institute of Forensic Medicine, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)

    2014-06-15

    To investigate frequent findings in cases of fatal opioid intoxication in whole-body post-mortem computed tomography (PMCT). PMCT of 55 cases in which heroin and/or methadone had been found responsible for death were retrospectively evaluated (study group), and were compared with PMCT images of an age- and sex-matched control group. Imaging results were compared with conventional autopsy. The most common findings in the study group were: pulmonary oedema (95 %), aspiration (66 %), distended urinary bladder (42 %), cerebral oedema (49 %), pulmonary emphysema (38 %) and fatty liver disease (36 %). These PMCT findings occurred significantly more often in the study group than in the control group (p < 0.05). The combination of lung oedema, brain oedema and distended urinary bladder was seen in 26 % of the cases in the study group but never in the control group (0 %). This triad, as indicator of opioid-related deaths, had a specificity of 100 %, as confirmed by autopsy and toxicological analysis. Frequent findings in cases of fatal opioid intoxication were demonstrated. The triad of brain oedema, lung oedema and a distended urinary bladder on PMCT was highly specific for drug-associated cases of death. (orig.)

  1. Forensic aspects of carbon monoxide poisoning by charcoal burning in Denmark, 2008-2012: an autopsy based study.

    Science.gov (United States)

    Nielsen, Pia Rude; Gheorghe, Alexandra; Lynnerup, Niels

    2014-09-01

    Carbon monoxide (CO) inhalation is a well-known method of committing suicide. There has been a drastic increase in suicide by inhalation of CO, produced from burning charcoal, in some parts of Asia, and a few studies have reported an increased number of these deaths in Europe. CO-related deaths caused by charcoal burning have, to our knowledge, not been recorded in the Danish population before. In this retrospective study we present all autopsied cases of CO poisoning caused by charcoal burning in the period 2008-2012. 19 autopsied cases were identified, comprising 11 suicides, 4 accidents, and 2 cases of maternal/paternal filicide-suicide. The mean age of decedents was 38.2 years and the majority of the decedents were men. In 16 cases carboxyhemoglobin levels were above 50 % and in 14 cases we found distinctive cherry red livor mortis. Various concentrations of ethanol and drugs were found in 9 cases. Data suggest that this method of death has increased significantly in Denmark. Therefore, it is highly relevant to draw attention to the subject, to increase awareness as well as prevent future escalation. PMID:25002407

  2. Hemoperitoneo secundario a rotura de carcinoma hepatocelular: Hallazgos de autopsia / Hemoperitoenum due to hepatocellular carcinoma: Autopsy findings

    Scientific Electronic Library Online (English)

    M., Subirana Domènech; M., Ortega Sánchez; G., Font Valsecchi; J.I., Galtés Vicente; J., Castellà García.

    2012-03-01

    Full Text Available El hemoperitoneo secundario a la rotura de un carcinoma hepatocelular (CH) es una complicación poco frecuente en nuestro medio, siendo más infrecuente su hallazgo como causa de muerte en individuos no diagnosticados de CH. Presentamos el caso de una mujer de 87 años con antecedentes patológicos de h [...] epatitis C crónica e hipertensión arterial y sin constancia de traumatismo abdominal previo, que debutó con un cuadro inespecífico de malestar general, náuseas y vómitos de varias horas de evolución, motivo por el cual se le prescribió y administró domiciliariamente metoclopramida. Falleció a las pocas horas de la atención médica, motivo por el cual se practicó la autopsia judicial. Durante la misma se evidenció un hemoperitoneo de 3.000 cc secundario a una rotura intratumoral sobre un hígado cirrótico. Abstract in english Hemoperitoneum secondary to rupture of hepatocellular carcinoma (CH) is a rare complication in our environment. His find, still more, is uncommon cause of death in individuals not diagnosed of CH. We report the case of a woman of 87 years-old with clinical history of chronic hepatitis C, hypertensio [...] n, and abdominal trauma without evidence of prior, which debuted with a nonspecific malaise, nausea and vomiting several hours of evolution, why was prescribed and administered metoclopramide home. She died a few hours after care, which is why judicial autopsy was performed. The autopsy was shown a 3000 cc hemoperitoneum secondary to rupture intratumoral in a cirrhotic liver.

  3. Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

    International Nuclear Information System (INIS)

    To investigate frequent findings in cases of fatal opioid intoxication in whole-body post-mortem computed tomography (PMCT). PMCT of 55 cases in which heroin and/or methadone had been found responsible for death were retrospectively evaluated (study group), and were compared with PMCT images of an age- and sex-matched control group. Imaging results were compared with conventional autopsy. The most common findings in the study group were: pulmonary oedema (95 %), aspiration (66 %), distended urinary bladder (42 %), cerebral oedema (49 %), pulmonary emphysema (38 %) and fatty liver disease (36 %). These PMCT findings occurred significantly more often in the study group than in the control group (p < 0.05). The combination of lung oedema, brain oedema and distended urinary bladder was seen in 26 % of the cases in the study group but never in the control group (0 %). This triad, as indicator of opioid-related deaths, had a specificity of 100 %, as confirmed by autopsy and toxicological analysis. Frequent findings in cases of fatal opioid intoxication were demonstrated. The triad of brain oedema, lung oedema and a distended urinary bladder on PMCT was highly specific for drug-associated cases of death. (orig.)

  4. Evaluation of the World Health Organization 2009 classification of dengue severity in autopsied individuals, during the epidemics of 2011 and 2012 in Brazil

    Directory of Open Access Journals (Sweden)

    Luciano Pamplona de Góes Cavalcanti

    2015-12-01

    Full Text Available Abstract: INTRODUCTION: The dengue classification proposed by the World Health Organization (WHO in 2009 is considered more sensitive than the classification proposed by the WHO in 1997. However, no study has assessed the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue. In the present study, we evaluated the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue in Northeast Brazil, where the disease is endemic. METHODS: This retrospective study included 121 autopsied individuals suspected of having dengue in Northeast Brazil during the epidemics of 2011 and 2012. All the autopsied individuals included in this study were confirmed to have dengue based on the findings of laboratory examinations. RESULTS: The median age of the autopsied individuals was 34 years (range, 1 month to 93 years, and 54.5% of the individuals were males. According to the WHO 1997 classification, 9.1% (11/121 of the cases were classified as dengue hemorrhagic fever (DHF and 3.3% (4/121 as dengue shock syndrome. The remaining 87.6% (106/121 of the cases were classified as dengue with complications. According to the 2009 classification, 100% (121/121 of the cases were classified as severe dengue. The absence of plasma leakage (58.5% and platelet counts <100,000/mm3 (47.2% were the most frequent reasons for the inability to classify cases as DHF. CONCLUSIONS: The WHO 2009 classification is more sensitive than the WHO 1997 classification for identifying dengue deaths among autopsied individuals suspected of having dengue.

  5. Characterization of autopsy-proven fatal asthma patients in São Paulo, Brazil Caracterización de los pacientes fallecidos por asma certificada por autopsia en São Paulo, Brasil

    OpenAIRE

    Thais Mauad; Ferreira, Diogenes S.; Maria Beatriz G. Costa; Bianca B. Araujo; Luiz Fernando F. Silva; Martins, Milton A; Wenzel, Sally E.; Marisa Dolhnikoff

    2008-01-01

    Few data are available on autopsy-proven fatal asthma patients in São Paulo, Brazil. We characterized 73 asthma patients who were autopsied at the Serviço de Verificação de Óbitos da Universidade de São Paulo between 1996 and 2004. An interview with the next of kin assessed socioeconomic status, history, and treatment of asthma. There were 42 women and 31 men. Fifty-six (76.7%) of them were older than 34 years. Sixty-three percent were Caucasians, 77.3% had < 8 years of schooling, and the med...

  6. Disease-specific mortality burdens in a rural Gambian population using verbal autopsy, 1998–2007

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    Momodou Jasseh

    2014-10-01

    Full Text Available Objective: To estimate and evaluate the cause-of-death structure and disease-specific mortality rates in a rural area of The Gambia as determined using the InterVA-4 model. Design: Deaths and person-years of observation were determined by age group for the population of the Farafenni Health and Demographic Surveillance area from January 1998 to December 2007. Causes of death were determined by verbal autopsy (VA using the InterVA-4 model and ICD-10 disease classification. Assigned causes of death were classified into six broad groups: infectious and parasitic diseases; cancers; other non-communicable diseases; neonatal; maternal; and external causes. Poisson regression was used to estimate age and disease-specific mortality rates, and likelihood ratio tests were used to determine statistical significance. Results: A total of 3,203 deaths were recorded and VA administered for 2,275 (71%. All-age mortality declined from 15 per 1,000 person-years in 1998–2001 to 8 per 1,000 person-years in 2005–2007. Children aged 1–4 years registered the most marked (74% decline from 27 to 7 per 1,000 person-years. Communicable diseases accounted for half (49.9% of the deaths in all age groups, dominated by acute respiratory infections (ARI (13.7%, malaria (12.9% and pulmonary tuberculosis (10.2%. The leading causes of death among infants were ARI (5.59 per 1,000 person-years [95% CI: 4.38–7.15] and malaria (4.11 per 1,000 person-years [95% CI: 3.09–5.47]. Mortality rates in children aged 1–4 years were 3.06 per 1,000 person-years (95% CI: 2.58–3.63 for malaria, and 1.05 per 1,000 person-years (95% CI: 0.79–1.41 for ARI. The HIV-related mortality rate in this age group was 1.17 per 1,000 person-years (95% CI: 0.89–1.54. Pulmonary tuberculosis and communicable diseases other than malaria, HIV/AIDS and ARI were the main killers of adults aged 15 years and over. Stroke-related mortality increased to become the leading cause of death among the elderly aged 60 years or more in 2005–2007. Conclusions: Mortality in the Farafenni HDSS area was dominated by communicable diseases. Malaria and ARI were the leading causes of death in the general population. In addition to these, diarrhoeal disease was a particularly important cause of death among children under 5 years of age, as was pulmonary tuberculosis among adults aged 15 years and above.

  7. Remodeling of the pulmonary artery induced by metastatic gastric carcinoma: a histopathological analysis of 51 autopsy cases

    International Nuclear Information System (INIS)

    Gastric carcinoma remains the second commonest cause of cancer deaths worldwide. Presence of the carcinoma cell in the pulmonary artery is serious condition that might cause remodeling of the pulmonary artery. The present study conducted detailed histopathological analyses to elucidate how gastric carcinoma cells may affect the structure and hemodynamics of pulmonary arteries. Remodeling of the pulmonary artery was assessed based on measurements of arterial diameters and stenosis rates from the autopsies, and their correlation were also validated. We additionally calculated 95 percent confidential intervals (CIs) for the rate of stenosis in groups of pulmonary arteries of different caliber zones (under 100, 100 to 300, and over 300 micrometer). The right ventricular thickness was measured and examined whether it correlated with the rate of pulmonary arterial stenosis. A total of 4612 autopsy cases were recorded at our institute, among which 168 had gastric carcinoma. Finally, 51 cases of the gastric carcinoma were employed for the study which had carcinoma cells in the lumen of the pulmonary artery. The mean right ventricular wall thickness of these cases was 3.14 mm. There were significant positive associations between the rates of pulmonary arterial stenosis and right ventricular thickness from pulmonary arteries of diameter under 100, 100 to 300, and over 300 micrometer. In these zones, 31, 31, and 33 cases had rates of pulmonary arterial stenosis that were below the lower limit of the 95 percent CI values, respectively. On the other hand, among cases with significant pulmonary stenosis, 17 of 18 cases with stenosis in the over 300 micrometer zone involved pulmonary arteries of both in the under 100 and 100 to 300 micrometer zones. One-third of autopsy with advanced gastric carcinoma had carcinoma cells in lumen of pulmonary artery, but implantation and proliferation may be essential to induce intimal thickening that causes an increasing of pulmonary arterial pressure, because our study revealed a significant positive association between the rate of pulmonary arterial stenosis and right ventricular thickness. In addition, diffuse type gastric carcinoma may be apt to cause the remodeling of the pulmonary artery

  8. Deaths of infants subject to forensic autopsy in Estonia from 2001 to 2005: what can we learn from additional information?

    Directory of Open Access Journals (Sweden)

    Grjibovski Andrej M

    2010-10-01

    Full Text Available Abstract Background Deaths from childhood injury are a public health problem worldwide. A relatively high proportion of child deaths of undetermined manner in Estonia raises concerns about potential underestimation of intentional deaths, especially in infants. This suggests that more information on the circumstances surrounding death is needed to establish the manner of death correctly and, more importantly, to prevent these deaths. The objective of this study was to detect, describe, and analyze the circumstances around deaths of infants subject to forensic autopsy in Estonia to reveal hidden cases of child abuse and more accurately determine causes of death. Methods Study cases included all infant deaths in Estonia from 2001 to 2005 subject to forensic autopsy at the Estonian Bureau of Forensic Medicine. Additional information was obtained from a series of visits to general practitioners, including characteristics of infant health, family composition, parents' education and employment, living conditions, and circumstances around death as perceived by medical staff in charge of outpatient services for these families. Results The total number of infant deaths in Estonia between 2001 and 2005 subject to forensic autopsy was 98, with 40 (40.8% deaths attributed to a disease and 58 deaths (59.2% resulting from injury. Elements of child abuse were involved in as many as 57.7% (95% CI 46.9-68.1 of the deaths for which medical records were available (n = 90. At death, the majority of these cases were registered as diseases or deaths from unintentional injury. Average annual mortality from external causes in Estonian infants, 2001-2005, previously reported by us as 88.1 per 100,000 (95% CI 68.1-113.6 would decrease to 41.0 (95% CI 26.9-57.8. Many infants in the studied group had faced multiple threats and were living in poor hygienic conditions. In a number of cases, they were left alone or looked after by older siblings. Parents' alcohol abuse played an important role in a considerable number of cases. Conclusions Using additional sources of information revealed new information about child abuse not reflected in the cause of death diagnosis. Effective interventions aimed at parent education and improved follow-up of children by medical staff may reduce mortality from external causes among Estonian infants by more than half.

  9. Virtual autopsy in forensic sciences and its applications in the forensic odontology / A autópsia virtual nas ciências forenses e sua aplicação na Odontologia forense

    Scientific Electronic Library Online (English)

    Ademir Franco do, Rosário Junior; Paulo Henrique Couto, Souza; Walter, Coudyzer; Patrick, Thevissen; Guy, Willems; Reinhilde, Jacobs.

    Full Text Available Atualmente os avanços tecnológicos se fazem cada vez mais importantes nas ciências forenses. Por outro lado a autópsia ainda é uma abordagem tradicional na prática médica-odontológica, na qual evidências são coletadas por meio fotográfico e radiológico. Neste contexto, a Autópsia Virtual surge como [...] uma ferramenta útil e complementar para o exame cadavérico. Através da alta tecnologia radiológica a Autópsia Virtual fornece uma visão eficiente e precisa do caso a ser analisado. Esta revisão crítica tem o objetivo de atualizar os Cirurgiões-dentistas apresentando o primeiro trabalho com o conteúdo voltado a Autópsia Virtual. Abstract in english Nowadays, technological advances are becoming more and more important in forensic sciences. Yet autopsy is still one of the very traditional methods. This also applies for dentalautopsies, in which visual, photographic and radiological evidences are collected. In this context, Virtual Autopsy appear [...] s as a helpful and complementary tool for dental and medical cadaveric examination. Usinghigh-tech radiological approaches, Virtual Autopsy may provide, through images, an efficient and more accurate view on the individual case. This critical review aims to update the dental professionalspresenting the first national paper with explanations on Virtual Autopsy.

  10. Interobserver agreement of the injury diagnoses obtained by postmortem computed tomography of traffic fatality victims and a comparison with autopsy results

    DEFF Research Database (Denmark)

    Leth, Peter Mygind; Struckmann, Henrik

    2013-01-01

    The present study investigated the interobserver variation between a radiologist and a forensic pathologist in 994 injury diagnoses obtained by postmortem computed tomography (CT) of 67 traffic fatality victims, and the results were compared with diagnoses obtained by autopsy. The injuries were coded according to the abbreviated injury scale (AIS). We found a low interobserver variability for postmortem CT injury diagnoses, and the variability was the lowest for injuries with a high AIS severity score. The radiologist diagnosed more injuries than the pathologist, especially in the skeletal system, but the pathologist diagnosed more organ injuries. We recommend the use of a radiologist as a consultant for the evaluation of postmortem CT images. Training in radiology should be included in forensic medicine postgraduate training. CT was superior to autopsy in detecting abnormal air accumulations, but autopsy was superior to CT in the detection of organ injuries and aortic ruptures. We recommend a combination of CT and autopsy for the postmortem investigation of traffic fatality victims.

  11. A state-of-the-art pipeline for postmortem CT and MRI visualization: from data acquisition to interactive image interpretation at autopsy

    International Nuclear Information System (INIS)

    The importance of autopsy procedures leading to the establishment of the cause of death is well-known. A recent addition to the autopsy work flow is the possibility of conducting postmortem imaging, in its 3D version also called virtual autopsy (VA), using multidetector computed tomography (MDCT) or magnetic resonance imagining (MRI) data from scans of cadavers displayed with direct volume rendering (DVR) 3D techniques. The use of the data and their workflow are presented. Data acquisition was performed and high quality data-sets with submillimeter precision were acquired. New data acquisition techniques such as dual-energy CT (DECT) and quantitative MRI, then were implemented and provided additional information. Particular findings hardly visualized in conventional autopsy can rather easy be seen at the full body CT, such as air distribution, e.g. pneumothorax, pneumopericardium, air embolism, and wound channels. MRI shows natural deaths such as myocardial infarctions. Interactive visualization of these 3D data-sets can provide valuable insight into the corpses and enables non-invasive diagnostic procedures. In postmortem CT imaging, not being limited by a patient depending radiation dose limit the data-sets can, however, be generated with such a high resolution that they become difficult to handle in today's archive retrieval and interactive visualization systems, specifically in the case of full body scans. To take full advantage of these new technologies the postmortem workflow needs to be tailored to the demands and opportunities that the new technologies allow

  12. Postmortem CT morphometry of great vessels with regard to the cause of death for investigating terminal circulatory status in forensic autopsy.

    Science.gov (United States)

    Sogawa, Nozomi; Michiue, Tomomi; Ishikawa, Takaki; Inamori-Kawamoto, Osamu; Oritani, Shigeki; Maeda, Hitoshi

    2015-05-01

    Postmortem CT (PM-CT) is useful to investigate the viscera in situ before opening the body cavities at autopsy. The present study involved a virtual morphometric analysis of thoracic and abdominal great vessels with regard to the cause of death as a possible index of terminal circulatory status in forensic autopsy cases, using PM-CT data of forensic autopsy cases within 3 days postmortem (n?=?93). Perimeters and cross-sectional areas of the aorta and vena cava depended on the age and/or gender of subjects; however, when the vessel flattening index (vFI) was calculated as the ratio of the cross-sectional area (a) to the estimated circle area having the same perimeter (l), using the formula vFI?=?4?a/l(2), the vFI showed distinct differences among the causes of death without significant postmortem time dependence. The index was low for each vessel in fatal bleeding, while the vFI of the abdominal aorta and inferior vena cava was low in hyperthermia (heatstroke), but higher in drowning, hypothermia (cold exposure) and sudden cardiac death. These CT findings provide quantitative data as supplementary indicators to reinforce autopsy findings for interpreting terminal circulatory status. PMID:25194711

  13. A state-of-the-art pipeline for postmortem CT and MRI visualization: from data acquisition to interactive image interpretation at autopsy

    Energy Technology Data Exchange (ETDEWEB)

    Persson, Anders (Center for Medical Image Science and Visualization (CMIV), Univ. of Linkoeping, Linkoeping (Sweden); Dept. of Radiology of Medical and Health Sciences (IMH), Linkoeping Univ. Hospital, Linkoeping (Sweden)), email: anders.persson@cmiv.liu.se; Lindblom, Maria (Dept. of Radiology of Medical and Health Sciences (IMH), Linkoeping Univ. Hospital, Linkoeping (Sweden)); Jackowski, Christian (Inst. of Legal Medicine, Univ. of Zurich, Zurich (Switzerland))

    2011-06-15

    The importance of autopsy procedures leading to the establishment of the cause of death is well-known. A recent addition to the autopsy work flow is the possibility of conducting postmortem imaging, in its 3D version also called virtual autopsy (VA), using multidetector computed tomography (MDCT) or magnetic resonance imagining (MRI) data from scans of cadavers displayed with direct volume rendering (DVR) 3D techniques. The use of the data and their workflow are presented. Data acquisition was performed and high quality data-sets with submillimeter precision were acquired. New data acquisition techniques such as dual-energy CT (DECT) and quantitative MRI, then were implemented and provided additional information. Particular findings hardly visualized in conventional autopsy can rather easy be seen at the full body CT, such as air distribution, e.g. pneumothorax, pneumopericardium, air embolism, and wound channels. MRI shows natural deaths such as myocardial infarctions. Interactive visualization of these 3D data-sets can provide valuable insight into the corpses and enables non-invasive diagnostic procedures. In postmortem CT imaging, not being limited by a patient depending radiation dose limit the data-sets can, however, be generated with such a high resolution that they become difficult to handle in today's archive retrieval and interactive visualization systems, specifically in the case of full body scans. To take full advantage of these new technologies the postmortem workflow needs to be tailored to the demands and opportunities that the new technologies allow

  14. An autopsy study of cerebrovascular disease in Japanese men who lived in Hiroshima, Japan and Honolulu, Hawaii

    International Nuclear Information System (INIS)

    Evidence of cerebrovascular disease at autopsy was compared in two groups of men, 186 long time residents of Hiroshima, Japan and 253 men of Japanese ancestry long resident in Honolulu, Hawaii. They were from 45 to 71 years of age at death. Atherosclerosis of the circle of Willis and its major branches, sclerosis of the intraparenchymal arteries and the frequency of cerebral hemorrhage and cerebral infarct were compared in the two populations. The Honolulu subjects had significantly more atherosclerosis of the circle of Willis, but less intraparenchymal artery sclerosis and less cerebral infarction. Cerebral hemorrhage was equally frequent in the two cities. It was concluded that cerebral infarction is more frequent in Japanese men in Hiroshima than Honolulu, and that men of Japanese ancestry in Honolulu are spared an appreciable risk of cerebral infarction through decreased frequency of intraparenchymal arterial sclerosis despite higher levels of atherosclerosis of large intracranial arteries. (author)

  15. An autopsy case of acute multiple sclerosis with multifocal low density areas in the cerebral white matter on CT scans

    International Nuclear Information System (INIS)

    A 34-year-old woman presented with urination difficulty and consciousness disturbance, followed by persistent neurologic findings, such as semicomatose mental status and bilateral optic neuritis, and monophasic clinical course. Cranial CT showed multifocal low density areas in cerebral white matter. The patient was clinically diagnosed as having acute disseminated encephalomyelitis. She died of sepsis four months later. Autopsy revealed multifocal large demyelinating lesions confined to the cerebral white matter, shown as low density areas on CT scans, and demyelinating plaques scattered in the optic nerves and chiasm, and cerebral peduncle. The final diagnosis was acute multiple sclerosis. The CT appearance of multifocal low density areas was most likely due to demyelinating lesions causing edema and tissue necrosis. (Namekawa, K.)

  16. Autopsy findings in a case of a small cell lung cancer complicated by radiotherapy induced acute interstitial pneumonia

    International Nuclear Information System (INIS)

    The authors describe the case of a 71-year-old man who had been referred to his hospital because of a dry cough and an associated abnormality that had been detected by x-ray. Based on chest x-ray evaluations and the endoscopic bronchial biopsy findings the diagnosis was a small cell lung cancer. The patient thus received a 2 time regimen of cisplatin chemotherapy and subsequent radiotherapy (40 Gy). Two weeks after this radiotherapy, however the patient complained of an increasing dyspnea. Two days later, he was readmitted to hospital because of pneumonia and severe dyspnea, but died of respiratory failure on the same day. The autopsy findings revealed diffuse organized alveolar duct damage that had been induced by radiotherapy directed toward a relatively large area that included the right lower lung and the mediastinum. (author)

  17. Clinical and Autopsy Diagnoses of Visceral Affections of Patients Who Died Because of Complicated Burns with Multi-organ Failure.

    Science.gov (United States)

    Taran, A; Baciu, N; Rafulea, V; German, A

    2005-12-31

    The anatomicopathological investigations carried out in a total number of 186 cadavers during the last decade were reviewed. In these retrospective studies of necropsy protocols related to different affections of visceral organ systems that evolved asymptomatically, 30.1% involved the neurological system, 36.0% the uropoiesis system, 34.4% the gastrointestinal system, 52.0% the hepatobiliary system, and 39.7% the cardiovascular system, with a prevalence in the pulmonary system of 64.2%. A comparative analysis of the incidence of affections detected in various visceral organs (on the basis of necropsy data in the 186 burn patients) and the incidence of their clinical manifestations showed that in 35% of patients with extensive and deep burns all of these conditions developed asymptomatically and were diagnosed only through autopsy. PMID:21991003

  18. Mononeuritis multiplex due to thrombotic ischemia of primary antiphospholipid antibody syndrome without vasculitis: an autopsy case report.

    Science.gov (United States)

    Takahashi, Masatoshi; Katada, Fumiaki; Sato, Susumu; Shibayama, Hidehiro; Fukutake, Toshio; Murayama, Shigeo

    2015-12-23

    The patient was a 78-year-old man. Three years before admission, he developed transient peripheral neuropathy and purpura, and at admission, he presented with livedo reticularis of both his lower extremities and with mononeuritis multiplex. Vasculitis was not observed, and antiphospholipid antibodies were detected. The nerve and skin biopsies revealed no inflammation; axonal degeneration accompanied by thrombi was found in his arterioles and venules. Based on these findings, he was diagnosed with ischemic peripheral neuropathy due to primary antiphospholipid syndrome. Administration of anticoagulant therapy resulted in an improvement in symptoms; however, two months later, a relapse occurred, and the patient contracted an infection while undergoing immunosuppressive therapy. The infection became fulminant, and the patient succumbed to multiple organ failure. The autopsy revealed a systemic arterial and venous embolism; however, no vasculitis was observed. Antiphospholipid syndrome, which is responsive to antithrombotic treatment, should be considered as a differential diagnosis of mononeuritis multiplex. PMID:26511022

  19. An autopsy case of hemiconvulsion-hemiplegia-epilepsy syndrome manifesting as cerebral hemiatrophy in an elderly man.

    Science.gov (United States)

    Iwase, Tamaki; Yoshida, Mari; Mizuno, Tomoyuki; Sato, Shinya; Nokura, Kazuya

    2015-12-01

    We report an autopsy case of hemiconvulsion-hemiplegia-epilepsy (HHE) syndrome in a 79-year-old man. HHE syndrome usually occurs in children younger than 4 years of age. Although most HHE syndrome patients live into adult life, only a few cases of the syndrome have been reported in the elderly. In our case, cerebral hemiatrophy, left mesial temporal sclerosis and crossed cerebellar atrophy were observed. Because this is the oldest case ever reported, we further investigated age-related neuropathological changes and found an interhemispheric difference in amyloid-?-related neuropathologic changes. There were almost no senile plaques or amyloid-laden vessels in the left hemisphere. As far as we know, this is the first report of age-related neuropathology in a brain manifesting HHE syndrome. PMID:26179932

  20. Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias / Morphological prognostic factors in nosocomial pneumonia: an autopsy study

    Scientific Electronic Library Online (English)

    Luiz Mário Baptista, Martinelli; Paulo José Fortes Villas, Boas; Thais Thomaz, Queluz; Hugo Hyung Bok, Yoo.

    2010-02-01

    Full Text Available OBJETIVO: Determinar a prevalência de pneumonia nosocomial nas autópsias em um hospital público universitário; identificar os fatores de risco relacionados à pneumonia nosocomial e os potenciais fatores prognósticos relacionados à ocorrência de pneumonia nosocomial fatal; e correlacionar os achados [...] anatomopatológicos com a ocorrência de pneumonia nosocomial e/ou pneumonia aspirativa. MÉTODOS: Estudo retrospectivo de 199 pacientes autopsiados, maiores de 1 ano de idade, internados no Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista entre 1999 e 2006, cuja causa de morte (causa básica ou associada) foi pneumonia nosocomial. Testou-se a associação dos dados demográficos, clínicos e anatomopatológicos com os desfechos pneumonia nosocomial fatal e pneumonia aspirativa fatal. As variáveis significativas entraram na análise multivariada. RESULTADOS: A idade média foi de 59 ± 19 anos. A prevalência de pneumonia nosocomial em autópsias foi 29%, e essa foi a causa mortis de 22,6% dos pacientes autopsiados. A pneumonia nosocomial fatal correlacionou-se com os achados anatomopatológicos de alterações estruturais tabágicas (OR = 3,23; IC95%: 1,26-2,95; p = 0,02) e acometimento pulmonar bilateral (OR = 3,23; IC95%: 1,26-8,30; p = 0,01). Não houve associações significativas entre as variáveis e pneumonia aspirativa fatal. CONCLUSÕES: Em nossa amostra, a pneumonia nosocomial teve prevalência elevada e foi responsável por quase 25% das mortes. A mortalidade é favorecida por alterações estruturais tabágicas e pneumonia bilateral. Esses achados corroboram os resultados de diversos estudos clínicos sobre pneumonia nosocomial. Abstract in english OBJECTIVE: To determine the prevalence of nosocomial pneumonia in autopsies at a public university hospital; to identify the risk factors for nosocomial pneumonia and the potential prognostic factors associated with fatal nosocomial pneumonia and with fatal aspiration pneumonia; and to determine whe [...] ther anatomopathological findings correlate with nosocomial pneumonia or aspiration pneumonia. METHODS: A retrospective study involving 199 autopsied patients, older than 1 year of age, who had been admitted to the São Paulo State University Botucatu School of Medicine Hospital das Clínicas and died of nosocomial pneumonia (underlying or contributing cause), between 1999 and 2006. Demographic, clinical and anatomopathological variables were tested regarding their association with the outcomes (fatal nosocomial pneumonia and fatal aspiration pneumonia). The significant variables were analyzed using multivariate analysis. RESULTS: The mean age was 59 ± 19 years. The prevalence of nosocomial pneumonia in autopsies was 29%, and the disease was the cause of death in 22.6% of the autopsied patients. Fatal nosocomial pneumonia correlated with the following anatomopathological findings: tobacco-associated structural lesions (OR = 3.23; 95% CI: 1.26-2.95; p = 0.02) and bilateral pneumonia (OR = 3.23; 95% CI: 1.26-8.30; p = 0.01). None of the variables were found to be significantly associated with fatal aspiration pneumonia. CONCLUSIONS: In our sample, there was a high prevalence of nosocomial pneumonia, which was responsible for almost 25% of all of the deaths. Smoking-related structural lesions and bilateral pneumonia all favored mortality. These findings corroborate the results of various clinical studies on nosocomial pneumonia.

  1. An autopsy case of progressive generalized muscle atrophy over 14 years due to post-polio syndrome.

    Science.gov (United States)

    Oki, Ryosuke; Uchino, Akiko; Izumi, Yuishin; Ogawa, Hirohisa; Murayama, Shigeo; Kaji, Ryuji

    2016-01-29

    We report the case of a 72-year-old man who had contracted acute paralytic poliomyelitis in his childhood. Thereafter, he had suffered from paresis involving the left lower limb, with no relapse or progression of the disease. He began noticing slowly progressive muscle weakness and atrophy in the upper and lower extremities in his 60s. At the age of 72, muscle weakness developed rapidly, and he demonstrated dyspnea on exertion and dysphagia. He died after about 14 years from the onset of muscle weakness symptoms. Autopsy findings demonstrated motoneuron loss and glial scars not only in the plaque-like lesions in the anterior horns, which were sequelae of old poliomyelitis, but also throughout the spine. No Bunina bodies, TDP-43, and ubiquitin inclusions were found. Post-polio syndrome is rarely fatal due to rapid progressive dyspnea and dysphagia. Thus, the pathological findings in the patient are considered to be related to the development of muscle weakness. PMID:26616485

  2. An autopsy case of multiple myeloma with veno-occlusive disease of the liver induced by ionizing radiation

    International Nuclear Information System (INIS)

    An autopsy case of multiple myeloma which accompanied radiation-induced veno-occlusion of the liver is presented. A 62-year-old woman with a chief complaint of low back pain was diagnosed as having multiple myeloma. Approximately one year later, the patient was treated with chemotherapy, consisting of VCR, MCNU, ADR, PSL, and CPA, and X-irradiation of 30 Gy to the bilateral trunk for medically intractable rib pain. The irradiation field included the entire liver. Six months later, she was admitted to the hospital due to abdominal distention and massive amounts of ascites. Various examinations failed to make a qualitative diagnosis. Postmortem examination revealed fibrotic occlusion of the central vein which is typical for veno-occlusion disease of the liver. This finding was restricted to the area that was not shielded, irrespective of anatomical structure, strongly suggesting radiation-induced veno-occlusion of the liver. (N.K.)

  3. Neonatal mortality in India's rural poor: Findings of a household survey and verbal autopsy study in Rajasthan, Bihar and Odisha.

    Science.gov (United States)

    Dogra, Vishal; Khanna, Rajesh; Jain, Anuradha; Kumar, Ajay M V; Shewade, Hemant D; Majumdar, Suman S

    2015-06-01

    In 2011, Save the Children India launched a project for the disadvantaged population of Rajasthan, Bihar and Odisha. As a baseline activity, neonatal deaths during January-December 2012 were investigated using modified verbal autopsy tool in six sub-district-level administrative units (blocks) adopting 30-cluster sample survey approach. Our study reported a total of 189 neonatal deaths of which 50% occurred at home and 39% happened on Day 1. About half of the deaths occurred in blocks from Bihar. High number of neonatal deaths belonged to households that were below poverty line (64%) and other disadvantaged classes (46%); among mothers who were illiterate (65%), <20 years of age (54%) and during their first-order births (36%). Birth asphyxia was a major cause of neonatal deaths across all blocks. These findings indicate need for easy and early access to transport services, specialized neonatal care and advocacy targeted towards increasing community awareness. PMID:25825343

  4. A dynamic magnetic shift method to increase nanoparticle concentration in cancer metastases: a feasibility study using simulations on autopsy specimens

    Directory of Open Access Journals (Sweden)

    Nacev A

    2011-11-01

    Full Text Available Alek Nacev1, Skye H Kim2, Jaime Rodriguez-Canales2, Michael A Tangrea2, Benjamin Shapiro1, Michael R Emmert-Buck21Fischell Department of Bioengineering, University of Maryland, College Park, MD; 2Pathogenetics Unit, Laboratory of Pathology, Center for Cancer Research National Cancer Institute, National Institutes of Health, Bethesda, MD, USAAbstract: A nanoparticle delivery system termed dynamic magnetic shift (DMS has the potential to more effectively treat metastatic cancer by equilibrating therapeutic magnetic nanoparticles throughout tumors. To evaluate the feasibility of DMS, histological liver sections from autopsy cases of women who died from breast neoplasms were studied to measure vessel number, size, and spatial distribution in both metastatic tumors and normal tissue. Consistent with prior studies, normal tissue had a higher vascular density with a vessel-to-nuclei ratio of 0.48 ± 0.14 (n = 1000, whereas tumor tissue had a ratio of 0.13 ± 0.07 (n = 1000. For tumors, distances from cells to their nearest blood vessel were larger (average 43.8 µm, maximum 287 µm, n ? 5500 than normal cells (average 5.3 µm, maximum 67.8 µm, n ? 5500, implying that systemically delivered nanoparticles diffusing from vessels into surrounding tissue would preferentially dose healthy instead of cancerous cells. Numerical simulations of magnetically driven particle transport based on the autopsy data indicate that DMS would correct the problem by increasing nanoparticle levels in hypovascular regions of metastases to that of normal tissue, elevating the time-averaged concentration delivered to the tumor for magnetic actuation versus diffusion alone by 1.86-fold, and increasing the maximum concentration over time by 1.89-fold. Thus, DMS may prove useful in facilitating therapeutic nanoparticles to reach poorly vascularized regions of metastatic tumors that are not accessed by diffusion alone.Keywords: cancer, metastases, vasculature, drug delivery, magnetic, nanoparticles

  5. Líneas guía en autopsias por sospecha de mala praxis asistencial / Guidelines of autopsy in cases of suspected clinical malpractice

    Scientific Electronic Library Online (English)

    J., Aso Escario.

    2011-12-01

    Full Text Available El presente trabajo revisa las líneas seguidas en casos de autopsia por sospecha de mala praxis. Se revisan las indicaciones, propósitos generales, técnicas de disección, exámenes complementarios, junto con los problemas éticos, de acuerdo con la experiencia del autor y la literatura. Un grado signi [...] ficativo de entrenamiento y experiencia tanto clínica como patológica es requerido en estos casos. Esta necesidad puede contrastar con la relativa falta de expertizatión de los médicos forenses en España, y con las limitaciones de la autopsia médico-legal. Algunas guías para solucionar este problema, como consulta con especialistas independientes, o con los comités de las especialidades médicas, son consideradas. Existen importantes problemas éticos en estos fallecimientos. En consecuencia, hay una necesidad de enfoque correcto de estos problemas. Se consideran algunas orientaciones en este sentido. Abstract in english The present paper reviews the guidelines for autopsy in cases of suspected clinical malpractice. Indications, general purposes, dissection techniques, laboratory and complementary examinations, as well as ethical problems are revised, according to the author's experience and literature review. A sig [...] nificant degree of training and skill, both clinical and pathologically, are required. This needing can contrast with the relative lack of specialization of Forensic Pathologists in Spain, and limitations of the judicial autopsy in these cases. Some guidelines to solve this problem, like independent expert consultation or advise by the Specialties Boards, are considered. Important ethical issues can arise from these deaths, therefore, a needing of correct address of these issues is perceived. Some orientations in this subject are considered.

  6. Discrepâncias clínico-patológicas e achados cardiovasculares em 409 autópsias consecutivas / Clinical and pathological discrepancies and cardiovascular findings in 409 consecutive autopsies

    Scientific Electronic Library Online (English)

    Aline Fusco, Fares; Jorge, Fares; Gislaine Fusco, Fares; José Antônio, Cordeiro; Marcelo Arruda, Nakazone; Patrícia Maluf, Cury.

    2011-12-01

    Full Text Available FUNDAMENTO: As discrepâncias entre os diagnósticos clínicos e em autópsia persistem em todo o mundo. OBJETIVO: Avaliamos as autópsias em um hospital-escola para analisar a precisão dos diagnósticos cardiovasculares clínicos em comparação aos achados post-mortem. MÉTODOS: As 409 autópsias consecutiva [...] s entre 2003 e 2006 foram analisadas em um hospital terciário de São José do Rio Preto, São Paulo (SP), Brasil. A comparação dos achados cardiovasculares clínicos e patológicos foi realizada por meio da classificação de discrepâncias de Goldman. RESULTADOS: A taxa de autópsia no hospital foi de 8%. As causas cardiovasculares de óbito representavam 42,8% (175 de 409 pacientes) dos diagnósticos de autópsia. Em 98 pacientes (56%), houve discrepâncias significativas (classes I e II), o que representa uma grande proporção de diagnósticos equivocados de infarto mesentérico (84,6%), infarto agudo do miocárdio (64,7%), dissecção da aorta (64,2%) e embolia pulmonar (62,5%). Foram observadas maiores taxas de concordância para a insuficiência cardíaca congestiva (59%) e para o acidente vascular cerebral isquêmico agudo (58,8%). A idade, o sexo, o tempo de permanência e a última unidade de admissão no hospital não foram associados aos critérios de Goldman. CONCLUSÃO: As discrepâncias dos diagnósticos clínicos e em autópsia relativos à morte cardiovascular permanecem elevados no Brasil, a despeito dos recursos tecnológicos disponíveis. Além disso, nossos achados reforçam a importância do exame post-mortem como uma contribuição para a melhoria da assistência médica. Abstract in english BACKGROUND: Discrepancies between clinical and autopsy diagnoses persists worldwide. OBJECTIVE: We evaluated autopsies in a university hospital in order to assess the accuracy of clinical cardiovascular diagnosis compared to postmortem findings. METHODS: Four hundred nine consecutive autopsies betwe [...] en 2003 and 2006 were analyzed in a tertiary-care hospital in São José do Rio Preto, SP, Brazil. The comparison of clinic-pathological cardiovascular findings was performed using Goldman's discrepancies classification. RESULTS: Autopsy rate at the hospital was 8%. Cardiovascular causes of death represented 42.8% (175 out of 409 patients) of autopsy diagnoses. In 98 (56%) patients, there were major discrepancies (class I and II), representing a large proportion of misdiagnoses for mesenteric infarction (84.6%), acute myocardial infarction (64.7%), aorta dissection (64.2%), and pulmonary embolism (62.5%). Highest concordance rates were observed in congestive heart failure (59%) and acute ischemic stroke (58.8%). Age, sex, length of stay and the last admission unit at the hospital were not associated with Goldman criteria. CONCLUSION: Clinic-autopsy discrepancies concerning cardiovascular death remain high in Brazil, despite technological resources available. Moreover, our findings reinforce the importance of postmortem examination in contributing to medical care improvement.

  7. Hipertrofia cardíaca esquerda e direita em necropsias de hipertensos / Left and right ventricular hypertrophy at autopsy of hypertensive individuals

    Scientific Electronic Library Online (English)

    Mirella Pessoa, Sant' Anna; Roberto José Vieira de, Mello; Luciano Tavares, Montenegro; Mônica Modesto, Araújo.

    2012-02-01

    Full Text Available OBJETIVO: Medir a espessura ventricular direita e esquerda em falecidos com história de hipertensão arterial, submetidos a necropsias clínicas. MÉTODOS: Foram selecionados 90 casos do Serviço de Verificação de Óbitos de Recife -PE, de ambos os sexos, com história de hipertensão arterial essencial, c [...] om relação à espessura das paredes cardíacas, além da correlação com outros achados de necropsia e informes clínicos. RESULTADOS: Observouse associação significativa entre a presença de hipertrofia ventricular esquerda (HVE) e direita (HVD), e de cardiopatia hipertensiva grave e HVD. Houve predomínio da HVD e HVE em homens, na faixa etária dos 60-79 anos, com maior prevalência nas etnias parda e negra, e naqueles com estado nutricional adequado ou com sobrepeso e em obesos. CONCLUSÃO: Observou-se que a presença de HVD relaciona-se com HVE, sugerindo que há fatores patogênicos semelhantes envolvidos no desenvolvimento da hipertrofia bilateral. A HVD parece associar-se à doença cardíaca mais grave, podendo, a partir de outros estudos, ser considerada novo fator prognóstico na avaliação dos pacientes hipertensos. Abstract in english OBJECTIVE: To measure the right and left ventricular thickness in deceased individuals with a history of hypertension submitted to clinical autopsies. METHODS: We selected 90 cases from the Death Verification Service of the city of Recife, state of Pernambuco, Brazil, of both sexes, with a history o [...] f essential arterial hypertension related to heart wall thickness, in addition to correlation with autopsy findings and other clinical reports. RESULTS: There was a significant association between the presence of left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH) and between severe hypertensive cardiomyopathy and RVH. There was a predominance of RVH and LVH in men aged 60-79 years and a higher prevalence in the Brazilian mulatto and Black ethnic groups and in those with adequate nutritional status or overweight and obese individuals. CONCLUSION: It was observed that the presence of RVH was related to LVH, suggesting that there are similar pathogenic factors involved in the development of bilateral hypertrophy. The RVH seems to be associated with more severe heart disease and may, based on other studies, be considered as a new prognostic factor in the evaluation of hypertensive patients.

  8. Observar, ouvir, compartilhar: trabalho de campo para autópsias psicossociais Watching, listening and sharing: field work for psychosocial autopsies

    Directory of Open Access Journals (Sweden)

    Maria Cecília de Souza Minayo

    2012-08-01

    Full Text Available O artigo descreve as etapas de realização do trabalho de campo da pesquisa. É possível prevenir a antecipação do fim? Suicídio de Idosos no Brasil e possibilidades de Atuação do Setor de Saúde, realizada em 10 municípios das cinco regiões do país. A amostra composta por 51 autópsias psicossociais abrangeu cinco idosos que faleceram por suicídio em nove municípios e seis em um deles. Oitenta e quatro familiares foram entrevistados. Trabalhou-se com um roteiro denominado autópsia psicossocial e com observação do contexto. Cada entrevista durou 60 minutos em média, e na maioria dos casos, houve mais de um encontro com os familiares. O estudo foi construído por meio de um processo coletivo que abrangeu compartilhamento da revisão bibliográfica, discussão do universo, das amostras, das estratégias de abordagem, dos resultados de campo e das análises empíricas. Este artigo destaca a preparação teórica, conceitual e prática dos pesquisadores; o processo de elaboração dos instrumentos para o trabalho de campo; informações sobre as fontes de dados existentes e sobre as efetivamente acessadas; apresentação de credencial institucional; entrada no contexto das famílias, dificuldades e estratégias para realização do estudo empírico; entrada e saída do campo; e impacto da pesquisa sobre os investigadores.The article describes the research realization phases of field work in ten municipalities in five regions entitled "Is it possible to prevent the anticipation of the end? Suicide among the elderly in Brazil and the possibilities for action by the Health Sector." The sample comprises 51 psychosocial autopsies of 5 elderly people who committed suicide in 9 locations and 6 in another. 84 family members were interviewed. Semi-structured psychosocial autopsies and contextual observations were used. Each interview lasted 60 minutes on average and in the majority of the cases there was more than one encounter with family members. The study consisted of a collective process that involved bibliographic review, discussion of the samples, approach strategies, field results and empirical analysis. This article highlights the theoretical, conceptual and practical preparation of researchers and production and standardization of instruments; information about existing data sources and those that are actually used; introduction of institutional credentials; assessment of the family context, difficulties and strategies for empirical study; entrance to and exit from the field; and the impact of the research on the investigators.

  9. Observar, ouvir, compartilhar: trabalho de campo para autópsias psicossociais / Watching, listening and sharing: field work for psychosocial autopsies

    Scientific Electronic Library Online (English)

    Maria Cecília de Souza, Minayo; Sonia, Grubits; Fátima Gonçalves, Cavalcante.

    2012-08-01

    Full Text Available O artigo descreve as etapas de realização do trabalho de campo da pesquisa. É possível prevenir a antecipação do fim? Suicídio de Idosos no Brasil e possibilidades de Atuação do Setor de Saúde, realizada em 10 municípios das cinco regiões do país. A amostra composta por 51 autópsias psicossociais ab [...] rangeu cinco idosos que faleceram por suicídio em nove municípios e seis em um deles. Oitenta e quatro familiares foram entrevistados. Trabalhou-se com um roteiro denominado autópsia psicossocial e com observação do contexto. Cada entrevista durou 60 minutos em média, e na maioria dos casos, houve mais de um encontro com os familiares. O estudo foi construído por meio de um processo coletivo que abrangeu compartilhamento da revisão bibliográfica, discussão do universo, das amostras, das estratégias de abordagem, dos resultados de campo e das análises empíricas. Este artigo destaca a preparação teórica, conceitual e prática dos pesquisadores; o processo de elaboração dos instrumentos para o trabalho de campo; informações sobre as fontes de dados existentes e sobre as efetivamente acessadas; apresentação de credencial institucional; entrada no contexto das famílias, dificuldades e estratégias para realização do estudo empírico; entrada e saída do campo; e impacto da pesquisa sobre os investigadores. Abstract in english The article describes the research realization phases of field work in ten municipalities in five regions entitled "Is it possible to prevent the anticipation of the end? Suicide among the elderly in Brazil and the possibilities for action by the Health Sector." The sample comprises 51 psychosocial [...] autopsies of 5 elderly people who committed suicide in 9 locations and 6 in another. 84 family members were interviewed. Semi-structured psychosocial autopsies and contextual observations were used. Each interview lasted 60 minutes on average and in the majority of the cases there was more than one encounter with family members. The study consisted of a collective process that involved bibliographic review, discussion of the samples, approach strategies, field results and empirical analysis. This article highlights the theoretical, conceptual and practical preparation of researchers and production and standardization of instruments; information about existing data sources and those that are actually used; introduction of institutional credentials; assessment of the family context, difficulties and strategies for empirical study; entrance to and exit from the field; and the impact of the research on the investigators.

  10. HELLP syndrome in pregnancy as a cause of sudden unexpected death and spontaneous hepatic rupture: A medico-legal autopsy case report.

    Science.gov (United States)

    Sujirachato, Kanchana; Srisont, Smith; Peonim, Vichan

    2012-04-01

    This is the first reported medico-legal autopsy case in Thailand. It is a case of a 26-year-old Thai female with primigravida and 34 weeks gestational age that had sudden unexpected death. The laboratory investigations before death revealed evidence of hemolysis, which is decreased hematocrit, elevated lactate dehydrogenase (865 U/L), and low platelet count (8.7 x 10(9) cells/L). These findings were compatible with HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelets) syndrome. The autopsy findings showed two ruptures of the right lobe of the liver hepatic subcapsular hematoma, rupture of Glisson's capsule, and massive hemoperitoneum with abruptio placentae. Histological features of liver and kidneys revealed specific characteristics that can assist the forensic pathologist to diagnose HELLP syndrome when laboratory examinations are not available. PMID:22612019

  11. A case of radiation-induced cutaneous angiosarcoma 15 years after simultaneously occurring uterine cervical and gastric cancers discovered by autopsy

    International Nuclear Information System (INIS)

    A case of cutaneous angiosarcoma in the skin on the left hip previously irradiated for cervical uterine squamous cell carcinoma is discovered by autopsy. The patient, a 79-year-old woman, at age 64 had been then underwent radiotherapy for the cervical uterine carcinoma. A total dose of 50 Gy was administrated. At 79 years of age, she noticed multiple purple black nodular skin lesions on the left hip and thigh. She was hospitalized for 8 days, but her general condition rapidly deteriorated and she died. An autopsy revealed that the skin lesion was composed of atypical polygonal cell proliferation forming irregularly anastomosing vascularity, together with hemorrhage and necrosis. The tumor cells were positive for both CD34 and factor 8-related antigens. The final diagnosis was angiosarcoma. (author)

  12. Myocardial contrast defect associated with thrombotic coronary occlusion: Pre-autopsy diagnosis of a cardiac death with post-mortem CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Heon; Cha, Jang Gyu [Dept. of Radiology, Soonchunhyang University Hospital, Bucheon (Korea, Republic of); Park, Hye Jin; Lee, Soo Kyoung; Yang, Kyung Moo [Dept. of Forensic Medicine, National Forensic Service, Wonju (Korea, Republic of)

    2015-10-15

    We report the case of a female who died of suspected acute myocardial infarction. Post-mortem CT angiography (PMCTA) was performed with intravascular contrast infusion before the standard autopsy, and it successfully demonstrated the complete thrombotic occlusion of a coronary artery and also a corresponding perfusion defect on myocardium. We herein describe the PMCTA findings of a cardiac death with special emphasis on the potential benefits of this novel CT technique in forensic practice.

  13. An autopsy case of acute cor pulmonale and paradoxical systemic embolism due to tumour cell microemboli in a patient with breast cancer

    OpenAIRE

    Uga, Sayuri; Ikeda, Shuntaro; Matsukage, Sho-ichi; Hamada, Mareomi

    2012-01-01

    A 62-year-old woman was admitted to our hospital because of severe respiratory distress. Diagnostic imaging studies suggested the existence of inexplicable cor pulmonale. Although we immediately sought the aetiology of her severe condition, she died suddenly on the fourth day after admission. Postmortem autopsy revealed tumour cell microemboli in the small pulmonary arteries. In addition, tumour cell embolisation identical to that in primary breast cancer cells was also observed in microvesse...

  14. Verbal autopsy interpretation: a comparative analysis of the InterVA model versus physician review in determining causes of death in the Nairobi DSS

    OpenAIRE

    Kyobutungi Catherine; Oti Samuel O

    2010-01-01

    Abstract Background Developing countries generally lack complete vital registration systems that can produce cause of death information for health planning in their populations. As an alternative, verbal autopsy (VA) - the process of interviewing family members or caregivers on the circumstances leading to death - is often used by Demographic Surveillance Systems to generate cause of death data. Physician review (PR) is the most common method of interpreting VA, but this method is a time- and...

  15. Performance criteria for verbal autopsy-based systems to estimate national causes of death: development and application to the Indian Million Death Study

    OpenAIRE

    Aleksandrowicz, L; Malhotra, V.; Dikshit, R; Gupta, PC; R. Kumar; Sheth, J.; Rathi, SK; Suraweera, W; Miasnikof, P; Jotkar, R; Sinha, D; S Awasthi; Bhatia, P; Jha, P

    2014-01-01

    BACKGROUND Verbal autopsy (VA) has been proposed to determine the cause of death (COD) distributions in settings where most deaths occur without medical attention or certification. We develop performance criteria for VA-based COD systems and apply these to the Registrar General of India's ongoing, nationally-representative Indian Million Death Study (MDS). METHODS Performance criteria include a low ill-defined proportion of deaths before old age; reproducibility, including consistency of...

  16. The quality and diagnostic value of open narratives in verbal autopsy: a mixed-methods analysis of partnered interviews from Malawi

    OpenAIRE

    King, C.; Zamawe, C.; Banda, M.; Bar-Zeev, N; Beard, J; Bird, J.; Costello, A; Kazembe, P.; Osrin, D.; Fottrell, E

    2016-01-01

    Background: Verbal autopsy (VA), the process of interviewing a deceased’s family or caregiver about signs and symptoms leading up to death, employs tools that ask a series of closed questions and can include an open narrative where respondents give an unprompted account of events preceding death. The extent to which an individual interviewer, who generally does not interpret the data, affects the quality of this data, and therefore the assigned cause of death, is poorly documented. We aimed t...

  17. Aplicación del sistema de puntuación del daño múltiple de órganos en autopsias / Application of the scoring system of multiple organ failure at autopsy

    Scientific Electronic Library Online (English)

    Idalmis, Rodríguez Rivera; Teresita, Montero González; José Hurtado, de Mendoza Amat; Pablo Luis, Cabrera Rosell.

    2012-12-01

    Full Text Available Introducción: el estudio sistemático de las autopsias ha permitido caracterizar el daño múltiple de órganos. El sistema de puntuación, comprobado primero en un modelo experimental y adaptado posteriormente a la morfología humana, permite modificar los criterios diagnósticos sobre dicho daño, y por e [...] nde, una interpretación más objetiva del estudio. Objetivo: caracterizar el empleo del referido sistema de puntuación en la práctica del trabajo asistencial para estudiar las autopsias. Métodos: se revisaron las autopsias contenidas en la base de datos del Sistema Automatizado de Registro y Control de Anatomía Patológica para identificar el diagnóstico del daño y reevaluarlos con los criterios actuales. Resultados: la reevaluación de los casos mostró la presencia del daño múltiple de órganos en el 87 % de los casos estudiados, excluyendo al 13 % de este criterio diagnóstico. Conclusiones: el sistema de puntuación para el diagnóstico del daño múltiple de órganos aplicado en la reevaluación de autopsias, permite caracterizar con mayor precisión y objetividad este diagnóstico. Abstract in english Introduction: the systematic study of autopsies has allowed the characterization of multiple organ failure. The scoring system, first tested in experimental and subsequently adapted to human morphology, allows modifying the diagnostic criteria for such damage, and therefore a more objective interpre [...] tation of the study. Objective: To describe the use of this scoring system in practice care to study the autopsies. Methods: The autopsies, contained in the database of the Automated System of Registration and Control of Pathology, were reviewed to identify the diagnosis of the damage and reassess current criteria. Results: Re-assessment of cases showed the presence of multiple organ failure in 87 % of the cases studied, excluding 13 % from this diagnostic criterion. Conclusions: The scoring system for the diagnosis of multiple organ failure, applied for reassessing autopsies allows characterizing this diagnosis much precisely and objectively.

  18. Hepatobiliary alterations in massive biliary ascariasis: histopathological aspects of an autopsy case Lesões hepatobiliares em ascaridíase biliar maciça: aspectos histopatológicos em um caso de autópsia

    OpenAIRE

    Luiz Carlos da Costa Gayotto; Regina Maria Leitão Muszkat; Irene Vieira de Souza

    1990-01-01

    Hepatobiliary alterations found in an autopsy case of massive Biliary Ascariasis, are reported on histological grounds. Severe cholangitis was the main finding, but other changes were also detected, such as pyloric and intestinal metaplasia, hyperplasia of the epithelial lining, with intraductal papillomas and adenomatous proliferation. Remnants of the worm were observed tightly adhered to the epithelium, forming microscopic intrahepatic calculi. Mucopolysaccharides, especially acid, showed t...

  19. The 2002 results of the first series of follow-up studies on Japanese Thorotrast patients and their relationships to autopsy series

    International Nuclear Information System (INIS)

    In 1963, a follow-up study was started on 262 war-wounded Japanese ex-servicemen who had been injected with thorotrast into blood vessels between 1931 and 1945. This first series of our follow-up studies on thorotrast patients covered a total of 71 years from 1931 to the present 2002 survey. It was supplemented in 1979 by another follow-up study called the second or Aichi series performed on other thorotrast-injected war-wounded persons. The 2002 survey of the first series indicated that 5 (1.9%) of 262 thorotrast cases were still alive, while 257 (98.1%) had died. Among 1,630 control war-wounded persons not treated with thorotrast, 348 (21.3%) were still alive and 1,282 (78.7%) had died. In an age-matched control population of 3,999,000 persons, 837,175 (20.9%) were alive and 3,161,825 (79.1%) had died. The life span of thorotrast patients was; thus, markedly shorten (about 18 years, P2 test showed that the incidence of these disorders was significantly higher in the thorotrast group than the control group. From 1945 to 2002, autopsies have been performed on 404 thorotrast-treated-patients - 392 injected with thorotrast by vascular route and 12 injected by other routes. In vascularly injected autopsy cases, 266 liver malignancies (67.9%), 28 liver cirrhoses (7.1%), 12 cancers of extrahepatic bile duct (3.1%), 30 hematopoietic malignancies (7.7%); 2 bone sarcomas (0.5%), 16 lung cancers (4.1%), one hemangiosarcoma of the spleen (0.3%), 4 malignant peritoneal tumors (1.0%), and 7 sarcomas at the injection site (1.8%) were found. The relative risk estimate of liver malignancies and hematopoietic malignancies was significantly higher in the autopsied thorotrast patients than in the autopsied controls. (orig.)

  20. Myocardial contrast defect associated with thrombotic coronary occlusion: Pre-autopsy diagnosis of a cardiac death with post-mortem CT angiography

    International Nuclear Information System (INIS)

    We report the case of a female who died of suspected acute myocardial infarction. Post-mortem CT angiography (PMCTA) was performed with intravascular contrast infusion before the standard autopsy, and it successfully demonstrated the complete thrombotic occlusion of a coronary artery and also a corresponding perfusion defect on myocardium. We herein describe the PMCTA findings of a cardiac death with special emphasis on the potential benefits of this novel CT technique in forensic practice

  1. Release of metals from osteosynthesis implants as a method for identification: post-autopsy histopathological and ultrastructural forensic study.

    Science.gov (United States)

    Palazzo, Elisa; Andreola, Salvatore; Battistini, Alessio; Gentile, Guendalina; Zoja, Riccardo

    2011-01-01

    Metal structures--especially of stainless steel, titanium and their alloys (biomaterials)--are widely used in orthopaedic practice and the subject of constant study in bioengineering and preventive medicine. This study presents the first experience of forensic research into the presence of permanent tissue variations around metal implants in various bone structures for the purpose of identification, with particular reference to skeletal remains or severely decomposed corpses in the absence of other identifying elements. The evaluation was conducted on 12 corpses who had undergone osteosynthesis intra-vitam, whose implants were still in place or had been removed, in comparison with five controls who had never undergone osteosynthesis. Bone fragments taken during autopsy were subjected to histopathological and scanning electron microscope-energy dispersive electroscopy examination in order to reveal and characterise any metal particles originating from osteosynthesis. The study enabled the discovery of intra-bone metal particles in tissues treated by osteosynthesis even in bone areas where the implants had been removed and even where there were no longer any radiological signs of their application. These results are therefore of considerable forensic importance, especially in the area of identification, providing a valid means of recognition beyond that of the well-established use of in situ metal implants. PMID:19956966

  2. Fatal renal failure due to the Chinese herb "GuanMu Tong" (Aristolochia manshuriensis): autopsy findings and review of literature.

    Science.gov (United States)

    Shaohua, Zhu; Ananda, Sunnassee; Ruxia, Yuan; Liang, Ren; Xiaorui, Chen; Liang, Liu

    2010-06-15

    Herbal remedies have been used since ancient times and it is now known that they are not completely free of adverse effects. We present the case of a 41-year-old Chinese man, who died in renal failure because he consumed a herbal preparation called "Fen Qing Wu Lin Wan", having GuanMu Tong as main ingredient, for about 1 month. GuanMu Tong is derived from the plant Aristolochia manshuriensis which contains aristolochic acid. Aristolochic acid is being reported as the causative agent of what is now called aristolochic acid nephropathy (AAN) which includes Chinese herb nephropathy (CHN) and Balkan endemic nephropathy (BEN), all having renal impairment as hallmark for the disease. The gross autopsy showed multiple punctate hemorrhages over the limbs, pleural effusion, and edematous lungs with consolidation, mild myocardial hypertrophy and normal-looking kidneys. Microscopic renal tissue examination showed severe degeneration, necrosis and desquamation of renal tubular epithelial cells, presence of protein cast and a widened, edematous interstitium with interstitial fibrosis. We also provide the clinical presentation of the deceased as reported in the medical records and briefly review the literature pertinent to similar cases. PMID:20193994

  3. Frequency of myocarditis in cases of fatal meningococcal infection in children: observations on 31 cases studied at autopsy

    Directory of Open Access Journals (Sweden)

    Garcia Norma S.

    1999-01-01

    Full Text Available The frequency of myocarditis associated with meningococcal disease in children was reported only in two autopsied series (United States and South Africa. Here we report the frequency of associated myocarditis in 31 children who died of meningoccal infection at Hospital Infantil N.S. da Glória in Vitória, Espirito Santo State, Brazil. The diagnosis was confirmed by isolation of Neisseria meningitidis . At least three sections of fragments of both atria and ventricles were studied using the Dallas Criteria for the morphologic diagnosis of myocarditis. The mean age was 47.6 ± 39.8 months and the mean survival time after the onset of symptoms was 46.1 ± 26.5h (12-112h. Myocarditis was present in 13 (41.9% patients, being of minimal severity in 11 cases and of moderate severity in 2 cases. There were no cases with severe diffuse myocarditis. The frequency of myocarditis was not influenced by sex, presence of meningitis, survival time after the onset of symptoms or use of vasoactive drugs. The frequency of myocarditis reported here was intermediate between the values reported in the only two case series published in the literature (57% in the United States and 27% in South Africa. Although our data confirm the high frequency of myocaditis in meningoccal disease, further investigations are necessary to elucidate the contribution of myocarditis to myocardial dysfunction observed in cases of meningococcal infection in children.

  4. Bone marrow necrosis and fat embolism: an autopsy report of a severe complication of hemoglobin SC disease

    Directory of Open Access Journals (Sweden)

    Fernando Peixoto Ferraz de Campos

    2014-06-01

    Full Text Available Sickle Cell Disease encompasses a group of disorders related with the hemoglobin S and other hemoglobin genotypes. The clinical manifestation and the severity of symptoms are dependent on the specific genotype. In this setting, homozygous genotype (HbSS presents an early onset of symptoms and a low expectancy of lifetime. However, the SC genotype (HbSC, which apparently shows a less severe clinical course, may exhibit the same complications of HbSS. These complications are usually manifested late in the course of life, when compared with the HbSS patients. It is noteworthy that HbSC may present a normal hematocrit, and therefore stays unknown until the first complication, that may be disastrous. The authors report a case of an African-Descendant woman, aging 65 years, with no previous diagnosis of anemia who sought medical attention because of a thoracic back pain followed by fever and altered mental status. The clinical picture deteriorated very fast with multiple organ failure and death. The autopsy findings concluded by generalized vaso-occlusive crisis, bone marrow necrosis and bone marrow and fat embolism, mainly to the lungs and kidney. The authors call attention for the knowledge of this severe life threatening complication, mainly in a country with a high Afro-Descendant population.

  5. An autopsied case of Sjogren's syndrome with massive necrotic and demyelinating lesions of the cerebellar white matter.

    Science.gov (United States)

    Ichikawa, Hiroo; Ishihara, Kenji; Fujimoto, Ryuhachiro; Katoh, Takayuki; Arai, Masanobu; Kawamura, Mitsuru; Nakano, Imaharu

    2004-10-15

    A 69-year-old woman developed subacute cerebellar ataxia and tremors in all four limbs in April 1996. Laboratory examination showed elevated antibodies against Ro and La. Head magnetic resonance imaging showed T(2) high-intensity lesions in the cerebellar white matter bilaterally and later in the pons. In April 2000, she died of multiple organ failure with incidental colon cancer. The autopsy showed atrophic parotid glands with an accumulation of lymphocytes around the ducts, confirming the diagnosis of Sjogren's syndrome histopathologically. The neuropathological examination revealed severe necrotic lesions in the cerebellar white matter bilaterally with several foci of perivenous demyelination in the periphery of the lesions and similar demyelinated areas in the pons. Immunohistochemistry with anti-JC virus antibody demonstrated no positive inclusions. A single focus of granulomatous arteritis was observed in one subarachnoid artery. The combination of Sjogren's syndrome, granulomatous angitis, and foci of perivenous demyelination suggests that an autoimmune mechanism played an important role in causing the necrotic lesions in the cerebellar white matter in this case. PMID:15465098

  6. Comparison of methods in the recovery of nucleic acids from archival formalin-fixed paraffin-embedded autopsy tissues.

    Science.gov (United States)

    Okello, John B A; Zurek, Jaymi; Devault, Alison M; Kuch, Melanie; Okwi, Andrew L; Sewankambo, Nelson K; Bimenya, Gabriel S; Poinar, Debi; Poinar, Hendrik N

    2010-05-01

    Archival formalin-fixed paraffin-embedded (FFPE) human tissue collections are typically in poor states of storage across the developing world. With advances in biomolecular techniques, these extraordinary and virtually untapped resources have become an essential part of retrospective epidemiological studies. To successfully use such tissues in genomic studies, scientists require high nucleic acid yields and purity. In spite of the increasing number of FFPE tissue kits available, few studies have analyzed their applicability in recovering high-quality nucleic acids from archived human autopsy samples. Here we provide a study involving 10 major extraction methods used to isolate total nucleic acid from FFPE tissues ranging in age from 3 to 13years. Although all 10 methods recovered quantifiable amounts of DNA, only 6 recovered quantifiable RNA, varying considerably and generally yielding lower DNA concentrations. Overall, we show quantitatively that TrimGen's WaxFree method and our in-house phenol-chloroform extraction method recovered the highest yields of amplifiable DNA, with considerable polymerase chain reaction (PCR) inhibition, whereas Ambion's RecoverAll method recovered the most amplifiable RNA. PMID:20079706

  7. A retrospective autopsy study of histopathologic spectrum and etiologic trend of fulminant hepatic failure from north India

    Directory of Open Access Journals (Sweden)

    Jain Deepali

    2007-07-01

    Full Text Available Abstract Background Fulminant hepatic failure (FHF is rapidly fatal and liver transplant is the treatment of choice. The condition is known for its heterogeneity of defining criteria, clinical presentation, histologic spectrum and etiologic factors. The etiology of FHF varies widely, some of which includes viral hepatitis, drug overdose and idiosyncratic drug reactions. The identification of the etiology of FHF is critically important, because it influences the management. A histopathological classification of FHF has not been reported earlier in the literature. Methods The current study was conducted retrospectively on 224 autopsies at a tertiary care hospital in India. In all of these cases the liver was examined grossly and microscopically. Clinical findings, serological data and immunohistochemical findings were correlated with the morphological subtypes and a consensus morphological classification was formulated. Results Young females, especially those in the reproductive age group were most susceptible to the disease. Hepatotropic viruses and drugs were the likely causes in most of the patients. Clinical presentation is important, as delayed onset of encephalopathy or the subacute FHFs lead to maximum mortality. After careful gross and microscopic examination the morphological findings of FHF were divided into four distinct categories. Histologic typing can sometimes be misleading if solely made on H & E slides without application of special stains. Conclusion Fulminant hepatic failure is a medical emergency, proper histological categorization can help in deciding the treatment modalities.

  8. Autopsy studies of Hashimoto's thyroiditis in Hiroshima and Nagasaki (1954-1974): relation to atomic bomb radiation

    Energy Technology Data Exchange (ETDEWEB)

    Asano, M. (Radiation Effects Research Foundation, Hiroshima, Japan); Norman, J.E. Jr.; Kato, H.; Yagawa, K.

    1978-01-01

    The authors examined 155 autopsy cases of Hashimoto's thyroiditis in the Life Span Study sample including both A-bomb survivors and controls in Hiroshima and Nagasaki (1954 to 1974). Hashimoto's thyroiditis was classified into lymphoid, diffuse and fibrous types and the following results were obtained. No difference existed in the effects of A-bomb radiation in the incidence and ATB. The ratio of males to females did not reveal statistical significance, even though reversed ratio was noted in the high dose group. The variation of thyroid gland weight in T65 dose or by variant showed no significant pattern, even though the smallest average weight was found in the highest radiation exposure group. The complications in the patients with Hashimoto's thyroiditis were noted to have high prevalance of ovarian cancer and low prevalence of stomach cancer and total cancer. Only two patients with Hashimoto's thyroiditis were found to be complicated with thyroid carcinoma. Among collagen diseases, the prevalence of rheumatic fever and rheumatoid arthritis was high as complication. And the prevalence of combined diseases suggested that no late effect of A-bomb radiation existed.

  9. Relation of radiation of gastric carcinoma obserbed in autopsy cases in a fixed population Hiroshima and Nagasaki

    International Nuclear Information System (INIS)

    The relationship between exposure dose and the occurrence of stomach cancer, especially the histological type of the cancer was studied in 535 autopsy cases which has died of stomach cancer from 1961 to 1974 in the Radiation Effect Research Foundation. The incidence of stomach cancer tended to be higher in the group with high exposure dose in Hiroshima, and only in the group with 300 - 399 rads in Nagasaki. The relationship between the incidence of stomach cancer by age at the exposure and the exposure dose was studied by the relative risk (200-499 rads/ 0 rads) of the incidence of stomach cancer by age. The relative risk was 1.56 in the group which had been more than 50 years old at exposure in both Hiroshima and Nagasaki. The risk of stomach cancer was higher in more aged persons at the exposure. From the aspect of the relationship between histological type of stomach cancer and exposure dose, the incidence of intestinal type or diffuse type tended to be higher in the persons who had much more doses. Because there were small number of cases, there was no statistically significant differences between the incidence of stomach cancer and the exposure dose. (Serizawa, K.)

  10. [Autopsy case of von Recklinghausen's disease associated with lung cancer, gastrointestinal stromal tumor of the stomach, and duodenal carcinoid tumor].

    Science.gov (United States)

    Satoh, Miki; Wakabayashi, Osamu; Araya, Yoshikazu; Jinushi, Eisei; Yoshida, Fumiaki

    2009-09-01

    A 58-year-old man with von Recklinghausen's disease was admitted for further investigation of right chest pain. Chest X-ray revealed multiple emphysematous bullae in both lungs and a tumor shadow in the right upper lobe. Bronchofiberscopy was performed, but an adequate specimen was not obtained. The tumor was diagnosed as a non-small-cell lung cancer with direct invasion to the adjacent rib. Although chemotherapy and radiotherapy resulted in decrease in tumor size, the tumor subsequently increased in size and the patient died 14 months after the first admission. Autopsy revealed multiple emphysematous bullae, poorly differentiated adenosquamous cell carcinoma of the lung, gastrointestinal stromal tumor of the stomach, and duodenal carcinoid tumor. This case suggests the possibility that von Recklinghausen's disease associated with emphysematous bullae is a risk factor for lung cancer. It has also been suggested that the genetic abnormality responsible for von Recklinghausen's disease increases the risk for various types of malignancy. Although von Recklinghausen's disease is reportedly associated with various malignant tumors, it is quite rare for von Recklinghausen's disease to be associated with triple non-neurogenic tumors. Careful observation is mandatory for patients with von Recklinghausen's disease. PMID:19827584

  11. Intrahepatic cholangiocarcinoma in a worker at an offset color proof-printing company: An autopsy case report.

    Science.gov (United States)

    Tomimaru, Yoshito; Kobayashi, Shogo; Wada, Hiroshi; Hama, Naoki; Kawamoto, Koichi; Eguchi, Hidetoshi; Kira, Toshihiko; Morii, Eiichi; Doki, Yuichiro; Mori, Masaki; Nagano, Hiroaki

    2015-04-01

    A 40-year-old Japanese man visited our hospital after test results indicated elevated hepatobiliary enzymes. He had worked at a printing plant for 8 years and been exposed to organic solvents, including 1,2-dichloropropane (1,2-DCP) and dichloromethane (DCM). Abdominal computed tomography (CT) showed an intrahepatic tumor with dilation of the intrahepatic bile duct. He was diagnosed with intrahepatic cholangiocarcinoma. He had no known risk factors for cholangiocarcinoma. Extended left hepatectomy with lymph node dissection was performed and the tumor was histologically diagnosed as well-differentiated adenocarcinoma. A histological examination also showed biliary intraepithelial preneoplastic lesions in non-cancerous liver areas. Two years after surgery, the patient developed jaundice, esophageal varices and ascites. A CT examination showed liver cirrhosis without recurrence of the cholangiocarcinoma. Although a liver transplantation was planned as a therapeutic option for his liver cirrhosis, his liver failure progressed rapidly and he died before transplantation could be performed. At autopsy, fibrosis was found in the whole liver, especially in the wall of the bile duct and periductal area suggesting chronic bile duct injury due to exposure to organic solvents. Taken together, the current case may suggest that exposure to organic solvents, including 1,2-DCP and DCM, is a risk factor for cholangiocarcinoma. Identifying risk factors for cholangiocarcinoma will help identify the mechanism and help prevent development of the disease. PMID:24849871

  12. [Autopsy case of pulmonary zygomycosis and pneumocystis pneumonia in a patient with interstitial pneumonia treated by corticosteroid therapy].

    Science.gov (United States)

    Mukasa, Yosuke; Ichiyasu, Hidenori; Akaike, Kimitaka; Okamoto, Shinichiro; Komohara, Yoshihiro; Kohrogi, Hirotsugu

    2010-11-01

    We report a 75-year-old man with pneumoconiosis, interstitial pneumonia and diabetes mellitus, who had carcinoma of the buccal mucosa. After resection of the carcinoma, he was given corticosteroids for the deterioration of interstitial pneumonia, but 38 days after initiating steroid therapy, he was admitted to our hospital with severe hypoxemia and multiple cavitary lesions superimposed on ground-glass attenuation in both lung fields. The Aspergillus antigen was positive in his serum and examination of his bronchoalveolar lavage (BAL) fluid revealed mixed infections with filamentous fungus and Pneumocystis jirovecii. Pulmonary aspergillosis and pneumocystis pneumonia with an immunocompromised state was diagnosed, and voriconazole, sulfamethoxazole-trimethoprim and high-dose corticosteroids were given. At 20 days after these treatments he developed bloody sputum, and Cunninghamella bertholletiae was isolated from the BAL fluid obtained at admission. A diagnosis of pulmonary zygomycosis was finally established. Amphotericin B therapy was started, and the dose was increased thereafter. Despite intensive treatment he died 18 days later. Histological examination of lung tissue obtained at autopsy showed invasive growth of zygomycetes in the necrotic tissue and the cavity wall. To the best of our knowledge, this is the first report of concurrent Cunninghamella bertholletiae and Pneumocystis jirovecii infection during steroid therapy for interstitial pneumonia. PMID:21141065

  13. LA AUTOPSIA PSICOLÓGICA COMO INSTRUMENTO DE INVESTIGACIÓN PSYCHOLOGYCAL AUTOPSY AS AN INVESTIGATION TOOL

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    IVÁN ALBERTO JIMÉNEZ ROJAS

    2001-09-01

    Full Text Available Se define el concepto de autopsia psicológica desde su origen en los años cincuenta en California cuando empezó a utilizarse buscando un acercamiento a la comprensión de las circunstancias que rodearon la muerte de un individuo, investigando retrospectivamente sus características de personalidad y las condiciones que tuvo en vida. Se establecen las características del método y su utilidad en psiquiatría clínica y en psiquiatría forense, siendo relevante su aplicación en psiquiatría forense, siendo relevante su aplicaci ón potencial en el diseño de políticas de promoción de la salud y prevención de suicidio, homicidio o accidentes. Finalmente se resumen algunos resultados obtenidos mediante su aplicación en el Instituto Nacional de Medicina Legal y Ciencias Forenses de Colombia.From its origins in California, in the fifties, the concept of psychological autopsy is defined. Understand of circunstances around the death of an individual, along with the study of his or her distinctive personality traits and life condition constitute its aim. Method characteristics and its usefulness in clinical forensic psychiatry, and accidents programs in suicide, homicide and accidents are established. Finally, some results in the National Institute of Legal Medicine and Forensic of Colombia are here presented.

  14. Sample registration of vital events with verbal autopsy: a renewed commitment to measuring and monitoring vital statistics

    Directory of Open Access Journals (Sweden)

    Philip W. Setel

    2005-08-01

    Full Text Available Registration of births, recording deaths by age, sex and cause, and calculating mortality levels and differentials are fundamental to evidence-based health policy, monitoring and evaluation. Yet few of the countries with the greatest need for these data have functioning systems to produce them despite legislation providing for the establishment and maintenance of vital registration. Sample vital registration (SVR, when applied in conjunction with validated verbal autopsy procedures and implemented in a nationally representative sample of population clusters represents an affordable, cost-effective, and sustainable short- and medium-term solution to this problem. SVR complements other information sources by producing age-, sex-, and cause-specific mortality data that are more complete and continuous than those currently available. The tools and methods employed in an SVR system, however, are imperfect and require rigorous validation and continuous quality assurance; sampling strategies for SVR are also still evolving. Nonetheless, interest in establishing SVR is rapidly growing in Africa and Asia. Better systems for reporting and recording data on vital events will be sustainable only if developed hand-in-hand with existing health information strategies at the national and district levels; governance structures; and agendas for social research and development monitoring. If the global community wishes to have mortality measurements 5 or 10 years hence, the foundation stones of SVR must be laid today.

  15. Sclerosing encapsulating peritonitis (abdominal cocoon) associated with liver cirrhosis and diffuse large B-cell lymphoma: autopsy case.

    Science.gov (United States)

    Yamada, Sohsuke; Tanimoto, Akihide; Matsuki, Yasumasa; Hisada, Yuji; Sasaguri, Yasuyuki

    2009-09-01

    A case of sclerosing encapsulating peritonitis (SEP) associated with liver cirrhosis (LC) and complicated by diffuse large B-cell lymphoma (DLBCL) is reported herein. A 49-year-old Japanese man had undergone peritoneo-venous shunt against refractory ascites due to hepatitis C virus-positive uncompensated LC for 2 years. After he received a diagnosis of DLBCL of the left neck lymph node 3 months before his death, palliative care was given because of his poor general condition. He developed severe abdominal distention and pain over 1 week and was found to have marked ascites and whole bowel lumped together on abdominal CT. At autopsy, the peritoneum was covered with a thick white membrane and the bowel could not be distinguished, which was macroscopically characterized by a cocoon-like appearance. Histology indicated a proliferation of diffusely thickened or hyalinized fibrocollagenous tissue in the entire peritoneum with a slight chronic inflammatory infiltrate and without remarkable change of mucosa. A diagnosis of SEP, also known as abdominal cocoon, was established based on these features. Additionally, in the abdominal cavity, a large amount of serous ascites and multiple peritoneal nodules or masses involved by DLBCL were recognized. To the authors' knowledge this is the first case report of SEP associated with LC and complicated by the invasion of DLBCL in the abdominal cavity. PMID:19712139

  16. The effects of aging on biceps brachii muscle fibers: a morphometrical study from biopsies and autopsies Efeitos do envelhecimento sobre as fibras do músculo biceps braquial: estudo morfométrico em biópsias e autópsias

    OpenAIRE

    Ana Cláudia Mattiello-Sverzut; Leila Chimelli; Maria Silvia de Assis Moura; Silvia Teixeira; José Alberto Mello de Oliveira

    2003-01-01

    OBJECTIVES: In order to study the morphology and size of muscle fibers, cross sections of biceps brachii samples from autopsies, up to 9 hours after death, and biopsies of 72 subjects were compared. The subjects aged 13 to 84 years in both sexes. METHODS: The samples obtained from autopsies (n=47) were from subjects with sudden death, or who died after acute disease without evidence of neuromuscular involvement. The biopsies (n=25) were from patients with symptoms suggestive of inflammatory o...

  17. Comparative study of abnormalities of central nervous system in children and adults autopsied after bone marrow transplantation Estudo comparativo das alterações no sistema nervoso central de crianças e adultos autopsiados após transplante de medula óssea

    OpenAIRE

    Paulo R. Benites Filho; Luis G. M. Pinto de Almeida; José Zanis Neto; Ricardo Pasquini; LUIZ F. BLEGGI-TORRES

    2007-01-01

    BACKGROUND: We compare neuropathological abnormalities in children and adults after bone marrow transplantation (BMT) by means of autopsy in the Department of Medical Pathology, Universidade Federal do Paraná (UFPR), Brazil. METHODS: Autopsy reports of 180 patients were reviewed. They were divided in two groups: patients under 15 years old and those 15 or older. Age, gender, clinical diagnosis at time of BMT, survival time, neuropathological abnormalities and cause of death were analyzed. RES...

  18. Pathology image of the month. Black esophagus detected at autopsy in a patient with abdominal pain and bloody diarrhea. DIAGNOSIS: Acute esophageal necrosis, ischemic and pseudomembranous colitis.

    Science.gov (United States)

    Tsao, Christin; Thomas, Louise; McGoey, Robin R

    2014-01-01

    A 73-year-old African-American male was transported to the emergency department due to what emergency personnel described as "coffee ground emesis." He was pronounced dead shortly after arrival. An unlimited autopsy examination was conducted under authorization of the coroner's office. Medical record review revealed that the decedent had been discharged from the hospital just one day prior to his death following a three-day admission for abdominal pain, bloody diarrhea, and a 22-lb unintentional weight loss. Medical history documented hypertension, chronic obstructive lung disease, and a 57-pack-year smoking history. Alcohol abuse was also endorsed, but cessation of use was reported six months prior. During that admit, he was treated for volume-depletion, a urinary tract infection, and suspected infective colitis with antibiotics. Symptoms had resolved on hospital day three, and the patient was discharged home with a two-week course of ciprofloxacin and metronidazole and a follow-up colonoscopy appointment in one month. At the time of autopsy, the decedent was described as cachectic. Figure 1a shows the decedent's esophagus, opened longitudinally. Figure 1b shows the corresponding histology from the esophagus. Other findings documented at autopsy included ischemic bowel disease in the descending colon with patchy superimposed pseudomembranous colitis, emphysematous change, papillary renal cell carcinoma of the right kidney, microscopic prostatic adenocarcinoma, hepatic fibrosis, and intact hepatic hemangiomata. PMID:25311465

  19. An autopsied case of human chorionic gonadotropin (HCG)-producing lung cancer accompanied by bilateral radiation pneumonitis due to small doses of irradiation

    International Nuclear Information System (INIS)

    An autopsied case of human chorionic gonadotropin (HCG)-producing lung cancer accompanied by bilateral radiation pneumonitis is reported. A 68 year-old male was admitted to our hospital because of an abnormal shadow in his chest x-ray. Lung cancer was diagnosed and treated with radiotherapy. The radiotherapy (1,200 cGy) was discontinued, however because his general condition deteriorated. Chest x-rays then showed a pneumonia-like shadow in the projected field of irradiation. The same shadow was observed in the contralateral lung field one month later. Gynecomastia and an elevated level of serum HCG were noticed during hospitalization. The patient died and an autopsy was performed. Histopathological examination upon autopsy confirmed a large cell carcinoma of the lung which stained positively for HCG with an immunoenzyme labelling technique using the PAP method. Marked fibrosis and thickening of the alveolar septae were histologically demonstrated in the projected field of irradiation and the contralateral field where chest x-rays showed the pneumonia-like shadow. (author)

  20. An autopsied case of human chorionic gonadotropin (HCG)-producing lung cancer accompanied by bilateral radiation pneumonitis due to small doses of irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Tano, Yoshihiko; Adachi, Michifumi; Kimura, Makoto; Matsushima, Toshiharu; Torii, Takashi (Kawasaki Medical School, Kawasaki Hospital, Okayama (Japan))

    1990-07-01

    An autopsied case of human chorionic gonadotropin (HCG)-producing lung cancer accompanied by bilateral radiation pneumonitis is reported. A 68 year-old male was admitted to our hospital because of an abnormal shadow in his chest x-ray. Lung cancer was diagnosed and treated with radiotherapy. The radiotherapy (1,200 cGy) was discontinued, however because his general condition deteriorated. Chest x-rays then showed a pneumonia-like shadow in the projected field of irradiation. The same shadow was observed in the contralateral lung field one month later. Gynecomastia and an elevated level of serum HCG were noticed during hospitalization. The patient died and an autopsy was performed. Histopathological examination upon autopsy confirmed a large cell carcinoma of the lung which stained positively for HCG with an immunoenzyme labelling technique using the PAP method. Marked fibrosis and thickening of the alveolar septae were histologically demonstrated in the projected field of irradiation and the contralateral field where chest x-rays showed the pneumonia-like shadow. (author).

  1. Comparing verbal autopsy cause of death findings as determined by physician coding and probabilistic modelling: a public health analysis of 54?000 deaths in Africa and Asia

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    Peter Byass

    2015-06-01

    Full Text Available Background: Coverage of civil registration and vital statistics varies globally, with most deaths in Africa and Asia remaining either unregistered or registered without cause of death. One important constraint has been a lack of fit–for–purpose tools for registering deaths and assigning causes in situations where no doctor is involved. Verbal autopsy (interviewing care–givers and witnesses to deaths and interpreting their information into causes of death is the only available solution. Automated interpretation of verbal autopsy data into cause of death information is essential for rapid, consistent and affordable processing. Methods: Verbal autopsy archives covering 54182 deaths from five African and Asian countries were sourced on the basis of their geographical, epidemiological and methodological diversity, with existing physician–coded causes of death attributed. These data were unified into the WHO 2012 verbal autopsy standard format, and processed using the InterVA–4 model. Cause–specific mortality fractions from InterVA–4 and physician codes were calculated for each of 60 WHO 2012 cause categories, by age group, sex and source. Results from the two approaches were assessed for concordance and ratios of fractions by cause category. As an alternative metric, the Wilcoxon matched–pairs signed ranks test with two one–sided tests for stochastic equivalence was used. Findings: The overall concordance correlation coefficient between InterVA–4 and physician codes was 0.83 (95% CI 0.75 to 0.91 and this increased to 0.97 (95% CI 0.96 to 0.99 when HIV/AIDS and pulmonary TB deaths were combined into a single category. Over half (53% of the cause category ratios between InterVA–4 and physician codes by source were not significantly different from unity at the 99% level, increasing to 62% by age group. Wilcoxon tests for stochastic equivalence also demonstrated equivalence. Conclusions: These findings show strong concordance between InterVA–4 and physician–coded findings over this large and diverse data set. Although these analyses cannot prove that either approach constitutes absolute truth, there was high public health equivalence between the findings. Given the urgent need for adequate cause of death data from settings where deaths currently pass unregistered, and since the WHO 2012 verbal autopsy standard and InterVA–4 tools represent relatively simple, cheap and available methods for determining cause of death on a large scale, they should be used as current tools of choice to fill gaps in cause of death data.

  2. Traumatic brain injury as a risk factor for Alzheimer disease. Comparison of two retrospective autopsy cohorts with evaluation of ApoE genotype

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    Wrocklage Christian

    2001-07-01

    Full Text Available Abstract Background and Purpose The impact of traumatic brain injury (TBI on the pathogenesis of Alzheimer disease (AD is still controversial. The aim of our retrospective autopsy study was to assess the impact of TBE and ApoE allele frequency on the development of AD. Material and Methods We examined 1. the incidence of AD pathology (Braak stageing, CERAD, NIA-Reagan Institute criteria in 58 consecutive patients (mean age ± SD 77.0 ± 6.8 years with residual closed TBI lesions, and 2. the frequency of TBI residuals in 57 age-matched autopsy proven AD cases. In both series, ApoE was evaluated from archival paraffin-embedded brain material. Results 1. TBE series: 12.1 % showed definite and 10.3% probable AD (mean age 77.6 and 75.2 years, only 2/13 with ApoEε3/4. From 45 (77.6% non-AD cases (mean age 78.2 years, 3 had ApoEε3/4. The prevalence of 22.4% AD in this small autopsy cohort was significantly higher than 3.3% in a recent large clinical series and 14% in the general population over age 70. 2. In the AD cohort with ApoEε4 allele frequency of 30% similar to other AD series, residuals of closed TBI were seen in 4 brains (7% (mean age ± SD 78.2 ± 6.4, all lacking the ApoEε4 allele. TBI incidence was slightly lower than 8.5% in the clinical MIRAGE study. Conclusions The results of this first retrospective autopsy study of TBI, ApoEε allele frequency, and AD confirm clinical studies suggesting severe TBI to be a risk factor for the development AD higher in subjects lacking ApoEε4 alleles. Further studies in larger autopsy series are needed to elucidate the relationship between TBI, genetic predisposition, and AD.

  3. Cerebral and cardiac amyloidosis in autopsied elderly individuals / Beta-fibrilose encefálica e cardíaca em idosos autopsiados

    Scientific Electronic Library Online (English)

    Lucas Martins de Exel, Nunes; Ana Karina Marques, Salge; Flávia Aparecida de, Oliveira; Vicente de Paula A., Teixeira; Marlene Antônia dos, Reis.

    2006-04-01

    Full Text Available RESUMO INTRODUÇÃO: A amiloidose em idosos pode ser uma alteração independente e própria do envelhecimento. Entretanto, as características clínicas, fisiopatológicas e bioquímicas da Amiloidose relacionada à idade ainda permanecem incertas. OBJETIVO: Verificar se o coração e o encéfalo de indivíduos [...] acima de 60 anos apresentavam depósito amilóide. MATERIAL E MÉTODOS: Foram estudados laudos consecutivos de autópsias de indivíduos acima de 60 anos realizadas entre 1976 e 2000, que apresentavam corações sem cardiopatias, com sorologia negativa para Doença de Chagas e encéfalos sem alterações morfológicas de encefalopatias, chegando a um n de 10 casos. Lâminas de fragmentos do coração e de encéfalo foram processadas e analisadas em microscopia de luz comum e polarizada. RESULTADOS: Dos 10 casos, 3 apresentaram depósito amilóide no encéfalo e 1 no encéfalo e no coração. Em 50% dos casos, os indivíduos tinham entre 60 e 69 anos. A relação entre o peso encefálico e o peso corporal mostrou ter uma associação significativa com os casos positivos, sendo esta menor em relação aos negativos. CONCLUSÃO: A análise conjunta de depósitos amilóides em encéfalo e coração de indivíduos idosos talvez direcione para um acometimento sistêmico comum ao envelhecimento natural. Alguma alteração adicional do organismo poderia determinar a quebra de um equilíbrio natural sobre o acúmulo dessas proteínas, levando dessa forma aos contextos patológicos da amiloidose. Abstract in english INTRODUCTION: Amyloidosis in elderly individuals can be an independent alteration and a characteristic of aging. However, the clinical, pathophysiologic, and biochemical characteristics of amyloidosis related to age remain uncertain. OBJECTIVE: The purpose of this study was to determine the extent t [...] o which the heart and/or the brain of individuals aged 60 years or over exhibits amyloid deposits. MATERIALS AND METHODS: The autopsy findings of individuals who were at least 60 years old were studied. The autopsies took place between the years of 1976 and 2000. A total of 10 cases were selected that had hearts without cardiopathies, had negative serology for Chagas' disease, and had brains without morphological changes related to encephalopathies. Slides with fragments of heart and brain were processed and analyzed using polarized and common light microscopy. RESULTS: Of the 10 cases, 4 were positive for amyloidosis. All had positive findings in the brain, and 1 case also had positive findings in the heart. Among the positive cases, 50% were of people aged 60 to 69 years. There appeared to be a relationship between the presence of amyloid deposits and the ratio of brain and body weight, with the ratio in the positive cases being smaller than in the negative cases. CONCLUSIONS: The analysis of amyloid deposits in the brains and hearts of elderly individuals shows that such deposits may lead to a systemic attack of senility, common to natural aging. It is not certain that beta-amyloid deposits would alone bring such drastic repercussions to the individual. Some additional disorders of the organism could cause the breakdown of the natural balance related to the accumulation of these proteins, leading the way to the pathological contexts of amyloidosis.

  4. Targeted next generation sequencing application in cardiac channelopathies: Analysis of a cohort of autopsy-negative sudden unexplained deaths.

    Science.gov (United States)

    Farrugia, A; Keyser, C; Hollard, C; Raul, J S; Muller, J; Ludes, B

    2015-09-01

    Genetic testing for cardiac channelopathies in sudden unexplained death (SUD) has developed substantially over the last years. The Next Generation Sequencing (NGS) technology provides an unprecedented opportunity to screen for genetic variations underlying arrhythmogenic genes in a short period of time at a low cost. The present study aimed to perform genetic testing with NGS technologies on the Ion Torrent Personal Genome Machine™ (Ion PGM™) sequencer, in targeting a total of 23 genes reported to be associated with inherited cardiac channelopathies in order to identify the possible cause of death in a cohort of post-mortem cases. The molecular analyses focused on 16 cases of SUD, aged less than 35 years old. In all cases, the cause of death could not be determined after a rigorous autopsy associated with histopathological and toxicological analyses according to the guidelines of the Association for European Cardiovascular Pathology. DNA was extracted from fresh frozen tissue. An average of 200 variants was identified per case. However, after the prioritization process using a new scoring program (VaRank) and after the conjunction of clinical data and molecular findings, four "likely pathogenic" variants (including two undescribed variants), were identified in three cases (18.75%) of our cohort in the genes KCNH2, ANK2, SCN5A and RYR2. One case, who died during psychiatric hospitalization after administration of a QT prolonging drug, showed a double "likely pathogenic" variant in Long QT genes (ANK2 and SCN5A) which may have predisposed to drug-induced cardiac arrhythmias. Our study illustrates that the NGS approach based on AmpliSeq™ libraries and Ion Torrent PGM™ sequencing may be an efficient approach, integrated to post-mortem examination. Given the massive amount of information generated by NGS, a rigorous filtration strategy of variants coupled with multidisciplinary collaboration is crucial to determine the potential pathogenic role of identified variants in the cause of death. PMID:26164358

  5. Revealing the burden of maternal mortality: a probabilistic model for determining pregnancy-related causes of death from verbal autopsies

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    Desta Teklay

    2007-02-01

    Full Text Available Abstract Background Substantial reductions in maternal mortality are called for in Millennium Development Goal 5 (MDG-5, thus assuming that maternal mortality is measurable. A key difficulty is attributing causes of death for the many women who die unaided in developing countries. Verbal autopsy (VA can elicit circumstances of death, but data need to be interpreted reliably and consistently to serve as global indicators. Recent developments in probabilistic modelling of VA interpretation are adapted and assessed here for the specific circumstances of pregnancy-related death. Methods A preliminary version of the InterVA-M probabilistic VA interpretation model was developed and refined with adult female VA data from several sources, and then assessed against 258 additional VA interviews from Burkina Faso. Likely causes of death produced by the model were compared with causes previously determined by local physicians. Distinction was made between free-text and closed-question data in the VA interviews, to assess the added value of free-text material on the model's output. Results Following rationalisation between the model and physician interpretations, cause-specific mortality fractions were broadly similar. Case-by-case agreement between the model and any of the reviewing physicians reached approximately 60%, rising to approximately 80% when cases with a discrepancy were reviewed by an additional physician. Cardiovascular disease and malaria showed the largest differences between the methods, and the attribution of infections related to pregnancy also varied. The model estimated 30% of deaths to be pregnancy-related, of which half were due to direct causes. Data derived from free-text made no appreciable difference. Conclusion InterVA-M represents a potentially valuable new tool for measuring maternal mortality in an efficient, consistent and standardised way. Further development, refinement and validation are planned. It could become a routine tool in research and service settings where levels and changes in pregnancy-related deaths need to be measured, for example in assessing progress towards MDG-5.

  6. [An autopsy case of complicated form of spastic paraplegia with amyotrophy, mental deficiency, sensory impairment, and parkinsonism].

    Science.gov (United States)

    Iwabuchi, K; Yagishita, S; Amano, N; Yokoi, S; Honda, H; Tanabe, T; Kinoshita, J; Kosaka, K

    1990-11-01

    An autopsied case of complicated form of spastic paraplegia with many unusual clinical and pathological features is reported. Present case: a 31-year-old male. His parents are first cousins. Pregnancy and delivery had been unremarkable. Though he was mentally retarded, his physical development was normal. He was considered normal until age 10. He suffered from progressive disturbance in gait at the age of 11. He could not walk without assistance at the age of 22. Neurological examination revealed the following findings. He was obese and mentally deteriorated. Spastic paraplegia with increased tendon reflexes and pathological reflexes was prominent. Though slight sensory disturbance was present in the lower extremities, neither involuntary movement nor cerebellar ataxia was observed. In the age of late 20's, dementia, general muscular atrophy, and Parkinsonism developed. At the age of 30, he could not move by himself. He was apathic and indifferent, and showed forced laughing. Muscle tonus was flaccid because of general muscular atrophy and peripheral neuropathy. He died of acute gastric enlargement. Neuropathological findings were characterized by mal-development of the central nervous system (CNS) and the multisystem degeneration. There existed cerebral white matter hypoplasia with hypogenesis of the corpus callosum and ectopia of neurons of the cerebral and cerebellar cortex. Hypoplasia of melanin pigment was also observed in the remaining neurons of the substantia nigra and the locus ceruleus. Many neurons in the CNS included lipofuscin granules of variable shapes. Some of them showed clusters of several block-like inclusions which were green with luxol fast blue and cresyl violet stain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2076353

  7. Verbal autopsy: an analysis of the common causes of childhood death in the Barekese sub-district of Ghana

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    Stephen Manortey

    2011-05-01

    Full Text Available The availability of mortality data for any society plays an essential role in health monitoring and evaluation, as well as in the design of health interventions. However, most resource-poor countries such as Ghana have no reliable vital registration system. In these instances, verbal autopsy (VA may be used as an alternative method to gather mortality data. In rural Ghana, the research team utilized a VA questionnaire to interview caretakers who were present with a child under the age of five prior to death. The data was given to two physicians who independently assigned the most probable cause of death for the child. A third, blinded physician analyzed the data in the cases where the first two physicians disagreed. When there was agreement between physicians, this was assigned as the cause of death for the individual child. During the study period, we recorded 118 deaths from 92 households. Twenty-nine (24.6% were neonatal deaths with the leading causes of death being neonatal sepsis, birth asphyxia and pneumonia. The remaining 89 (75.4% were post-neonatal deaths with the most common causes of death being pneumonia, malaria and malnutrition. While 63/118 (53.4% deaths occurred in the home, there is no statistically significant relationship between the location of the home and the time of travel to the nearest health facility (P=0.132. VA is an important epidemiological tool for obtaining mortality data in communities that lack reliable vital registration systems. Improvement in health care is necessary to address the large number of deaths occurring in the home.

  8. Suicidio y género en Antioquia (Colombia): estudio de autopsia psicológica / Suicide and Gender in Antioquia (Colombia): A Psychological Autopsy Study

    Scientific Electronic Library Online (English)

    Andrea, González; Ángela, Rodríguez Betancur; Alejandro, Aristizábal; Jenny, García Valencia; Carlos, Palacio; Carlos, López Jaramillo.

    2010-06-01

    Full Text Available Objetivo: Identificar diferencias en las características sociodemográficas y clínicas entre hombres y mujeres suicidas en una muestra de Antioquia (Colombia). Método: Se estudiaron mediante autopsia psicológica 144 sujetos que se habían suicidado entre 2006 y 2007. Se determinaron las diferencias en [...] tre suicidas por sexos y las características que se asociaron de manera independiente con ser hombre o mujer. Resultados: Se identificaron diferencias significativas independientes del sexo. La manera de muerte con arma de fuego, vivir solo y suicidio bajo efectos del alcohol se asociaron con el sexo masculino; mientras, el suicidio en casa y dejar una nota previa se asociaron con el sexo femenino. Conclusiones: El presente estudio, realizado en población antioqueña, identificó diferencias en variables sociodemográficas, clínicas y características del acto suicida entre hombres y mujeres. A Zesar de las limitaciones, los presentes hallazgos apuntan hacia la posibilidad de realizar intervenciones de salud mental de prevención del suicidio de mayor especificidad teniendo en cuenta el sexo de la población. Abstract in english Objective: To identify differences in the socio-demographic and clinical characteristics between suicidal men and women in a sample from Antioquia (Colombia). Method: 144 subjects who committed suicide between 2006 and 2007 were studied by means of a psychological autopsy. Gender differences and cha [...] racteristics associated independently to being a man or a woman were determined. Results: Significant differences independent of sex were identified. Death by firearm, living alone and suicide under the effects of alcohol intoxication were associated with the male gender, whereas suicide at home and leaving a note were associated with the female gender. Conclusions: The present study identified differences in socio-demographic and clinical variables, and characteristics of the suicide act, between men and women. In spite of its limitations, the present findings point towards the possibility of carrying out more specific actions in suicide prevention by taking gender into account.

  9. Combining diagnostic categories to improve agreement between death certificate and autopsy classifications of cause of death for atomic bomb survivors, 1950-87

    International Nuclear Information System (INIS)

    Several investigators have observed less-than-desirable agreement between death certificate diagnoses and autopsy diagnoses for most specific causes of death, and even for some causes grouped by major disease category. Our results from data on 5130 autopsies of members of the Life Span Study cohort of atomic bomb survivors in Hiroshima and Nagasaki conducted prior to September 1987 were equally discouraging. Among diseases with more than 10 cases observed, confirmation rates ranged from 13 % to 97 % and detection rates from 6 % to 90 %. Both rates were greater than 70 % for only 6 of 60 disease categories studied and for only 1 of 16 categories defined by major International Classification of Disease categories (neoplasms). This deficiency suggests cautious interpretation of results from studies based on death certificate diagnoses. To determine whether any groupings of diagnoses might meet acceptable accuracy requirements, we applied a hierarchical clustering method to data from these 5130 cohort members. The resulting classification system had 10 categories: breast cancer; other female cancers; cancers of the digestive organs; cancer of the larynx; leukemia; nasal, ear, or sinus cancer; tongue cancer; external causes; vascular disease; and all other causes. Confirmation and detection rates for each of these categories were at least 66 %. Although the categories are broad, particularly for nonneoplastic diseases, further divisions led to unacceptable accuracy rates for some of the resulting diagnostic groups. Using the derived classification system, there was 72 % agreement overall between death certificate and autopsy diagnoses compared to 53 % agreement for a second system obtained by grouping strictly by major disease category. Eighty-seven percent agreement was observed for a similar classification system with vascular disease grouped with all other nonneoplastic diseases. Further agglomeration achieved very little additional improvement. (J.P.N.)

  10. Combining diagnostic categories to improve agreement between death certificate and autopsy classifications of cause of death for atomic bomb survivors, 1950-87

    Energy Technology Data Exchange (ETDEWEB)

    Carter, R.L.; Ron, E.; Mabuchi, Kiyohiko

    1993-05-01

    Several investigators have observed less-than-desirable agreement between death certificate diagnoses and autopsy diagnoses for most specific causes of death, and even for some causes grouped by major disease category. Our results from data on 5130 autopsies of members of the Life Span Study cohort of atomic bomb survivors in Hiroshima and Nagasaki conducted prior to September 1987 were equally discouraging. Among diseases with more than 10 cases observed, confirmation rates ranged from 13 % to 97 % and detection rates from 6 % to 90 %. Both rates were greater than 70 % for only 6 of 60 disease categories studied and for only 1 of 16 categories defined by major International Classification of Disease categories (neoplasms). This deficiency suggests cautious interpretation of results from studies based on death certificate diagnoses. To determine whether any groupings of diagnoses might meet acceptable accuracy requirements, we applied a hierarchical clustering method to data from these 5130 cohort members. The resulting classification system had 10 categories: breast cancer; other female cancers; cancers of the digestive organs; cancer of the larynx; leukemia; nasal, ear, or sinus cancer; tongue cancer; external causes; vascular disease; and all other causes. Confirmation and detection rates for each of these categories were at least 66 %. Although the categories are broad, particularly for nonneoplastic diseases, further divisions led to unacceptable accuracy rates for some of the resulting diagnostic groups. Using the derived classification system, there was 72 % agreement overall between death certificate and autopsy diagnoses compared to 53 % agreement for a second system obtained by grouping strictly by major disease category. Eighty-seven percent agreement was observed for a similar classification system with vascular disease grouped with all other nonneoplastic diseases. Further agglomeration achieved very little additional improvement. (J.P.N.).

  11. Effect of metallothionein core promoter region polymorphism on cadmium, zinc and copper levels in autopsy kidney tissues from a Turkish population

    International Nuclear Information System (INIS)

    Metallothioneins (MTs) are metal-binding, low molecular weight proteins and are involved in pathophysiological processes like metabolism of essential metals, metal ion homeostasis and detoxification of heavy metals. Metallothionein expression is induced by various heavy metals especially cadmium, mercury and zinc; MTs suppress toxicity of heavy metals by binding themselves to these metals. The aim of this study was to investigate the association between the - 5 A/G metallothionein 2A (MT2A) single nucleotide polymorphism (SNP) and Cd, Zn and Cu levels in the renal cortex from autopsy cases. MT2A core promoter region - 5 A/G SNP was analyzed by PCR-RFLP method using 114 autopsy kidney tissues and the genotype frequencies of this polymorphism were found as 87.7% homozygote typical (AA), 11.4% heterozygote (AG) and 0.9% homozygote atypical (GG). In order to assess the Cd, Zn and Cu levels in the same autopsy kidney tissues, a dual atomic absorption spectrophotometer system was used and the average levels of Cd, Zn and Cu were measured as 95.54 ± 65.58 ?g/g, 181.20 ± 87.72 ?g/g and 17.14 ± 16.28 ?g/g, respectively. As a result, no statistical association was found between the - 5 A/G SNP in the MT2A gene and the Zn and Cu levels in the renal cortex (p > 0.05), but considerably high accumulation of Cd was monitored for individuals having AG (151.24 ± 60.21 ?g/g) and GG genotypes (153.09 ?g/g) compared with individuals having AA genotype (87.72 ± 62.98 ?g/g) (p < 0.05). These results show that the core promoter region polymorphism of metallothionein 2A increases the accumulation of Cd in human renal cortex.

  12. Autopsias realizadas en el Hospital "Dr. Luis Díaz Soto" de 1962 a 1995 / Autopsies performed at "Dr. Luis Diaz Soto" hospital from 1962 to 1995

    Scientific Electronic Library Online (English)

    José, Hurtado de Mendoza Amat; Reynaldo, Álvarez Santana; Verónica, Walwyn Salas; Teresita de Jesús, Montero González; Roberto, Carriles Martínez-Pinillos; Jesús, Rodríguez Guerra.

    1997-12-01

    Full Text Available Para conocer la información fundamental contenida en el banco de datos de autopsias realizadas en el Hospital "Dr Luis Díaz Soto", creado mediante el Sistema Automatizado de Registo y Control de Anatomía Patológica, se procesaron las 10 099 autopsias realizadas entre diciembre de 1962 y diciembre de [...] 1995, y de ellas se estudiaron en particular 7 886 de adultos. El sexo masculino predominó, así como el grupo de edad de 65-74 años. Medicina Interna, Terapia Intensiva y Medicina de Urgencia fueron las especialidades de egreso más representadas. Las principales causas básicas de muerte fueron los trastornos cardiovasculares, en especial aterosclerosis, y los tumores malignos, y en partícular el cáncer del pulmón. Sus complicaciones se correspondieron con las principales causas directas e intermedias de muerte. En general, los trastornos cardiovasculares, las infecciones, los tumores malignos y el daño multiorgánico constituyeron los grupos de trastornos de mayor trascendencia tanto como causa de muerte como en la morbilidad asociada. Entre 1987 y 1995 hubo el 32,6 % de discrepancias diagnósticas pre y postmortem en causas básicas de muerte y 28,5 % en causas directas e intermedias de muerte. Se destacó la importancia del estudio de las causas directas e intermedias de muerte (multicausalidad), la evaluación de la calidad de los diagnósticos premortem y la utilidad de la creación de un banco de datos de autopsias para continuar este estudio. Abstract in english A number of 10 099 autopsies performed between December, 1962 and December, 1985 were processed in order to know the main information contained in the databank of autopsies performed at "Dr: Luis Díaz Soto"hospital, created by the Automated System of Register and Control of Pathologic Anatomy. Of th [...] ese autopsies 7 886 of adult subjects were studied in particular. Male sex predominated, as well as the 65-74 years old age group. The most represented specialties were Internal Medicine, Intensive Therapy, and Emergency Medicine. The principal basic causes of death were cardiovascular disorders, especially atherosclerosis, and malignant tumors, particularly lung cancer. The complications were in agreement with the principal direct or intermediate causes of death. In general, cardiovascular disorders, infections, malignant tumors, and multiorgan damage constituted the groups with a higher frequency as a cause of death in associated morbidity. Between 1987 and 1995 there was a 32.6% of diagnostic discrepancies regarding the basic causes of death and 28.5% with respect to direct or intermediate causes of death. The importance of the study the direct and intermediate causes of death (multicausality),the evaluation of the quality of premorten diagnosis, and the usefulness of the creation of an autopsy databank were higlighted in order to continue this study.

  13. Achados clínicopatológicos na tromboembolia pulmonar: estudo de 24 anos de autópsias / Clinicopathological findings in pulmonary thromboembolism: a 24-year autopsy study

    Scientific Electronic Library Online (English)

    Hugo Hyung, Bok Yoo; Fabiana Guandalini, Mendes; Christine Elisabete Rubio, Alem; Alexandre Todorovic, Fabro; José Eduardo, Corrente; Thais Thomaz, Queluz.

    2004-10-01

    Full Text Available INTRODUÇÃO: Tromboembolia pulmonar (TEP) é ainda uma afecção enigmática em diversos aspectos clínicos e epidemiológicos e frequentemente erroneamente diagnosticada. OBJETIVO: Descrever a prevalência e os achados anatomopatológicos de TEP em uma série de 5261 autópsias realizadas em um hospital unive [...] rsitário de nível terciário, correlacionar estes achados com as doenças de base e verificar a freqüência de suspeita clínica antemortem de TEP. MÉTODO: Revisão dos registros das autópsias consecutivas realizadas de 1979 a 2002 para um estudo retrospectivo. Dos prontuários e dos relatórios de autópsias dos pacientes que tiveram TEP documentada, macro e/ou microscopicamente, foram extraídos dados demográficos, doenças de base, suspeita antemortem de TEP, localização dos trombos nos pulmões e provável local de origem da TEP. RESULTADOS: A freqüência de autópsias foi de 42,0% e TEP foi encontrada em 544 pacientes, sendo a principal causa da morte (TEP fatal) em 225 casos. Doenças infecciosas (p=0,0003) foram associadas com TEP não fatal e trauma (p=0,007) com TEP fatal. A taxa de não suspeita antemortem de TEP foi 84,6% e 40,0% destes pacientes apresentaram TEP fatal. Doenças do sistema circulatório (p=0,0001), infecções (p Abstract in english BACKGROUND: Pulmonary thromboembolism (PTE) is still an enigmatic disorder in many epidemiological and clinical features, remaining one of the most commonly misdiagnosed disorders. OBJECTIVE: To describe the prevalence and pathological findings of PTE in a series of autopsies, to correlate these fin [...] dings with underlying diseases, and to verify the frequency of PTE clinically suspected before death. METHOD: The reports on 5261 consecutive autopsies performed from 1979 to 2002 in a Brazilian tertiary referral medical school were reviewed for a retrospective study. From the medical records and autopsy reports of the patients found with macroscopically and/or microscopically documented PTE, were gathered data on demographics, underlying diseases, antemortem suspicion of PTE, and probable PTE site of origin. RESULTS: The autopsy rate was 42.0% and PTE was found in 544 patients. In 225 cases, PTE was the main cause of death (fatal PTE). Infections (p=0.0003) were associated with nonfatal PTE and trauma (p=0.007) with fatal PTE. The rate of antemortem unsuspected PTE was 84.6% and 40.0% of these patients presented fatal PTE. Diseases of the circulatory system (p=0.0001), infections (p

  14. Local perceptions of causes of death in rural South Africa: a comparison of perceived and verbal autopsy causes of death

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    Laith Hussain-Alkhateeb

    2015-07-01

    Full Text Available Background: Understanding how lay people perceive the causes of mortality and their associated risk factors is important for public health. In resource-limited settings, where verbal autopsy (VA is used as the most expedient method of determining cause of death, it is important to understand how pre-existing concepts of cause of death among VA-informants may influence their VA-responses and the consequential impact on cause of death assessment. This study describes the agreement between VA-derived causes of death and informant-perceived causes and associated influential factors, which also reflects lay health literacy in this setting. Method: Using 20 years of VA data (n=11,228 from the Agincourt Health and Demographic Surveillance System (HDSS site in rural South Africa, we explored the agreement between the causes of death perceived by the VA-informants and those assigned by the automated Inter-VA tool. Kappa statistics and concordance correlation coefficients were applied to measure agreement at individual and population levels, respectively. Multivariable regression models were used to explore factors associated with recognised lay perceptions of causes of mortality. Results: Agreement between informant-perceived and VA-derived causes of death at the individual level was limited, but varied substantially by cause of death. However, agreement at the population level, comparing cause-specific mortality fractions was higher, with the notable exception of bewitchment as a cause. More recent deaths, those in adults aged 15–49 years, deaths outside the home, and those associated with external causes showed higher concordance with InterVA. Conclusion: Overall, informant perception of causes of death was limited, but depended on informant characteristics and causes of death, and to some extent involved non-biomedical constructs. Understanding discordance between perceived and recognised causes of death is important for public health planning; low community understanding of causes of death may be detrimental to public health. These findings also illustrate the importance of using rigorous and standardised VA methods rather than relying on informants’ reported causes of death.

  15. Development of atherosclerosis over a 25 year period: an epidemiological autopsy study in males of 11 towns.

    Science.gov (United States)

    Zhdanov, V S; Sternby, N H; Vikhert, A M; Galakhov, I E

    1999-01-01

    We conducted an analysis of the data from two epidemiological autopsy studies of atherosclerosis in men aged 20-59 years in 1963-66 (the first study, 7470 cases) and in 1985-88 (the second study, 9600 cases). The investigations were performed in accordance with a special program of the World Health Organization in 11 town populations: Ashkhabad (Turkmenistan), Bishkek (Kirgizstan), Irkutsk and Yakutsk (Russia), Malmo (Sweden), Prague (Czech Republic), Riga (Latvia), Tallinn and Tartu (Estonia), and Kharkov and Yalta (Ukraine). Native and non-native populations were studied separately in Ashkhabad, Bishkek, and Yakutsk. Atherosclerosis was studied by the visual morphometrical method in the descending thoracic aorta, abdominal aorta and three main coronary arteries. In each vessel the prevalence and extent (percent of intimal surface) of fatty streaks, fibrous plaques, complicated, calcified and also raised lesions (all lesions except fatty streaks) were determined. Coronary stenosis was estimated in arteries as narrowed by more than 50%. Accelerated development of coronary atherosclerosis, especially in the 40-59 year age group, was noted in the second study in the male populations of most towns except Prague and Malmo. In Prague the extent of raised lesions in coronary arteries was practically the same in both studies, in Malmo it decreased in the second study. Aortic atherosclerosis also accelerated the rate of progression in all towns except Prague, where significant differences were not observed between the studies. Accelerated development of atherosclerosis in male populations from towns of Asia was combined with an increase of fatty streaks in all vessels, while in European populations it was not so obvious. In the native populations of Ashkhabad, Bishkek and Yakutsk, atherosclerosis was much less than in non-natives in both studies. In natives of these towns, accelerated development of atherosclerosis begins only from 40 years, in non-natives from 30. For the second study, there was typically an increase of the prevalence and extent of calcified lesions that were combined with an increased prevalence of coronary stenosis in all towns. The average percentage of stenosis in the coronary left anterior descending artery for men of 40-59 years of age was 12% in the first study and 24.9% in the second; for the coronary right artery, 7.4 and 13.8%, respectively. In accordance with findings of more severe atherosclerosis in males in most towns in the second study, there was an increase in the frequency of death from coronary heart disease in the second study in these towns. The data of this study indicate that the development of atherosclerosis in human populations may change very much in the course of the life of one generation. PMID:10077406

  16. Coexistence of amyotrophic lateral sclerosis with neuro-Behçet's disease presenting as a longitudinally extensive spinal cord lesion: clinicopathologic features of an autopsied patient.

    Science.gov (United States)

    Sato, Tomoe; Ouchi, Haruka; Shimbo, Junsuke; Sato, Aki; Yamazaki, Motoyoshi; Hashidate, Hideki; Igarashi, Shuichi; Kakita, Akiyoshi

    2014-04-01

    We report the clinical and autopsy features of a 65-year-old Japanese man who clinically exhibited overlap of both neuro-Behçet's disease (NBD) and amyotrophic lateral sclerosis (ALS). The patient had a HLA-B51 serotype, a recent history of uveitis and had suffered paraparesis, sensory and autonomic disturbance, frontal signs and tremor. A brain and spine MRI study revealed a longitudinally extensive thoracic cord (Th) lesion, but no apparent intracranial abnormalities. The lesion extended ventrally from Th4 to Th9, exhibiting low intensity on T1-weighted images, high intensity on T2-weighted and fluid-attenuated inversion recovery images and gadolinium enhancement. The patient's upper and lower motor neuron signs and sensory disturbance worsened and he died 16 months after admission. At autopsy, the spinal cord and brain exhibited characteristic histopathological features of both NBD and ALS, including chronic destruction of the ventral thoracic white and gray matter, perivascular lymphocytic infiltration, binucleated neurons, lower and upper motor neuron degeneration, Bunina bodies and skein-like inclusions. Although incidental coexistence of these rare disorders could occur in an individual, this case raises the possibility of a pathomechanistic association between NBD and ALS. PMID:24118427

  17. Anatomical distribution of HTLV-I proviral sequence in an autopsy case of HTLV-I associated myelopathy: a polymerase chain reaction study.

    Science.gov (United States)

    Sueyoshi, K; Goto, M; Johnosono, M; Sato, E; Shibata, D

    1994-01-01

    HTLV-I associated myelopathy (HAM) is a slowly progressive paraplegia of the lower extremities observed among HTLV-I carriers. An autopsy of a typical HAM case in which perivascular lymphocytic infiltration was not limited to the central nervous system was examined. Spinal dorsal roots, salivary gland, lungs, liver and kidney showed non-specific, but unusual sporadic perivascular lymphocytic infiltration, which resembled the findings in the spinal cord. To investigate the anatomical distribution of HTLV-I provirus, the HTLV-I proviral sequences, tax and pol, were amplified from the formalin-fixed paraffin-embedded tissues of the autopsy case using polymerase chain reaction (PCR). By PCR, strong HTLV-I provirus signals were detected in the spinal cord, peripheral nerve, muscle, lungs and liver. Weak signals were detected in the medulla oblongata, optic nerve and lymph node, while the other organs, including the cerebrum, were negative. The data from this study show the specific distribution of HTLV-I provirus in the distinct organs of a HAM patient. PMID:8025646

  18. A report of two cases: post flood autopsy findings in urban patients with an unusual presentation of leptospirosis with hemorrhagic pneumonia in government medical college, Surat

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    Mandakini M Patel, Bhavna Gamit, R D Patel, Rahul Modi

    2011-01-01

    Full Text Available South Gujarat is endemic zone for leptospirosis in paddy workers but recently we have post flood plenty of urban patients who were presented with high grade fever, dyspnea & haemoptysis with rapid deterioration. Clinicians were suspecting an outbreak of Hantavirus or leptospirosis. Both our patients were serologically negative for leptospirosis ante mortem, but alveolar hemorrhage & raised urea was the only finding. Both our patient rapidly deteriorated. We performed autopsy & took post mortem samples for serologically & HP Examination of tissue. Serological finding showed one patient positive for PCR and second was positive for Leptocheck and IgM ELISA. On HP examination we observed massive intra-alveolar hemorrhage, interstitial nephritis, vasculitis in spleen and kidney, myocarditis & hemorrhage in various organs like heart, suprarenal gland, and subarachnoid space in both our patient. Levaditi’s stain was also performed but results were not conclusive. IHC for kidney tissue was not possible due to lack of facility. Extensive hemorrhage in lung was the cause of death in both patients. Follow up autopsy studies of 30 patients were showing same histopathological findings.

  19. An autopsied case of myelofibrosis which had been exposed to the atomic bomb near the site of blast (1,112m from that area)

    International Nuclear Information System (INIS)

    A study was made on the autopsy of a subject who had been exposed at the age of 10 months old to the atomic bomb at a distance of 1,112 m from a bombed area, and who found to have myelofibrosis which followed aplastic anemia-like symptoms. The autopsy findings showed 400 ml of bloody ascites, hyperplastic bone marrow in which no fatty cells were observed but many reticular cell-like cells and granular hematopoiesis were observed, and diffuse proliferation of reticular fibers without remarkable new bone findings in the trabecula. The liver was enlarged to the weight of 3.18 g, and showed extramedullary hematopoiesis. Infiltration of lymphocytes, slight fibrosis, and marked accumulation of hemosiderin (caused by the transfusion of the blood) were seen in the Glisson's sheath. The spleen, which was enlarged to the weight of 1.54 g, was brown, and showed fibrosis, extramedullary hematopoiesis and many plasma cells. Lymphatic glands were swollen in the mesentery, in the retroperitoneum, around the gastro-pancreatic area, and at the bifurcation of the trachea, where marked extramedullary hematopoiesis and many giant globuli were observed. Extramedullary hematopoiesis was also seen in other sites such as the subdura, both of the renal pelvises, and in a hyperplastic polyp in the gastric pit. Therefore, this patient was diagnosed as having myelofibrosis and hematopoietic dysplasia caused by radiation. (Kanao, N.)

  20. Cardiac biomarkers in blood, and pericardial and cerebrospinal fluids of forensic autopsy cases: A reassessment with special regard to postmortem interval.

    Science.gov (United States)

    Chen, Jian-Hua; Inamori-Kawamoto, Osamu; Michiue, Tomomi; Ikeda, Sayuko; Ishikawa, Takaki; Maeda, Hitoshi

    2015-09-01

    Previous studies suggested possible application of postmortem biochemistry of myocardial biomarkers to the investigation of sudden cardiac death; however, differences from clinical findings should be considered in autopsy materials. The present study involved a comprehensive investigation of cardiac troponin T and I (cTnT and cTnI), and creatine kinase MB (CK-MB) in cardiac and peripheral external iliac venous blood, pericardial fluid (PCF) and cerebrospinal fluid (CSF) for reassessment, with special regard to the estimated postmortem interval in relation to the cause of death, reviewing a large number of forensic autopsy cases (n=1923). These cardiac biomarkers showed cause-of-death- and postmortem-time-dependent differences: blood and PCF levels of each marker were higher in hyperthermia (heatstroke), bathwater drowning and chronic congestive heart disease in cases of postmortem interval (PMI) disease, showed substantial elevations, while these markers remained low in acute hemorrhagic death from sharp instrument injury, hypothermia (cold exposure) and sea-/freshwater drowning during PMI of disease, but indicate the severity of myocardial injury in postmortem investigation. PMID:26052007

  1. Necropsia e mortalidade por causa mal definida no Estado de São Paulo, Brasil Autopsy and ill-defined cause of death in the state of São Paulo, Brazil

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    Mauro Abrahão Rozman

    2006-11-01

    Full Text Available OBJETIVO: Investigar a proporção de mortes por causa mal definida no Estado de São Paulo entre 1980 e 2002, considerando a influência da realização de necropsia nessa proporção. MÉTODO: O número de óbitos foi obtido do Ministério da Saúde. Dividiu-se o Estado de São Paulo em três áreas: 1 municípios com serviço de verificação de óbitos (SVO, que pode realizar necropsias; 2 municípios sem SVO; e 3 Baixada Santista, região onde houve um aumento marcante na proporção de mortes por causa mal definida entre 1980 e 1995. O impacto das necropsias na proporção de óbitos por causa mal definida foi medido com base na classificação da causa de óbito pelo primeiro médico avaliador (aquele que encaminhou o caso para o SVO para necropsia ou que preencheu a declaração de óbito sem encaminhar o caso. Os óbitos por causas externas foram excluídos por ter necropsia obrigatória. Foram avaliadas as proporções 1 de casos classificados como de causa mal definida pelo primeiro avaliador; 2 de necropsias no total de óbitos excluindo causas externas; e 3 de óbitos com causa esclarecida por necropsia entre os classificados como de causa mal definida pelo primeiro avaliador. RESULTADOS: A proporção de óbitos classificados como de causa mal definida pelo primeiro avaliador aumentou entre 1980 e 2002 em todas as áreas: nos municípios com SVO, nos municípios sem SVO e na Baixada Santista. Para o Estado de São Paulo como um todo, o aumento foi de quase 30% no período de 1980 a 2002. Para o período de 1998 a 2002, a proporção média de necropsias no total de óbitos excluindo causas externas foi de 21,2, 6,4 e 2,6%, respectivamente, nas áreas com e sem SVO e na Baixada Santista. Entre 1998 e 2002, a proporção de óbitos com causa mal definida esclarecidos pela necropsia foi de 92,9 nas áreas com SVO, 32,5 nas áreas sem SVO e 10,7% na Baixada Santista. CONCLUSÕES: A realização de necropsias explica a diferença na mortalidade proporcional por causa mal definida entre as áreas estudadas. O aumento observado entre 1980 e 2002 na classificação de óbitos por causa mal definida pelo primeiro avaliador no Estado de São Paulo indica uma importante piora na qualidade do preenchimento da declaração de óbito nessa instância. São necessárias investigações adicionais para esclarecer as causas dessa mudança.OBJECTIVE: To investigate the proportion of deaths with an ill-defined cause in the Brazilian state of São Paulo between 1980 and 2002, taking into account the influence of autopsies on this proportion. METHOD: Data on the number of deaths were obtained from the Brazilian Ministry of Health. The communities of the state of São Paulo were divided into three groups: (1 municipalities with a service to verify the cause of death (and that may conduct an autopsy, (2 municipalities without a cause of death verification service, and (3 the region of Baixada Santista, which had an extremely large increase in the proportion of deaths from ill-defined causes between 1980 and 1995. The impact of autopsies on the proportion of deaths with an ill-defined cause was defined based on the classification made by the first physician evaluating the cause of death, that is, the physician who referred the case to the verification service for autopsy or who completed the death certificate without referring the case to the verification service. Deaths from external causes were excluded, since autopsy is mandatory in these cases. The following were evaluated: (1 proportion of cases classified by the first evaluating physician as having an ill-defined cause, (2 proportion of autopsies in relation to the total number of deaths (except from external causes, and (3 proportion of deaths classified as ill-defined by the first evaluating physician but explained by the autopsy. RESULTS: The proportion of deaths classified by the first evaluating physician as having an ill-defined cause increased over the 1980-2002 period in all three groups studied: the municipalities with a verification service, the

  2. Direct estimates of national neonatal and child cause–specific mortality proportions in Niger by expert algorithm and physician–coded analysis of verbal autopsy interviews

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    Henry D. Kalter

    2015-06-01

    Full Text Available Background This study was one of a set of verbal autopsy investigations undertaken by the WHO/UNCEF–supported Child Health Epidemiology Reference Group (CHERG to derive direct estimates of the causes of neonatal and child deaths in high priority countries of sub–Saharan Africa. The objective of the study was to determine the cause distributions of neonatal (0–27 days and child (1–59 months mortality in Niger. Methods Verbal autopsy interviews were conducted of random samples of 453 neonatal deaths and 620 child deaths from 2007 to 2010 identified by the 2011 Niger National Mortality Survey. The cause of each death was assigned using two methods: computerized expert algorithms arranged in a hierarchy and physician completion of a death certificate for each child. The findings of the two methods were compared to each other, and plausibility checks were conducted to assess which is the preferred method. Comparison of some direct measures from this study with CHERG modeled cause of death estimates are discussed. Findings The cause distributions of neonatal deaths as determined by expert algorithms and the physician were similar, with the same top three causes by both methods and all but two other causes within one rank of each other. Although child causes of death differed more, the reasons often could be discerned by analyzing algorithmic criteria alongside the physician's application of required minimal diagnostic criteria. Including all algorithmic (primary and co–morbid and physician (direct, underlying and contributing diagnoses in the comparison minimized the differences, with kappa coefficients greater than 0.40 for five of 11 neonatal diagnoses and nine of 13 child diagnoses. By algorithmic diagnosis, early onset neonatal infection was significantly associated (?2?=?13.2, P?autopsy conducted in the context of a national mortality survey can provide useful estimates of the cause distributions of neonatal and child deaths. While the current study found reasonable agreement between the expert algorithm and physician analyses, it also demonstrated greater plausibility for two algorithmic diagnoses and validation work is needed to ascertain the findings. Direct, large–scale measurement of causes of death complement, can strengthen, and in some settings may be preferred over modeled estimates.

  3. An autopsy case of acute cor pulmonale and paradoxical systemic embolism due to tumour cell microemboli in a patient with breast cancer.

    Science.gov (United States)

    Uga, Sayuri; Ikeda, Shuntaro; Matsukage, Sho-ichi; Hamada, Mareomi

    2012-01-01

    A 62-year-old woman was admitted to our hospital because of severe respiratory distress. Diagnostic imaging studies suggested the existence of inexplicable cor pulmonale. Although we immediately sought the aetiology of her severe condition, she died suddenly on the fourth day after admission. Postmortem autopsy revealed tumour cell microemboli in the small pulmonary arteries. In addition, tumour cell embolisation identical to that in primary breast cancer cells was also observed in microvessels in systemic multiple organs, such as the liver, brain, kidneys, spleen, uterus, bone marrow and adrenal glands-with simultaneous findings of peripheral infarction. Systemic tumour cell embolism mediated through the patent foramen ovale superimposed on pulmonary tumour cell emboli (PTCE) is considered to be the mechanism underlying inexplicable cor pulmonale. The rapid aggravation of her condition terminated in death. PMID:23035163

  4. Lung cancer at autopsy in A-bomb survivors and controls, Hiroshima and Nagasaki, 1961--1970. II. Smoking, occupation and A-bomb exposure

    International Nuclear Information System (INIS)

    The apparent effect of ionizing radiation on lung cancer in A-bomb survivors has not been large enough to still doubts as to its validity. It has seemed essential to determine whether the apparent radiation effect could have resulted from a confounding of heavy smoking and high radiation dose, or if the occupational exposure of high-dose subjects with lung cancer was suggestive of the influence of environmental hazards other than radiation. The available series consists of 204 subjects with lung cancer verified by autopsy, 61 of whom were low-dose (less than 1 rad) and 13 high-dose (200+ rads) subjects. No evidence could be found that the influence of either smoking or occupational exposure upon lung cancer was exerted so as to suggest that the apparent radiation effect is other than real. The study also provides additional evidence of the relationship between lung cancer and smoking in Japan

  5. Síndrome da imunodeficiência adquirida: descrição anátomo-patológica de dois casos de necropsia / Acquired immunodeficiency syndrome: pathologic description of two autopsy cases

    Scientific Electronic Library Online (English)

    Vera L. C., Delmonte; Rubin M., Tuder; Wilma T. T., Vieira; Vilna M. S., Cunha; Iraci S., Nakaguma; Francisco, Bonasser Filho; Carlos de Melo, Capitani.

    1984-08-01

    Full Text Available Os Autores apresentam dois casos de Síndrome de Imunodeficiência Adquirida com ênfase aos achados de necropsia. A criptococose generalizada de padrão miliar, infreqüente, e a pneumocistose foram infecções oportunísticas de curso fatal pela destruição parenquimatosa de órgãos vitais que acarretaram. [...] É destacado o papel etiopatogênico do citomegalovírus, pela concomitância de infecção em ambos os casos e associação aos órgãos mais afetados. Extensa necrose de supra-renal foi constatada, possivelmente secundária à destruição celular viral pelo CMV. Abstract in english Two autopsy cases of acquired immunodeficiency disease syndrome are reported. One case showed widespread miliar cryptococcosis, with scarce inflammatory response. The other developed respiratory failure due to pulmonary infection by P. carinii. In both cases we could observe generalized cytomegalic [...] infection, with striking adrenal involvement. Special emphasis is given to the pathologic changes and the possible etiopathogenic role of cytomegaloviroses in the acquired immunodeficiency cases.

  6. Síndrome da imunodeficiência adquirida: descrição anátomo-patológica de dois casos de necropsia Acquired immunodeficiency syndrome: pathologic description of two autopsy cases

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    Vera L. C. Delmonte

    1984-08-01

    Full Text Available Os Autores apresentam dois casos de Síndrome de Imunodeficiência Adquirida com ênfase aos achados de necropsia. A criptococose generalizada de padrão miliar, infreqüente, e a pneumocistose foram infecções oportunísticas de curso fatal pela destruição parenquimatosa de órgãos vitais que acarretaram. É destacado o papel etiopatogênico do citomegalovírus, pela concomitância de infecção em ambos os casos e associação aos órgãos mais afetados. Extensa necrose de supra-renal foi constatada, possivelmente secundária à destruição celular viral pelo CMV.Two autopsy cases of acquired immunodeficiency disease syndrome are reported. One case showed widespread miliar cryptococcosis, with scarce inflammatory response. The other developed respiratory failure due to pulmonary infection by P. carinii. In both cases we could observe generalized cytomegalic infection, with striking adrenal involvement. Special emphasis is given to the pathologic changes and the possible etiopathogenic role of cytomegaloviroses in the acquired immunodeficiency cases.

  7. Mercury accumulations in brains from populations exposed to high and low dietary levels of methyl mercury. Concentration, chemical form and distribution of mercury in brain samples from autopsies

    DEFF Research Database (Denmark)

    Pedersen, M B; Hansen, J C

    1999-01-01

    Autopsy samples from 17 Greenlanders and 12 Danes were analysed for total and organic mercury by atomic absorption spectrophotometry, and for cellular localisation by autometallography. The concentration of total mercury in the Greenlanders (median: 174 micrograms Hg/kg wet weight brain tissue, range 59-4782, highest in cerebellum: 492) was found to be significantly higher than in the Danish group (3.7 micrograms Hg/kg w.w., range 1.2-11.8). Furthermore, the total concentration of mercury was positively correlated to age (rho = 0.56, p <0.05), and the fraction of methyl mercury was negatively correlated to age (rho = -0.66, p <0.01) among the Greenlanders. This suggests an age dependent accumulation of total mercury and a slow transformation of methyl mercury to inorganic mercury in the brain. The autometallographically demonstrable mercury was primarily located in glia cells.

  8. Mercury accumulations in brains from populations exposed to high and low dietary levels of methyl mercury. Concentration, chemical form and distribution of mercury in brain samples from autopsies

    DEFF Research Database (Denmark)

    Pedersen, M B; Hansen, J C; Mulvad, G; Pedersen, Henning Sloth; Gregersen, M; Danscher, Gorm

    1999-01-01

    Autopsy samples from 17 Greenlanders and 12 Danes were analysed for total and organic mercury by atomic absorption spectrophotometry, and for cellular localisation by autometallography. The concentration of total mercury in the Greenlanders (median: 174 micrograms Hg/kg wet weight brain tissue......, range 59-4782, highest in cerebellum: 492) was found to be significantly higher than in the Danish group (3.7 micrograms Hg/kg w.w., range 1.2-11.8). Furthermore, the total concentration of mercury was positively correlated to age (rho = 0.56, p <0.05), and the fraction of methyl mercury was negatively...... correlated to age (rho = -0.66, p <0.01) among the Greenlanders. This suggests an age dependent accumulation of total mercury and a slow transformation of methyl mercury to inorganic mercury in the brain. The autometallographically demonstrable mercury was primarily located in glia cells....

  9. Post-mortem Whole exome sequencing with gene-specific analysis for autopsy-negative sudden unexplained death in the young: a case series.

    Science.gov (United States)

    Narula, Nupoor; Tester, David J; Paulmichl, Anna; Maleszewski, Joseph J; Ackerman, Michael J

    2015-04-01

    Annually, thousands of sudden deaths in individuals under 35 years remain unexplained following comprehensive medico-legal autopsy. Previously, post-mortem genetic analysis by Sanger sequencing of four major cardiac channelopathy genes revealed that approximately one-fourth of these autopsy-negative sudden unexplained death in the young (SUDY) cases harbored an underlying mutation. However, there are now over 100 sudden death-predisposing cardiac channelopathy-, cardiomyopathy-, and metabolic disorder-susceptibility genes. Here, we set out to determine whether post-mortem whole exome sequencing (WES) is an efficient strategy to detect ultra-rare, potentially pathogenic variants. We performed post-mortem WES and gene-specific analysis of 117 sudden death-susceptibility genes for 14 consecutively referred Caucasian SUDY victims (average age at death 17.4 ± 8.6 years) to identify putative SUDY-associated mutations. On average, each SUDY case had 12,758 ± 2,016 non-synonymous variants, of which 79 ± 15 localized to these 117 genes. Overall, eight ultra-rare variants (seven missense, one in-frame insertion) absent in three publically available exome databases were identified in six genes (three in TTN, and one each in CACNA1C, JPH2, MYH7, VCL, RYR2) in seven of 14 cases (50 %). Of the seven missense alterations, two (T171M-CACNA1C, I22160T-TTN) were predicted damaging by three independent in silico tools. Although WES and gene-specific surveillance is an efficient means to detect rare genetic variants that might underlie the pathogenic cause of death, accurate interpretation of each variant is challenging. Great restraint and caution must be exercised otherwise families may be informed prematurely and incorrectly that the root cause has been found. PMID:25500949

  10. The autopsy archive of former uranium miners of the East German WISMUT company - a valuable resource for research on ionizing radiation in interaction with other carcinogens and cancer

    International Nuclear Information System (INIS)

    In East Germany, uranium mining was undertaken on a large scale for the Soviet nuclear industry from 1946 to 1989. Poor working conditions especially in the early years led to a high level of occupational diseases, in particular lung cancer. For WISMUT miners, comprehensive data is available on working histories and exposure to radiation and quartz dust. After German reunification, the autopsy archive of the Institute of Pathology in Stollberg was opened for research as part of the WISMUT Health Data Archive of the Bundesanstalt fuer Arbeitsschutz und Arbeitsmedizin. It contains protocols of about 30,000 persons (including 17,000 miners), 400,000 slides, 66,000 tissue blocks, and 200 whole lungs. Now, the tissue repository is held in trust at BGFA and Institute of Pathology in Bochum, Germany. The source population of the cases is not defined. The archive contains tissues from many - but not from all - former WISMUT miners as well as from local people. For 12,923 miners, median radon exposure was 621 WLM, including about 800 workers with exposure above 1800 WLM. Smoking information is poor, but prevalence of smoking was high. A leading diagnosis was lung cancer in about 5,300 persons, mainly underground miners. A database has been developed at Deutsches Krebsforschungszentrum to document relevant autopsy information on the cases. Histopathological classification of 5,270 lung cancer cases has been re-assessed by three pathologists. U.S. NIOSH conducted a study on the feasibility of research on pathologic types of lung cancer. Laboratory studies on the quality of the material for molecular-biological investigations are under way. A project is ongoing to investigate the interaction of radiation and crystalline silica on lung cancer development. A workshop was scheduled December 10, 2004 to discuss the resources, the findings, the pitfalls and challenges presented by the material and the future use of that archive in research. (orig.)

  11. Accuracy of Lipoarabinomannan and Xpert MTB/RIF Testing in Cerebrospinal Fluid To Diagnose Tuberculous Meningitis in an Autopsy Cohort of HIV-Infected Adults.

    Science.gov (United States)

    Cox, Janneke A; Lukande, Robert L; Kalungi, Sam; Van Marck, Eric; Lammens, Martin; Van de Vijver, Koen; Kambugu, Andrew; Nelson, Ann M; Colebunders, Robert; Manabe, Yukari C

    2015-08-01

    Point-of-care tests for tuberculous meningitis (TBM) are needed. We studied the diagnostic accuracy of the lipoarabinomannan (LAM) lateral flow assay (LFA), LAM enzyme-linked immunosorbent assay (ELISA), and Xpert MTB/RIF in cerebrospinal fluid (CSF) in an autopsy cohort of Ugandan HIV-infected adults. We obtained written informed consent postmortem from the next of kin. A complete autopsy was done and CSF obtained. We performed LAM LFA (on unprepared and supernatant CSF after heating and spinning), LAM ELISA, and Xpert MTB/RIF on the CSF samples. Accuracy parameters were calculated for histopathological TBM and also for the composite standard, including Xpert MTB/RIF-positive cases. We tested CSF of 91 patients. LAM LFA had a sensitivity of 75% for definite histopathological TBM, ELISA a sensitivity of 43%, and Xpert MTB/RIF a sensitivity of 100% and specificities of 87%, 91%, and 87%, respectively. LAM LFA had a sensitivity of 50% for definite and probable histopathological TBM, ELISA a sensitivity of 38%, and Xpert MTB/RIF a sensitivity of 86% and specificities of 70%, 91%, and 87%, respectively. LAM LFA had a sensitivity of 68% for the composite standard and ELISA a sensitivity of 48% and specificities of 78% and 98%, respectively. The rapid diagnostic tests detected TBM in 22% to 78% of patients not on anti-TB treatment. Point-of-care tests have high accuracy in diagnosis of TBM in deceased HIV-infected adults. LAM LFA in CSF is a useful additional diagnostic tool. PMID:26063865

  12. Birth attendants as perinatal verbal autopsy respondents in low-and middle-income countries: a viable alternative? / Les sages-femmes pour répondre aux questions de l'autopsie verbale périnatale dans les pays à revenu faible et moyen: une alternative viable? / Las matronas como encuestadas en autopsias verbales perinatales en países de ingresos bajos y medios: ¿una alternativa viable?

    Scientific Electronic Library Online (English)

    C, Engmann; A, Garces; I, Jehan; J, Ditekemena; M, Phiri; V, Thorsten; M, Mazariegos; E, Chomba; O, Pasha; A, Tshefu; D, Wallace; EM, McClure; RL, Goldenberg; WA, Carlo; LL, Wright; C, Bose.

    2012-03-01

    Full Text Available OBJETIVO: Evaluar la viabilidad de utilizar matronas como encuestadas en autopsias verbales perinatales en lugar de madres que han perdido un hijo/a. MÉTODOS: Las entrevistas para las autopsias verbales de muertes neonatales prematuras y alumbramientos mortinatos se realizaron por separado entre mad [...] res (estándar de referencia) y matronas en 38 comunidades de cuatro países en desarrollo. Se calculó la concordancia entre las respuestas maternas y las respuestas de las matronas para todas las preguntas, tanto para las categorías de preguntas como para las preguntas individuales. Se evaluaron la sensibilidad y especificidad de las preguntas individuales con la matrona como encuestada. RESULTADOS: En las muertes neonatales prematuras, la concordancia en todas las preguntas fue del 94%. La concordancia fue de al menos el 95% para más de la mitad de las preguntas sobre el historial médico materno, atención en el parto y características neonatales. La concordancia de cualquier pregunta determinada no fue en ningún caso inferior al 80%. La sensibilidad y la especificidad variaron en las preguntas individuales. En este caso, más del 80% de las preguntas presentaron una sensibilidad de al menos el 80% y una especificidad de al menos el 90%. En cuanto a los alumbramientos mortinatos, la concordancia en todas las preguntas fue del 93%. La concordancia fue del 95% o más durante más de la mitad del tiempo para preguntas relacionadas con la atención en el parto, el centro de parto y las características de la mortinatalidad. La sensibilidad y especificidad variaron en las preguntas individuales. Más del 60% de las preguntas presentaron una sensibilidad de al menos el 80%. En este caso, más del 80% de las preguntas presentaron una especificidad de al menos el 90%. Globalmente, las causas de muerte establecidas mediante autopsia verbal fueron similares, independientemente de la persona encuestada. CONCLUSIÓN: Las matronas pueden sustituir a las madres que han perdido un hijo/a como encuestadas en autopsias verbales. Es necesario perfeccionar las preguntas de los cuestionarios de autopsia verbal armonizados existentes, ya que su sensibilidad y especificidad difieren ampliamente. Abstract in english OBJECTIVE: To assess the feasibility of using birth attendants instead of bereaved mothers as perinatal verbal autopsy respondents. METHODS: Verbal autopsy interviews for early neonatal deaths and stillbirths were conducted separately among mothers (reference standard) and birth attendants in 38 com [...] munities in four developing countries. Concordance between maternal and attendant responses was calculated for all questions, for categories of questions and for individual questions. The sensitivity and specificity of individual questions with the birth attendant as respondent were assessed. FINDINGS: For early neonatal deaths, concordance across all questions was 94%. Concordance was at least 95% for more than half the questions on maternal medical history, birth attendance and neonate characteristics. Concordance on any given question was never less than 80%. Sensitivity and specificity varied across individual questions, more than 80% of which had a sensitivity of at least 80% and a specificity of at least 90%. For stillbirths, concordance across all questions was 93%. Concordance was 95% or greater more than half the time for questions on birth attendance, site of delivery and stillborn characteristics. Sensitivity and specificity varied across individual questions. Over 60% of the questions had a sensitivity of at least 80% and over 80% of them had a specificity of at least 90%. Overall, the causes of death established through verbal autopsy were similar, regardless of respondent. CONCLUSION: Birth attendants can substitute for bereaved mothers as verbal autopsy respondents. The questions in existing harmonized verbal autopsy questionnaires need further refinement, as their sensitivity and specificity differ widely.

  13. Importancia y diagnóstico del daño múltiple de órganos en autopsias clínicas / Importance and diagnosis of multiple organ failure in clinical autopsies

    Scientific Electronic Library Online (English)

    Teresita, Montero González; José, Hurtado de Mendoza Amat; Verónica, Walwyn Salas; Reynaldo, Álvarez Santana.

    2008-06-01

    Full Text Available El estudio de más de 14 000 autopsias ha permitido integrar un conjunto de alteraciones morfológicas con el término de daño múltiple de órganos. El propósito del presente trabajo fue determinar la vigencia de los elementos diagnósticos iniciales del daño múltiple de órganos en fallecidos con factore [...] s causales. Se realizó un estudio de estos y se analizaron las relaciones de las causas de muerte con los factores causales y el número de órganos afectados con la estadía hospitalaria. Se revisaron 448 fallecidos y a quienes se les había realizado autopsia en el Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto". Se revisaron los protocolos de autopsias, historias clínicas y láminas histopatológicas. Se seleccionaron los 145 casos con criterio de daño múltiple de órganos que constituyeron el objeto de estudio del presente trabajo. Los resultados muestran la presencia del daño múltiple de órganos en un tercio de los fallecidos, que fue mayormente en los menores de 50 años y en los procedentes de las terapias y unidades de cuidados intermedios. Se destacan entre las causas de muerte el daño tisular severo y la infección. Los órganos más afectados fueron los pulmones, el intestino, las glándulas suprarrenales, el hígado y el cerebro. Estuvo presente el daño múltiple de órganos en el 59,3 % de los fallecidos entre los primeros 4 días de estadía hospitalaria, con predominio del daño en 5 y 6 órganos. El daño múltiple de órganos se presentó en más de un tercio de los casos estudiados. La respuesta del organismo ante los factores causales, desencadena la respuesta inflamatoria sistémica que se expresa morfológicamente en el daño múltiple de órganos y puede llevar al paciente a la muerte. Abstract in english The study of more than 14 000 autopsies has allowed to integrate a series of morphological alterations with the term of multiple organ damage. The purpose of this paper was to determine the validity of the initial diagnostic elements in the deceased with causal factors. A study of them was carried o [...] ut and the relations of the death causes with the causal factors and of the number of organs affected with the hospital stay were analyzed. 448 dead, whose autopsy had been performed at "Dr. Luis Díaz Soto" Higher Institute of Military Medicine, were examined. The protocols of the autopsy, medical histories and histopathological laminae were reviewed. The 145 cases with criterion of multiple organ damage that were the object of study of this paper, were selected. The results showed the presence of multiple organ damage in a third of the dead. It was mostly observed in those under 50 and in the ones coming from the intermediate therapy and care units. Among the death causes, the severe tissue damage and infection stood out. The most affected organs were the lungs, the bowels, the suprarenal glands, the liver and the brain. Multiple organ damage was present in 59.3 % of the deceased in the first 4 days of hospital stay, with predominance of damage in 5 and 6 organs. The response of the organism to the causal factors triggers the systemic inflammatory response that is morphologically expressed in the multiple organ damage and may cause the death of the patient.

  14. La autopsia en los 50 años del Hospital Militar Central "Dr. Luis Díaz Soto" / Autopsies in the 50 years of "Dr. Luis Díaz Soto" Central Military Hospital"

    Scientific Electronic Library Online (English)

    Teresita, Montero González; José, Hurtado de Mendoza Amat.

    2013-12-01

    Full Text Available Introducción: en 1985 se presentó el Sistema Automatizado de Registro y Control de Anatomía Patológica, objeto de estudio para la docencia y múltiples investigaciones. Objetivo: actualizar las principales causas de muerte en adultos y obtener las experiencias para elevar la calidad de la asistencia [...] médica que se brinda. Métodos: estudio retrospectivo, longitudinal con el referido sistema entre los años 1962 y 2011 de las autopsias realizadas en el Hospital Militar Central "Dr. Luis Díaz Soto". Se analizaron los grupos de edad, sexo, especialidad de egreso, presencia de infección, cáncer, daño múltiple de órganos, causas de muerte y relación clínico-patológica. Resultados: la mitad de los casos fallecidos ocurrió en el área de atención al grave y el daño múltiple de órganos afectó casi el 50 %. La bronconeumonía y el infarto cardiaco constituyeron las principales causas de muerte, mientras que en las básicas resultaron las aterosclerosis. Las discrepancias para ambas causas de muerte fueron de una cada cinco autopsias. Conclusiones: las principales causas de muerte permiten caracterizar los principales problemas de salud. El Sistema Automatizado de Registro y Control de Anatomía Patológica y el daño múltiple de órganos han sido logros importantes de la especialidad obtenidos en 50 años en el Hospital Militar Central "Dr. Luis Díaz Soto". La metodología de trabajo alcanzada en el estudio de la autopsia en dicha institución constituye referencia para otros hospitales y permite elevar la calidad de la asistencia médica que se brinda. Abstract in english Introduction: the Automated Pathological Anatomy Registration and Control System was first introduced in the year 1985 as an object of study for both teaching and a large number of research tasks. Objective: update the main causes of death among adults and obtain experience useful to improve the qua [...] lity of the medical care offered. Methods: retrospective longitudinal study, based on the aforementioned system, of the autopsies performed at "Dr. Luis Díaz Soto" Central Military Hospital between the years 1962 and 2011. The variables analyzed were age group, sex, discharge specialty, presence of infection, cancer, multiple organ damage, cause of death and clinico-pathological relationship. Results: half of the deaths occurred in the critical care area, and multiple organ damage affected nearly 50 %. Bronchopneumonia and cardiac infarction were the main causes of death, whereas atherosclerosis were the basic causes of death. Discrepancies for both causes of death were one in every five autopsies. Conclusions: the main causes of death make it possible to characterize the main health problems. The Automated Registration and Control System for Pathological Anatomy and multiple organ damage is an important achievement obtained by the specialty in the 50 years of "Dr. Luis Díaz Soto" Central Military Hospital. The methodology developed for the study of autopsies in the center constitutes a reference for other hospitals, and makes it possible to improve the quality of the medical care offered.

  15. Importancia y diagnóstico del daño múltiple de órganos en autopsias clínicas Importance and diagnosis of multiple organ failure in clinical autopsies

    Directory of Open Access Journals (Sweden)

    Teresita Montero González

    2008-06-01

    Full Text Available El estudio de más de 14 000 autopsias ha permitido integrar un conjunto de alteraciones morfológicas con el término de daño múltiple de órganos. El propósito del presente trabajo fue determinar la vigencia de los elementos diagnósticos iniciales del daño múltiple de órganos en fallecidos con factores causales. Se realizó un estudio de estos y se analizaron las relaciones de las causas de muerte con los factores causales y el número de órganos afectados con la estadía hospitalaria. Se revisaron 448 fallecidos y a quienes se les había realizado autopsia en el Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto". Se revisaron los protocolos de autopsias, historias clínicas y láminas histopatológicas. Se seleccionaron los 145 casos con criterio de daño múltiple de órganos que constituyeron el objeto de estudio del presente trabajo. Los resultados muestran la presencia del daño múltiple de órganos en un tercio de los fallecidos, que fue mayormente en los menores de 50 años y en los procedentes de las terapias y unidades de cuidados intermedios. Se destacan entre las causas de muerte el daño tisular severo y la infección. Los órganos más afectados fueron los pulmones, el intestino, las glándulas suprarrenales, el hígado y el cerebro. Estuvo presente el daño múltiple de órganos en el 59,3 % de los fallecidos entre los primeros 4 días de estadía hospitalaria, con predominio del daño en 5 y 6 órganos. El daño múltiple de órganos se presentó en más de un tercio de los casos estudiados. La respuesta del organismo ante los factores causales, desencadena la respuesta inflamatoria sistémica que se expresa morfológicamente en el daño múltiple de órganos y puede llevar al paciente a la muerte.The study of more than 14 000 autopsies has allowed to integrate a series of morphological alterations with the term of multiple organ damage. The purpose of this paper was to determine the validity of the initial diagnostic elements in the deceased with causal factors. A study of them was carried out and the relations of the death causes with the causal factors and of the number of organs affected with the hospital stay were analyzed. 448 dead, whose autopsy had been performed at "Dr. Luis Díaz Soto" Higher Institute of Military Medicine, were examined. The protocols of the autopsy, medical histories and histopathological laminae were reviewed. The 145 cases with criterion of multiple organ damage that were the object of study of this paper, were selected. The results showed the presence of multiple organ damage in a third of the dead. It was mostly observed in those under 50 and in the ones coming from the intermediate therapy and care units. Among the death causes, the severe tissue damage and infection stood out. The most affected organs were the lungs, the bowels, the suprarenal glands, the liver and the brain. Multiple organ damage was present in 59.3 % of the deceased in the first 4 days of hospital stay, with predominance of damage in 5 and 6 organs. The response of the organism to the causal factors triggers the systemic inflammatory response that is morphologically expressed in the multiple organ damage and may cause the death of the patient.

  16. An epidemiological study on pattern of thoraco-abdominal injuries sustained in fatal road traffic accidents of Bangalore: Autopsy-based study

    Directory of Open Access Journals (Sweden)

    N Bayapa Reddy

    2014-01-01

    Full Text Available Background: The statistical profile reflects a global estimate of 5.1 million deaths in 2000, which was due to injuries that accounted for 10% of deaths due to all causes. Out of this, a quarter of injury-related deaths occurred in the South-East Asian region. Road Traffic Accident (RTA is one among the top 5 causes of morbidity and mortality in South-East Asian countries. Most common cause of blunt abdominal trauma in India is road traffic accident followed by pedestrian accidents, abdominal blows, and fall from heights. Aims: To analyze the epidemiology and pattern of fatal thoraco-abdominal injuries in road traffic accidents. Materials and Methods: An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 100 post-mortems of road traffic accident between November 2008 and May 2010 subjected to medico-legal autopsy at the department of Forensic Medicine, KIMS Hospital Bangalore. Results: The majority of the victims were aged 21 to 40 years, 50 (50.0%, most of the victims were male 92 (92.0%; and male/female ratio was 11.5:1. Commonest offending agents in heavy motor vehicles were 54 (54.0%. Bony cage sustained injuries were observed in 71; out of this, fractures of ribs were observed in 45 (63.3% victims, clavicle in 14 (19.7%, sternum was 6 (8.4%, and vertebrae 6 (8.4% of fatal road traffic accidents. Internal thoracic injuries were observed in 26 cases. Among internal thoracic injuries, lungs were the most commonly involved organ 24 (92.3% followed by the heart 2 (7.6%. Lung sustained more lacerations 19 (79.1% than contusions 5 (20.8%. Internal abdominal injuries were observed in 49 cases. In road traffic accidents, the most commonly injured abdominal organs were solid organs such as liver 16 (32.6% followed by spleen 9 (18.3%. Conclusions: Majority of the times in road traffic accidents, young and productive males were injured or lost their life. This study may help the planners to take safety measures, to implement strict traffic rules, to risk stratification in the susceptible population to educate the people, and the study of nature of offending agent in RTA can help the authorities to plan better availability of health care on roads.

  17. Autópsias psicológicas sobre suicídio de idosos no Rio de Janeiro Psychogical autopsies into suicide among the elderly in Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Maria Cecília de Souza Minayo

    2012-10-01

    Full Text Available Esse estudo analisa autópsias psicológicas e contextualiza problemas e fatores que levaram algumas pessoas idosas a acabar com a própria vida na cidade do Rio de Janeiro, entre 2004 e 2007. O estudo parte de 26 laudos periciais de homens e mulheres que cometeram suicídios no centro, na zona norte e na zona sul da cidade. As famílias desses idosos foram contatadas por carta e telefone e depois, pessoalmente. Foram oito autópsias psicológicas, por meio das quais foram coletados dados de identificação, genograma da família e uma entrevista que reconstituiu o modo de vida e as razões da violência autoinfligida. Os entrevistados foram familiares, amigos e conhecidos das vítimas. Os suicídios estão associados a depressão, a enfermidades físicas e mentais graves e a fatores socioculturais como decadência profissional e socioeconômica. Esses eventos ocorreram com e sem apoio familiar, com e sem acompanhamento médico. A fragilização cumulativa de recursos pessoais e sociais no ciclo vital revela que o risco do suicídio em idosos exige cuidados permanentes de saúde pública.This study analyses psychological autopsies and contextualizes problems and issues that led to elderly people taking their own lives in the city of Rio de Janeiro between 2004 and 2007. The study began with an analysis of 26 expert findings of elderly men and women who committed suicide in the central, northern and southern areas of Rio de Janeiro. The sample was contacted by letter and telephone and after that, by a one-on-one conversation. Eight psychological autopsies were conducted, in which identification data and family genograms were collected followed by an interview to profile the life style and the reasons for the self-inflicted violence. The interviewees were family members, friends and acquaintances of the victims. The suicides are associated with depression, serious physical and mental illness, as well as socio-cultural factors related to professional and socio-economic decline. The suicides occurred with and without family support, with and without medical care. The cumulative fragility of personal and social resources within the life cycle reveals that the risk of suicide among the elderly demands permanent care from the public health authorities.

  18. Hematoma Disecante de la Parte Torácica de la Aorta: Estudio Anatomopatológico de Siete Casos de Autopsias Dissecting Hematoma of the Thoracic Aorta: Pathology Study of Seven Autopsy Cases

    Directory of Open Access Journals (Sweden)

    Julio César Guerini

    2011-12-01

    Full Text Available El hematoma disecante de aorta (HDA se define como la disección de la pared aórtica por la sangre, con formación de una nueva luz. Es la patología letal de la aorta más frecuentemente diagnosticada y ocurre con una frecuencia tres veces mayor que la rotura del aneurisma de la aorta abdominal. Nuestro objetivo es presentar siete casos de HDA observados en autopsias, describir los hallazgos anatomopatológicos y comentar la literatura. Los casos estudiados corresponden al Servicio de Patología del Instituto de Medicina Forense de Córdoba, Argentina. Los tejidos fueron fijados en formol al 10%, incluidos en parafina y coloreados con hematoxilina-eosina, tricrómico de Masson y PAS (Peryodic Acid Schiff. De los siete casos presentados cuatro correspondieron a mujeres (57,1% y tres a hombres (42,8%. Todos los casos estudiados tenían antecedentes de hipertensión arterial. La evolución posible de la disección aórtica incluye: rotura de la adventicia con hemorragia masiva y muerte, comunicación nuevamente con la luz aórtica, propagación al ostium coronario, isquemia de órganos y la formación de un aneurisma.Dissecting aortic hematoma (DAH is defined as the dissection of the aortic wall by the blood, with formation of a new light. It is the deadliest disease of the aorta and occurs more frequently diagnosed at a rate three times greater than the ruptured aneurysm of the abdominal aorta. Our goal is to present seven cases of DAH observed in autopsies, describe the autopsy findings and comment on the literature. All cases studied belong to the Department of Pathology, Institute of Forensic Medicine of Cordoba, Argentina. The tissues were fixed in 10% formalin, embedded in paraffin and stained with hematoxylin-eosin, Masson trichrome and PAS (Peryodic Acid Schiff. Of all the cases studied, four were women (57.1% and three men (42.8%. All had a history of hypertension. Evolution of aortic dissection may include: failure of the adventitia with massive hemorrhage and death, again communication with the aortic lumen, spread the coronary ostium, organ ischemia and aneurysm formation.

  19. Hematoma Disecante de la Parte Torácica de la Aorta: Estudio Anatomopatológico de Siete Casos de Autopsias / Dissecting Hematoma of the Thoracic Aorta: Pathology Study of Seven Autopsy Cases

    Scientific Electronic Library Online (English)

    Julio César, Guerini; Andrea, Storniolo Squintone; Alba, Borchert; Ismael Bernardo, Fonseca; Rodolfo Esteban, Avila; Luis Santos, Spitale.

    2011-12-01

    Full Text Available El hematoma disecante de aorta (HDA) se define como la disección de la pared aórtica por la sangre, con formación de una nueva luz. Es la patología letal de la aorta más frecuentemente diagnosticada y ocurre con una frecuencia tres veces mayor que la rotura del aneurisma de la aorta abdominal. Nuest [...] ro objetivo es presentar siete casos de HDA observados en autopsias, describir los hallazgos anatomopatológicos y comentar la literatura. Los casos estudiados corresponden al Servicio de Patología del Instituto de Medicina Forense de Córdoba, Argentina. Los tejidos fueron fijados en formol al 10%, incluidos en parafina y coloreados con hematoxilina-eosina, tricrómico de Masson y PAS (Peryodic Acid Schiff). De los siete casos presentados cuatro correspondieron a mujeres (57,1%) y tres a hombres (42,8%). Todos los casos estudiados tenían antecedentes de hipertensión arterial. La evolución posible de la disección aórtica incluye: rotura de la adventicia con hemorragia masiva y muerte, comunicación nuevamente con la luz aórtica, propagación al ostium coronario, isquemia de órganos y la formación de un aneurisma. Abstract in english Dissecting aortic hematoma (DAH) is defined as the dissection of the aortic wall by the blood, with formation of a new light. It is the deadliest disease of the aorta and occurs more frequently diagnosed at a rate three times greater than the ruptured aneurysm of the abdominal aorta. Our goal is to [...] present seven cases of DAH observed in autopsies, describe the autopsy findings and comment on the literature. All cases studied belong to the Department of Pathology, Institute of Forensic Medicine of Cordoba, Argentina. The tissues were fixed in 10% formalin, embedded in paraffin and stained with hematoxylin-eosin, Masson trichrome and PAS (Peryodic Acid Schiff). Of all the cases studied, four were women (57.1%) and three men (42.8%). All had a history of hypertension. Evolution of aortic dissection may include: failure of the adventitia with massive hemorrhage and death, again communication with the aortic lumen, spread the coronary ostium, organ ischemia and aneurysm formation.

  20. Autopsia por silico-asbestosis: revisión a propósito de un caso forense / Autopsy by silico-asbestosis: a review of a forensic case

    Scientific Electronic Library Online (English)

    A., Sibón Olano; E., Sánchez Rodríguez; E., Barrera Pérez; J., Larrondo Espinosa; M., Salguero Villadiego.

    2014-09-01

    Full Text Available Se presenta el caso de un varón de 72 años de edad, ex fumador desde hace años, diagnosticado de silicosis y carcinoma epidermoide de pulmón derecho, solicitándose por parte de la familia autopsia judicial por la sospecha de padecimiento de asbestosis y tras su confirmación reclamación como enfermed [...] ad profesional. La exposición de este suceso nos permite realizar una revisión de una enfermedad profesional que suele pasar como desconocida en las salas de autopsia, a pesar de su repercusión judicial. La asbestosis es un tipo de neumoconiosis reconocida como enfermedad profesional producida por la inhalación de fibras de asbesto. Su inhalación provoca fibrosis pulmonar. Presenta un tiempo de latencia clínica inversamente proporcional al nivel de exposición. Además de fibrosis pulmonar pueden producirse derrames pleurales, placas fibrosas pleurales, mesoteliomas, carcinomas pleurales y carcinoma de laringe. La silicosis es la neumoconiosis producida por inhalación de partículas de sílice, entendiendo por neumoconiosis la enfermedad ocasionada por el depósito de polvo en los pulmones con una reacción patológica frente a este, en especial de tipo fibroso. La silicosis es una enfermedad fibrótica-pulmonar de carácter irreversible y considerada enfermedad profesional incapacitante en muchos países, una de cuyas variantes más raras es la silico-asbestosis, la cual requiere exposición al sílice y al amianto. Abstract in english The case is presented the case of a 72-year-old ex-smoker for years, diagnosed with silicosis and squamous cell carcinoma of the right lung, being requested by the judicial autopsy family suspected of suffering from asbestosis and after confirmation complaint as an occupational disease. The exposure [...] of this event allows us to conduct a review of an occupational disease usually happens as unknown in autopsy rooms despite its legal repercussions. Asbestosis is a type of pneumoconiosis recognized as an occupational disease caused by inhaling asbestos fibers. Inhalation causes pulmonary fibrosis in the lung presenting a time inversely proportional to the exposure level clinical latency. Besides pulmonary fibrosis may occur pleural effusions, pleural fibrous plaques, mesothelioma, pleural carcinomas and laryngeal carcinoma. Silicosis is produced by inhalation pneumoconiosis silica particles, meaning the disease caused by pneumoconiosis dust deposit in the lungs with a pathological reaction to the same, especially fibrous. Silicosis is a fibrotic lung disease-and considered irreversible disabling occupational disease in many countries one of which is the more rare variants silico asbestosis, which requires exposure to silica and asbestos.

  1. A social autopsy of neonatal mortality suggests needed improvements in maternal and neonatal interventions in Balaka and Salima districts of Malawi

    Directory of Open Access Journals (Sweden)

    Alain K. Koffi

    2015-06-01

    Full Text Available Background The Every Newborn Action Plan calls for reducing the neonatal mortality rates to fewer than 10 deaths per 1000 live births in all countries by 2035. The current study aims to increase our understanding of the social and modifiable factors that can be addressed or reinforced to improve and accelerate the decline in neonatal mortality in Malawi. Methods The data come from the 2013 Verbal and Social Autopsy (VASA study that collected data in order to describe the biological causes and the social determinants of deaths of children under 5 years of age in Balaka and Salima districts of Malawi. This paper analyses the social autopsy data of the neonatal deaths and presents results of a review of the coverage of key interventions along the continuum of normal maternal and newborn care and the description of breakdowns in the care provided for neonatal illnesses within the Pathway to Survival framework. Results A total of 320 neonatal deaths were confirmed from the VASA survey. While one antenatal care (ANC visit was high at 94%, the recommended four ANC visits was much lower at 41% and just 17% of the mothers had their urines tested during the pregnancy. 173 (54% mothers of the deceased newborns had at least one labor/delivery complication that began at home. The caregivers of 65% (n?=?75 of the 180 newborns that were born at home or born and left a health facility alive perceived them to be severely ill at the onset of their illness, yet only 44% (n?=?80 attempted and 36% (n?=?65could reach the first health provider after an average of 91 minutes travel time. Distance, lack of transport and cost emerged as the most important constraints to formal care–seeking during delivery and during the newborn fatal illness. Conclusions This study suggests that maternal and neonatal health organizations and the local government of Malawi should increase the demand for key maternal and child health interventions, including the recommended 4 ANC visits, and ensure urine screening for all pregnant women. Early recognition and referrals of women with obstetric complications and interventions to promote maternal recognition of neonatal illnesses and care–seeking before the child becomes severely ill are also needed to improve newborn survival in Balaka and Salima districts of Malawi.

  2. Autópsias psicológicas sobre suicídio de idosos no Rio de Janeiro / Psychogical autopsies into suicide among the elderly in Rio de Janeiro

    Scientific Electronic Library Online (English)

    Maria Cecília de Souza, Minayo; Fátima Gonçalves, Cavalcante; Raimunda Matilde do Nascimento, Mangas; Juliana Rangel Alves de, Souza.

    2012-10-01

    Full Text Available Esse estudo analisa autópsias psicológicas e contextualiza problemas e fatores que levaram algumas pessoas idosas a acabar com a própria vida na cidade do Rio de Janeiro, entre 2004 e 2007. O estudo parte de 26 laudos periciais de homens e mulheres que cometeram suicídios no centro, na zona norte e [...] na zona sul da cidade. As famílias desses idosos foram contatadas por carta e telefone e depois, pessoalmente. Foram oito autópsias psicológicas, por meio das quais foram coletados dados de identificação, genograma da família e uma entrevista que reconstituiu o modo de vida e as razões da violência autoinfligida. Os entrevistados foram familiares, amigos e conhecidos das vítimas. Os suicídios estão associados a depressão, a enfermidades físicas e mentais graves e a fatores socioculturais como decadência profissional e socioeconômica. Esses eventos ocorreram com e sem apoio familiar, com e sem acompanhamento médico. A fragilização cumulativa de recursos pessoais e sociais no ciclo vital revela que o risco do suicídio em idosos exige cuidados permanentes de saúde pública. Abstract in english This study analyses psychological autopsies and contextualizes problems and issues that led to elderly people taking their own lives in the city of Rio de Janeiro between 2004 and 2007. The study began with an analysis of 26 expert findings of elderly men and women who committed suicide in the centr [...] al, northern and southern areas of Rio de Janeiro. The sample was contacted by letter and telephone and after that, by a one-on-one conversation. Eight psychological autopsies were conducted, in which identification data and family genograms were collected followed by an interview to profile the life style and the reasons for the self-inflicted violence. The interviewees were family members, friends and acquaintances of the victims. The suicides are associated with depression, serious physical and mental illness, as well as socio-cultural factors related to professional and socio-economic decline. The suicides occurred with and without family support, with and without medical care. The cumulative fragility of personal and social resources within the life cycle reveals that the risk of suicide among the elderly demands permanent care from the public health authorities.

  3. Infective endocarditis (IE) first diagnosed at autopsy: analysis of 31 cases in Ribeirão Preto, Brazil Endocardite infecciosa (EI) com diagnóstico feito apenas à necrópsia: análise de 31 casos ocorridos entre 1992 e 1997, em Ribeirão Preto, Brasil

    OpenAIRE

    Figueiredo, Luiz Tadeu M.; RUIZ-JUNIOR Everaldo; SCHIRMBECK Tarciso

    2001-01-01

    Thirty one infective endocarditis (IE) fatal cases whose diagnosis was first obtained at autopsy were studied. The clinical data of these patients (Group 1) showed significant differences compared to other 141 IE cases (Group 2). The average age of 53 years in Group 1 patients was 18 years higher than that of Group 2. The Group 1 patients had a low frequency of IE predisposing heart disease. Both patient groups presented fever (about 87%), but a significant low frequency of cardiac murmur (25...

  4. [Analysis of cases of deliberate injuries with a fatal outcome during 1972-1981 from autopsy material of the Institute of Forensic Medicine at the Medical School Hospital in Martin].

    Science.gov (United States)

    Hulejová, T; Osif, E

    1984-08-01

    Authors had performed statistical analysis of decenal autopsy material from Department of Forensic Medicine, Faculty Hospital, Martin, with particular focusing on deliberated fatal injuries (81 cases). The analysis of circumstances and mode of the crime with focusing on the personality and relations between the agressor and the victim was also done. The future step in the analysis will be forwarded to explain possible bioclimatological influences on committment of such kind of violences. PMID:6505756

  5. Primary lymphoma of the central nervous system: a clinical-pathological and immunohistochemical study of ten autopsy cases Linfoma primário do sistema nervoso central: estudo clínico-patológico e imuno-histoquímico de dez casos de necropsia

    OpenAIRE

    Henrique Costa; Marcello Franco; Myriam Dumas Hahn

    2006-01-01

    CONTEXT: Primary central nervous system lymphomas (PCNSL) are a rare subgroup of lymphomas generally associated with HIV and EBV. OBJECTIVE: To study ten autopsy cases of PCNSL, to describe the neuropathological findings, to characterize the phenotype of the neoplastic cells, to detect EBV in the lesion and to compare the findings with the clinical and laboratory data of the patients. METHOD: The clinical, histological and immunohistochemical data of ten cases of PCNSL, eight cases from patie...

  6. Causas de óbito em pacientes com síndrome da imunodeficiência adquirida, necropsiados na Fundação de Medicina Tropical do Amazonas Causes of death among patients with acquired immunodeficiency syndrome autopsied at the Tropical Medicine Foundation of Amazonas

    Directory of Open Access Journals (Sweden)

    Sílvia Leopoldina Santos de Souza

    2008-06-01

    Full Text Available O objetivo deste estudo foi verificar em 129 pacientes com AIDS, necropsiados na Fundação de Medicina Tropical do Amazonas de 1996 a 2003, as causas do óbito, observando o grau de concordância entre os diagnósticos necroscópicos com os diagnósticos clínicos. A doença mais freqüente que causou o óbito foi tuberculose 28%, seguida de pneumonia bacteriana 17%, histoplasmose 13%, toxoplasmose 10%, pneumocistose 8%, criptococose 5%, sepse bacteriana 4% e 15% outras causas. A concordância entre o diagnóstico clínico antemortem e a necropsia foi de 51,9%. O principal órgão acometido foi o pulmão 82,2%. O tempo de sobrevivência após o diagnóstico laboratorial até o óbito variou entre um mês e 120 meses. A média de sobrevivência foi 15 dias e 56% morreram menos de um mês após o diagnóstico, 15 pacientes morreram na mesma data do diagnóstico. Esses resultados demonstram a importância da necropsia na causa mortis em pacientes com AIDS.The aim of this study was to investigate the causes of death among 129 AIDS patients that were autopsied at the Tropical Medicine Foundation of Amazonas between 1996 and 2003. The degree of concordance between the autopsy diagnoses and the clinical diagnoses was observed. The disease that most frequently caused death was tuberculosis (28%, followed by bacterial pneumonia (17%, histoplasmosis (13%, toxoplasmosis (10%, pneumocystosis (8%, cryptococcosis (5%, bacterial sepsis (4% and other causes (15%. The concordance between the clinical diagnosis before death and the autopsy was 51.9%. The main organ involved was the lungs (82.2%. The length of survival from the time of the laboratory diagnosis to death ranged from one month to 120 months. The mean length of survival was 15 days and 56% died less than one month after the diagnosis, while 15 patients died on the same day that they were diagnosed. These results show the importance of autopsies in elucidating the causes of death among AIDS patients.

  7. Causas de óbito em pacientes com síndrome da imunodeficiência adquirida, necropsiados na Fundação de Medicina Tropical do Amazonas / Causes of death among patients with acquired immunodeficiency syndrome autopsied at the Tropical Medicine Foundation of Amazonas

    Scientific Electronic Library Online (English)

    Sílvia Leopoldina Santos de, Souza; Pablo Vinícius Silveira, Feitoza; José Ribamar de, Araújo; Rosilene Viana de, Andrade; Luiz Carlos de Lima, Ferreira.

    2008-06-01

    Full Text Available O objetivo deste estudo foi verificar em 129 pacientes com AIDS, necropsiados na Fundação de Medicina Tropical do Amazonas de 1996 a 2003, as causas do óbito, observando o grau de concordância entre os diagnósticos necroscópicos com os diagnósticos clínicos. A doença mais freqüente que causou o óbit [...] o foi tuberculose 28%, seguida de pneumonia bacteriana 17%, histoplasmose 13%, toxoplasmose 10%, pneumocistose 8%, criptococose 5%, sepse bacteriana 4% e 15% outras causas. A concordância entre o diagnóstico clínico antemortem e a necropsia foi de 51,9%. O principal órgão acometido foi o pulmão 82,2%. O tempo de sobrevivência após o diagnóstico laboratorial até o óbito variou entre um mês e 120 meses. A média de sobrevivência foi 15 dias e 56% morreram menos de um mês após o diagnóstico, 15 pacientes morreram na mesma data do diagnóstico. Esses resultados demonstram a importância da necropsia na causa mortis em pacientes com AIDS. Abstract in english The aim of this study was to investigate the causes of death among 129 AIDS patients that were autopsied at the Tropical Medicine Foundation of Amazonas between 1996 and 2003. The degree of concordance between the autopsy diagnoses and the clinical diagnoses was observed. The disease that most frequ [...] ently caused death was tuberculosis (28%), followed by bacterial pneumonia (17%), histoplasmosis (13%), toxoplasmosis (10%), pneumocystosis (8%), cryptococcosis (5%), bacterial sepsis (4%) and other causes (15%). The concordance between the clinical diagnosis before death and the autopsy was 51.9%. The main organ involved was the lungs (82.2%). The length of survival from the time of the laboratory diagnosis to death ranged from one month to 120 months. The mean length of survival was 15 days and 56% died less than one month after the diagnosis, while 15 patients died on the same day that they were diagnosed. These results show the importance of autopsies in elucidating the causes of death among AIDS patients.

  8. Verbal/Social Autopsy in Niger 2012-2013: A new tool for a better understanding of the neonatal and child mortality situation.

    Science.gov (United States)

    Bensaïd, Khaled; Yaroh, Asma Gali; Kalter, Henry D; Koffi, Alain K; Amouzou, Agbessi; Maina, Abdou; Kazmi, Narjis

    2016-06-01

    Niger, one of the poorest countries in the world, recently used for the first time the integrated verbal and social autopsy (VASA) tool to assess the biological causes and social and health system determinants of neonatal and child deaths. These notes summarize the Nigerien experience in the use of this new tool, the steps taken for high level engagement of the Niger government and stakeholders for the wide dissemination of the study results and their use to support policy development and maternal, neonatal and child health programming in the country. The experience in Niger reflects lessons learned by other developing countries in strengthening the use of data for evidence-based decision making, and highlights the need for the global health community to provide continued support to country data initiatives, including the collection, analysis, interpretation and utilization of high quality data for the development of targeted, highly effective interventions. In Niger, this is supporting the country's progress toward achieving Millennium Development Goal 4. A follow-up VASA study is being planned and the tool is being integrated into the National Health Management Information System. VASA studies have now been completed or are under way in additional sub-Saharan African countries, in each through the same collaborative process used in Niger to bring together health policy makers, program planners and development partners. PMID:26955472

  9. The high prevalence of undiagnosed prostate cancer at autopsy: implications for epidemiology and treatment of prostate cancer in the Prostate-specific Antigen-era.

    Science.gov (United States)

    Jahn, Jaquelyn L; Giovannucci, Edward L; Stampfer, Meir J

    2015-12-15

    Widespread prostate-specific antigen (PSA) screening detects many cancers that would have otherwise gone undiagnosed. To estimate the prevalence of unsuspected prostate cancer, we reviewed 19 studies of prostate cancer discovered at autopsy among 6,024 men. Among men aged 70-79, tumor was found in 36% of Caucasians and 51% of African-Americans. This enormous prevalence, coupled with the high sensitivity of PSA screening, has led to the marked increase in the apparent incidence of prostate cancer. The impact of PSA screening on clinical practice is well-recognized, but its effect on epidemiologic research is less appreciated. Before screening, a larger proportion of incident prostate cancers had lethal potential and were diagnosed at advanced stage. However, in the PSA era, overall incident prostate cancer mainly is indolent disease, and often reflects the propensity to be screened and biopsied. Studies must therefore focus on cancers with lethal potential, and include long follow-up to accommodate the lead time induced by screening. Moreover, risk factor patterns differ markedly for potentially lethal and indolent disease, suggesting separate etiologies and distinct disease entities. Studies of total incident or indolent prostate cancer are of limited clinical utility, and the main focus of research should be on prostate cancers of lethal potential. PMID:25557753

  10. The relationship between impulsivity and suicide among rural youths aged 15-35 years: a case-control psychological autopsy study.

    Science.gov (United States)

    Lin, Lin; Zhang, Jie; Zhou, Li; Jiang, Chao

    2016-04-01

    In China, the gender ratio of suicide rates did not match the Western patterns, which was higher for females than males. However, the rural men were at relatively high risk of suicide in Liaoning province. Impulsivity was an important factor of suicide behaviors, but there was a lack of studies in China. This research aimed to study the relationship between impulsive personality traits and suicidal behavior among Chinese rural youths. Suicides were consecutively sampled from six randomly selected counties in Liaoning Province in China. Between 2005 and 2007, a total of 162 suicide victims were enrolled in the study along with 162 community controls matched for age, gender, and location. The psychological autopsy method was used to collect data from informants knowledgeable about the selected suicide victims and controls. The results showed the suicide victims in the study were more likely to demonstrate dysfunctional impulsivity and less likely to demonstrate functional impulsivity compared with the controls. Mental disorders, acute negative life events, and dysfunctional impulsivity contributed to the risk of suicide; educational and functional impulsivity were protective factors. Suicide prevention efforts in rural China may address impulsivity. PMID:26110614

  11. In-depth analyses of organic matters in a full-scale seawater desalination plant and an autopsy of reverse osmosis membrane

    KAUST Repository

    Jeong, Sanghyun

    2016-02-17

    In order to facilitate the global performance of seawater reverse osmosis (SWRO) systems, it is important to improve the feed water quality before it enters the RO. Currently, many desalination plants experience production losses due to incidents of organic and biofouling. Consequently, monitoring or characterizing the pretreatment step using more advanced organic and biological parameters are required for better operation to lessen fouling issues. In this study, the performance of pretreatment processes (including coagulation, dual media filtration (DMF), polishing with cartridge filter (CF) coupled with anti-scalant) used at Perth Seawater Desalination Plant (PSDP) located in Western Australia were characterized in terms of organic and biological fouling parameters. These analyses were carried out using liquid chromatography with organic carbon detector (LC-OCD), three dimensional-fluorescence excitation emission matrix (3D-FEEM) and assimilable organic carbon (AOC). Furthermore, the used (exhausted) RO membrane and CF were autopsied so that the fates and behaviors of organic foulants in these treatment systems could be better understood.

  12. Contribution of forensic autopsy to scene reconstruction in mass fire casualties: a case of alleged arson on a floor consisting of small compartments in a building.

    Science.gov (United States)

    Michiue, Tomomi; Ishikawa, Takaki; Oritani, Shigeki; Maeda, Hitoshi

    2015-01-01

    A fire is an important cause of mass disasters, involving various forensic issues. Before dawn on an early morning, 16 male visitors in their twenties to sixties were killed in a possibly incendiary fire at a 'private video parlor' consisting of small compartments in a building. The main causes of death as determined by forensic autopsy were acute carbon monoxide (CO) intoxication for all of the 15 found-dead victims, and hypoxic-ischemic encephalopathy following acute CO intoxication for a victim who died in hospital. Burns were mild (carboxyhemoglobin saturation (COHb) was higher for victims found dead in the inner area. Blood cyanide levels were sublethal, moderately correlated to COHb, but were higher in victims found around the estimated fire-outbreak site. There was no evidence of thinner, alcohol or drug abuse, or an attack of disease as a possible cause of an accidental fire outbreak. These observations contribute to evidence-based reconstruction of the fire disaster, and suggest how deaths could have been prevented by appropriate disaster measures. PMID:25311374

  13. The Experience of ICD Utilization on Verbal Autopsy Data to Obtain Trend of Cause of Death in Indonesian Population (1992–2007

    Directory of Open Access Journals (Sweden)

    Sarimawar Djaja

    2014-11-01

    Full Text Available Background: Cause of death data is necessary for arranging health programs. The needs of these data is not fulfill yet through reporting and recording system from health facilities only,therefore national health survei should be conducted regularly. Objective: To obtain cause of death trends in the populations from VA data. Methods: Material taken from Nasional Health Survey 1992, 1995, 2001, 2007 covering 65,664 households (HH, 206,240 HH, 211,168 HH, 258,366 HH respectively, selected by stratified random sampling technique using core and module sample of Socio Economic National Survey (Susenas and taken with a Probability Proportional to Size method. Cause of death data was collected by structured questionnaire using verbal autopsy (VA technique and was classified based on ICD 9 and ICD 10. Results: The disease patterns of cause of death from 1992 to 2007 showed the non-communicable disease is increasing continuously while communicable disease (infectious, maternal and perinatal, nutritional deficiencies is decreasing; however the burden of disease is still present on both groups of diseases. Conclusions: The little bit less accurate VA data (1992–2007 collected is able to produce national statistic data of cause of death and could be used to suggest health planning program managers in Indonesia

  14. An inferior sinus venosus interatrial communication associated with a secundum atrial septal defect, clinically presenting in an adult patient: autopsy report

    Directory of Open Access Journals (Sweden)

    Silvana Maria Lovisolo

    2011-12-01

    Full Text Available Atrial septal defects (ASD are the most common congenital cardiac lesionin adults, representing up to 40% of acyanotic shunt lesions in patients olderthan 40 years. Secundum ASD comprises defects in the area of the ovalfossa, and may be associated with other types of interatrial communications.We present a case of a 25 year-old female patient who was asymptomaticuntil the age 22 when she started presenting exertion dyspnea and lowerlimbs edema, during her third pregnancy. The patient was admitted in theemergency department because of a febrile respiratory distress syndromedying in less than 36 hours after her arrival. The autopsy examination revealedpneumonia and a secundum ASD, associated with a rare form of interatrialcommunication, the inferior sinus venosus defect, which is characterized byan anomalous connection of the right pulmonary veins to the inferior caval veinat its opening in the right atrial cavity, while retaining partially their connectionto the left atrium. A dysplastic and thickened mitral valve was also present.Signs of pulmonary hypertension confirm the Eisenmenger syndrome in thisadult patient.

  15. Polymorphisms in IL-10 and INF-? genes are associated with early atherosclerosis in coronary but not in carotid arteries: A study of 122 autopsy cases of young adults.

    Science.gov (United States)

    Esperança, José Carlos P; Miranda, William R R; Netto, José B; Lima, Fabiane S; Baumworcel, Leonardo; Chimelli, Leila; Silva, Rosane; Ürményi, Turán P; Cabello, Pedro H; Rondinelli, Edson; Faffe, Débora S

    2015-06-01

    Atherosclerosis is a complex disease, involving both genetic and environmental factors. However, the influence of genetic variations on its early development remains unclear. This study examined the association of 12 different polymorphisms with atherosclerosis severity in anterior descending coronary (DA, n = 103) and carotid arteries (CA, n = 66) of autopsied young adults (projectile or car accident was the main cause of death, and no information about classical risk factors was available. Histological analysis showed high prevalence of type III atherosclerotic lesions in both DA (69%) and CA (39%) arteries, while severe type IV and V lesions were observed in 14% (DA) and 33% (CA). Allele frequencies and genotype distributions were determined. Among the polymorphisms studied, IFN-? and IL-10 (- 1082 A/G) were related to atherosclerosis severity in DA artery. No association between genotypes and lesion severity was found in CA. In conclusion, we observed that the high prevalence of early atherosclerosis in young adults is associated with IFN-? (p < 0.001) and IL-10 (p = 0.013) genotypes. This association is blood vessel dependent. Our findings suggest that the vascular system presents site specialization, and specific genetic variations may provide future biomarkers for early disease identification. PMID:26674973

  16. Development of proton-induced x-ray emission techniques with application to multielement analyses of human autopsy tissues and obsidian artifacts

    International Nuclear Information System (INIS)

    A method of trace element analysis using proton-induced x-ray emission (PIXE) techniques with energy dispersive x-ray detection methods is described. Data were processed using the computer program ANALEX. PIXE analysis methods were applied to the analysis of liver, spleen, aorta, kidney medulla, kidney cortex, abdominal fat, pancreas, and hair from autopsies of Pima Indians. Tissues were freeze dried and low temperature ashed before analysis. Concentrations were tabulated for K, Ca, Ti, Mn, Fe, Co, Ni, Cu, Zn, Pb, Se, Br, Rb, Sr, Cd, and Cs and examined for significant differences related to diabetes. Concentrations of Ca and Sr in aorta, Fe and Rb in spleen and Mn in liver had different patterns in diabetics than in nondiabetics. High Cs concentrations were also observed in the kidneys of two subjects who died of renal disorders. Analyses by atomic absorption and PIXE methods were compared. PIXE methods were also applied to elemental analysis of obsidian artifacts from Campeche, Mexico. Based on K, Ba, Mn, Fe, Rb, Sr and Zr concentrations, the artifacts were related to several Guatemalan sources. (Diss. Abstr. Int., B)

  17. An unusual autopsy case of incomplete decapitation of a motorcyclist with herniation of thoracic organs through a helmet-related neck wound.

    Science.gov (United States)

    Gioia, Sara; Suadoni, Fabio; Carlini, Luigi; Lancia, Massimo; Bacci, Mauro

    2013-12-01

    The authors report an unusual autopsy case of a motorcyclist who wore a full-face type helmet and had incomplete decapitation and herniation of the heart and a portion of the right lung through an extensive lacerate wound on the front of the neck after his motorcycle crashed. The authors identified 2 main offensive dynamics that occurred simultaneously: First, partial decapitation with a extensive gaping wound on the neck caused by the chin strap after a violent angular movement of the head; second, the translocation of the abdominal organs into the thorax and the herniation of the thoracic organs through the neck wound generated by a compressive trauma of the thorax and abdomen. This singular case, like few others in forensic literature, shows the possibility of helmet chin strap-related traumas and highlights the limitations of modern protective helmets. If the postulated mechanism is confirmed despite the massive benefits derived from the compulsory use of protective helmets, the properties of the helmet chin strap would need to be reassessed to improve the protection of the soft tissue and bones in the neck. PMID:24189629

  18. Methodological trends in studies based on verbal autopsies before and after published guidelines / Tendances méthodologiques des études reposant sur des autopsies verbales avant et après la publication de directives / Tendencias metodológicas de los estudios basados en autopsias verbales antes y después de la publicación de directrices al respecto

    Scientific Electronic Library Online (English)

    Rohina, Joshi; Andre Pascal, Kengne; Bruce, Neal.

    2009-09-01

    Full Text Available OBJETIVO: Informar sobre el seguimiento de las directrices publicadas a comienzos de los años noventa con recomendaciones específicas para el diseño de los futuros estudios de vigilancia de la mortalidad basados en autopsias verbales. MÉTODOS: Llevamos a cabo una búsqueda sistemática de la bibliogra [...] fía para localizar todos los estudios basados en autopsias verbales publicados antes de enero de 2006 y extraer de ellos un conjunto estándar de datos. Para comparar los estudios diseñados antes y después de que se formularan las recomendaciones se emplearon siete indicadores metodológicos clave. RESULTADOS: Hallamos 102 estudios realizados en 39 países; 60 se habían diseñado antes de que se publicaran las directrices, y 42 después de su publicación. Se observaron diferencias considerables en los métodos utilizados por esos 102 estudios. Aunque se detectaron algunas tendencias alentadoras, no hay indicios de que se hayan aplicado sistemáticamente las recomendaciones en materia de diseño. Más concretamente, no aumentó claramente la proporción de estudios con un cuestionario combinado (63% antes de las recomendaciones frente a 74% después de las mismas; p = 0,3), un encuestador adiestrado (70% frente a 70%; p = 1,0), un encuestado idóneo (98% frente a 100%; p = 1,0), un periodo de rememoración óptimo (84% frente a 97%; p = 0,2), algoritmos predefinidos (28% frente a 38%; p = 0,4), una opción para asignar varias causas de defunción (30% frente a 38%; p = 0,3), o un estudio de validación de seguimiento (83% frente a 72%; p = 0,7). CONCLUSIÓN: Las recomendaciones formuladas por los expertos para optimizar el diseño de los estudios basados en autopsias verbales se han aplicado solo parcialmente hasta la fecha. Un mayor cumplimiento de ese tipo de recomendaciones gracias a una colaboración más idónea entre los equipos de investigación permitiría probablemente obtener mejores estadísticas de mortalidad a partir del creciente número de estudios basados en autopsias verbales. Abstract in english OBJECTIVE: To report on the uptake of guidelines published in the early 1990s with specific recommendations about the design of future studies based on verbal autopsy conducted for mortality surveillance. METHODS: We conducted a systematic literature search of all verbal autopsy studies published be [...] fore January 2006 and extracted from the studies a standard set of data. We then compared studies designed before and after the recommendations were issued in terms of seven key methodological indicators. FINDINGS: We found 102 studies conducted in 39 countries; 60 were designed before and 42 after the guidelines were issued. The methods used in these 102 studies varied considerably. While some encouraging trends were noted, there is no evidence that the design recommendations have been systematically implemented. Specifically, there was no clear increase in the proportion of studies with a combined questionnaire (63% before recommendations versus 74% after; P = 0.3), a trained interviewer (70% versus 70%; P = 1.0), a suitable respondent (98% versus 100%; P = 1.0), an optimal recall period (84% versus 97%; P = 0.2), predefined algorithms (28% versus 38%; P = 0.4), an option for assigning multiple causes of death (30% versus 38%; P = 0.3), or a follow-up validation study (83% versus 72%; P = 0.7). CONCLUSION: Expert recommendations for optimal design of verbal autopsy studies have been incompletely implemented to date. Better uptake of design recommendations through enhanced collaboration between research teams is likely to produce better mortality statistics from an increasing number of verbal autopsy studies.

  19. The effects of aging on biceps brachii muscle fibers: a morphometrical study from biopsies and autopsies Efeitos do envelhecimento sobre as fibras do músculo biceps braquial: estudo morfométrico em biópsias e autópsias

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    Ana Cláudia Mattiello-Sverzut

    2003-09-01

    Full Text Available OBJECTIVES: In order to study the morphology and size of muscle fibers, cross sections of biceps brachii samples from autopsies, up to 9 hours after death, and biopsies of 72 subjects were compared. The subjects aged 13 to 84 years in both sexes. METHODS: The samples obtained from autopsies (n=47 were from subjects with sudden death, or who died after acute disease without evidence of neuromuscular involvement. The biopsies (n=25 were from patients with symptoms suggestive of inflammatory or metabolic myopathy, not confirmed morphologically. The lesser diameter of muscle fibers was measured using the ATPase reaction. RESULTS: Morphological analysis showed that aging changes were present from the sixth decade in autopsies, and consisted of atrophy and/or type-grouping. The statistical models adjusted for females in both autopsies and biopsies were linear straight with no variation in fiber size with increasing age. The models adjusted for males in both groups were quadratic, indicating that age influenced the size of different type fibers. In males type 2 were larger than type 1 fibers, and than fibers in females. CONCLUSIONS: These values might be useful as controls, helping interpretation of changes in fiber size in samples obtained from biopsies and autopsies.OBJETIVOS: Para estudar a morfologia e o tamanho das fibras musculares, foram comparadas cortes transversos do bíceps braquial autopsiados, até 9 horas após o óbito, com biopsias musculares, em 72 indivíduos de ambos os sexos e idades entre 13 e 84 anos. MÉTODO: As amostras das autópsias (n=47 foram obtidas de indivíduos que morreram subitamente, ou após uma doença aguda sem evidência de comprometimento neuromuscular. As biópsias (n=25 foram obtidas de pacientes com sintomas sugestivos de miopatias inflamatória ou metabólica, não confirmadas morfologicamente. O diâmetro menor das fibras foi obtido usando a reação de ATPase. RESULTADOS: A análise morfológica mostrou que as mudanças induzidas pelo envelhecimento estiveram presentes a partir da sexta década para autópsias e consistiu de atrofia e grupamento de tipo. O modelo estatístico ajustado para mulheres, para autópsias e biópsias, foi linear e não indicou variação do tamanho das fibras com o aumento da idade. O modelo ajustado para homens, para ambos os casos, foi quadrático, indicando que a idade influenciou o tamanho dos diferentes tipos de fibras. Para homens, as fibras tipo 2 apresentaram-se maiores que as de tipo 1, e maiores que as das mulheres. CONCLUSÃO: Os valores encontrados podem ser úteis como controles, auxiliando na interpretação de modificações no tamanho das fibras para amostras provindas de biópsia e autópsia.

  20. The effects of aging on biceps brachii muscle fibers: a morphometrical study from biopsies and autopsies / Efeitos do envelhecimento sobre as fibras do músculo biceps braquial: estudo morfométrico em biópsias e autópsias

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    Ana Cláudia, Mattiello-Sverzut; Leila, Chimelli; Maria Silvia de Assis, Moura; Silvia, Teixeira; José Alberto Mello de, Oliveira.

    2003-09-01

    Full Text Available OBJETIVOS: Para estudar a morfologia e o tamanho das fibras musculares, foram comparadas cortes transversos do bíceps braquial autopsiados, até 9 horas após o óbito, com biopsias musculares, em 72 indivíduos de ambos os sexos e idades entre 13 e 84 anos. MÉTODO: As amostras das autópsias (n=47) fora [...] m obtidas de indivíduos que morreram subitamente, ou após uma doença aguda sem evidência de comprometimento neuromuscular. As biópsias (n=25) foram obtidas de pacientes com sintomas sugestivos de miopatias inflamatória ou metabólica, não confirmadas morfologicamente. O diâmetro menor das fibras foi obtido usando a reação de ATPase. RESULTADOS: A análise morfológica mostrou que as mudanças induzidas pelo envelhecimento estiveram presentes a partir da sexta década para autópsias e consistiu de atrofia e grupamento de tipo. O modelo estatístico ajustado para mulheres, para autópsias e biópsias, foi linear e não indicou variação do tamanho das fibras com o aumento da idade. O modelo ajustado para homens, para ambos os casos, foi quadrático, indicando que a idade influenciou o tamanho dos diferentes tipos de fibras. Para homens, as fibras tipo 2 apresentaram-se maiores que as de tipo 1, e maiores que as das mulheres. CONCLUSÃO: Os valores encontrados podem ser úteis como controles, auxiliando na interpretação de modificações no tamanho das fibras para amostras provindas de biópsia e autópsia. Abstract in english OBJECTIVES: In order to study the morphology and size of muscle fibers, cross sections of biceps brachii samples from autopsies, up to 9 hours after death, and biopsies of 72 subjects were compared. The subjects aged 13 to 84 years in both sexes. METHODS: The samples obtained from autopsies (n=47) w [...] ere from subjects with sudden death, or who died after acute disease without evidence of neuromuscular involvement. The biopsies (n=25) were from patients with symptoms suggestive of inflammatory or metabolic myopathy, not confirmed morphologically. The lesser diameter of muscle fibers was measured using the ATPase reaction. RESULTS: Morphological analysis showed that aging changes were present from the sixth decade in autopsies, and consisted of atrophy and/or type-grouping. The statistical models adjusted for females in both autopsies and biopsies were linear straight with no variation in fiber size with increasing age. The models adjusted for males in both groups were quadratic, indicating that age influenced the size of different type fibers. In males type 2 were larger than type 1 fibers, and than fibers in females. CONCLUSIONS: These values might be useful as controls, helping interpretation of changes in fiber size in samples obtained from biopsies and autopsies.

  1. Evaluating the performance of interpreting Verbal Autopsy 3.2 model for establishing pulmonary tuberculosis as a cause of death in Ethiopia: a population-based cross-sectional study

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    Tadesse Sebsibe

    2012-11-01

    Full Text Available Abstract Background In resource- poor settings, verbal autopsy data are often reviewed by physicians in order to assign the probable cause of death. But in addition to being time and energy consuming, the method is liable to produce inconsistent results. The aim of this study is to evaluate the performance of the InterVA 3.2 model for establishing pulmonary tuberculosis as a cause of death in comparison with physician review of verbal autopsy data. Methods A population-based cross-sectional study was conducted from March to April, 2012. All adults aged ?14 years and died between 01 January 2010 and 15 February 2012 were included in the study. Data were collected by using a pre-tested and modified WHO designed verbal autopsy questionnaire. The verbal autopsy interviews were reviewed by the InterVA model and the physicians. Cohen’s kappa statistic, receiver operating characteristic curves, sensitivity, and specificity values were applied to compare the agreement between the InterVA model and the physician review. Results A total of 408 adult deaths were studied. The proportion of tuberculosis-specific mortality was established to be 36.0% and 23.0% by the InterVA model and the physicians, respectively. The InterVA model predicted pulmonary tuberculosis as a cause of death with the probability of 0.80 (95% CI: 0.75-0.85. In classifying all deaths as tuberculosis and non-tuberculosis, the sensitivity and specificity values were 0.82 and 0.78, respectively. A moderate agreement was found between the model and physicians in assigning pulmonary tuberculosis as a cause of deaths [kappa= 0.5; 95% CI: (0.4-0.6]. Conclusions This study has revealed that the InterVA model showed a more promising result as a community-level tool for generating pulmonary tuberculosis-specific mortality data from verbal autopsy. The conclusion is believed to provide policymakers with a highly needed piece of information for allocating resources for health intervention.

  2. O decréscimo vertiginoso das autópsias em um hospital universitário do Brasil nos últimos 20 anos / The dramatic decline of the autopsies at a Brazilian university hospital in the last 20 years

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    Fabiana Resende, Rodrigues; Vânia Glória Silami, Lopes; Consuelo Lozoya, Lopez; Porphírio José, Soares Filho; Rita de Cássia Lauria Gonçalves da, Silva; Licínio Esmeraldo da, Silva; Graça Helena M. de Canto, Teixeira.

    2011-08-01

    Full Text Available INTRODUÇÃO: O declínio no número de autópsias em hospitais e instituições universitárias é evento amplamente reportado, inicialmente em países do primeiro mundo e posteriormente em muitos países em desenvolvimento, como o Brasil. As causas para essa tendência são múltiplas e complexas, incluindo asp [...] ectos religiosos, familiares e médicos. Entre estes últimos, salientam-se razões diagnósticas, caracterizadas pelo significativo avanço tecnológico na imagenologia, com a suposição de que todos os diagnósticos agora podem ser feitos em vida, e a crescente ansiedade de processos judiciais contra médicos por má prática. OBJETIVO: Demonstrar o decréscimo vertiginoso e drástico do número de autópsias em um hospital universitário no Brasil. MATERIAL E MÉTODO: Avaliou-se o número de registros nos livros de autópsias consecutivas realizadas no Departamento de Patologia do Hospital Universitário Antonio Pedro da Universidade Federal Fluminense (HUAP/UFF), Niterói, Rio de Janeiro, criando um banco dados em tabela do programa Microsoft Excel. RESULTADOS: Durante os anos 1966 a 2009, foram realizadas 23.813 necrópsias, sendo 12.702 de adultos e 11.111 de fetos. Entre os anos 1966 e 1998, foram realizadas mais necrópsias, no total de 23.321, sendo 12.482 de adultos e 10.839 de fetos. Já entre os anos 1999 e 2009, foi observado o declínio acentuado e drástico das mesmas, totalizando apenas 492 necrópsias, sendo 220 de adultos e 272 de fetos. CONCLUSÃO: Acreditamos que a principal causa para esse declínio é a pouca informação da população, que desconhece que o saber é fruto de estudo, pesquisa, prática e aprimoramento. Abstract in english INTRODUCTION: The decline in the number of autopsies at hospitals and university hospitals has been widely reported, initially in developed countries and afterwards in several developing countries including Brazil. The causes for this trend are multiple and complex, encompassing religious, family an [...] d medical aspects. Among the latter, we highlight diagnostic reasons, which are characterized by major technological advances in clinical imaging associated with the underlying assumption that all diagnoses can currently be made before death. Furthermore, there is a growing concern about malpractice lawsuits. OBJECTIVE: To demonstrate the sharp decrease in the number of autopsies at a university hospital in Brazil. MATERIAL AND METHODS: We evaluated the number of autopsies conducted at the Pathology Department of Antonio Pedro University Hospital (HUAP), Niterói, Rio de Janeiro, and a database spreadsheet was created at Microsoft Excel. RESULTS: From 1966 to 2009, 23,813 autopsies were performed, comprising 12,702 adults and 11,111 fetuses. The highest number of autopsies occurred from 1966 to 1998, when 23,321 autopsies were performed, comprising 12,482 adults and 10,839 fetuses. Whereas, there was a dramatic decline from 1999 to 2009, when 492 autopsies were performed, including 220 adults and 272 fetuses. CONCLUSION: We believe that the main cause of this reduction is the lack of information among laypeople and medical professionals, who have neglected the fact that knowledge is ultimately acquired through study, investigation and practice.

  3. Sudden Cardiac Death in Brazil: A Community-Based Autopsy Series (2006-2010) / Morte Súbita Cardíaca no Brasil: Análise dos Casos de Ribeirão Preto (2006-2010)

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    Maria Fernanda, Braggion-Santos; Gustavo Jardim, Volpe; Antonio, Pazin-Filho; Benedito Carlos, Maciel; José Antonio, Marin-Neto; André, Schmidt.

    2015-02-01

    Full Text Available Fundamento: Morte súbita cardíaca (MSC) é um evento súbito e inesperado, de causa cardiovascular, que ocorre em menos de uma hora após o início dos sintomas, em indivíduo sem qualquer condição clínica prévia potencialmente fatal ou assintomático nas últimas 24 horas antes do óbito, em caso de morte [...] não testemunhada. Apesar de ser um evento relativamente frequente, há poucos dados confiáveis na literatura sobre países em desenvolvimento. Objetivo: Descrever as características da MSC em Ribeirão Preto (SP 600.000 habitantes) baseando-se nos relatórios de autopsias do Serviço de Verificação de Óbitos do Interior. Métodos: Foram revisados retrospectivamente 4.501 relatórios de autopsias entre 2006 e 2010, para identificar casos de MSC. Foram coletados dados como causa específica do óbito, características demográficas e comorbidades das vítimas, data, local e hora do evento, e se foram realizadas manobras de ressuscitação cardiopulmonar (RCP). Resultados: Foram identificados 899 casos de MSC (20%; razão 30/100.000 habitantes por ano). A principal causa de MSC foi doença arterial coronariana (DAC - 64%), acometendo homens (67%) entre a sexta e a sétima década de vida. A maior parte dos eventos ocorreu durante a manhã, no domicílio (53,3%), e a RCP foi realizada em quase metade das vítimas (49,7%). A comorbidade mais prevalente foi hipertensão arterial sistêmica (57,3%). Doença de Chagas foi detectada em 49 casos (5,5%). Conclusão: A maioria dos casos de MSC ocorreu por DAC em homens entre a sexta e a sétima década de vida. Doença de Chagas, um importante problema de saúde pública na América Latina, foi detectada em 5,5% dos casos. Abstract in english Background: Sudden cardiac death (SCD) is a sudden unexpected event, from a cardiac cause, that occurs in less than one hour after the symptoms onset, in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before found dead. Although it is a r [...] elatively frequent event, there are only few reliable data in underdeveloped countries. Objective: We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000 residents) according to Coroners’ Office autopsy reports. Methods: We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to identify cases of SCD. Specific cause of death as well as demographic information, date, location and time of the event, comorbidities and whether cardiopulmonary resuscitation (CPR) was attempted were collected. Results: We identified 899 cases of SCD (20%); the rate was 30/100000 residents per year. The vast majority of cases of SCD involved a coronary artery disease (CAD) (64%) and occurred in men (67%), between the 6th and the 7th decades of life. Most events occurred during the morning in the home setting (53.3%) and CPR was attempted in almost half of victims (49.7%). The most prevalent comorbidity was systemic hypertension (57.3%). Chagas’ disease was present in 49 cases (5.5%). Conclusion: The majority of victims of SCD were men, in their sixties and seventies and the main cause of death was CAD. Chagas’ disease, an important public health problem in Latin America, was found in about 5.5% of the cases.

  4. Sudden Cardiac Death in Brazil: A Community-Based Autopsy Series (2006-2010) / Morte Súbita Cardíaca no Brasil: Análise dos Casos de Ribeirão Preto (2006-2010)

    Scientific Electronic Library Online (English)

    Maria Fernanda, Braggion-Santos; Gustavo Jardim, Volpe; Antonio, Pazin-Filho; Benedito Carlos, Maciel; José Antonio, Marin-Neto; André, Schmidt.

    Full Text Available Fundamento: Morte súbita cardíaca (MSC) é um evento súbito e inesperado, de causa cardiovascular, que ocorre em menos de uma hora após o início dos sintomas, em indivíduo sem qualquer condição clínica prévia potencialmente fatal ou assintomático nas últimas 24 horas antes do óbito, em caso de morte [...] não testemunhada. Apesar de ser um evento relativamente frequente, há poucos dados confiáveis na literatura sobre países em desenvolvimento. Objetivo: Descrever as características da MSC em Ribeirão Preto (SP 600.000 habitantes) baseando-se nos relatórios de autopsias do Serviço de Verificação de Óbitos do Interior. Métodos: Foram revisados retrospectivamente 4.501 relatórios de autopsias entre 2006 e 2010, para identificar casos de MSC. Foram coletados dados como causa específica do óbito, características demográficas e comorbidades das vítimas, data, local e hora do evento, e se foram realizadas manobras de ressuscitação cardiopulmonar (RCP). Resultados: Foram identificados 899 casos de MSC (20%; razão 30/100.000 habitantes por ano). A principal causa de MSC foi doença arterial coronariana (DAC - 64%), acometendo homens (67%) entre a sexta e a sétima década de vida. A maior parte dos eventos ocorreu durante a manhã, no domicílio (53,3%), e a RCP foi realizada em quase metade das vítimas (49,7%). A comorbidade mais prevalente foi hipertensão arterial sistêmica (57,3%). Doença de Chagas foi detectada em 49 casos (5,5%). Conclusão: A maioria dos casos de MSC ocorreu por DAC em homens entre a sexta e a sétima década de vida. Doença de Chagas, um importante problema de saúde pública na América Latina, foi detectada em 5,5% dos casos. Abstract in english Background: Sudden cardiac death (SCD) is a sudden unexpected event, from a cardiac cause, that occurs in less than one hour after the symptoms onset, in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before found dead. Although it is a r [...] elatively frequent event, there are only few reliable data in underdeveloped countries. Objective: We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000 residents) according to Coroners’ Office autopsy reports. Methods: We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to identify cases of SCD. Specific cause of death as well as demographic information, date, location and time of the event, comorbidities and whether cardiopulmonary resuscitation (CPR) was attempted were collected. Results: We identified 899 cases of SCD (20%); the rate was 30/100000 residents per year. The vast majority of cases of SCD involved a coronary artery disease (CAD) (64%) and occurred in men (67%), between the 6th and the 7th decades of life. Most events occurred during the morning in the home setting (53.3%) and CPR was attempted in almost half of victims (49.7%). The most prevalent comorbidity was systemic hypertension (57.3%). Chagas’ disease was present in 49 cases (5.5%). Conclusion: The majority of victims of SCD were men, in their sixties and seventies and the main cause of death was CAD. Chagas’ disease, an important public health problem in Latin America, was found in about 5.5% of the cases.

  5. Verbal autopsy completion rate and factors associated with undetermined cause of death in a rural resource-poor setting of Tanzania

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    Maliti Deodatus V

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy (VA is a widely used tool to assign probable cause of death in areas with inadequate vital registration systems. Its uses in priority setting and health planning are well documented in sub-Saharan Africa (SSA and Asia. However, there is a lack of data related to VA processing and completion rates in assigning causes of death in a community. There is also a lack of data on factors associated with undetermined causes of death documented in SSA. There is a need for such information for understanding the gaps in VA processing and better estimating disease burden. Objective The study's intent was to determine the completion rate of VA and factors associated with assigning undetermined causes of death in rural Tanzania. Methods A database of deaths reported from the Ifakara Health and Demographic Surveillance System from 2002 to 2007 was used. Completion rates were determined at the following stages of processing: 1 death identified; 2 VA interviews conducted; 3 VA forms submitted to physicians; 4 coding and assigning of cause of death. Logistic regression was used to determine factors associated with deaths coded as "undetermined." Results The completion rate of VA after identification of death and the VA interview ranged from 83% in 2002 and 89% in 2007. Ninety-four percent of deaths submitted to physicians were assigned a specific cause, with 31% of the causes coded as undetermined. Neonates and child deaths that occurred outside health facilities were associated with a high rate of undetermined classification (33%, odds ratio [OR] = 1.33, 95% confidence interval [CI] (1.05, 1.67, p = 0.016. Respondents reporting high education levels were less likely to be associated with deaths that were classified as undetermined (24%, OR = 0.76, 95% CI (0.60, -0.96, p = 0.023. Being a child of the deceased compared to a partner (husband or wife was more likely to be associated with undetermined cause of death classification (OR = 1.35, 95% CI (1.04, 1.75, p = 0.023. Conclusion Every year, there is a high completion rate of VA in the initial stages of processing; however, a number of VAs are lost during the processing. Most of the losses occur at the final step, physicians' determination of cause of death. The type of respondent and place of death had a significant effect on final determination of the plausible cause of death. The finding provides some insight into the factors affecting full coverage of verbal autopsy diagnosis and the limitations of causes of death based on VA in SSA. Although physician review is the most commonly used method in ascertaining probable cause of death, we suggest further work needs to be done to address the challenges faced by physicians in interpreting VA forms. There is need for an alternative to or improvement of the methods of physician review.

  6. Autopsias psicológicas de treinta suicidios en la IV Región de Chile / Psychological autopsies of thirty suicides of the IV Region of Chile

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    Alejandro, Gómez Ch; Raquel, Opazo P; Rosa, Levi A; María Soledad, Gómez Ch; Carolina, Ibáñez H; Carlos, Núñez M.

    2014-03-01

    Full Text Available Introducción: El suicidio es un problema de salud pública relevante en Chile. Este es el primer estudio chileno con el método de la autopsia psicológica (AP). Objetivos: a) identificar factores de riesgo de suicidio en víctimas chilenas; b) identificar indicadores de riesgo para la intervención temp [...] rana; c) evaluar la aceptabilidad del método de la AP por los informantes. Método: La muestra consistió en 30 sujetos (24 hombres y 6 mujeres) que cometieron suicidio en la IV Región de Chile (diciembre de 2008-septiembre de 2010). La información fue recogida de entrevistas a informantes. El instrumento principal fue el Protocolo de Entrevista para Autopsia Psicológica. Resultados: La edad promedio fue 35,8 años. La mayoría comunicó intención suicida antes de consumarlo. Casi todos experimentaron eventos negativos, frecuentemente poco antes del suicidio. La mitad había intentado suicidarse previamente, algunos durante el mes precedente. El 36% estaba en tratamientos de salud mental al fallecer y un cuarto había visitado recientemente a profesionales de salud mental. Se identificó trastornos psiquiátricos (CIE-10) en el 90%, principalmente trastorno depresivo y por uso de sustancias. Los trastornos de personalidad fueron evidentes en ocho víctimas (33%): disocial (4), emocionalmente inestable (2), paranoide (1) y ansioso (evitativo) (1). Conclusiones: Se confirmó una elevada tasa de trastornos psiquiátricos. El antecedente de intentos previos es un predictor sensible de suicidio. La comunicación de intención suicida es frecuente y puede ser una oportunidad de intervención. El suicidio es frecuentemente precedido por eventos vitales negativos. La prevención del suicidio puede mejorar mediante el tratamiento efectivo de trastornos psiquiátricos e intervenciones psicosociales focalizadas. El seguimiento intensivo de intentadores parece altamente relevante. La AP es aceptable para los informantes. Abstract in english Background: Suicide is a relevant public health problem in Chile. This is the first Chilean study with the psychological autopsy method (PA). Aims: a) to identify risk factors for suicide in Chilean victims; b) to identify risk indicators for early intervention; c) to assess acceptability of the PA [...] method by informants. Method: Sample consisted of 30 subjects (24 males, six females) who commited suicide in the IV Region of Chile (December 2008-September 2010). Data was collected from informant interviews. Main instrument was the Psychological Autopsy Interview Protocol. Results: Mean age at suicide was 35.8 years. Most victims communicated suicidal intent before consummation. Almost all experienced negative life events, in many cases shortly before suicide. One half had attempted suicide previously, some during the preceding month. Thirty-six percent were in mental health treatments at time of death. A quarter had recently visited mental health professionals. Psychiatric disorders (ICD-10) were identified in 90%, mainly depressive and substance use disorders. Personality disorders were evident in eight victims (33%): dissocial (4), emotionally unstable (2), paranoid (1), and anxious (avoidant) (1). Conclusions: A high rate of psychiatric disorders was confirmed. Previous suicide attempts are sensitive predictors of completed suicide. Communication of suicide intent is frequent, and may be an opportunity for intervention. Suicide is often preceded by negative life events. Prevention of suicide may be improved by effective treatment of psychiatric disorders, and focused psychosocial interventions. Intensive follow-up of attempters seems highly relevant. PA is an acceptable method for informants.

  7. Valor del diagnóstico de la tuberculosis pulmonar por autopsia en Cuba / Importance of the pulmonary tuberculosis diagnosis by autopsy in Cuba

    Scientific Electronic Library Online (English)

    Ana Ivonne, Martínez Portuondo; José, Hurtado de Mendoza Amat; Edilberto, González Ochoa.

    2012-03-01

    Full Text Available El diagnóstico de la tuberculosis pulmonar por autopsia mide la calidad de la atención médica y el comportamiento de la enfermedad. Objetivo: Determinar los fallecidos que murieron con y por Tuberculosis pulmonar y la concordancia entre los diagnósticos clínico y anatomopatológico en el período estu [...] diado. Método: Se examinaron 77 341 necropsias del Registro Nacional de Autopsias de Cuba, en adultos, del 1994 -2003. Se realizó un análisis multicausal de la muerte. Resultados: El 0.2 % de los pacientes murió con tuberculosis pulmonar y 0.04 % por tuberculosis pulmonar. El 71 % correspondió al sexo masculino y la edad promedio, 69 años de edad. La causa directa más frecuente de la muerte fue a expensas de la bronconeumonía. La discrepancia diagnóstica entre el diagnóstico clínico y el anatomopatológico señaló 26 % en la causa directa y 53 % en la causa básica de la muerte. Conclusiones: Los pacientes fallecieron en edades avanzadas y un porcentaje importante por Bronconeumonía. El estudio confirma que existe una frecuencia muy baja de tuberculosis pulmonar activa y concordancia diagnóstica en la mitad de los pacientes. También una discrepancia diagnóstica en la tercera parte de los casos como causa directa de la muerte. Quedaría definir por otras investigaciones los factores que influyen en los casos diagnosticados postmortem que mantienen la transmisión oculta de la enfermedad. Abstract in english The quality of medical care and the behaviour of the illness can be valued through the achievement of the pulmonary tuberculosis diagnosis by autopsy. Objective: To determine the patients who died with pulmonary tuberculosis and because of it and to establish the agreement between the clinical and t [...] he pathological diagnoses in the analized period. Method: A total of 77 341 necropsies taken from the Cuban national autopsies register were analized taking as reference a period of ten years (1994-2003).The clinical records were examined in those cases in which active tuberculosis was found. Results: The 0,2 % of the patients died with pulmonary tuberculosis and a 0.04 % died because of it. The average age was 69 years and 71 % of the persons were men. Broncho-pneumonia was the most important cause of death. The diagnostic discrepancy between clinical and pathological diagnosis showed a 26 % as the direct cause of death and a 53 % as the basic cause of death. Conclusion: An important percent of the deaths were by broncho-pneumonia and most of the patients died at an advanced age. It was confirmed a low frecuency of active pulmonary tuberculosis and there was diagnostic agreement in half of the patients. There was also a diagnostic disagreement in a third of the cases with direct cause of death. Other investigations could define the factors of the post-mortem cases diagnosed with pulmonary tuberculosis which keep hidden the transmission of this disease.

  8. El daño multiorgánico en autopsias realizadas en Cuba en 1994 The multiple organ injury in autopsies carried out in Cuba in 1994

    Directory of Open Access Journals (Sweden)

    José Hurtado de Mendoza Amat

    1997-06-01

    Full Text Available Se exponen las experiencias en el estudio del daño multiorgánico vinculadas al estudio de 17 739 autopsias de adultos fallecidos en Cuba en 1994. El daño multiorgánico ocurrió en el 10 % de los casos. El 47 % procedió de las unidades de cuidados intensivos e intermedios y el 17 % tuvo una estadía hospitalaria menor de 24 horas. Como factores causales más frecuentes se presentaron el daño tisular severo y las infecciones. Los órganos más afectados fueron: bazo, hígado, cerebro, pulmón, tubo digestivo y riñón. Las causas directas de muerte más frecuentes: el propio daño multiorgánico, sus manifestaciones en determinados órganos y las causas que lo producen cuando persisten. Se confirmó que cuando un factor causal desata en el organismo una respuesta inmediata, fundamentalmente inmunológica, que se hace sistémica y produce lesiones características en diversos órganos, ocurre el daño multiorgánico. De acuerdo con su magnitud éste puede producir la muerte inmediata, regresar espontánea o terapéuticamente o manifestarse clínicamente como un síndrome de disfunción múltiple de órganos.The experiences obtained from the study of multiple organ injury linked to the investigation of 17 739 autopsies of adults who died in Cuba in 1994 are exposed. The multiple organ injury was found in 10 % of the cases. 47 % came from the intensive and intermediate care units, whereas 17 % were in hospital less than 24 hours. The severe tissue damage and infections were the most frequent causal factors. The most affected organs were: spleen, liver, brain, lung, digestive tube, and kidney. The most common direct causes of death were: the multiple organ injury itself, its manifestations in certain organs, and its causes when they persist. It was confirmed that the multiple organ injury occurs when a causal factor provokes in the organism an immediate response, mainly immunological, which becomes systemic and produces characteristic lesions in different organs. According to its magnitude, it may cause immediate death, cure spontaneous or therapeutically, or manifest itself clinically as a multiple organ failure syndrome.

  9. El daño multiorgánico en autopsias realizadas en Cuba en 1994 / The multiple organ injury in autopsies carried out in Cuba in 1994

    Scientific Electronic Library Online (English)

    José, Hurtado de Mendoza Amat; Teresita, Montero González; Verónica, Walwyn Salas; Reynaldo, Álvarez Santana.

    1997-06-01

    Full Text Available Se exponen las experiencias en el estudio del daño multiorgánico vinculadas al estudio de 17 739 autopsias de adultos fallecidos en Cuba en 1994. El daño multiorgánico ocurrió en el 10 % de los casos. El 47 % procedió de las unidades de cuidados intensivos e intermedios y el 17 % tuvo una estadía ho [...] spitalaria menor de 24 horas. Como factores causales más frecuentes se presentaron el daño tisular severo y las infecciones. Los órganos más afectados fueron: bazo, hígado, cerebro, pulmón, tubo digestivo y riñón. Las causas directas de muerte más frecuentes: el propio daño multiorgánico, sus manifestaciones en determinados órganos y las causas que lo producen cuando persisten. Se confirmó que cuando un factor causal desata en el organismo una respuesta inmediata, fundamentalmente inmunológica, que se hace sistémica y produce lesiones características en diversos órganos, ocurre el daño multiorgánico. De acuerdo con su magnitud éste puede producir la muerte inmediata, regresar espontánea o terapéuticamente o manifestarse clínicamente como un síndrome de disfunción múltiple de órganos. Abstract in english The experiences obtained from the study of multiple organ injury linked to the investigation of 17 739 autopsies of adults who died in Cuba in 1994 are exposed. The multiple organ injury was found in 10 % of the cases. 47 % came from the intensive and intermediate care units, whereas 17 % were in ho [...] spital less than 24 hours. The severe tissue damage and infections were the most frequent causal factors. The most affected organs were: spleen, liver, brain, lung, digestive tube, and kidney. The most common direct causes of death were: the multiple organ injury itself, its manifestations in certain organs, and its causes when they persist. It was confirmed that the multiple organ injury occurs when a causal factor provokes in the organism an immediate response, mainly immunological, which becomes systemic and produces characteristic lesions in different organs. According to its magnitude, it may cause immediate death, cure spontaneous or therapeutically, or manifest itself clinically as a multiple organ failure syndrome.

  10. (13)Carbon and (15)nitrogen isotopes in autopsy liver tissue samples from Greenlandic Inuit and Danes: consumption of marine versus terrestrial food

    DEFF Research Database (Denmark)

    Milman, N.; Laursen, J.

    2010-01-01

    Background/Objectives: The content of C-13 and N-15 isotopes is higher in marine than in terrestrial food. C-13 and N-15 in human tissue therefore reflects the relative proportions of marine and terrestrial food consumed by the individual. The objective of this study was to measure C-13 and N-15 in liver tissue from Greenlandic Inuit and Danes. Subjects/Methods: Normal liver tissue was obtained at autopsy in 1992-1994 from 60 Inuit with a median age of 61 years (range 25-83) and in 1986 from 15 ethnic Danes with a median age of 84 years (range 66-93). By sieving, liver tissue was separated in a 'cellular fraction' and a 'connective tissue fraction'. C-13 and N-15 in dry liver tissue was measured on a mass spectrometer. delta C-13 indicates the C-13 content relative to the IAEA-CH-6 reference standard. delta N-15 indicates N-15 content relative to the atmospheric nitrogen reference standard. Results: Inuit: median delta C-13 was -21.2 parts per thousand in cellular and -20.0 parts per thousand in connective tissue fractions (P = 001). Median delta N-15 was 10.6 parts per thousand in both cellular and connective tissue fractions. Body mass index was negatively correlated with delta C-13 in the connective tissue fraction (r(s) = -0.42, P = 0.057). Danes: median delta C-13 was -27.0% in cellular and -24.3% in connective tissue fractions (P = 0.11). Median delta N-15 was 9.5 parts per thousand in cellular and 8.9 parts per thousand in connective tissue fractions (P = 0.5). Inuit had higher delta C-13 than Danes in both cellular and connective tissue fractions (P

  11. Polymorphisms in IL-10 and INF-? genes are associated with early atherosclerosis in coronary but not in carotid arteries: A study of 122 autopsy cases of young adults

    Directory of Open Access Journals (Sweden)

    José Carlos P. Esperança

    2015-06-01

    Full Text Available Atherosclerosis is a complex disease, involving both genetic and environmental factors. However, the influence of genetic variations on its early development remains unclear. This study examined the association of 12 different polymorphisms with atherosclerosis severity in anterior descending coronary (DA, n = 103 and carotid arteries (CA, n = 66 of autopsied young adults (<30 years old. Histological sections (H-E were classified according to the American Heart Association. Polymorphisms in ACE, TNF-? (?308G/A and ?238 G/A, IFN-? (+874 A/T, MMP-9 (?1562 C/T, IL-10 (?1082 A/G and ?819 C/T, NOS3 (894 G/T, ApoA1 (rs964184, ApoE (E2E3E4 isoforms, and TGF-? (codons 25 and 10 genes were genotyped by gel electrophoresis or automatic DNA sequencing. Firearm projectile or car accident was the main cause of death, and no information about classical risk factors was available. Histological analysis showed high prevalence of type III atherosclerotic lesions in both DA (69% and CA (39% arteries, while severe type IV and V lesions were observed in 14% (DA and 33% (CA. Allele frequencies and genotype distributions were determined. Among the polymorphisms studied, IFN-? and IL-10 (?1082 A/G were related to atherosclerosis severity in DA artery. No association between genotypes and lesion severity was found in CA. In conclusion, we observed that the high prevalence of early atherosclerosis in young adults is associated with IFN-? (p < 0.001 and IL-10 (p = 0.013 genotypes. This association is blood vessel dependent. Our findings suggest that the vascular system presents site specialization, and specific genetic variations may provide future biomarkers for early disease identification.

  12. Misoprostol como abortivo en España: A propósito de un caso de autopsia judicial Misoprostol as an abortive in Spain: Report of a judicial autopsy case

    Directory of Open Access Journals (Sweden)

    PM. Garamendi González

    2004-10-01

    Full Text Available El Misoprostol es un agente farmacológico introducido en el mercado español bajo la forma de un fármaco protector gástrico y comercializado actualmente en asociación con un antinflamatorio. Desde hace varios años, se desarrolla un debate internacional sobre el hecho de que este mismo producto cumple las características de un abortivo extremadamente eficaz. No obstante, el uso inadecuado del Misoprostol puede causar daños severos a la madre y al feto, tanto si el producto se usa con fines abortivos como si se administra accidentalmente durante una gestación, incluso a las dosis recomendadas. Por otra parte, el Misoprostol tiene un rápido metabolismo y no es fácilmente identificable por los laboratorios toxicológicos de referencia, limitando su posible identificación en casos de uso inadecuado, voluntario o accidental. Se presenta un caso de autopsia médico legal tras un posible episodio de aborto inducido por la administración de Misoprostol.Misoprostol is a drug commercialized in Spain as a gastric protector. Nowadays it is sold in our country also associated with diclofenac to prevent gastric damages produced by anti-inflammatories. During the last few years, there has been a public debate in medical press about the fact that Misoprostol has also proved to be an excellent abortive. Nevertheless, when it is not properly used Misoprostol can be the cause of severe damages to the fetus and the mother. This Prostaglandin E1 analog is a drug rapidly metabolized in humans and it is not easy to identify in toxicological analyses. This is the main bias when trying to identify it in forensic cases of accidental damages after using it as a gastric protector or voluntary administration as an abortive. We present a case report about a forensic autopsy following a possible Misoprostol induced abortion.

  13. Unnatural Deaths in Shanghai from 2000 to 2009: A Retrospective Study of Forensic Autopsy Cases at the Shanghai Public Security Bureau

    Science.gov (United States)

    Lin, Jun-Yi; Ma, Kai-Jun; Li, Bei-Xu

    2015-01-01

    Shanghai is the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB). There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.9±18.7 years. Traffic accidents (84.2%) were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6%) was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5%) was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health. PMID:26110435

  14. Hallazgos morfológicos en casos fatales de síndrome cardiopulmonar por hantavirus: Estudio de 7 autopsias Morphological findings in fatal cases of hantavirus cardiopulmonary syndrome: Report of 7 autopsies

    Directory of Open Access Journals (Sweden)

    Pablo Guzmán G

    2010-10-01

    Full Text Available Introducción: El síndrome cardiopulmonar por hantavirus (SCPH es una enfermedad infecciosa aguda, caracterizada por insuficiencia cardio-respiratoria súbita y alta mortalidad, causada por un virus ARN del género Hantavirus, familia Bunyaviridae. Un 15% de los casos chilenos ha sido pesquisado en la Araucanía. Objetivo: Conocer en casos fatales de SCPH, sus características clínicas y morfológicas. Material y Método: Estudio descriptivo-retrospectivo de siete casos fatales con examen postmortem, de SCPH, atendidos entre 1997 y 2009 en el Hospital Regional de Temuco. Resultados: Los casos fueron principalmente pacientes jóvenes, rurales, con un cuadro de compromiso respiratorio progresivo, con leucocitosis, trombopenia e infiltrado pulmonar intersticial bilateral. Los principales hallazgos histopatológicos fueron un acentuado edema pulmonar intra-alveolar e intersticial, con escaso daño epitelial e infiltrado mono-nuclear y leve edema miocárdico con infiltrado mononu-clear. Conclusiones: Los antecedentes epidemiológicos, clínicos y laboratorio permiten sospechar SCPH. En los casos fatales la autopsia permite diferenciar el SCPH de otras patologías similares y aporta tejidos para confirmar el diagnóstico.Introduction: Hantavirus cardiopulmonary syndrome (HCPS is an acute infectious disease characterized by sudden cardiorespiratory failure and high mortality, caused by a RNA virus of the genus Hantavirus, family Bunyaviridae, 15% of Chilean cases have been detected in the Araucania Region. Objective: To determine in fatal cases of HCPS, clinical and morphological characteristics. Materials and Methods: Descriptive-retrospective analysis of seven fatal cases with postmortem study of HCPS, attended between 1997 and 2009 at the Hospital of Temuco, Chile. Results: Cases were young patients from rural areas, and presented as an illness of progressive respiratory failure, with leukocytosis, thrombocytopenia and bilateral interstitial pulmonary infiltrates. Main morphological findings were marked intersticial and intraalveolar pulmonary edema, with minimal epithelial injury and mononuclear cell intersticial infiltrate and mild edematous intersticial inflamatory process. Conclusions: Epidemiological, clinical and laboratory background allow to suspect HCPS. In fatal cases, the autopsy makes possible to discard other similar pathologies and provide tissue for confirmation of the disease.

  15. [Decreased myocardial uptake of meta-iodobenzylguanidine in an autopsy-confirmed case of corticobasal degeneration with Lewy bodies restricted to the sympathetic ganglia].

    Science.gov (United States)

    Mori, Keiko; Iwasaki, Yasushi; Ito, Masumi; Mimuro, Maya; Yoshida, Mari

    2012-01-01

    We report on an autopsy case of corticobasal degeneration (CBD) with Lewy bodies in only the sympathetic ganglia. A 79-year-old man showed walking disturbance as an initial symptom, and developed dementia and bradykinesia within the next 2 years. Neurological examination revealed parkinsonism-like akinesia and rigidity in the trunk and neck without resting tremor. Brain magnetic resonance imaging showed frontal lobe atrophy predominantly on the right side. Cardiac uptake of meta-iodobenzylguanidine (MIBG) was reduced (H/M ratio: 1.14). A diagnosis of dementia with Lewy bodies (DLB) was made, but L-dopa treatment was not effective. Seven years later he died of pneumonia. On pathological examination, the frontal cortex and white matter were degenerated, predominantly on the right side. Gallyas-Braak silver staining and AT-8 immunostaining revealed neurofibrillary tangles, pretangles, argyrophilic threads, and astrocytic plaques in the cerebral cortex and basal ganglia, confirming the diagnosis of CBD. Lewy bodies, which were not seen in the central nervous system, were seen only in the sympathetic ganglia, and a severe loss of nerve fibers was apparent in the sympathetic nerve endings in the heart. MIBG is currently used to differentiate DLB from other parkinsonisms, such as CBD, multiple system atrophy, and progressive supranuclear palsy, because reduced cardiac uptake of MIBG represents a pathological change in the sympathetic nerve endings in the heart. However, the distribution of Lewy bodies cannot be determined from this finding. Thus, MIBG should not be used alone to confirm a diagnosis of DLB; other neurodegenerative diseases with incidental Lewy body disease, as in the present case, must be also considered. PMID:22790801

  16. Evaluation of a teaching strategy based on integration of clinical subjects, virtual autopsy, pathology museum, and digital microscopy for medical students**

    Science.gov (United States)

    Diaz-Perez, Julio A.; Raju, Sharat; Echeverri, Jorge H.

    2014-01-01

    Background: Learning pathology is fundamental for a successful medical practice. In recent years, medical education has undergone a profound transformation toward the development of an integrated curriculum incorporating both basic science and clinical material. Simultaneously, there has been a shift from a magisterial teaching approach to one centered around problem-based learning. Now-a-days, informatics tools are expected to help better implement these strategies. Aim: We applied and evaluated a new teaching method based on an active combination of clinical problems, gross pathology, histopathology, and autopsy pathology, all given through informatics tools, to teach a group of medical students at the Universidad de Santander, Colombia. Design: Ninety-four medical students were followed in two consecutive semesters. Students were randomized to receive teaching either through traditional methodology or through the new integrated approach. Results: There was no significant difference between the intervention group and the control group at baseline. At the end of the study, the scores in the intervention group were significantly higher compared to the control group (3.91/5.0 vs. 3.33/5.0, P = 0.0008). Students and tutors endorsed the benefits of the integrated approach. Participants were very satisfied with this training approach and rated the program an 8.7 out of 10, on average. Conclusion: This study confirms that an integrated curriculum utilizing informatics systems provides an excellent opportunity to associate pathology with clinical medicine early in training of medical students. This can be possible with the use of virtual microscopy and digital imaging. PMID:25191624

  17. A lost cause? Extending verbal autopsy to investigate biomedical and socio-cultural causes of maternal death in Burkina Faso and Indonesia.

    Science.gov (United States)

    D'Ambruoso, Lucia; Byass, Peter; Qomariyah, Siti Nurul; Ouédraogo, Moctar

    2010-11-01

    Maternal mortality in developing countries is characterised by disadvantage and exclusion. Women who die whilst pregnant are typically poor and live in low-income and rural settings where access to quality care is constrained and where deaths, within and outside hospitals, often go unrecorded and unexamined. Verbal autopsy (VA) is an established method of determining cause(s) of death for people who die outside health facilities or without proper registration. This study extended VA to investigate socio-cultural factors relevant to outcomes. Interviews were conducted with relatives of 104 women who died during pregnancy, childbirth or postpartum in two rural districts in Indonesia and for 70 women in a rural district in Burkina Faso. Information was collected on medical signs and symptoms of the women prior to death and an extended section collected accounts of care pathways and opinions on preventability and cause of death. Illustrative quantitative and qualitative analyses were performed and the implications for health surveillance and planning were considered. The cause of death profiles were similar in both settings with infectious diseases, haemorrhage and malaria accounting for half the deaths. In both settings, delays in seeking, reaching and receiving care were reported by more than two-thirds of respondents. Relatives also provided information on their experiences of the emergencies revealing culturally-derived systems of explanation, causation and behaviour. Comparison of the qualitative and quantitative results suggested that the quantified delays may have been underestimated. The analysis suggests that broader empirical frameworks can inform more complete health planning by situating medical conditions within the socio-economic and cultural landscapes in which healthcare is situated and sought. Utilising local knowledge, extended VA has potential to inform the relative prioritisation of interventions that improve technical aspects of life-saving services with those that address the conditions that underlie health, for those whom services typically fail to reach. PMID:20646807

  18. Polymorphisms in IL-10 and INF-? genes are associated with early atherosclerosis in coronary but not in carotid arteries: A study of 122 autopsy cases of young adults

    Science.gov (United States)

    Esperança, José Carlos P.; Miranda, William R.R.; Netto, José B.; Lima, Fabiane S.; Baumworcel, Leonardo; Chimelli, Leila; Silva, Rosane; Ürményi, Turán P.; Cabello, Pedro H.; Rondinelli, Edson; Faffe, Débora S.

    2015-01-01

    Atherosclerosis is a complex disease, involving both genetic and environmental factors. However, the influence of genetic variations on its early development remains unclear. This study examined the association of 12 different polymorphisms with atherosclerosis severity in anterior descending coronary (DA, n = 103) and carotid arteries (CA, n = 66) of autopsied young adults (< 30 years old). Histological sections (H-E) were classified according to the American Heart Association. Polymorphisms in ACE, TNF-? (? 308G/A and ? 238 G/A), IFN-? (+ 874 A/T), MMP-9 (? 1562 C/T), IL-10 (? 1082 A/G and ? 819 C/T), NOS3 (894 G/T), ApoA1 (rs964184), ApoE (E2E3E4 isoforms), and TGF-? (codons 25 and 10) genes were genotyped by gel electrophoresis or automatic DNA sequencing. Firearm projectile or car accident was the main cause of death, and no information about classical risk factors was available. Histological analysis showed high prevalence of type III atherosclerotic lesions in both DA (69%) and CA (39%) arteries, while severe type IV and V lesions were observed in 14% (DA) and 33% (CA). Allele frequencies and genotype distributions were determined. Among the polymorphisms studied, IFN-? and IL-10 (? 1082 A/G) were related to atherosclerosis severity in DA artery. No association between genotypes and lesion severity was found in CA. In conclusion, we observed that the high prevalence of early atherosclerosis in young adults is associated with IFN-? (p < 0.001) and IL-10 (p = 0.013) genotypes. This association is blood vessel dependent. Our findings suggest that the vascular system presents site specialization, and specific genetic variations may provide future biomarkers for early disease identification. PMID:26674973

  19. Hallazgos morfológicos en casos fatales de síndrome cardiopulmonar por hantavirus: Estudio de 7 autopsias / Morphological findings in fatal cases of hantavirus cardiopulmonary syndrome: Report of 7 autopsies

    Scientific Electronic Library Online (English)

    Pablo, Guzmán G; Oscar, Tapia E; Miguel, Villaseca H; Juan, Araya O; Lilia, Antonio P; Bolívar, Lee O; Juan, Roa S.

    2010-10-01

    Full Text Available Introducción: El síndrome cardiopulmonar por hantavirus (SCPH) es una enfermedad infecciosa aguda, caracterizada por insuficiencia cardio-respiratoria súbita y alta mortalidad, causada por un virus ARN del género Hantavirus, familia Bunyaviridae. Un 15% de los casos chilenos ha sido pesquisado en la [...] Araucanía. Objetivo: Conocer en casos fatales de SCPH, sus características clínicas y morfológicas. Material y Método: Estudio descriptivo-retrospectivo de siete casos fatales con examen postmortem, de SCPH, atendidos entre 1997 y 2009 en el Hospital Regional de Temuco. Resultados: Los casos fueron principalmente pacientes jóvenes, rurales, con un cuadro de compromiso respiratorio progresivo, con leucocitosis, trombopenia e infiltrado pulmonar intersticial bilateral. Los principales hallazgos histopatológicos fueron un acentuado edema pulmonar intra-alveolar e intersticial, con escaso daño epitelial e infiltrado mono-nuclear y leve edema miocárdico con infiltrado mononu-clear. Conclusiones: Los antecedentes epidemiológicos, clínicos y laboratorio permiten sospechar SCPH. En los casos fatales la autopsia permite diferenciar el SCPH de otras patologías similares y aporta tejidos para confirmar el diagnóstico. Abstract in english Introduction: Hantavirus cardiopulmonary syndrome (HCPS) is an acute infectious disease characterized by sudden cardiorespiratory failure and high mortality, caused by a RNA virus of the genus Hantavirus, family Bunyaviridae, 15% of Chilean cases have been detected in the Araucania Region. Objective [...] : To determine in fatal cases of HCPS, clinical and morphological characteristics. Materials and Methods: Descriptive-retrospective analysis of seven fatal cases with postmortem study of HCPS, attended between 1997 and 2009 at the Hospital of Temuco, Chile. Results: Cases were young patients from rural areas, and presented as an illness of progressive respiratory failure, with leukocytosis, thrombocytopenia and bilateral interstitial pulmonary infiltrates. Main morphological findings were marked intersticial and intraalveolar pulmonary edema, with minimal epithelial injury and mononuclear cell intersticial infiltrate and mild edematous intersticial inflamatory process. Conclusions: Epidemiological, clinical and laboratory background allow to suspect HCPS. In fatal cases, the autopsy makes possible to discard other similar pathologies and provide tissue for confirmation of the disease.

  20. [An autopsied case of zygomycosis invasing in the central nervous system and vessels, which is difficult in the differential diagnosis from aspergillosis].

    Science.gov (United States)

    Ueno, Asako; Yoneda, Makoto; Kimura, Yuiti; Ookoshi, Tadakazu; Naiki, Hironobu; Kuriyama, Masaru

    2012-01-01

    A 59-year-old man with a long history of under-treated diabetes mellitus presented with severe inflammation that had spread from the sinus to the left orbital cavity. The bilateral internal carotid arteries were severely stenotic, causing multiple infarctions in the brain parenchyma. There was no ?-D-glucan detected in the cerebrospinal fluid. Based on the presence of central nervous system (CNS) inflammation and vascular involvements that spread from the sinusitis, we tentatively diagnosed this patient as having invasive fungal CNS infection, i.e. zygomycosis or aspergillosis. Although the patient was treated with anti-fungal drugs such as liposomal amphotericin B and voriconazole, he died of respiratory failure. Pathological examination of the autopsied tissues demonstrated zygomycosis in the brain and heart. The prevalence of zygomycosis is generally very low (-5% of CNS infections) compared with that of other fungal infections. The lack of an appropriate diagnostic marker may lead to the under- or mis-diagnosis of zygomycosis. Moreover, it is hard to differentiate zygomycosis from aspergillosis because the two diseases share common clinical features such as the association of sinusitis and vascular involvement. The clinically diagnostic points that discriminate zygomycosis from aspergillosis are as followed; i) ?-D-glucan is negative in zygomycosis but positive in aspergillosis; ii) diabetes is more frequent in patients with zygomycosis to those with aspergillosis; iii) the infectious lesion in aspergillosis shows an iso-low-intensity on T(2) weighted MRI image but shows a high intensity lesion in zygomycosis. The mortality rate of CNS zygomycosis is so high that an early diagnosis of it is warranted and the start appropriate anti-fungal treatments or surgical drainage in the early stage of the disease. PMID:22354231

  1. [A 95-year-old female with autopsy-proven cerebral necrosis due to candidiasis who developed stroke-like manifestations].

    Science.gov (United States)

    Hideyama, Takuto; Aono, Go; Uesaka, Yoshikazu; Kunimoto, Masanari; Nasu, Michiyo

    2005-03-01

    A 95-year-old woman complained of sudden onset of disturbance of consciousness and right hemiparesis on April 20, 2003 and was admitted on the next day. She was drowsy and showed moderate right motor and sensory hemiparesis. The blood laboratory tests showed slight inflammatory reaction. A low density area was found in the left basal ganglia by brain CT, which was also coincided with the high signal region in T2, FLAIR and diffusion-MR images. The MRA of the intracerebral arteries presented no remarkable abnormality. The hemiparesis and impaired consciousness improved partially in the following week. However, she did not fully recover, since aspiration pneumonia and mild generalized inflammation continued. Percutaneous gastrostomy and intravenous hyperalimentation were started to improve her nutrition. The moderate inflammatory state persisted for several weeks. Her blood pressure suddenly fell and she died on June 12. Autopsy showed a mildly brownish and necrotic lesion from the left caudate to the putamen through the internal capsule. There was no liquefaction. On the microscopic examination, the necrosis surrounded by small vessels was consisted of numerous neutrophils and macrophages with pseudohypha and blastospore of candida. Small fragments of fungus were phagocytosed by macrophages. Small abscesses and necrotic foci due to candidiasis were observed in the bladder, kidneys, lungs, myocardium and thyroid gland. In this case, cerebral candidiasis probably occurred via hematogenous dissemination from a primary focus in the urinary tract. The intracerebral arteries revealed rather mild atherosclerotic changes and there was no occlusion by thromboembolism. Intracerebral lesion was diagnosed as candidiasis and there was no cerebral infarction by thromboembolism. If the infection occurred after cerebral infarction, there should not be any inflammatory reaction in the center of necrotic area. There have been few reports of cerebral candidal infection in patients without diabetes mellitus or immunosuppressive conditions. None of them had been diagnosed before death. Caution should be exercised for the presence of systemic candidiasis in elderly patients who are bedridden and with continuous low grade inflammatory reactions. PMID:15835294

  2. Assessing the repeatability of verbal autopsy for determining cause of death: two case studies among women of reproductive age in Burkina Faso and Indonesia

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    Ouédraogo Moctar

    2009-05-01

    Full Text Available Abstract Background Verbal autopsy (VA is an established tool for assessing cause-specific mortality patterns in communities where deaths are not routinely medically certified, and is an important source of data on deaths among the poorer half of the world's population. However, the repeatability of the VA process has never been investigated, even though it is an important factor in its overall validity. This study analyses repeatability in terms of the overall VA process (from interview to cause-specific mortality fractions (CSMF, as well as specifically for interview material and individual causes of death, using data from Burkina Faso and Indonesia. Methods Two series of repeated VA interviews relating to women of reproductive age in Burkina Faso (n = 91 and Indonesia (n = 116 were analysed for repeatability in terms of interview material, individual causes of death and CSMFs. All the VA data were interpreted using the InterVA-M model, which provides 100% intrinsic repeatability for interpretation, and thus eliminated the need to consider variations or repeatability in physician coding. Results The repeatability of the overall VA process from interview to CSMFs was good in both countries. Repeatability was moderate in the interview material, and lower in terms of individual causes of death. Burkinabé data were less repeatable than Indonesian, and repeatability also declined with longer recall periods between the death and interview, particularly after two years. Conclusion While these analyses do not address the validity of the VA process in absolute terms, repeatability is a prerequisite for intrinsic validity. This study thus adds new understanding to the quest for reliable cause of death assessment in communities lacking routine medical certification of deaths, and confirms the status of VA as an important and reliable tool at the community level, but perhaps less so at the individual level.

  3. Autopsia bucal post-exhumación en víctimas de un desastre masivo: Masacre de la Cárcel de Sabaneta, Maracaibo, Venezuela Post-exhumation buccal autopsy in victims of a massive disaster: the Sabaneta Jail Massacre, Maracaibo, Venezuela

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    J.L. Fereira Paz

    2002-10-01

    Full Text Available Ante la solicitud presentada por los parientes de víctimas no identificadas de la Masacre de la Cárcel de Sabaneta, Maracaibo, Venezuela, un tribunal ordenó la exhumación de cuatro cadáveres, quince días después de haber sido sepultados. Se observó una buena conservación de los restos con apreciable mantenimiento de las estructuras y contornos faciales. Se evidenció que el método de acceso a la cavidad oral empleado en la autopsia bucal pre-inhumación facilitó el abordaje para la autopsia post-exhumación, sin provocar mayor destrucción de los tejidos blandos y permitiendo la correcta manipulación tanto de las estructuras orales como de los dispositivos protésicos aportados como evidencias. En todos los casos se verificó la coincidencia de los datos obtenidos durante la autopsia pre-sepultura. Se concluye que cuando el proceso de inhumación se lleva a cabo siguiendo una adecuada planificación, se facilita una futura recuperación del cadáver cuando esta es requerida para completar el procedimiento de identificación.In view of the petition presented by the relatives of the unidentified victims of the Sabaneta Jail Massacre, Maracaibo, Venezuela, a court ordered the exhumation of four corpses, fifteen days after they were buried. The remains were well preserved, the structure and facial outline were well conserved. It was evidenced that the method of access to the oral cavity employed in the pre-inhumation buccal autopsy facilitated the approach to the post-inhumation autopsy, without causing major destruction of the soft tissues and allowing for the correct manipulation of the oral structures as well as of the prosthetic appliances presented as evidence. In all cases, the coincidence of the data obtained during the pre-burial autopsy was verified. It was concluded that adequate planning of the inhumation process facilitates future recuperation of the bodies when this is required to complete the identification procedure.

  4. Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil Envolvimento renal na raiva em humanos: manifestações clínicas e achados de autópsia de nove casos do nordeste do Brasil

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    Elizabeth De Francesco Daher; Geraldo Bezerra da Silva Júnior; Marúsia Thomaz Ferreira; Fernando Antonio de Sousa Barros; Tiago Magalhães Gurgel; Régia Maria do Socorro Vidal Patrocínio

    2005-01-01

    A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days). The time until death ranged from one to nine days (mean 3.3 ± 5.5 days). The signs and symptoms presented were fever, hydrophobia, aerophobia, ...

  5. An autopsy case of frontotemporal lobar degeneration with the appearance of fused in sarcoma inclusions (basophilic inclusion body disease) clinically presenting corticobasal syndrome.

    Science.gov (United States)

    Matsumoto, Arifumi; Suzuki, Hiroyoshi; Fukatsu, Reiko; Shimizu, Hiroshi; Suzuki, Yasushi; Hisanaga, Kinya

    2016-02-01

    We describe an autopsy case of basophilic inclusion body disease (BIBD), a subtype of frontotemporal lobar degeneration (FTLD) with the appearance of fused in sarcoma (FUS) inclusions (FTLD-FUS), clinically presenting corticobasal syndrome (CBS). A 54-year-old man initially developed worsening of stuttering and right hand clumsiness. Neurological examinations revealed rigidity in the right upper and lower extremities, buccofacial apraxia, and right-side dominant limb-kinetic and ideomotor apraxia. Neuroimaging showed asymmetric left-dominant brain atrophy and a cerebral blood flow reduction in the ipsilateral frontal region. At 56?years, his apraxia had advanced, and ideational apraxia was observed. Furthermore, the asymmetry in the limb-kinetic and ideomotor apraxia had disappeared, and both conditions had become bilateral. He had a new onset of aphasia. His symptoms progressed and he died 9 years after the initial symptoms. The brain weighed 955?g. Diffuse brain atrophy was most obvious in the bilateral frontotemporal regions. The atrophy of the left superior frontal and precentral gyri and bilateral basal ganglia was remarkable. Histologically, there was a marked loss of neurons with gliosis in the affected areas, where basophilic neuronal cytoplasmic inclusions were observed. The inclusions were immunoreactive for FUS, p62, and TATA-binding protein-associated factor 15 (TAF15), but not for phosphorylated tau, transactive response DNA-binding protein of 43?kDa (TDP-43), neurofilament protein, or Ewing sarcoma (EWS). From these pathological findings, this case was diagnosed as having BIBD as an FTLD-FUS variant. Spinal cord lower motor neurons were spared in number, similar to primary lateral sclerosis. Mutations in FUS were undetectable. Common background pathologies for CBS include corticobasal degeneration, Alzheimer's disease, PSP, FTLD with phosphorylated TDP-43 inclusions (FTLD-TDP), Pick's disease, Lewy body disease and CJD. However, FTLD-FUS (BIBD) has been rarely reported. Our case suggested further pathological heterogeneity in CBS than had previously been reported. It is necessary to consider FTLD-FUS (BIBD) as a background pathology for CBS in the future. PMID:26227957

  6. Causes of death in two rural demographic surveillance sites in Bangladesh, 2004–2010: automated coding of verbal autopsies using InterVA-4

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    Nurul Alam

    2014-10-01

    Full Text Available Objective: Population-based information on causes of death (CoD by age, sex, and area is critical for countries with limited resources to identify and address key public health issues. This study analysed the demographic surveillance and verbal autopsy (VA data to estimate age- and sex-specific mortality rates and cause-specific mortality fractions in two well-defined rural populations within the demographic surveillance system in Abhoynagar and Mirsarai subdistricts, located in different climatic zones. Design: During 2004–2010, the sample demographic surveillance system registered 1,384 deaths in Abhoynagar and 1,847 deaths in Mirsarai. Trained interviewers interviewed the main caretaker of the deceased with standard VA questionnaires to record signs and symptoms of diseases or conditions that led to death and health care experiences before death. The computer-automated InterVA-4 method was used to analyse VAs to determine probable CoD. Results: Age- and sex-specific death rates revealed a higher neonatal mortality rate in Abhoynagar than Mirsarai, and death rates and sex ratios of male to female death rates were higher in the ages after infancy. Communicable diseases (CDs accounted for 16.7% of all deaths in Abhoynagar and 21.2% in Mirsarai – the difference was due mostly to more deaths from acute respiratory infections, pneumonia, and tuberculosis in Mirsarai. Non-communicable diseases (NCDs accounted for 56.2 and 55.3% of deaths in each subdistrict, respectively, with leading causes being stroke (16.5–19.3%, neoplasms (13.2% each, cardiac diseases (8.9–11.6%, chronic obstructive pulmonary diseases (5.1–6.3%, diseases of the digestive system (3.1–4.1%, and diabetes (2.8–3.5%, together accounting for 49.2–51.2% points of the NCD deaths in the two subdistricts. Injury and other external causes accounted for another 7.5–7.7% deaths, with self-harm being higher among females in Abhoynagar. Conclusions: The computer-automated coding of VA to determine CoD reconfirmed that NCDs were the leading CoD with some differences between the sites. Incorporating VA into the national sample vital registration system can help policy makers to identify the leading CoDs for public health planning.

  7. Aterosclerosis coronaria y daño miocárdico. Estudio de autopsias utilizando el Sistema Aterométrico / Coronary aterosclerosis and myocardial damage. An autopsy material study applying the Atherometric System

    Scientific Electronic Library Online (English)

    Yanira Noalis, Díaz Valdés; Myrna, Moreno Miravalles; Jorge, Bacallao Gallestey; José Emilio, Fernández-Britto Rodríguez.

    2013-03-01

    Full Text Available Introducción: se estudió el corazón y las arterias coronarias epicárdicas derecha (CD), descendente anterior (DA) y circunfleja izquierda (CI) de 472 fallecidos, cuyas necropsias se practicaron en el Hospital Universitario "Dr. Carlos J. Finlay". Objetivos: describir la asociación entre las lesiones [...] ateroscleróticas de las arterias coronarias y las lesiones de fibrosis y necrosis del corazón. Caracterizar las lesiones coronarias y miocárdicas, según la existencia o no de antecedentes de cardiopatía isquémica. Material y Métodos: se realizó análisis cuantitativo y cualitativo de la lesión aterosclerótica utilizando el Sistema Aterométrico (SA). Se practicó un análisis de correlaciones canónicas para evaluar la asociación de la lesión miocárdica con la lesión de las coronarias. Para caracterizar la lesión se emplearon los cosenos del vector lesional que describen la importancia relativa de cada modalidad de lesión. Resultados: hay correlaciones moderadas pero significativas entre las lesiones coronarias y las lesiones miocárdicas. Las placas fibrosas son la lesión predominante, pero las estrías adiposas y las placas graves diferencian mejor a los fallecidos con y sin antecedentes de cardiopatía isquémica. Conclusiones: las estrías adiposas y las placas graves se asocian con las áreas de fibrosis y necrosis en el corazón. En los fallecidos con antecedentes de cardiopatía isquémica hay más placas graves y menos estrías adiposas que en los que no tienen antecedentes. Abstract in english Introduction: the heart and the main epicardiac coronary arteries from 472 autopsies done at the University Hospital Dr. Carlos J. Finlay were analyzed and studied. Objectives: to describe the association between coronary and cardiac lesions. 2.- To characterize coronary and myocardial lesions relat [...] ed to history of ischemic heart disease. Materials and Methods: we performed the quantitative and qualitative analyses as part of the Atherometic System (AS). A canonical correlation analysis was done to assess the association between coronary and myocardial lesion. Cosines of the lesion vector were used to describe and assess the relative importance of each type of lesion. Results: there are moderate but statistically significant correlations between myocardial fibrosis and necrosis, and coronary lesion. Fibrous plaques are the predominant lesion, but fatty streaks and severe plaques are more discriminant between cases with and without history of ischemic heart disease. Conclusions: fatty streaks and severe plaques are associated with the areas of fibrosis and necrosis of the heart. Cases with history of ischemic heart disease have more severe plaques and less fatty streaks than cases without history of ischemic heart disease.

  8. Guías para la práctica de la autopsia en casos de muerte súbita cardíaca / Guidelines for autopsy investigation of sudden cardiac death

    Scientific Electronic Library Online (English)

    C., Basso; M., Burke; P., Fornes; P. J., Gallagher; R. H. de, Gouveia; M., Sheppard; G., Thiene; A., van der Wal.

    2009-01-01

    Full Text Available A pesar de que la muerte súbita cardíaca es una de las formas más importantes de muerte en los países occidentales, este problema no ha recibido la atención que merece por parte de los patólogos y de los médicos de los sistemas públicos de salud. Se han desarrollado nuevos métodos de prevención de a [...] rritmias potencialmente mortales, y el diagnóstico de certeza de las causas de muerte súbita cardíaca es en este momento de particular importancia. Los patólogos son responsables de determinar la causa exacta de la muerte súbita pero existen diferencias considerables en el modo en el que se aborda esta cada vez más compleja tarea. La Asociación Europea de Patología Cardiovascular desarrolló unas guías que representan el estándar mínimo necesario en la práctica habitual de la autopsia para la valoración de la muerte súbita cardíaca, incluyendo no sólo un protocolo para el examen del corazón y el muestreo histopatológico, sino también para la investigación toxicológica y molecular. Nuestras recomendaciones son aplicables a centros médicos universitarios, a hospitales regionales y locales y a todo tipo de Institutos de Medicina Forense. La adopción a lo largo de la Unión Europea de un método uniforme de investigación supondrá la mejora de la práctica habitual, permitirá realizar comparaciones significativas entre distintas comunidades y regiones y, lo que es más importante aún, favorecerá que se monitoricen los patrones de las enfermedades que causan una muerte súbita. Abstract in english Although sudden cardiac death is one of the most important mode of death in Western Countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed, and the accurate diagnosis of t [...] he causes of sudden cardiac death is now of particular importance. Pathologists are responsible for determining the precise cause of sudden death but there is considerable variation in the way in which they approach this increasingly complex task. The Association for European Cardiovascular Pathology developed guidelines, which represent the minimum standard that is required in the routine autopsy practice for the adequate assessment of sudden cardiac death, including not only a protocol for heart examination and histological sampling, but also for toxicology and molecular investigation. Our recommendations apply to university medical centres, regional and district hospitals and all types of forensic medicine institutes. If a uniform method of investigation is adopted throughout the European Union, this will lead to improvements in standards of practice, allow meaningful comparisons between different communities and regions and, most importantly, permit future trends in the patterns of disease causing sudden death to be monitored.

  9. Autópsia psicológica e psicossocial sobre suicídio de idosos: abordagem metodológica Psychological and psychosocial autopsy on suicide among the elderly: a methodological approach

    Directory of Open Access Journals (Sweden)

    Fátima Gonçalves Cavalcante

    2012-08-01

    Full Text Available O artigo analisa a qualidade e a consistência de um roteiro de entrevista semiestruturada, adaptado para o estudo do suicídio de pessoas idosas e apresenta o método das autópsias psicossociais que resultou da aplicação desse instrumento. O objetivo é demonstrar como o uso da entrevista em profundidade e sua forma de organização e análise de dados foram testados e aperfeiçoados por uma rede de pesquisadores de vários centros de pesquisa do Brasil. O método envolveu a aplicação do instrumento em que se socializou um manual de instruções sobre a coleta, sistematização e análise de dados. A metodologia foi aplicada no estudo de 51 casos de idosos que faleceram por suicídio em dez municípios brasileiros, e permitiu a verificação da consistência do instrumento usado e a aplicabilidade do seu método, durante o processo e ao final, por meio de uma avaliação em rede. O roteiro aperfeiçoado e as instruções para replicá-lo e analisá-lo são aqui apresentados. Os resultados apontam o rigor e a credibilidade dessa abordagem metodológica testada e qualificada de um modo interdisciplinar e interinstitucional.The article analyzes the quality and consistency of a semi-structured interview script, adapted for the study on suicide among elderly people, and presents the psychological and psychosocial autopsy method, which is the result of application of this instrument. The objective is to demonstrate how the in-depth interview and subsequent data organization and analyses were tested and improved by a network of researchers from eight regions in Brazil. Evaluation of the method was conducted before and after the application of the instruments to collect, systematize and analyze the data. This methodology was applied in 51 cases of elderly people who committed suicide in ten Brazilian municipalities. The study did more than just collect data with scientific rigor, since it also verified the consistency of the instrument used and the applicability of the method. The improved script and the instructions of how to apply and analyze it are thus presented here. The results reveal the rigor and credibility of this methodological approach tested and qualified by a multidisciplinary and inter-institutional procedure.

  10. Autópsias psicológicas e psicossociais de idosos que morreram por suicídio no Brasil Psychological and psychosocial autopsies of the elderly who committed suicide in Brazil

    Directory of Open Access Journals (Sweden)

    Fátima Gonçalves Cavalcante

    2012-08-01

    Full Text Available Analisam-se 51 casos de suicídio de idosos em dez municípios brasileiros, visando a conhecer a interação de variáveis associadas ao fenômeno. Uma revisão sobre o tema dá suporte teórico ao estudo. Tendo como base o método da autópsia psicológica, o estudo parte de um roteiro de entrevista semiestruturada, aplicada e analisada por pares de pesquisadores, mediante um mesmo procedimento de coleta, organização e análise dos dados. O conjunto foi reexaminado através de uma meta-análise de enfoque psicossocial e qualitativo sobre dados dos familiares entrevistados, interpretações dos pesquisadores, contextualização socioantropológica e categorias de relevância. Foram estudadas formas de perpetração e letalidade por sexo, faixa etária, perfil socioeconômico; fatores associados; e motivos atribuídos. Analisou-se a interação de fatores precipitantes relevantes. As conclusões apontam convergências entre estudos epidemiológicos e qualitativos. Doenças graves, deficiências e transtornos mentais juntos formam as principais causas, seguidas de depressão, conflitos familiares e conjugais. Recomenda-se atenção à qualidade de vida dos idosos, especialmente dos homens, que constituem o grupo de maior risco para suicídio.The authors analyze 51 cases of suicide among the elderly from ten Brazilian municipalities. The objective is to understand the interaction of variables associated with suicide among the elderly. A bibliographic review gives theoretical support to this study. Based on psychological autopsy, the study begins with a semi-structured interview format, which was applied and analyzed by peer researchers, using the same procedure for gathering, organizing and analyzing the data. This material was reviewed using a psychosocial and qualitative meta-analysis approach based on family interview data, researchers' interpretations, socio-anthropological contextualization and relevance categories. Ways of committing suicide, reasons for suicide, associated factors, attributed motives and lethality were studied by sex, age and socioeconomic characteristics. The interaction of major precipitant factors was analyzed. The conclusions showed that there are convergences among epidemiological and qualitative studies. Severe illness, disabilities and mental disorders are the major causes, followed by depression and family and marital conflicts. Close attention to the quality of life of the elderly is recommended, especially of men who constitute the main suicide risk group.

  11. Deriving causes of child mortality by re–analyzing national verbal autopsy data applying a standardized computer algorithm in Uganda, Rwanda and Ghana

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    Li Liu

    2015-06-01

    Full Text Available Background To accelerate progress toward the Millennium Development Goal 4, reliable information on causes of child mortality is critical. With more national verbal autopsy (VA studies becoming available, how to improve consistency of national VA derived child causes of death should be considered for the purpose of global comparison. We aimed to adapt a standardized computer algorithm to re–analyze national child VA studies conducted in Uganda, Rwanda and Ghana recently, and compare our results with those derived from physician review to explore issues surrounding the application of the standardized algorithm in place of physician review. Methods and Findings We adapted the standardized computer algorithm considering the disease profile in Uganda, Rwanda and Ghana. We then derived cause–specific mortality fractions applying the adapted algorithm and compared the results with those ascertained by physician review by examining the individual– and population–level agreement. Our results showed that the leading causes of child mortality in Uganda, Rwanda and Ghana were pneumonia (16.5–21.1% and malaria (16.8–25.6% among children below five years and intrapartum–related complications (6.4–10.7% and preterm birth complications (4.5–6.3% among neonates. The individual level agreement was poor to substantial across causes (kappa statistics: –0.03 to 0.83, with moderate to substantial agreement observed for injury, congenital malformation, preterm birth complications, malaria and measles. At the population level, despite fairly different cause–specific mortality fractions, the ranking of the leading causes was largely similar. Conclusions The standardized computer algorithm produced internally consistent distribution of causes of child mortality. The results were also qualitatively comparable to those based on physician review from the perspective of public health policy. The standardized computer algorithm has the advantage of requiring minimal resources from the health care system and represents a promising way to re–analyze national or sub-national VA studies in place of physician review for the purpose of global comparison.

  12. Autópsia psicológica e psicossocial sobre suicídio de idosos: abordagem metodológica / Psychological and psychosocial autopsy on suicide among the elderly: a methodological approach

    Scientific Electronic Library Online (English)

    Fátima Gonçalves, Cavalcante; Maria Cecília de Souza, Minayo; Stela Nazareth, Meneghel; Raimunda Magalhães da, Silva; Denise Machado Duran, Gutierrez; Marta, Conte; Ana Elisa Bastos, Figueiredo; Sonia, Grubits; Ana Célia Sousa, Cavalcante; Raimunda Matilde do Nascimento, Mangas; Luiza Jane Eyre de Souza, Vieira; Gracyelle Alves Remigio, Moreira.

    2012-08-01

    Full Text Available O artigo analisa a qualidade e a consistência de um roteiro de entrevista semiestruturada, adaptado para o estudo do suicídio de pessoas idosas e apresenta o método das autópsias psicossociais que resultou da aplicação desse instrumento. O objetivo é demonstrar como o uso da entrevista em profundida [...] de e sua forma de organização e análise de dados foram testados e aperfeiçoados por uma rede de pesquisadores de vários centros de pesquisa do Brasil. O método envolveu a aplicação do instrumento em que se socializou um manual de instruções sobre a coleta, sistematização e análise de dados. A metodologia foi aplicada no estudo de 51 casos de idosos que faleceram por suicídio em dez municípios brasileiros, e permitiu a verificação da consistência do instrumento usado e a aplicabilidade do seu método, durante o processo e ao final, por meio de uma avaliação em rede. O roteiro aperfeiçoado e as instruções para replicá-lo e analisá-lo são aqui apresentados. Os resultados apontam o rigor e a credibilidade dessa abordagem metodológica testada e qualificada de um modo interdisciplinar e interinstitucional. Abstract in english The article analyzes the quality and consistency of a semi-structured interview script, adapted for the study on suicide among elderly people, and presents the psychological and psychosocial autopsy method, which is the result of application of this instrument. The objective is to demonstrate how th [...] e in-depth interview and subsequent data organization and analyses were tested and improved by a network of researchers from eight regions in Brazil. Evaluation of the method was conducted before and after the application of the instruments to collect, systematize and analyze the data. This methodology was applied in 51 cases of elderly people who committed suicide in ten Brazilian municipalities. The study did more than just collect data with scientific rigor, since it also verified the consistency of the instrument used and the applicability of the method. The improved script and the instructions of how to apply and analyze it are thus presented here. The results reveal the rigor and credibility of this methodological approach tested and qualified by a multidisciplinary and inter-institutional procedure.

  13. Autópsias psicológicas e psicossociais de idosos que morreram por suicídio no Brasil / Psychological and psychosocial autopsies of the elderly who committed suicide in Brazil

    Scientific Electronic Library Online (English)

    Fátima Gonçalves, Cavalcante; Maria Cecília de Souza, Minayo.

    2012-08-01

    Full Text Available Analisam-se 51 casos de suicídio de idosos em dez municípios brasileiros, visando a conhecer a interação de variáveis associadas ao fenômeno. Uma revisão sobre o tema dá suporte teórico ao estudo. Tendo como base o método da autópsia psicológica, o estudo parte de um roteiro de entrevista semiestrut [...] urada, aplicada e analisada por pares de pesquisadores, mediante um mesmo procedimento de coleta, organização e análise dos dados. O conjunto foi reexaminado através de uma meta-análise de enfoque psicossocial e qualitativo sobre dados dos familiares entrevistados, interpretações dos pesquisadores, contextualização socioantropológica e categorias de relevância. Foram estudadas formas de perpetração e letalidade por sexo, faixa etária, perfil socioeconômico; fatores associados; e motivos atribuídos. Analisou-se a interação de fatores precipitantes relevantes. As conclusões apontam convergências entre estudos epidemiológicos e qualitativos. Doenças graves, deficiências e transtornos mentais juntos formam as principais causas, seguidas de depressão, conflitos familiares e conjugais. Recomenda-se atenção à qualidade de vida dos idosos, especialmente dos homens, que constituem o grupo de maior risco para suicídio. Abstract in english The authors analyze 51 cases of suicide among the elderly from ten Brazilian municipalities. The objective is to understand the interaction of variables associated with suicide among the elderly. A bibliographic review gives theoretical support to this study. Based on psychological autopsy, the stud [...] y begins with a semi-structured interview format, which was applied and analyzed by peer researchers, using the same procedure for gathering, organizing and analyzing the data. This material was reviewed using a psychosocial and qualitative meta-analysis approach based on family interview data, researchers' interpretations, socio-anthropological contextualization and relevance categories. Ways of committing suicide, reasons for suicide, associated factors, attributed motives and lethality were studied by sex, age and socioeconomic characteristics. The interaction of major precipitant factors was analyzed. The conclusions showed that there are convergences among epidemiological and qualitative studies. Severe illness, disabilities and mental disorders are the major causes, followed by depression and family and marital conflicts. Close attention to the quality of life of the elderly is recommended, especially of men who constitute the main suicide risk group.

  14. Suicide study : a psychological autopsy

    OpenAIRE

    Santos, José Henrique Catarino

    2014-01-01

    RESUMO: O'suicídio'é'atualmente'um'problema'de'saúde'pública.'Estimarse'que'um'milhão'de'pessoas' morra'anualmente'devido'ao'suicídio.'De'acordo'com'diversas'agências'e'organizações'estimar 'que'ocorram'entre'20'a'40'tentativas'de'suicídio'por'cada'suicídio'consumado.'Os'custos'associados'ao'suicídio,'quer'humanos'quer'económicos'são'enormes'e'estendemrse'à'família,'emprego,'economia'e'finanças.'Os'números'oficiais'do'suicídio'em'Portugal'indicam'uma'taxa ligeiramente'acima'dos'10'por' cad...

  15. Diagnóstico del origen y la causa de la muerte después de la autopsia médico-legal (Parte I Diagnosis of the origin and cause of death after the medico-legal autopsy (Part I

    Directory of Open Access Journals (Sweden)

    J.L. Palomo Rando

    2010-12-01

    Full Text Available Una de las tareas más difíciles en patología forense puede ser determinar, después de la autopsia, el origen y la causa de la muerte cuando dichos extremos no están claros o son discutibles. Una autopsia técnicamente perfecta es condición necesaria pero no suficiente para cumplir adecuadamente esta decisión. En el presente trabajo se delimitan claramente los conceptos de causa y mecanismo de muerte, muerte natural y muerte violenta. Se revisan muchos de los aspectos relacionados con el diagnóstico del origen y la causa de la muerte; especialmente el enfoque actual del valor de la autopsia en el diagnóstico, la interacción entre traumatismo y enfermedad, la doctrina de la causalidad, la utilización de la CIE-10, la llamada etiología médico-legal, la autopsia psicológica, la "autopsia blanca" o negativa y el origen de la muerte por complicaciones de la terapéutica, etc., todos ellos se ilustran con ejemplos de casos representativos. Se discute el limitado papel del patólogo forense en España en la determinación de la denominada etiología médico-legal. Las conclusiones constituyen un conjunto de recomendaciones para el mejor cumplimiento de este trabajo, entre ellas el abandono de las denominadas causas de muerte inaceptables como parada cardiaca, parada cardiorrespiratoria o muerte cerebral, etc., la utilización siempre que sea posible de los diagnósticos de la CIE-10 y del formato del apartado de la causa de la muerte (parte I y II del modelo internacional de certificado médico de causa de defunción de la OMS. Todo ello como guía breve que facilite un resultado judicial adecuado y aumente la credibilidad del patólogo forense.One of the most difficult tasks in forensic pathology is deciding the origin and the cause of death after the autopsy when those issues are unclear or debatable. A technically perfect autopsy is a necessary but not a sufficient condition to adequately fulfil this decision. The present paper clearly defines the concepts of cause and mechanism of death, natural and violent death. We review many aspects related to the diagnosis of the origin and cause of death, especially the current approach of the value of autopsy in the diagnosis, the interaction between trauma and disease, the doctrine of causation, the use of ICD- 10, the so-called manner of death, the psychological autopsy, the negative autopsy and the origin of death from therapeutic complication, and so on., all of which are illustrated with relevant examples. We also discuss the limited role of the forensic pathologist in Spain in determining the so-called manner of death. The conclusions include(s a list of recommendations for the best performance of this work, including the abandonment of the so-called unacceptable causes of death -as cardiac arrest, cardiopulmonary arrest or brain death, and so on- and whenever possible the adoption of the classification of ICD-10 and the standard paragraph in which the cause of death is informed (part I and II, as proposed by the WHO international certificate of death. These conclusions intend to be a brief guide to provide a fair judicial outcome and enhance the forensic pathologist´s credibility.

  16. Diagnóstico del origen y la causa de la muerte después de la autopsia médico-legal (Parte II Diagnosis of the origin and cause of death after the medico-legal autopsy (Part II

    Directory of Open Access Journals (Sweden)

    J.L. Palomo Rando

    2011-03-01

    Full Text Available Una de las tareas más difíciles en patología forense puede ser determinar, después de la autopsia, el origen y la causa de la muerte cuando dichos extremos no están claros o son discutibles. Una autopsia técnicamente perfecta es condición necesaria pero no suficiente para cumplir adecuadamente esta decisión. En el presente trabajo se delimitan claramente los conceptos de causa y mecanismo de muerte, muerte natural y muerte violenta. Se revisan muchos de los aspectos relacionados con el diagnóstico del origen y la causa de la muerte; especialmente el enfoque actual del valor de la autopsia en el diagnóstico, la interacción entre traumatismo y enfermedad, la doctrina de la causalidad, la utilización de la CIE-10, la llamada etiología médico-legal, la autopsia psicológica, la "autopsia blanca" o negativa y el origen de la muerte por complicaciones de la terapéutica, etc., todos ellos se ilustran con ejemplos de casos representativos. Se discute el limitado papel del patólogo forense en España en la determinación de la denominada etiología médico-legal. Las conclusiones constituyen un conjunto de recomendaciones para el mejor cumplimiento de este trabajo, entre ellas el abandono de las denominadas causas de muerte inaceptables como parada cardiaca, parada cardiorrespiratoria o muerte cerebral, etc., la utilización siempre que sea posible de los diagnósticos de la CIE-10 y del formato del apartado de la causa de la muerte (parte I y II del modelo internacional de certificado médico de causa de defunción de la OMS. Todo ello como guía breve que facilite un resultado judicial adecuado y aumente la credibilidad del patólogo forense.One of the most difficult tasks in forensic pathology is deciding the origin and the cause of death after the autopsy when those issues are unclear or debatable. A technically perfect autopsy is a necessary but not a sufficient condition to adequately fulfil this decision. The present paper clearly defines the concepts of cause and mechanism of death, natural and violent death. We review many aspects related to the diagnosis of the origin and cause of death, especially the current approach of the value of autopsy in the diagnosis, the interaction between trauma and disease, the doctrine of causation, the use of ICD- 10, the so-called manner of death, the psychological autopsy, the negative autopsy and the origin of death from therapeutic complication, and so on., all of which are illustrated with relevant examples. We also discuss the limited role of the forensic pathologist in Spain in determining the so-called manner of death. The conclusions include(s a list of recommendations for the best performance of this work, including the abandonment of the so-called unacceptable causes of death -as cardiac arrest, cardiopulmonary arrest or brain death, and so on- and whenever possible the adoption of the classification of ICD-10 and the standard paragraph in which the cause of death is informed (part I and II, as proposed by the WHO international certificate of death. These conclusions intend to be a brief guide to provide a fair judicial outcome and enhance the forensic pathologist's credibility.

  17. The burden of disease in Maputo City, Mozambique: registered and autopsied deaths in 1994 / La charge de morbidité à Maputo (Mozambique): enregistrement et autopsie des personnes décédées en 1994 / La carga de morbilidad en Maputo (Mozambique), según los registros de defunciones y autopsias de 1994

    Scientific Electronic Library Online (English)

    Martinho, Dgedge; Ana, Novoa; Gloria, Macassa; Jahit, Sacarlal; James, Black; Catherine, Michaud; Julie, Cliff.

    Full Text Available OBJETIVO: Clasificar las causas de defunción en Maputo (Mozambique) empleando los métodos del estudio sobre la Carga Mundial de Morbilidad, a fin de facilitar información a los formuladores de políticas sanitarias y de obtener valores basales para llevar a cabo futuros estudios en Maputo y en capita [...] les de provincia del país. MÉTODO: Se utilizaron datos extraídos del registro de defunciones y los registros de autopsias de Maputo correspondientes a 1994. RESULTADOS: En el registro de defunciones se habían consignado en total 9011 fallecimientos, lo que representaba una cobertura de aproximadamente el 86%. De esas defunciones, 8114 (92%) estaban clasificadas por causas. Los trastornos transmisibles, maternos, perinatales y nutricionales, eran la causa de 5319 muertes; las enfermedades no transmisibles, de 1834; y los traumatismos, de 961. Las diez causas principales de las defunciones registradas fueron los trastornos perinatales (1643 defunciones); el paludismo (928); las enfermedades diarreicas (814); la tuberculosis (456); las infecciones respiratorias inferiores (416); los accidentes de carretera/tráfico (371); la anemia (269); las enfermedades cerebrovasculares (269); los homicidios (188); y las meningitis bacterianas (178). CONCLUSIÓN: Las enfermedades infecciosas de todo tipo, los traumatismos y las enfermedades cerebrovasculares eran las causas principales de defunción, según demostraban tanto los registros de autopsia como el registro de defunciones de la ciudad. Las muertes relacionadas con el SIDA estaban subnotificadas. Dada la rápida propagación de la infección por el VIH, el SIDA se añadirá a la ya alta carga de enfermedades infecciosas y mortalidad prematura que registra Maputo. Los resultados del estudio indican que la causa de defunción es un valioso indicador de los resultados para los programas de lucha contra las enfermedades. Abstract in english OBJECTIVE: To classify the causes of death in Maputo City, Mozambique, using the methods of the Global Burden of Disease study, in order to provide information for health policy-makers and to obtain a baseline for future studies in Maputo City and provincial capitals. METHODS: Data were taken from t [...] he Maputo City death register and autopsy records for 1994. FINDINGS: A total of 9011 deaths were recorded in the death register, representing a coverage of approximately 86%. Of these, 8114 deaths (92%) were classified by cause. Communicable, maternal, perinatal, and nutritional disorders accounted for 5319 deaths; noncommunicable diseases for 1834; and injuries for 961. The 10 leading causes of registered deaths were perinatal disorders (1643 deaths); malaria (928); diarrhoeal diseases (814); tuberculosis (456); lower respiratory infections (416); road-traffic accidents (371); anaemia (269); cerebrovascular diseases (269); homicide (188); and bacterial meningitis (178). CONCLUSIONS: Infectious diseases of all types, injuries, and cerebrovascular disease ranked as leading causes of death, according to both the autopsy records and the city death register. AIDS-related deaths were underreported. With HIV infection increasing rapidly, AIDS will add to the already high burden of infectious diseases and premature mortality in Maputo City. The results of the study indicate that cause of death is a useful outcome indicator for disease control programmes.

  18. Expresión Morfológica de la Arteria Basilar: Un Estudio con Material de Autopsia de Individuos Colombianos / Morphological Expression of the Basilar Artery: A Study with Colombian Population's Autopsy Material

    Scientific Electronic Library Online (English)

    Pedro Luis, Forero; Luis Ernesto, Ballesteros; Luis Miguel, Ramírez.

    2013-09-01

    Full Text Available La arteria basilar (AB) presenta una expresión variable, la cual es determinante en la etiología de eventos clínicos que comprometen el tallo cerebral. El propósito de este trabajo fue determinar la expresión morfológica de la AB en una muestra de población colombiana. Fueron estudiados 100 tallos c [...] erebrales de individuos a quienes se les practicó autopsia en el Institutode Medicina Legal de Bucaramanga. El sistema vertebro-basilar fue perfundido con resina sintética y evaluado los calibres, trayectorias, niveles de origen y finalización de la AB. La AB presentó trayectoria rectilínea en 68%, desviación a la derecha en 12%, sinuosa en 10% y desviación a la izquierda en 10%. La longitud total de la AB fue 30,2 mm DE 4,07 y la longitud con relación al origen de la arteria Cerebelar superior fue 28,1 mm DE 3,84. Los calibres proximal y distal de la AB fueron 3,96 mm DE 0,48 mm y 3,7 mm DE 0,58 respectivamente. Con relación a las arterias de origen de la AB, se observó hipoplasia ( 2 mm) de la arteria vertebral derecha en el 8% y de la arteria vertebral izquierda en el 11% (P = 0,30). Se observó el origen de la AB a tres niveles del surco pontomedular: a nivel en el 43%, por arriba de este en el 30% y por debajo de este surco en 27% de los casos. Las trayectorias sinuosas y desviadas de la AB observadas y la presencia de hipoplasias de la arteria vertebral son ligeramente superiores a los señalados en estudios previos, mientras que su longitud se ubica en un rango medio y su calibre es ligeramente inferior a lo señalado en la literatura. Abstract in english The basilar artery (BA) has a variable expression which is determinant in the etiology of clinical events that compromise the brain stem. The purpose of this study was to determine the morphological expression of BA in a Colombian population sample. We studied 100 brainstems of individuals which und [...] erwent an autopsy at the Instituto de Medicina Legal of Bucaramanga. The vertebra basilar system was perfused with synthetic resin and its calibers, paths, levels of origin and end of the BA were evaluated. The BA presented a rectilinear trajectory in 68%, deviation to the right in 12%, sinuous in 10% and deviation to the left in 10%. The total length of the BA was 30.2 mm SD 4.07, its length in relation to the origin of the superior cerebellar artery was 28.1 mm SD 3.84. The proximal and distal caliber of the BA were 3.96 mm SD 0.48 mm and 3.7 mm SD 0.58 respectively. In relation to the origin arteries of the AB, hypoplasia was observed ( 2 mm) of the right vertebral artery in 8% and the left vertebral artery in 11% (P = 0.30). The origin of BA was observed at different spontomedullary groove levels: at level in 43%, above it in 30% and below it in 27% of the cases. The sinuous and diverted paths from the BA observed and the presence of vertebral artery hypoplasia are slightly higher than those reported in previous studies, while its length is at medium range and its caliber is slightly lower than reported in the literature.

  19. Morphological changes in the digestive system of 93 human immunodeficiency virus positive patients: an autopsy study / Alterações morfológicas no sistema digestivo de 93 pacientes infectados pelo vírus da imunodeficiência humana: um estudo de autopsias

    Scientific Electronic Library Online (English)

    Lucinda Calheiros, Guimarães; Ana Cristina Araujo Lemos, Silva; Adilha Misson Rua, Micheletti; Everton Nunes Melo, Moura; Mario Leon, Silva-Vergara; Sheila Jorge, Adad.

    2012-04-01

    Full Text Available Envolvimento do sistema digestório em pacientes com síndrome da imunodeficiência adquirida (AIDS) é frequente e muitas alterações nesses pacientes são diagnosticadas apenas à autopsia. Há escassos estudos de autopsia com análise detalhada desse sistema e apenas um deles foi realizado no Brasil. Nest [...] e estudo avaliamos cada segmento do sistema digestório em 93 autopsias consecutivas de indivíduos infectados pelo vírus da imunodeficiência humana (HIV) e a importância dessas lesões para o óbito. Desses, 90 (96,8%) pacientes apresentavam AIDS. Revisamos prontuários médicos, relatórios de autopsias e cortes histológicos da língua ao reto corados pela técnica de hematoxilina-eosina. Quando necessário, analisamos colorações especiais e imuno-histoquímica para pesquisar infecções. Havia lesões no sistema digestório em 73 (78,5%) casos. As alterações mais comuns foram infecciosas: candidíase (42%), citomegalovirose (29%), histoplasmose (11,8%), toxoplasmose (9,7%) e infecção por micobactérias (9,7%). Neoplasias malignas foram raras, presentes em quatro (4,3%) casos (dois sarcomas de Kaposi, um adenocarcinoma gástrico e um carcinoma embrionário metastático). Todos os segmentos apresentaram lesões: língua (48,6%), esôfago (44,8%), estômago (44,7%), intestino grosso (43,2%) e intestino delgado (28,9%). As lesões encontradas foram causa imediata do óbito em cinco (5,4%) casos. Em outros 36 (38,7%) casos a doença básica era sistêmica comprometendo, também, o sistema digestório. Abstract in english Involvement of the digestive system in patients with acquired immunodeficiency syndrome (AIDS) is frequent and many changes in these patients are diagnosed only at autopsy. There are few studies of autopsy with detailed analysis of this system and only one was conducted in Brazil. We evaluated each [...] segment of the digestive system in 93 consecutive autopsies of patients infected with human immunodeficiency virus (HIV) and the importance of these lesions to death. Of these, 90 (96.8%) patients had AIDS. We reviewed medical records, autopsy reports and histological sections from tongue to rectum stained with hematoxylin-eosin. When necessary, we analyzed special stains and immunohistochemistry to investigate infections. There was damage to the digestive system in 73 (78.5%) cases. The most common infections were candidiasis (42%), cytomegalovirus (29%), histoplasmosis (11.8%), toxoplasmosis (9.7%) and mycobacterial infection (9.7%). Malignancies were rare, present in four (4.3%) cases (two Kaposi's sarcoma, one adenocarcinoma and one metastatic embryonal carcinoma). All segments showed lesions: tongue (48.6%), esophagus (44.8%), stomach (44.7%), colon (43.2%) and small intestine (28.9%). The lesions found were immediate cause of death in five (5.4%) cases. In another 36 (38.7%) cases the basic disease was systemic and also compromised the digestive system.

  20. Penetration Depth of Projectiles Fired from a Replica of Colt Navy of 1851 in 20% Gelatin Blocks Correlated with Fatal Injuries Assessed in an Autopsy of a 78-Year-Old Man.

    Science.gov (United States)

    Smędra-Kaźmirska, Anna; Barzdo, Maciej; Jurczyk, Agnieszka P; Berent, Jarosław

    2015-09-01

    Pursuant to the Polish Weapons and Ammunitions Law, muzzle-loading black powder weapons, manufactured before 1885, or their replicas, as well as suitable projectiles, can be possessed legally without registration and special licenses. The aim of the study was to assess the penetration depth of projectiles fired from a black powder weapon, replica of Colt Navy of 1851, in 20% gelatin blocks and to compare the obtained results with the actual injuries found on autopsy of a 78-year-old man who had committed suicide. In the experiments, we used the black powder weapon and ammunitions, as well as gelatin blocks serving as a soft tissue model. We ascertained that solid spherical projectiles fired from black powder weapons cause extensive injuries, especially in the initial segment of the wound canal. Additionally, based on the presence and location of the wad in the wound canal, the distance from which the shot was fired can be determined. PMID:25864492

  1. Affinities and densities of high-affinity [3H]muscimol (GABA-A) binding sites and of central benzodiazepine receptors are unchanged in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy

    International Nuclear Information System (INIS)

    The integrity of GABA-A receptors and of central benzodiazepine receptors was evaluated in membrane preparations from prefrontal cortex and caudate nuclei obtained at autopsy from nine cirrhotic patients who died in hepatic coma and an equal number of age-matched control subjects. Histopathological studies revealed Alzheimer Type II astrocytosis in all cases in the cirrhotic group; controls were free from neurological, psychiatric or hepatic diseases. Binding to GABA-A receptors was studied using [3H]muscimol as radioligand. The integrity of central benzodiazepine receptors was evaluated using [3H]flunitrazepam and [3H]Ro15-1788. Data from saturation binding assays was analyzed by Scatchard plot. No modifications of either affinities (Kd) or densities (Bmax) of [3H]muscimol of central benzodiazepine binding sites were observed. These findings do not support recent suggestions that alterations of either high-affinity GABA or benzodiazepine receptors play a significant role in the pathogenesis of hepatic encephalopathy

  2. Autometallographic silver enhancement of zinc sulfide crystals created in cryostat sections from human brain biopsies: a new technique that makes it feasible to demonstrate zinc ions in tissue sections from biopsies and early autopsy material

    DEFF Research Database (Denmark)

    Danscher, Gorm; Juhl, S; Stoltenberg, M; Krunderup, B; Schrøder, H D; Andreasen, A

    1997-01-01

    We present a new technique that allows zinc ions in synaptic and secretory vesicles of biopsy and early autopsy material (<2 hr post mortem) to be transformed to nanometer-sized zinc sulfide crystal lattices for subsequent autometallographic (AMG) development. Human brain biopsies, or other tissue...... samples containing zinc-enriched (ZEN) cells, are frozen in liquid nitrogen or by CO2 gas immediately after removal. The tissue blocks are cut in a cryostat and the sections placed on glass slides. The slides are transferred to an H2S exposure chamber placed in a -15 C freezer. After 1-24 hr of gas...... cryostat sections from neocortex biopsies of five individuals undergoing brain surgery. Biopsies from three patients resulted in satisfactory AMG-stained sections. Rat brains removed and frozen immediately after decapitation constituted the material on which the present technique was developed. Such...

  3. Correlación clinicopatológica en pacientes inmunocompetentes con Meningitis tuberculosa, reporte de casos de autopsia en el Hospital Universitario de Santander-Colombia Clinicopathological correlation in inmunocompetent patients with tuberculous meningitis, autopsy cases report in the Hospital Universitario de Santander-Colombia.

    Directory of Open Access Journals (Sweden)

    Julio Cesar Mantilla

    2012-04-01

    Full Text Available Introducción: describir tres casos fatales de tuberculosis meníngea y establecer correlación clinicopatológica. Materiales y métodos: revisión de protocolos de autopsia entre enero 1 y junio 30 de 2010 en el Departamento de Patología de la Universidad Industrial de Santander (UIS. Entre 121 protocolos de necropsias se encontraron 3 casos de tuberculosis meníngea, de los cuales se revisaron historias clínicas, preparaciones histopatológicas y fotografías. Resultados: tres casos de adultos con edad promedio de 39 años, sin inmunosupresión con tuberculosis meníngea. Las manifestaciones clínicas fueron cefalea, vómito, fiebre, disartria, compromiso de pares craneales, alteraciones motoras y del estado de conciencia. Conclusiones: la tuberculosis meníngea es la forma más grave de la enfermedad, con desenlace fatal en casos no diagnosticados. El bajo índice de sospecha y la similitud con otras infecciones del sistema nervioso central, no permiten diagnostico precoz ni tratamiento oportuno. Salud UIS 2012; 44 (1: 57-66Introduction: to describe three fatal cases of tuberculous meningitis and to establish clinical pathological correlation. Materials and methods: Revision of autopsy protocols between 01 january and june 30 of 2010 in the Department of Pathology of the Industrial University of Santander (UIS. Between 121 protocols of autopsies were 3 cases of tuberculous meningitis, of which clinical histories, histopathological slides and photographies were rewieved. Results: three cases of adults with age average of 39 years, without inmunosupresión with tuberculous meningitis. The clinical manifestations were migraine, vomit, fever, disartria, commitment of cranial nerves, motor alterations and disorders of consciousness. Conclusions: the tuberculous meningitis is the most serious form of the disease, with fatal course in nondiagnosed cases. The low index of suspicion and the similarity with other infections of the central nervous system, do not allow early diagnostic and nor opportune treatment. Salud UIS 2012; 44 (1: 57-66

  4. Correlación clinicopatológica en pacientes inmunocompetentes con Meningitis tuberculosa, reporte de casos de autopsia en el Hospital Universitario de Santander-Colombia / Clinicopathological correlation in inmunocompetent patients with tuberculous meningitis, autopsy cases report in the Hospital Universitario de Santander-Colombia.

    Scientific Electronic Library Online (English)

    Julio Cesar, Mantilla; Carlos Andrés, Buitrago; Jeshar, Arocha; Gustavo, Pradilla.

    2012-04-01

    Full Text Available Introducción: describir tres casos fatales de tuberculosis meníngea y establecer correlación clinicopatológica. Materiales y métodos: revisión de protocolos de autopsia entre enero 1 y junio 30 de 2010 en el Departamento de Patología de la Universidad Industrial de Santander (UIS). Entre 121 protoco [...] los de necropsias se encontraron 3 casos de tuberculosis meníngea, de los cuales se revisaron historias clínicas, preparaciones histopatológicas y fotografías. Resultados: tres casos de adultos con edad promedio de 39 años, sin inmunosupresión con tuberculosis meníngea. Las manifestaciones clínicas fueron cefalea, vómito, fiebre, disartria, compromiso de pares craneales, alteraciones motoras y del estado de conciencia. Conclusiones: la tuberculosis meníngea es la forma más grave de la enfermedad, con desenlace fatal en casos no diagnosticados. El bajo índice de sospecha y la similitud con otras infecciones del sistema nervioso central, no permiten diagnostico precoz ni tratamiento oportuno. Salud UIS 2012; 44 (1): 57-66 Abstract in english Introduction: to describe three fatal cases of tuberculous meningitis and to establish clinical pathological correlation. Materials and methods: Revision of autopsy protocols between 01 january and june 30 of 2010 in the Department of Pathology of the Industrial University of Santander (UIS). Betwee [...] n 121 protocols of autopsies were 3 cases of tuberculous meningitis, of which clinical histories, histopathological slides and photographies were rewieved. Results: three cases of adults with age average of 39 years, without inmunosupresión with tuberculous meningitis. The clinical manifestations were migraine, vomit, fever, disartria, commitment of cranial nerves, motor alterations and disorders of consciousness. Conclusions: the tuberculous meningitis is the most serious form of the disease, with fatal course in nondiagnosed cases. The low index of suspicion and the similarity with other infections of the central nervous system, do not allow early diagnostic and nor opportune treatment. Salud UIS 2012; 44 (1): 57-66

  5. Influencia da causa de morte no peso corporal e dos orgaos internos em autopsias perinatais / Influence of cause of death on body and internal organs weight in perinatal autopsies

    Scientific Electronic Library Online (English)

    Rosana Rosa Miranda, Correa; Laura Penna, Rocha; Caetano Galvao, Petrini; Vicente de Paula Antunes, Teixeira; Eumenia Costa da Cunha, Castro.

    2014-01-01

    Full Text Available OBJETIVO: Avaliar as variações do peso corporal e dos órgãos internos de crianças autopsiadas no período perinatal e sua relação com a causa de morte. MÉTODOS: Foram incluídos 153 casos de autópsias perinatais realizadas em um hospital universitário do Sudeste do Brasil. Informações sobre caus [...] a de morte perinatal, data da autópsia, idade gestacional, peso perinatal e dos órgãos foram recuperadas dos protocolos de autópsia e do prontuário da mãe e/ou do recém-nascido. Foram definidos quatro grupos de causa de morte: malformações congênitas, hipóxia/anóxia perinatal, infecção ascendente e membrana hialina. Encéfalo, fígado, pulmões, coração, baço, timo e suprarrenais foram analisados. RESULTADOS: O peso das crianças com hipóxia/anóxia perinatal (1.834,6±1.090,1 g versus 1.488 g), membrana hialina (1.607,2±820,1 g versus 1.125 g) e infecção ascendente (1.567,4±1.018,9 g versus 1.230 g) foi maior do que o esperado para a idade gestacional. O peso dos pulmões foi maior nos casos com infecção ascendente (36,6±22,6 g versus 11 g) e menor nos casos com malformação congênita (22,0±9,5 g versus 40 g). O peso do baço foi maior nos casos que apresentaram infecção ascendente (8,6±8,9 g versus 3,75 g ). O peso das suprarrenais foi menor nos casos com malformação congênita (3,9±2,1 g versus 5,5 g), o do timo foi menor nos casos com miscelânea (3,7±1,2 g versus 7,5 g) e o do baço foi menor nos casos com imaturidade pulmonar (0,4±0,1 g versus 1,7 g). Todos esses resultados apresentaram diferenças significativas. CONCLUSÕES: Este estudo demonstra que as variações do peso das crianças e de seus órgãos estão relacionadas aos tipos de causa de morte perinatal. Esses dados podem contribuir para uma melhor interpretação dos achados de autópsia e a sua relação anatomoclínica. Abstract in english PURPOSE: To evaluate changes in body and internal organ weight of autopsied children in the perinatal period and their relationship with the cause of death. METHODS: One hundred and fifty three cases of perinatal autopsies performed at a university hospital in Southeastern Brazil ere included. [...] Information about cause of perinatal death, date of autopsy, gestational age, perinatal weight and organ weight was obtained from the autopsy protocols and medical records of the mother and/or the newborn. Four groups of causes of death were defined: congenital malformations, perinatal hypoxia/anoxia, ascending infection and hyaline membrane. Brain, liver, lungs, heart, spleen, thymus and adrenals were analyzed. RESULTS: The weight of children with perinatal hypoxia/anoxi (1,834.6±1,090.1 g versus 1,488 g), hyaline membranes (1,607.2±820.1 g versus 1,125 g) and ascending infection (1,567.4±1,018.9 g versus 1,230 g) was higher than expected for the population. Lung weight was higher in cases with ascending infection (36.6±22.6 g versus 11 g) and lower in cases with congenital malformations (22.0±9.5 g versus 40 g). Spleen weight was higher in children with ascending infection (8.6±8.9 g versus 3.75 g ) and adrenal weight was lower in cases with congenital malformations (3.9±2.1 g versus 5.5 g). Thymus weight was lower in cases with miscellaneous causes (3.7±1.2 g versus 7.5 g) and spleen weight was lower in patients with lung immaturity (0.4±0.1 g versus 1.7 g). All results showed significant differences. CONCLUSIONS: This study demonstrates that variations in the weight of children and the weight of their organs are related to the types of cause of perinatal death. These data may contribute to a better interpretation of autopsy findings and their anatomical and clinical relationship.

  6. Use of verbal autopsy to determine mortality patterns in an urban slum in Kolkata, India / Utilisation de l'autopsie verbale pour détecter des modèles de mortalité dans un quartier urbain pauvre de Kolkata en Inde / Utilización de las autopsias verbales para determinar las causas de mortalidad en un barrio urbano pobre de Kolkata, India

    Scientific Electronic Library Online (English)

    Suman, Kanungo; Ataru, Tsuzuki; Jacqueline L, Deen; Anna Lena, Lopez; Krisnan, Rajendran; Byomkesh, Manna; Dipika, Sur; Deok Ryun, Kim; Vinay Kumar, Gupta; R Leon, Ochiai; Mohammad, Ali; Lorenz, von Seidlein; Sujit K, Bhattacharya; John D, Clemens.

    2010-09-01

    Full Text Available OBJETIVOS: Definir los patrones de mortalidad en un barrio urbano pobre de Kolkata, India, dentro del contexto de un proyecto contra el cólera y la fiebre tifoidea. MÉTODOS: En una población bien definida y sometida a vigilancia durante 18 meses se realizó el seguimiento de un conjunto de 63788 resi [...] dentes, cuyos hogares recibieron visitas mensuales del personal sanitario comunitario para identificar las defunciones. Las entrevistas con los familiares y allegados de las personas fallecidas fueron realizadas por médicos expertos, y los directores médicos atribuyeron la causa principal de la muerte siguiendo la Clasificación Internacional de Enfermedades, 10.a edición. Las causas de la muerte se clasificaron según las categorías de la Carga Mundial de Morbilidad del 2000 y se evaluaron las tasas de mortalidad general y específica de cada caso en función del grupo de edad y del sexo. RESULTADOS: Se registraron 544 muertes durante el seguimiento de 87921 años-persona. Estos datos generaron una tasa de mortalidad de 6,2 por 1000 años-persona. En el 89% de las muertes (482/544) se asignó una causa. Las principales causas de defunción, en orden descendente, fueron: las enfermedades cardiovasculares (fundamentalmente, entre los adultos mayores de 40 años), el cáncer, las enfermedades respiratorias y los trastornos digestivos. La mayoría de las muertes acaecidas en niños menores de cinco años se debieron a la tuberculosis, las infecciones respiratorias y las enfermedades diarreicas. CONCLUSIÓN: Aunque las causas más frecuentes de muerte infantil fueron las infecciosas, en los adultos predominaron las enfermedades infecciosas no contagiosas. Es necesario continuar con las intervenciones contra las enfermedades infecciosas, así como iniciar estrategias nuevas e innovadoras para luchar contra las enfermedades no infecciosas. Abstract in english OBJECTIVE: To define mortality patterns in an urban slum in Kolkata, India, in the context of a cholera and typhoid fever project. METHODS: In a well-defined population that was under surveillance for 18 months, we followed a dynamic cohort of 63788 residents whose households were visited monthly by [...] community health workers to identify deaths. Trained physicians performed verbal autopsies and experienced senior physicians assigned the primary cause of death according to the International classification of diseases, 10th edition. We tabulated causes of death in accordance with Global Burden of Disease 2000 categories and assessed overall and cause-specific mortality rates per age group and gender. FINDINGS: During 87921 person-years of follow-up, we recorded 544 deaths. This gave an overall mortality rate of 6.2 per 1000 person-years. We assigned a cause to 89% (482/544) of the deaths. The leading causes of death, in descending order, were cardiovascular diseases (especially among adults aged over 40 years), cancer, respiratory ailments and digestive disorders. Most deaths in children under 5 years of age were caused by tuberculosis, respiratory infections and diarrhoeal diseases. CONCLUSION: Although the most common causes of death in children were infectious, non-communicable diseases were predominant among adults. There is a need for continuing interventions against infectious diseases in addition to new and innovative strategies to combat non-infectious conditions.

  7. Assessing a new approach to verbal autopsy interpretation in a rural Ethiopian community: the InterVA model / Evaluation d'une nouvelle manière d'interpréter les autopsies verbales dans une communauté rurale en Ethiopie: le modèle InterVA / Evaluación de un nuevo sistema de interpretación (modelo InterVA) de las autopsias verbales en una comunidad de la Etiopía rural

    Scientific Electronic Library Online (English)

    Mesganaw, Fantahun; Edward, Fottrell; Yemane, Berhane; Stig, Wall; Ulf, Högberg; Peter, Byass.

    2006-03-01

    Full Text Available OBJETIVO: La autopsia verbal (AV) -entrevista a miembros de la familia o a cuidadores acerca de las circunstancias de una defunción después del evento- es un instrumento de uso arraigado en las zonas con sistemas inadecuados o inexistentes de registro sistemático de las defunciones. Evaluamos los re [...] sultados de un modelo probabilístico (InterVA) de interpretación de las entrevistas de AV comunitarias, a fin de investigar las pautas de mortalidad por causas específicas en una comunidad etíope rural, y comparamos esos resultados con los obtenidos por médicos locales a los que se dio a examinar las AV, con miras a validar el modelo como instrumento comunitario. MÉTODOS: Se completaron con éxito doscientas ochenta y nueve entrevistas de AV, que incluían la mayor parte de las defunciones ocurridas en una determinada comunidad durante un periodo de un año. Las entrevistas de AV fueron interpretadas por médicos y mediante el modelo, y se procedió a calcular las fracciones de mortalidad por causas específicas para el conjunto de la comunidad y para grupos de edad particulares utilizando los dos sistemas. RESUL