903 results match your criteria alternative autopsy

Cerebral amyloid angiopathy-related acute lobar intra-cerebral hemorrhage: diagnostic value of plain CT.

J Neurol 2021 Sep 12. Epub 2021 Sep 12.

Inserm U1266, Institut de Neurosciences et de Psychiatrie de Paris, Paris, France.

Background: Diagnosing probable cerebral amyloid angiopathy (CAA) after lobar intra-cerebral hemorrhage (l-ICH) currently relies on the MR-based modified Boston criteria (mBC). However, MRI has limited availability and the mBC have moderate sensitivity, with isolated l-ICH being classified as "possible CAA". A recent autopsy-based study reported potential value of finger-like projections (FLP) and subarachnoid hemorrhage (SAH) on acute CT. Read More

View Article and Full-Text PDF
September 2021

Who dies where? Estimating the percentage of deaths that occur at home.

Tim Adair

BMJ Glob Health 2021 Sep;6(9)

Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia

Introduction: The majority of low-income and middle-income countries (LMICs) have incomplete death registration systems and so the proportion of deaths that occur at home (ie, home death percentage) is generally unknown. However, home death percentage is important to estimate population-level causes of death from integration of data of deaths at home (verbal autopsies) and in hospitals (medical certification), and to monitor completeness of death notification and verbal autopsy data collection systems. This study proposes a method to estimate home death percentage using data readily available at the national and subnational level. Read More

View Article and Full-Text PDF
September 2021

The role of PMCT for the assessment of the cause of death in natural disaster (landslide and flood): a Sicilian experience.

Int J Legal Med 2021 Sep 2. Epub 2021 Sep 2.

Section of Legal Medicine, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Via del Vespro, 129, 90127, Palermo, Italy.

In this report, the authors provide a contribution of PMCT in assessing the cause of death due to natural disasters. Here, the PMCT findings of 43 subjects who died during both landslide and flood were described. The post-mortem imaging revealed, clearly, traumatic injuries and/or the presence of foreign material in airways allowing to assess the cause of death of each subject, together with external inspection and the collected circumstantial data. Read More

View Article and Full-Text PDF
September 2021

Novel Evaluation of Submandibular Salivary Gland Tissue for Use as an Alternative Postmortem Toxicology Specimen.

Am J Forensic Med Pathol 2021 Sep 2. Epub 2021 Sep 2.

From the Pathology Division, Toxicology Department, Western Michigan University Homer Stryker MD School of Medicine (WMed), Kalamazoo, MI.

Abstract: The collection of blood and tissue provides an opportunity for an objective comparison of autopsy results. Occasionally, a viable tissue sample is not available during autopsy. Expanding upon collected tissues to include a tissue that is accessible, is a possible drug depot, and is amendable to various analytical techniques may complement information obtained from other specimens. Read More

View Article and Full-Text PDF
September 2021

Rethinking low risk micropapillary thyroid cancer: an evidence review for recalibrating diagnostic thresholds and/or alternative labels.

Thyroid 2021 Sep 2. Epub 2021 Sep 2.

University of Sydney, School of Public Health, 127A Edward Ford Building (A27), University of Sydney, New South Wales, Australia, 2006;

Background: Recalibrating diagnostic thresholds or using alternative labels may mitigate overdiagnosis and overtreatment of microscopic papillary thyroid cancer (mPTC). We aimed to identify and collate relevant epidemiological evidence on mPTC, to assess the case for recalibration and/or new labels.

Methods: We searched EMBASE and PubMed databases from inception to December 2020 for natural history, autopsy, diagnostic drift and diagnostic reproducibility studies. Read More

View Article and Full-Text PDF
September 2021

Multiple-Organ Complement Deposition on Vascular Endothelium in COVID-19 Patients.

Biomedicines 2021 Aug 12;9(8). Epub 2021 Aug 12.

Laboratory of Immuno-Rheumatology, Istituto Auxologico Italiano, IRCCS, 20095 Milan, Italy.

Increased levels of circulating complement activation products have been reported in COVID-19 patients, but only limited information is available on complement involvement at the tissue level. The mechanisms and pathways of local complement activation remain unclear. The aim of this study was to investigate the deposition of complement components in the lungs, kidneys, and liver in patients with COVID-19 patients and to determine the pathway/s of complement activation. Read More

View Article and Full-Text PDF

Pneumocytes are distinguished by highly elevated expression of the ER stress biomarker GRP78, a co-receptor for SARS-CoV-2, in COVID-19 autopsies.

Cell Stress Chaperones 2021 Aug 12. Epub 2021 Aug 12.

Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.

Vaccinations are widely credited with reducing death rates from COVID-19, but the underlying host-viral mechanisms/interactions for morbidity and mortality of SARS-CoV-2 infection remain poorly understood. Acute respiratory distress syndrome (ARDS) describes the severe lung injury, which is pathologically associated with alveolar damage, inflammation, non-cardiogenic edema, and hyaline membrane formation. Because proteostatic pathways play central roles in cellular protection, immune modulation, protein degradation, and tissue repair, we examined the pathological features for the unfolded protein response (UPR) using the surrogate biomarker glucose-regulated protein 78 (GRP78) and co-receptor for SARS-CoV-2. Read More

View Article and Full-Text PDF

Cerebrospinal fluid in forensic toxicology: Current status and future perspectives.

J Forensic Leg Med 2021 Aug 6;82:102231. Epub 2021 Aug 6.

Department of Pharmacology, Medical University of Silesia in Katowice, Faculty of Medical Sciences in Zabrze, 38 Jordana Street, 41-808, Zabrze, Poland.

In forensic toxicology, alternative biological materials are very useful and important, e.g. in the case of lack of basic body fluids. Read More

View Article and Full-Text PDF

Perceptions of family, community and religious leaders and acceptability for minimal invasive tissue sampling to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study.

Reprod Health 2021 Aug 4;18(1):168. Epub 2021 Aug 4.

Department of Pediatrics, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, 110029, India.

Background: Minimal invasive tissue sampling (MITS) has emerged as a suitable alternative to complete diagnostic autopsy (CDA) for determination of the cause of death (CoD), due to feasibility and acceptability issues. A formative research was conducted to document the perceptions of parents, community and religious leaders on acceptability of MITS.

Methods: This qualitative study was conducted at and around the Safdarjung Hospital, Delhi, India. Read More

View Article and Full-Text PDF

Perinatal post-mortem magnetic resonance imaging (MRI) of the central nervous system (CNS): a pictorial review.

Insights Imaging 2021 Jul 22;12(1):104. Epub 2021 Jul 22.

Radiology Department, CDIC, Hospital Clínic de Barcelona, C/Villarroel no. 170, 08036, Barcelona, Spain.

Central nervous system (CNS) abnormalities cause approximately 32-37.7% of terminations of pregnancy (TOP). Autopsy is currently the gold standard for assessing dead foetuses and stillborn. Read More

View Article and Full-Text PDF

Simple implementation of muscle tissue into routine workflow of blood analysis in forensic cases - A validated method for quantification of 29 drugs in postmortem blood and muscle samples by UHPLC-MS/MS.

Forensic Sci Int 2021 Aug 4;325:110901. Epub 2021 Jul 4.

Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Whole blood is most often the matrix of choice for postmortem analysis but it is not always available. In these cases, muscle tissue can be used as an alternative matrix. Therefore, an ultra-high-performance liquid chromatography-tandem mass spectrometry method for the quantification of 29 drugs and metabolites of toxicological interest in postmortem muscle tissue was developed and validated. Read More

View Article and Full-Text PDF

Young athletes: Preventing sudden death by adopting a modern screening approach? A critical review and the opening of a debate.

Int J Cardiol Heart Vasc 2021 Jun 28;34:100790. Epub 2021 May 28.

Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, USA.

Preventing sudden cardiac death (SCD) in athletes is a primary duty of sports cardiologists. Current recommendations for detecting high-risk cardiovascular conditions (hr-CVCs) are history and physical examination (H&P)-based. We discuss the effectiveness of H&P-based screening versus more-modern and accurate methods. Read More

View Article and Full-Text PDF

Methadone, Buprenorphine, Oxycodone, Fentanyl, and Tramadol in Multiple Postmortem Matrices.

J Anal Toxicol 2021 Jun 12. Epub 2021 Jun 12.

Department of Forensic Sciences, Oslo University Hospital.

Peripheral blood concentrations are generally preferred for postmortem toxicological interpretation, but some autopsy cases may lack blood for sampling due to decomposition or large traumas etc. In such cases, other tissues or bodily fluids must be sampled; however, limited information exists on postmortem concentrations in matrices other than blood. Pericardial fluid, muscle, and vitreous humor have been suggested as alternatives to blood, but only a few studies have investigated the detection of opioids in these matrices. Read More

View Article and Full-Text PDF

Comparison of Spectrophotometric Methods for the Determination of Carboxyhemoglobin in Postmortem Blood.

J Anal Toxicol 2021 Sep;45(8):885-891

Miami-Dade County Medical Examiner Department, 1851 NW 10th Avenue, Miami, FL 33136, USA.

Carbon monoxide (CO) poisoning presents an interesting challenge for postmortem toxicology laboratories. The discontinuation of the CO-oximeter manufactured by Instrumentation Laboratories has left many forensic laboratories without this simple but reliable choice for the analysis of CO in blood. A comparable alternative that is quick and simple is analysis using a standard ultraviolet-visible spectrophotometer, which offers sufficient precision and accuracy for the measurement of percentage carboxyhemoglobin (%COHb) in postmortem blood. Read More

View Article and Full-Text PDF
September 2021

Pathophysiology of infection with SARS-CoV-2-What is known and what remains a mystery.

Respirology 2021 07 26;26(7):652-665. Epub 2021 May 26.

Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.

Coronavirus disease 2019 (COVID-19), caused by coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused extensive disruption and mortality since its recent emergence. Concomitantly, there has been a race to understand the virus and its pathophysiology. The clinical manifestations of COVID-19 are manifold and not restricted to the respiratory tract. Read More

View Article and Full-Text PDF

Polygenic Risk Score for Alzheimer's Disease in Caribbean Hispanics.

Ann Neurol 2021 Sep 17;90(3):366-376. Epub 2021 Jun 17.

Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY.

Objective: Polygenic risk scores (PRSs) assess the individual genetic propensity to a condition by combining sparse information scattered across genetic loci, often displaying small effect sizes. Most PRSs are constructed in European-ancestry populations, limiting their use in other ethnicities. Here we constructed and validated a PRS for late-onset Alzheimer's Disease (LOAD) in Caribbean Hispanics (CH). Read More

View Article and Full-Text PDF
September 2021

Post-mortem cardiac magnetic resonance parameters in normal and diseased conditions.

Cardiovasc Diagn Ther 2021 Apr;11(2):373-382

Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.

Background: Post-mortem cardiac magnetic resonance (CMR) is a non-invasive alternative to conventional autopsy. At present, diagnostic guidelines for cardiovascular conditions such as hypertrophic cardiomyopathy have not been established. We correlated post-mortem CMR images to definite conventional autopsy findings and hypothesed that elevated T2-weighted signal intensity and RV to LV area ratios can identify myocardial infarction and pulmonary emboli respectively. Read More

View Article and Full-Text PDF

Thrombosis is not a marker of bridging vein rupture in infants with alleged abusive head trauma.

Acta Paediatr 2021 Oct 20;110(10):2686-2694. Epub 2021 May 20.

Department of Clinical Medicine K1, University of Bergen, Bergen, Norway.

Aim: Thrombosis of bridging veins has been suggested to be a marker of bridging vein rupture, and thus AHT, in infants with subdural haematoma.

Methods: This is a non-systematic review based on Pubmed search, secondary reference tracking and authors' own article collections.

Results: Radiological studies asserting that imaging signs of cortical vein thrombosis were indicative of traumatic bridging vein rupture were unreliable as they lacked pathological verification of either thrombosis or rupture, and paid little regard to medical conditions other than trauma. Read More

View Article and Full-Text PDF
October 2021

Minimally Invasive Autopsy Practice in COVID-19 Cases: Biosafety and Findings.

Pathogens 2021 Apr 1;10(4). Epub 2021 Apr 1.

ISGlobal, Barcelona Institute for Global Health, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain.

Postmortem studies are crucial for providing insight into emergent diseases. However, a complete autopsy is frequently not feasible in highly transmissible diseases due to biohazard challenges. Minimally invasive autopsy (MIA) is a needle-based approach aimed at collecting samples of key organs without opening the body, which may be a valid alternative in these cases. Read More

View Article and Full-Text PDF

Human fetal whole-body postmortem microfocus computed tomographic imaging.

Nat Protoc 2021 05 14;16(5):2594-2614. Epub 2021 Apr 14.

Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, UK.

Perinatal autopsy is the standard method for investigating fetal death; however, it requires dissection of the fetus. Human fetal microfocus computed tomography (micro-CT) provides a generally more acceptable and less invasive imaging alternative for bereaved parents to determine the cause of early pregnancy loss compared with conventional autopsy techniques. In this protocol, we describe the four main stages required to image fetuses using micro-CT. Read More

View Article and Full-Text PDF

Endoscopic Hernia Repair: A Novel Technique for the Repair of Inguinal Hernia in a Cadaver Model.

Surg Laparosc Endosc Percutan Tech 2021 Apr 1;31(4):404-407. Epub 2021 Apr 1.

Autopsy Unit of Forensic Medical Institute, Istanbul, Turkey.

Background: The techniques of total extraperitoneal and transabdominal preperitoneal hernia repair have been conducted for laparoscopic repair of inguinal hernia since long. However, they offer significant disadvantages of requiring general anesthesia, producing negative cosmetic outcomes, and other serious complications. We examined the feasibility of applying an endoscopic method alternative to total extraperitoneal and transabdominal preperitoneal for laparoscopic repair of inguinal hernia in a cadaver model so as to overcome the disadvantages of the presently available techniques. Read More

View Article and Full-Text PDF

Identification of multiple system atrophy mimicking Parkinson's disease or progressive supranuclear palsy.

Brain 2021 05;144(4):1138-1151

Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK.

We studied a subset of patients with autopsy-confirmed multiple system atrophy who presented a clinical picture that closely resembled either Parkinson's disease or progressive supranuclear palsy. These mimics are not captured by the current diagnostic criteria for multiple system atrophy. Among 218 autopsy-proven multiple system atrophy cases reviewed, 177 (81. Read More

View Article and Full-Text PDF

Detection of H3K4me3 Identifies NeuroHIV Signatures, Genomic Effects of Methamphetamine and Addiction Pathways in Postmortem HIV+ Brain Specimens that Are Not Amenable to Transcriptome Analysis.

Viruses 2021 03 24;13(4). Epub 2021 Mar 24.

San Diego Biomedical Research Institute, San Diego, CA 92121, USA.

Human postmortem specimens are extremely valuable resources for investigating translational hypotheses. Tissue repositories collect clinically assessed specimens from people with and without HIV, including age, viral load, treatments, substance use patterns and cognitive functions. One challenge is the limited number of specimens suitable for transcriptional studies, mainly due to poor RNA quality resulting from long postmortem intervals. Read More

View Article and Full-Text PDF

Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy.

J Clin Med 2021 Mar 24;10(7). Epub 2021 Mar 24.

Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland.

Background: Mechanisms and causes of death in older patients with SARS-CoV-2 infection are still poorly understood.

Methods: We conducted in a retrospective monocentric study, a clinical chart review and post-mortem examination of patients aged 75 years and older hospitalized in acute care and positive for SARS-CoV-2. Full body autopsy and correlation with clinical findings and suspected causes of death were done. Read More

View Article and Full-Text PDF

Spatial mapping of SARS-CoV-2 and H1N1 lung injury identifies differential transcriptional signatures.

Cell Rep Med 2021 Apr 23;2(4):100242. Epub 2021 Mar 23.

Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

Severe SARS-CoV-2 infection often leads to the development of acute respiratory distress syndrome (ARDS), with profound pulmonary patho-histological changes post-mortem. It is not clear whether ARDS from SARS-CoV-2 is similar to that observed in influenza H1N1, another common viral cause of lung injury. Here, we analyze specific ARDS regions of interest utilizing a spatial transcriptomic platform on autopsy-derived lung tissue from patients with SARS-CoV-2 (n = 3), H1N1 (n = 3), and a dual infected individual (n = 1). Read More

View Article and Full-Text PDF

"Even when people live just across the road…they won't go": Community health worker perspectives on incentivized delays to under-five care-seeking in urban slums of Kampala, Uganda.

PLoS One 2021 26;16(3):e0244891. Epub 2021 Mar 26.

Departments of Learning Health Sciences and OB/GYN, University of Michigan, Ann Arbor, Michigan, United States of America.

Background: Although under-five (U5) mortality in Uganda has dropped over the past two decades, rates in urban slum neighborhoods remain high. As part of a broader verbal and social autopsy study of U5 deaths, this study explored the perspectives of volunteer community health workers, called Village Health Teams (VHTs), on why children under five in Kampala's informal settlements are still dying despite living in close proximity to nearby health facilities.

Methods: This exploratory, qualitative study took place between January and March 2020 in the Rubaga division of Kampala, Uganda. Read More

View Article and Full-Text PDF

New clinical algorithm including fungal biomarkers to better diagnose probable invasive pulmonary aspergillosis in ICU.

Ann Intensive Care 2021 Mar 8;11(1):41. Epub 2021 Mar 8.

Parasitology-Mycology Department, University Hospital of Besançon, 25000, Besançon, France.

Background: The classification of invasive pulmonary aspergillosis (IPA) issued by the European Organization for the Research and Treatment of Cancer/Mycoses Study Group Education and Research Consortium (EORTC/MSGERC) is used for immunocompromised patients. An alternative algorithm adapted to the intensive care unit (ICU) population has been proposed (AspICU), but this algorithm did not include microbial biomarkers such as the galactomannan antigen and the Aspergillus quantitative PCR. The objective of the present pilot study was to evaluate a new algorithm that includes fungal biomarkers (BM-AspICU) for the diagnosis of probable IPA in an ICU population. Read More

View Article and Full-Text PDF