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Fa Yi Xue Za Zhi Dec 2021In recent years, postmortem biochemistry analysis has gradually been applied to forensic practice, providing objective evidence for health conditions before death,... (Review)
Review
In recent years, postmortem biochemistry analysis has gradually been applied to forensic practice, providing objective evidence for health conditions before death, disease pathophysiological processes and forensic diagnosis of postmortem interval and cause of death. It is of great significance to understand the change patterns of postmortem biochemical indicators and their applications in forensic medicine. This article reviews the research progress of postmortem biochemistry and its application in forensic medicine, it summarizes the existing problems of postmortem biochemistry analysis in forensic medicine of China and discusses the application prospect of postmortem biochemistry analysis in forensic medicine. This review is expected to provide references for forensic practitioners.
Topics: Autopsy; China; Forensic Medicine; Forensic Pathology; Humans; Postmortem Changes
PubMed: 35243853
DOI: 10.12116/j.issn.1004-5619.2020.401205 -
International Journal of Cancer Oct 2015Prostate cancer screening may detect nonprogressive cancers, leading to overdiagnosis and overtreatment. The potential for overdiagnosis can be assessed from the... (Review)
Review
Prostate cancer screening may detect nonprogressive cancers, leading to overdiagnosis and overtreatment. The potential for overdiagnosis can be assessed from the reservoir of prostate cancer in autopsy studies that report incidental prostate cancer rates in men who died of other causes. We aimed to estimate the age-specific incidental cancer prevalence from all published autopsy studies. We identified eligible studies by searches of Medline and Embase, forward and backward citation searches and contacting authors. We screened the titles and abstracts of all articles; checked the full-text articles for eligibility and extracted clinical and pathology data using standardized forms. We extracted mean cancer prevalence, age-specific cancer prevalence and validity measures and then pooled data from all studies using logistic regression models with random effects. The 29 studies included in the review dated from 1948 to 2013. Incidental cancer was detected in all populations, with no obvious time trends in prevalence. Prostate cancer prevalence increased with each decade of age, OR = 1.7 (1.6-1.8), and was higher in studies that used the Gleason score, OR = 2.0 (1.1-3.7). No other factors were significantly predictive. The estimated mean cancer prevalence increased in a nonlinear fashion from 5% (95% CI: 3-8%) at age <30 years to 59% (95% CI: 48-71%) by age >79 years. There was substantial variation between populations in estimated cancer prevalence. There is a substantial reservoir of incidental prostate cancer which increases with age. The high risk of overdiagnosis limits the usefulness of prostate cancer screening.
Topics: Age Factors; Autopsy; Humans; Male; Prevalence; Prostatic Neoplasms
PubMed: 25821151
DOI: 10.1002/ijc.29538 -
Virchows Archiv : An International... Feb 2020Ischemic heart disease is one of the leading causes of morbidity and death worldwide. Consequently, myocardial infarctions are often encountered in clinical and forensic... (Review)
Review
Ischemic heart disease is one of the leading causes of morbidity and death worldwide. Consequently, myocardial infarctions are often encountered in clinical and forensic autopsies, and diagnosis can be challenging, especially in the absence of an acute coronary occlusion. Precise histopathological identification and timing of myocardial infarction in humans often remains uncertain while it can be of crucial importance, especially in a forensic setting when third person involvement or medical responsibilities are in question. A proper post-mortem diagnosis requires not only up-to-date knowledge of the ischemic coronary and myocardial pathology, but also a correct interpretation of such findings in relation to the clinical scenario of the deceased. For these reasons, it is important for pathologists to be familiar with the different clinically defined types of myocardial infarction and to discriminate myocardial infarction from other forms of myocardial injury. This article reviews present knowledge and post-mortem diagnostic methods, including post-mortem imaging, to reveal the different types of myocardial injury and the clinical-pathological correlations with currently defined types of myocardial infarction.
Topics: Autopsy; Death, Sudden, Cardiac; Forensic Pathology; Humans; Myocardial Infarction; Myocardium; Pathology, Clinical
PubMed: 31522288
DOI: 10.1007/s00428-019-02662-1 -
The American Journal of Pathology Sep 2019This Guest Editorial highlights the importance of autopsies in biomedical discovery.
This Guest Editorial highlights the importance of autopsies in biomedical discovery.
Topics: Autopsy; Genetic Testing; Genomics; Humans; Pathology, Clinical
PubMed: 31199923
DOI: 10.1016/j.ajpath.2019.05.006 -
Archives of Pathology & Laboratory... Feb 2018
Topics: Autopsy; Medicine
PubMed: 29372847
DOI: 10.5858/arpa.2017-0379-LE -
Virchows Archiv : An International... Dec 2017Although sudden cardiac death (SCD) is one of the most important modes of death in Western countries, pathologists and public health physicians have not given this...
Although sudden cardiac death (SCD) is one of the most important modes 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 the causes of SCD is now of particular importance. Pathologists are responsible for determining the precise cause and mechanism of sudden death but there is still considerable variation in the way in which they approach this increasingly complex task. The Association for European Cardiovascular Pathology has developed these guidelines, which represent the minimum standard that is required in the routine autopsy practice for the adequate investigation of SCD. The present version is an update of our original article, published 10 years ago. This is necessary because of our increased understanding of the genetics of cardiovascular diseases, the availability of new diagnostic methods, and the experience we have gained from the routine use of the original guidelines. The updated guidelines include a detailed protocol for the examination of the heart and recommendations for the selection of histological blocks and appropriate material for toxicology, microbiology, biochemistry, and molecular investigation. Our recommendations apply to university medical centers, regionals hospitals, and all healthcare professionals practicing pathology and forensic medicine. We believe that their adoption throughout Europe will improve the standards of autopsy practice, allow meaningful comparisons between different communities and regions, and permit the identification of emerging patterns of diseases causing SCD. Finally, we recommend the development of regional multidisciplinary networks of cardiologists, geneticists, and pathologists. Their role will be to facilitate the identification of index cases with a genetic basis, to screen appropriate family members, and ensure that appropriate preventive strategies are implemented.
Topics: Autopsy; Cause of Death; Death, Sudden, Cardiac; Europe; Humans
PubMed: 28889247
DOI: 10.1007/s00428-017-2221-0 -
Indian Journal of Pathology &... May 2022Fetal and perinatal autopsies are useful to identify the accurate cause of death and in the process recognize disorders which may require counselling for future... (Review)
Review
Fetal and perinatal autopsies are useful to identify the accurate cause of death and in the process recognize disorders which may require counselling for future pregnancies. Abnormalities of the CNS are an important cause of fetal loss and perinatal deaths. Most of these are structural abnormalities of the CNS, however a smaller portion show changes pertaining to prematurity, infections and even congenital tumors. In this review we evaluate CNS abnormalities of the fetus and the newborn as detected in autopsy series. We also describe our experience in a tertiary care hospital with a specialized neonatology unit over the last 8 years and discuss some of the newer methods like virtual autopsy.
Topics: Autopsy; Congenital Abnormalities; Female; Fetal Death; Fetus; Humans; Infant, Newborn; Pregnancy
PubMed: 35562151
DOI: 10.4103/ijpm.ijpm_977_21 -
European Heart Journal Jul 2022Historically, autopsy contributed to our current knowledge of cardiovascular anatomy, physiology, and pathology. Major advances in the understanding of cardiovascular... (Review)
Review
Historically, autopsy contributed to our current knowledge of cardiovascular anatomy, physiology, and pathology. Major advances in the understanding of cardiovascular diseases, including atherosclerosis and coronary artery disease, congenital heart diseases, and cardiomyopathies, were possible through autopsy investigations and clinicopathological correlations. In this review, the importance of performing clinical autopsies in people dying from cardiovascular disease, even in the era of advanced cardiovascular imaging is addressed. Autopsies are most helpful in the setting of sudden unexpected deaths, particularly when advanced cardiovascular imaging has not been performed. In this setting, the autopsy is often the only chance to make the correct diagnosis. In previously symptomatic patients who had undergone advanced cardiovascular imaging, autopsies still play many roles. Post-mortem examinations are important for furthering the understanding of key issues related to the underlying diseases. Autopsy can help to increase the knowledge of the sensitivity and specificity of advanced cardiovascular imaging modalities. Autopsies are particularly important to gain insights into both the natural history of cardiovascular diseases as well as less common presentations and therapeutic complications. Finally, autopsies are a key tool to quickly understand the cardiac pathology of new disorders, as emphasized during the recent coronavirus disease 2019 pandemic.
Topics: Autopsy; COVID-19; Cardiovascular Diseases; Cardiovascular System; Cause of Death; Death, Sudden; Humans
PubMed: 35514073
DOI: 10.1093/eurheartj/ehac220 -
Irish Journal of Medical Science Apr 2022The aim of this study is to share autopsy findings of COVID-19-positive cases and autopsy algorithms for safely handling of suspicious bodies during this pandemic.
BACKGROUND/AIMS
The aim of this study is to share autopsy findings of COVID-19-positive cases and autopsy algorithms for safely handling of suspicious bodies during this pandemic.
METHODS
COVID-19-positive cases of Istanbul Morgue Department were retrospectively analyzed. Sampling indications for PCR tests in suspicious deaths, macroscopic and microscopic findings obtained in cases with positive PCR tests were evaluated.
RESULTS
In the morgue department, 345(25.8%) of overall 1336 autopsy cases were tested for COVID-19. PCR test was found positive in 26 cases. Limited autopsy procedure was performed in 7 cases, while the cause of death was determined by external examination in the remaining 19 cases. Male-to-female ratio was found 3.3:1 and mean age was 60.0 ± 13.6 among all PCR-positive cases. Cause of death was determined as viral pneumonia in fully autopsied cases. Most common findings were sticky gelatinous fluid in cavities and firm and swollen lungs, varying degrees of consolidation. In microscopy, diffuse alveolar epithelial damage, type-II pneumocyte hyperplasia, hyaline membrane formation, fibrinous exudate, and fibrinous plaques in the alveoli were the most common findings.
CONCLUSIONS
In COVID-19 autopsies, pulmonary findings were found to be prominent and the main pathology was pneumonia. Older age and findings of chronic diseases indicate that the cases were in the multirisk group in terms of COVID-19 mortality.
Topics: Aged; Autopsy; COVID-19; Female; Humans; Lung; Male; Middle Aged; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2
PubMed: 33755916
DOI: 10.1007/s11845-021-02602-6 -
Legal Medicine (Tokyo, Japan) Nov 2020Autopsies are an essential tool for understanding new diseases. Against this background, it is incomprehensible why there is great reluctance worldwide to perform... (Review)
Review
Autopsies are an essential tool for understanding new diseases. Against this background, it is incomprehensible why there is great reluctance worldwide to perform autopsies on COVID-19 deceased patients. The article provides an overview of the status of the autopsy series published worldwide and shows the path taken by the city of Hamburg in Germany, where autopsies are ordered by the health authorities in the interests of disease control. The risk of infection posed by SARS-CoV-2-positive deceased persons may be overestimated. The scientific benefit that can be drawn from experience with autopsies and further examination of tissue samples is immeasurable.
Topics: Autopsy; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Infection Control; Infectious Disease Transmission, Patient-to-Professional; Pandemics; Pathology Department, Hospital; Pneumonia, Viral; SARS-CoV-2
PubMed: 32739876
DOI: 10.1016/j.legalmed.2020.101769