-
Clinical Research in Cardiology :... Mar 2023Cases of myocarditis, diagnosed clinically by laboratory tests and imaging have been described in the context of mRNA-based anti-SARS-CoV-2 vaccination. Autopsy-based...
Cases of myocarditis, diagnosed clinically by laboratory tests and imaging have been described in the context of mRNA-based anti-SARS-CoV-2 vaccination. Autopsy-based description of detailed histological features of vaccine-induced myocarditis is lacking. We describe the autopsy findings and common characteristics of myocarditis in untreated persons who received anti-SARS-CoV-2 vaccination. Standardized autopsies were performed on 25 persons who had died unexpectedly and within 20 days after anti-SARS-CoV-2 vaccination. In four patients who received a mRNA vaccination, we identified acute (epi-)myocarditis without detection of another significant disease or health constellation that may have caused an unexpected death. Histology showed patchy interstitial myocardial T-lymphocytic infiltration, predominantly of the CD4 positive subset, associated with mild myocyte damage. Overall, autopsy findings indicated death due to acute arrhythmogenic cardiac failure. Thus, myocarditis can be a potentially lethal complication following mRNA-based anti-SARS-CoV-2 vaccination. Our findings may aid in adequately diagnosing unclear cases after vaccination and in establishing a timely diagnosis in vivo, thus, providing the framework for adequate monitoring and early treatment of severe clinical cases.
Topics: Humans; Autopsy; Myocarditis; COVID-19; Vaccination; Heart Failure; RNA, Messenger
PubMed: 36436002
DOI: 10.1007/s00392-022-02129-5 -
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 -
Fa Yi Xue Za Zhi Feb 2020Traditional forensic identification relies on forensic experts to manually extract information and provide identification opinions based on medicine, biology and other... (Review)
Review
Traditional forensic identification relies on forensic experts to manually extract information and provide identification opinions based on medicine, biology and other fields of knowledge combined with personal work experience, which is not only time-consuming and require great effort, but also affected by subjective factors that are difficult to overcome. In the era of big data, the booming development of artificial intelligence brings new ideas to forensic medicine. In recent years, forensic researchers at home and abroad have conducted many studies based on artificial intelligence technology, such as face recognition, age and gender identification, DNA analysis, postmortem interval estimation, injury and cause of death identification, showing the feasibility and advantages of using artificial intelligence technology to solve forensic identification problems. As a new means of technology that has adapted to the development of the times, artificial intelligence has brought new vitality to forensic medicine, but at the same time also some new challenges. How to deal with these challenges scientifically and form a new mode of 'artificial intelligence plus forensic medicine' with artificial intelligence and forensic medicine developing collaboratively is a new direction for the development of forensic medicine in the era of big data.
Topics: Artificial Intelligence; Autopsy; Forensic Medicine
PubMed: 32250084
DOI: 10.12116/j.issn.1004-5619.2020.01.016 -
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 -
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 -
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 -
The British Journal of Radiology Jul 2023Post-mortem imaging for the investigation of perinatal deaths is an acceptable tool amongst parents and religious groups, enabling a less invasive autopsy examination.... (Review)
Review
Post-mortem imaging for the investigation of perinatal deaths is an acceptable tool amongst parents and religious groups, enabling a less invasive autopsy examination. Nevertheless, availability is scarce nationwide, and there is some debate amongst radiologists regarding the best practice and optimal protocols for performing such studies. Much of the published literature to date focusses on single centre experiences or interesting case reports. Diagnostic accuracy studies are available for a variety of individual imaging modalities ( post-mortem CT, MRI, ultrasound and micro-CT), however, assimilating this information is important when attempting to start a local service.In this article, we present a comprehensive review summarising the latest research, recently published international guidelines, and describe which imaging modalities are best suited for specific indications. When the antenatal clinical findings are not supported by the post-mortem imaging, we also suggest how and when an invasive autopsy may be considered. In general, a collaborative working relationship within a multidisciplinary team (consisting of radiologists, radiographers, the local pathology department, mortuary staff, foetal medicine specialists, obstetricians and bereavement midwives) is vital for a successful service.
Topics: Humans; Pregnancy; Female; Autopsy; Magnetic Resonance Imaging; Perinatal Death; Ultrasonography; Radiologists
PubMed: 35451852
DOI: 10.1259/bjr.20211078 -
Tidsskrift For Den Norske Laegeforening... Aug 2021Medical autopsies are rarely made subject to quality assurance. We have investigated the quality of autopsy reports in Norway and assessed the impact of errors on the...
BACKGROUND
Medical autopsies are rarely made subject to quality assurance. We have investigated the quality of autopsy reports in Norway and assessed the impact of errors on the cause of death statistics.
MATERIAL AND METHOD
Every fifth medical autopsy report for adults (> 2 years) in 2014 was reviewed. The significance of the autopsy result for the registration of cause of death was studied by comparing the death certificate issued by the clinician with the coding in the Cause of Death Registry after the autopsy.
RESULTS
A total of 389 autopsy reports from 15 departments of pathology were reviewed. The autopsy request, as well as the death certificate and the codes for the cause of death from the Cause of Death Registry were available for 339 and 360 cases respectively. Ninety-five requests had specified clinical questions, but were commented on by the pathologist in 33 cases. Obesity was rarely reported as a finding, even in cases of pathological deviations from a normal weight. A post-mortem virus examination or toxicology had been performed in 1 and 28 autopsies respectively. The average turnaround time for autopsies without and with a neuropathological examination was 99 and 138 days respectively. Errors in reporting the cause of death or inadequate reporting were evident in 69 cases (18 %), most frequently for deaths from cardiovascular diseases. The autopsy result led to a change to the cause of death in the Cause of Death Registry in 206 out of 360 (57 %) cases for which coding data were available. Errors in the formulation of the autopsy result resulted in erroneous coding of the cause of death in 22 out of 47 (47 %) of cases with errors.
INTERPRETATION
The proportion of autopsy reports with errors in the formulation of the cause of death was unexpectedly high and may have consequences for the cause of death statistics. Long turnaround times for autopsies complicate communication with the clinician about the findings.
Topics: Adult; Autopsy; Cause of Death; Diagnostic Tests, Routine; Humans; Medical Records; Norway; Registries
PubMed: 34423952
DOI: 10.4045/tidsskr.20.1000 -
Fa Yi Xue Za Zhi Oct 2021
Topics: Autopsy; Eye Injuries; Forensic Medicine; Humans
PubMed: 35191243
DOI: 10.12116/j.issn.1004-5619.2020.400312 -
Archives of Pathology & Laboratory... Sep 2020The novel coronavirus disease 2019 (COVID-19) pandemic is significantly changing methodologic approaches in all branches of the health system. From a forensic point of... (Review)
Review
CONTEXT.—
The novel coronavirus disease 2019 (COVID-19) pandemic is significantly changing methodologic approaches in all branches of the health system. From a forensic point of view, this event is partly changing the manner in which forensic pathologists and all those who work in autopsy services operate, but above all, it is changing the patterns established for years by which cadavers are analyzed postmortem.
OBJECTIVE.—
To present a review of the literature and a proposal for COVID-19 autopsy protocols. To contain the infection risk, a revision of all the protocols that until now have been applied to the examination of bodies that require autopsy services is required.
DATA SOURCES.—
Currently, the diagnosis and postmortem analysis of positive or suspected COVID-19 cases plays a crucial role in scientific research. A review of the main recommendations proposed by international scientific societies regarding the risk of infection during autopsy was carried out. Scientific papers currently available via the PubMed NCBI search engine on COVID-19 postmortem diagnosis were also examined.
CONCLUSIONS.—
Throughout the history of medicine, autopsy has been fundamental to the understanding of multiple pathogenic processes that are investigated postmortem. The purpose of the study is to propose an operating protocol that can be useful for all clinical and forensic autopsies, with particular reference to the correct methods to be applied to the examination of positive or suspected COVID-19 cases, regarding both the autopsy procedure and the collection and analysis of biological samples.
Topics: Autopsy; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Infection Control; Pandemics; Pneumonia, Viral; Risk Assessment; SARS-CoV-2; Specimen Handling
PubMed: 32383963
DOI: 10.5858/arpa.2020-0165-SA