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Scandinavian Journal of Public Health Jul 2020A clinical as well as forensic autopsy is a uniform medical investigation of the deceased, which mainly serves to verify the plausibility of information on the cause,... (Review)
Review
A clinical as well as forensic autopsy is a uniform medical investigation of the deceased, which mainly serves to verify the plausibility of information on the cause, mode and mechanism of death provided by the police and/or medical personnel. Despite its importance in the context of a conclusive assessment of a person's medical history and in detecting any criminal correlation or malpractice, a significant decline in autopsies is evident in Iceland. This article gives an overview on autopsy rates in Iceland and compares the situation with European countries.
Topics: Autopsy; Humans; Iceland
PubMed: 30632904
DOI: 10.1177/1403494818820748 -
Current Opinion in Pediatrics Dec 2013To assess the relevance of perinatal and pediatric autopsies in genetic and metabolic diseases. (Review)
Review
PURPOSE OF REVIEW
To assess the relevance of perinatal and pediatric autopsies in genetic and metabolic diseases.
RECENT FINDINGS
Genetic investigations are an important component of fetal autopsies. Despite the advances in imaging diagnosis, the autopsy can identify abnormalities not seen on ultrasound or MRI, as confirmed in recent comparative studies. This is crucial in the diagnosis of syndromic conditions in which the information may be essential to determine the syndrome. Genetic tests may also have a role in the investigation of intrauterine growth restriction and unexplained stillbirth. New techniques have increased the diagnostic yield, even in cases of macerated fetuses.The genetic autopsy is not limited to fetal loss. Genetic abnormalities underlie many cases presenting as sudden unexpected death in infancy, childhood and adolescence, and the need to obtain appropriate samples for genetic analysis applies not only to fetal autopsies.
SUMMARY
Fetal autopsies are still the gold standard in diagnosis of fetal abnormalities. Genetic studies are an important component, not only in cases of congenital malformations, but also in unexplained intrauterine death and sudden unexpected death in infancy, as well as in children and adults.
Topics: Abortion, Induced; Autopsy; Child, Preschool; Congenital Abnormalities; Female; Fetal Death; Genetic Counseling; Genetic Testing; Humans; Infant; Infant, Newborn; Male; Pregnancy; Sudden Infant Death; Syndrome; Tissue Banks
PubMed: 24240284
DOI: 10.1097/MOP.0b013e328365ae0d -
Surgical Pathology Clinics Jun 2015Many health care providers believe that the autopsy is no longer relevant in high-technology medicine era. This has fueled a decline in the hospital autopsy rate.... (Review)
Review
Many health care providers believe that the autopsy is no longer relevant in high-technology medicine era. This has fueled a decline in the hospital autopsy rate. Although it seems that advanced diagnostic tests answer all clinical questions, studies repeatedly demonstrate that an autopsy uncovers as many undiagnosed conditions today as in the past. The forensic autopsy rate has also declined, although not as precipitously. Pathologists are still performing a nineteenth century autopsy procedure that remains essentially unchanged. Informatics offers several potential answers that will evolve the low-tech autopsy into the high-tech autopsy.
Topics: Autopsy; Clinical Laboratory Information Systems; Humans; United States
PubMed: 26065791
DOI: 10.1016/j.path.2015.02.010 -
International Journal of Environmental... Sep 2022Autopsy examination, the gold standard for defining causes of death, is often difficult to apply in certain health care settings, especially in developing countries. The... (Review)
Review
Autopsy examination, the gold standard for defining causes of death, is often difficult to apply in certain health care settings, especially in developing countries. The COVID-19 pandemic and its associated difficulties in terms of implementing autopsy examinations have made the need for alternative means of determining causes of death even more evident. One of the most interesting alternatives to the conventional autopsy is the verbal autopsy, a tool that originated in Africa and Asia in the 1950s and consists of a structured interview with the deceased's family members concerning the symptoms manifested by the person and the circumstances of death. In the early 1990s, the first doubts emerged about the validity of verbal autopsies, especially about the real reliability of the cause of death identified through this tool. The objective of the review was to identify studies that had assayed the validity of verbal autopsies through a rigorous comparison of the results that emerged from it with the results of conventional autopsies. When starting from an initial pool of 256 articles, only 2 articles were selected for final review. These are the only two original research articles in which a verbal autopsy validation process was performed by employing the full diagnostic autopsy as the gold standard. The two papers reached opposite conclusions, one suggesting adequate validity of verbal autopsy in defining the cause of death and the other casting serious doubts on the real applicability of this tool. Verbal autopsy undoubtedly has extraordinary potential, especially in the area of health and demographic surveillance, even considering the implementation that could result from the use of artificial intelligence and deep learning. However, at present, there appears to be a lack of solid data to support the robust reliability of this tool in defining causes of death.
Topics: Artificial Intelligence; Autopsy; COVID-19; Cause of Death; Delivery of Health Care; Humans; Pandemics; Reproducibility of Results
PubMed: 36142022
DOI: 10.3390/ijerph191811749 -
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 -
The American Journal of Forensic... Dec 2022Acute and chronic alcohol use is associated with injury, and autopsies may be performed to ascertain injury deaths in persons with acute or chronic alcohol use. This... (Review)
Review
Acute and chronic alcohol use is associated with injury, and autopsies may be performed to ascertain injury deaths in persons with acute or chronic alcohol use. This study sought to determine how many decedents with a history of acute or chronic alcohol use had an internal physical injury diagnosed only at autopsy that caused or contributed to the death. The study reviewed medicolegal investigation and autopsy reports at the New York City Office of Chief Medical Examiner between January 1 and October 11, 2018, to identify 1000 consecutive persons with suspected acute or chronic alcohol use who were autopsied to ascertain whether internal physical injury caused or contributed to the death. Of 1000 persons with known or suspected acute or chronic alcohol use, 390 (39.0%) had an external injury. Although 115 (11.5%) had an internal injury at autopsy, only 29 (2.9%) had an injury that caused or contributed to the death. Only 1 decedent had an internal injury that caused the death with no associated external evidence of injury (0.1%). This study demonstrates the rarity of occult lethal injury diagnosed at autopsy in persons with acute or chronic alcohol use.
Topics: Humans; Autopsy; Coroners and Medical Examiners; Alcohol Drinking; New York City; Cause of Death
PubMed: 35551133
DOI: 10.1097/PAF.0000000000000765 -
Therapeutische Umschau. Revue... 2019Clinical autopsy in Switzerland - a status report The clinical autopsy is an important diagnostic instrument for quality assurance, for education and for the... (Review)
Review
Clinical autopsy in Switzerland - a status report The clinical autopsy is an important diagnostic instrument for quality assurance, for education and for the development of medicine in general. In recent decades, however, the number of clinical autopsies required by the clinicians and performed by pathologists has declined dramatically in many countries, including Switzerland. On the other hand, there are numerous efforts, especially from the field of pathology, in part in collaboration with clinical colleagues, aimed at improving the perception of autopsy in the clinic and the public in order to fulfill the duty of providing high quality and modern postmortem diagnostics. These activities include e. g. restructuring, communication concepts, intensified dialogue, as well as technical innovations. However, issues such as ethical, social and financial aspects are difficult and unclear. In this review, some of the activities to improve the state of autopsy in Switzerland are presented, but also relevant issues of the legal and economic framework are discussed.
Topics: Autopsy; Communication; Diagnosis, Differential; Humans; Prevalence; Switzerland
PubMed: 31913099
DOI: 10.1024/0040-5930/a001112 -
Singapore Medical Journal Feb 1997The autopsy can be divided into medico-legal and academic autopsies. The autopsy has proven its value in the elucidation of the cause of death, medical audit, clinical...
The autopsy can be divided into medico-legal and academic autopsies. The autopsy has proven its value in the elucidation of the cause of death, medical audit, clinical quality control, education and the continuing understanding of disease pathogenesis. In addition, the medico-legal autopsy plays an important role in the administration of justice. While the rate of medico-legal autopsies remains relatively stable, all over the world there has been a steady decline in the rate of academic autopsies. Most studies show an unsatisfactory agreement between the clinical diagnosis and the autopsy diagnosis. When the pattern of autopsies is skewed towards deaths of medico-legal significance, health statistics based on death certificates on which healthcare policies are formulated may not be useful. Therefore, the decline in autopsy rates should be reversed. All health professionals, hospital administrators, medical students and relatives should be educated about the relevance of the autopsy to each of them. There must be increased communication between the clinician and the pathologist.
Topics: Autopsy; Cause of Death; Humans; Pathology, Clinical; Singapore
PubMed: 9269365
DOI: No ID Found -
PLoS Medicine Jan 2016Clara Menéndez and colleagues consider the importance of conducting autopsies and possible alternative methods for determining cause of death in resource-limited... (Review)
Review
Clara Menéndez and colleagues consider the importance of conducting autopsies and possible alternative methods for determining cause of death in resource-limited settings.
Topics: Autopsy; Cause of Death; Humans; Poverty
PubMed: 26756992
DOI: 10.1371/journal.pmed.1001927 -
Histopathology May 2003Less invasive or non-invasive alternatives to the complete autopsy have been sought for some time, and a range of methods, ranging from needle sampling to endoscopy to... (Review)
Review
Less invasive or non-invasive alternatives to the complete autopsy have been sought for some time, and a range of methods, ranging from needle sampling to endoscopy to magnetic resonance imaging, have been considered. Evaluations of these methods are few and far between, but generally confirm the predictable conclusion that incomplete autopsies provide incomplete information. It is not difficult to envisage a situation whereby pressure for non-invasive autopsies will allow them to become prevalent, whether properly evaluated or not. However, used appropriately, non-invasive or less invasive autopsies may be valuable tools capable of answering specific questions in situations where it is not possible to perform a complete autopsy.
Topics: Autopsy; Diagnostic Imaging; Humans; Pathology; United Kingdom
PubMed: 12713617
DOI: 10.1046/j.1365-2559.2003.01596.x