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Frontiers in Veterinary Science 2023Ehlers-Danlos syndrome is a rare, heritable connective tissue disorder characterized by soft, hyperextensible skin, joint hypermobility, and tissue fragility, the...
Ehlers-Danlos syndrome is a rare, heritable connective tissue disorder characterized by soft, hyperextensible skin, joint hypermobility, and tissue fragility, the severity of which can range from mild to severe. A 9-month-old male entire miniature Dachshund was presented following peracute tetraparesis. Neurological examination was suggestive of intracranial vestibular disease or high cervical myelopathy. MRI revealed atlantoaxial instability and subluxation, resulting in marked spinal cord compression at C1-C2, which was surgically stabilized. On discharge from the hospital, skin fragility was noted as the result of skin tearing during tape removal. A piece of full-thickness antebrachial skin was submitted for histopathology which showed changes consistent with Ehlers-Danlos syndrome. This case report describes the first case of atlantoaxial instability and subluxation in a dog as the result of a confirmed underlying collagenopathy.
PubMed: 37601761
DOI: 10.3389/fvets.2023.1234995 -
Journal of Perinatal Medicine Nov 2023Shoulder dystocia is a peracute mechanical dystocia and a prepartum, usually unpredictable, life-threatening entity with significant forensic implications due to...
BACKGROUND
Shoulder dystocia is a peracute mechanical dystocia and a prepartum, usually unpredictable, life-threatening entity with significant forensic implications due to significantly poor perinatal outcome, especially permanent disability or perinatal death.
CONTENT
To better objectify the graduation and to include other important clinical parameters, we believe it is appropriate to present a proposal for a complete perinatal weighted graduation of shoulder dystocia, based on several years of numerous other and our own clinical and forensic studies and thematic biobibliography. Obstetric maneuvers, neonatal outcome, and maternal outcome are three components, which are evaluated according to the severity of 0-4 proposed components. Thus, the gradation is ultimately in four degrees according to the total score: I. degreee, score 0-3: slightly shoulder dystocia with simple obstetric interventions, but without birth injuries; II. degree, score 4-7: mild shoulder dystocia resolved by external, secondary interventions and minor injuries; III. degree, score 8-10: severe shoulder dystocia with severe peripartum injuries; IV. degree, score 11-12: extremely difficult, severe shoulder dystocia with ultima ratio interventions applied and resulting extremely severe injuries with chronic disability, including perinatal death.
SUMMARY
As a clinically evaluated graduation, it certainly has an applicable long-term anamnestic and prognostic component for subsequent pregnancies and access to subsequent births, as it includes all relevant components of clinical forensic objectification.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Shoulder Dystocia; Shoulder; Perinatal Death; Dystocia; Birth Injuries; Delivery, Obstetric; Risk Factors
PubMed: 37329307
DOI: 10.1515/jpm-2022-0513 -
Forensic Science, Medicine, and... Mar 2024The aims of this study are to retrospectively evaluate the diagnostic value of T- and T-weighted 3-T magnetic resonance imaging (MRI) for postmortem detection of...
The aims of this study are to retrospectively evaluate the diagnostic value of T- and T-weighted 3-T magnetic resonance imaging (MRI) for postmortem detection of myocardial infarction (MI) in terms of sensitivity and specificity and to compare the MRI appearance of the infarct area with age stages. Postmortem MRI examinations (n = 88) were retrospectively reviewed for the presence or absence of MI by two raters blinded to the autopsy results. The sensitivity and specificity were calculated using the autopsy results as the gold standard. A third rater, who was not blinded to the autopsy findings, reviewed all cases in which MI was detected at autopsy for MRI appearance (hypointensity, isointensity, hyperintensity) of the infarct area and the surrounding zone. Age stages (peracute, acute, subacute, chronic) were assigned based on the literature and compared with the age stages reported in the autopsy reports. The interrater reliability between the two raters was substantial (κ = 0.78). Sensitivity was 52.94% (both raters). Specificity was 85.19% and 92.59%. In 34 decedents, autopsy identified an MI (peracute: n = 7, acute: n = 25, chronic: n = 2). Of 25 MI classified as acute at autopsy, MRI classified peracute in four cases and subacute in nine cases. In two cases, MRI suggested peracute MI, which was not detected at autopsy. MRI could help to classify the age stage and may indicate the area for sampling for further microscopic examination. However, the low sensitivity requires further additional MRI techniques to increase the diagnostic value.
Topics: Humans; Reproducibility of Results; Retrospective Studies; Myocardial Infarction; Magnetic Resonance Imaging; Autopsy
PubMed: 36862287
DOI: 10.1007/s12024-023-00592-8