-
Forensic Science, Medicine, and... Dec 2022Injuries from motor vehicle collisions are frequently encountered in routine forensic practice. While the most common lethal events involve blunt force trauma with... (Review)
Review
Injuries from motor vehicle collisions are frequently encountered in routine forensic practice. While the most common lethal events involve blunt force trauma with injuries to the head and neck, chest, abdomen, pelvis and limbs, review of the literature and case files shows that a wide variety of other fatal situations can occur that may involve sharp force and penetrating trauma, incineration, drowning, asphyxia, organic diseases and combinations of these. The following overview details potential factors that may contribute to death following vehicle crashes.
Topics: Humans; Motor Vehicles; Accidents, Traffic; Wounds, Nonpenetrating; Asphyxia; Wounds, Penetrating
PubMed: 35881221
DOI: 10.1007/s12024-022-00503-3 -
EBioMedicine Jun 2023The pathobiological mechanisms associated with perinatal asphyxia and hypoxic-ischemic encephalopathy are complex and poorly understood. The metabolic effects of...
BACKGROUND
The pathobiological mechanisms associated with perinatal asphyxia and hypoxic-ischemic encephalopathy are complex and poorly understood. The metabolic effects of therapeutic hypothermia have been partially explored.
METHODS
We conducted a single-center longitudinal study to investigate the metabolic effects of perinatal asphyxia and hypoxic-ischemic encephalopathy on the urinary metabolome of a group of 12 asphyctic infants over time compared to 22 matched healthy newborns, using untargeted metabolomics based on mass spectrometry.
FINDINGS
Over-representation pathway analysis identified the steroidogenesis pathway as being significantly disrupted, with reduced steroid levels in the first three days of life despite treatment with hypothermia. Comparison with matched healthy newborns showed that the urinary steroid content was lower in asphyctic infants before hypothermia. The lysine degradation and carnitine synthesis pathways were also significantly affected.
INTERPRETATION
Steroidogenesis is significantly disrupted in asphyctic infants compared to healthy newborns. Given how neurosteroids are involved in neuromodulation and neuroprotection, translational research is warranted on the potential role of neurosteroid-based intervention in asphyctic infants.
FUNDING
None.
Topics: Pregnancy; Female; Humans; Infant, Newborn; Infant; Asphyxia; Hypoxia-Ischemia, Brain; Neurosteroids; Longitudinal Studies; Hypothermia; Asphyxia Neonatorum; Metabolomics
PubMed: 37257315
DOI: 10.1016/j.ebiom.2023.104636 -
Neurology India 2022Spastic cerebral palsy (CP) is the commonest physiological type according to literature which comes mainly from the developed countries where prematurity is a common...
INTRODUCTION
Spastic cerebral palsy (CP) is the commonest physiological type according to literature which comes mainly from the developed countries where prematurity is a common cause for cerebral palsy. In developing countries like India, the leading causes of cerebral palsy are birth asphyxia, infections, and hyperbilirubinemia and, hence, the physiological type of CP is likely to be different. However, the data from our country is scant.
METHODS
103 consecutive treatment-naive CP patients attending pediatric neurology clinic were evaluated in detail using an objective tool, hypertonia assessment tool (HAT) over a period of 6months. Based on the predominant tone, the cases were classified as spastic, dyskinetic, ataxic/hypotonic, and mixed. The type of cerebral palsy was correlated with perinatal details and neuroimaging findings.
RESULTS
Out of 103 children, the most common physiological type of CP seen was of dyskinetic type [54 (52.4%)], followed by spastic CP in 30 (29.1%) and mixed (dyskinetic+spastic) CP in 19 (18.4%) children. The most common cause for dyskinetic CP was perinatal asphyxia 33 (61%); for spastic CP was prematurity 17 (56.7%) and; for mixed CP, the main cause was perinatal asphyxia 12 (63.2%). The main neuroimaging finding in predominant dyskinetic CP was basal ganglia/thalamus involvement followed by pericentral and perirolandic gliosis, whereas in spastic CP, it was periventricular leucomalacia. In mixed CP, there was multicystic encephalomalacia.
CONCLUSIONS
Dyskinetic CP either as predominant type or along with spasticity is the most common physiological type of CP in India and is due to birth-asphyxia, hyperbilirubinemia, hypoglycemia, and infections.
Topics: Asphyxia; Cerebral Palsy; Child; Female; Humans; Hyperbilirubinemia; Muscle Spasticity; Neuroimaging; Pregnancy
PubMed: 35864637
DOI: 10.4103/0028-3886.349640 -
Frontiers in Public Health 2021Perinatal asphyxia is one of the main causes of morbidity and mortality in newborns. It generates high costs, both social and economic, and presents modifiable risk...
Perinatal asphyxia is one of the main causes of morbidity and mortality in newborns. It generates high costs, both social and economic, and presents modifiable risk factors. To determine the biological and psychosocial factors and risk behaviors associated with the development of perinatal asphyxia (Sarnat II-III) in newborns from low socioeconomic status in a tier III university hospital in the city of Cali, Colombia. With a case and control design, 216 patients were studied (54 cases/162 controls) (1 case/3 matched controls). The cases were defined as newborns with modified or severe perinatal asphyxia (Sarnat II-III) between 2012 and 2014, with gestational age ≥ 36 weeks, with neurological signs not attributable to other causes, multiorgan compromise, advanced reanimation, and presence of a sentinel event. For the analysis, conditional logistic regression models were developed to evaluate association (OR), considering that the cases and controls had been paired by the birth and gestational age variables. The final model showed that, from the group of biological variables, meconium amniotic fluid was identified as a risk factor (OR 15.28, 95%CI 2.78-83.94). Induction of labor lowered the risk of perinatal asphyxia by 97% (OR 0.03, 95%CI 0.01-0.21), and monitoring of fetal heart rate was associated with lower odds by 99% (OR 0.01, 95%CI 0.00-0.31) of developing perinatal asphyxia in the newborn. Regarding social variables, the lack of social support was identified as a risk factor for the development of perinatal asphyxia (OR 6.44, 95%CI 1.16-35.66); in contrast, secondary education lowered the odds of developing perinatal asphyxia by 85% when compared with pregnant women who only had primary school education (OR 0.15, 95%CI 0.03-0.77). Assessment of biological and psychosocial factors and social support is important in pregnant women to determine the risk of developing perinatal asphyxia in a low-income population.
Topics: Asphyxia; Case-Control Studies; Colombia; Female; Hospitals; Humans; Infant; Infant, Newborn; Pregnancy; Risk-Taking
PubMed: 34235127
DOI: 10.3389/fpubh.2021.535737 -
Medicine Mar 2023To investigate the associations between low birth weight (LBW) and perinatal asphyxia by a hospital-based study. The participants of this study were mothers who gave...
To investigate the associations between low birth weight (LBW) and perinatal asphyxia by a hospital-based study. The participants of this study were mothers who gave birth at our hospital in 2018. They were divided into case group and control group according to their children's asphyxia status. The bivariable and multivariable logistics regression were used to identify maternal and newborn factors with perinatal asphyxia. A total of 150 participants were enrolled in this study, including 50 participants in the case group and 100 participants in the control groups. The bivariate logistic regression analysis showed the significant relationship of LBW, the mother's age which was less than 20 years, and the gestational age with perinatal asphyxia (P < .05). The multivariate analysis was shown that LBW, male newborns, mothers who had preeclampsia/eclampsia, or mothers who were primipara or whose gestational age more than 37 weeks had higher risks of perinatal asphyxia (P < .05). However, there were no significant relationships of the age of mother or history of antenatal care with perinatal asphyxia. LBW of infants contributes to the higher risk of perinatal asphyxia.
Topics: Infant; Child; Infant, Newborn; Male; Pregnancy; Humans; Female; Young Adult; Adult; Asphyxia; Infant, Low Birth Weight; Prenatal Care; Mothers; Logistic Models; Risk Factors; Birth Weight
PubMed: 37000089
DOI: 10.1097/MD.0000000000033137 -
International Journal of Environmental... Sep 2021Avalanche accidents are common in mountain regions and approximately 100 fatalities are counted in Europe each year. The average mortality rate is about 25% and survival... (Review)
Review
Avalanche accidents are common in mountain regions and approximately 100 fatalities are counted in Europe each year. The average mortality rate is about 25% and survival chances are mainly determined by the degree and duration of avalanche burial, the patency of the airway, the presence of an air pocket, snow characteristics, and the severity of traumatic injuries. The most common cause of death in completely buried avalanche victims is asphyxia followed by trauma. Hypothermia accounts for a minority of deaths; however, hypothermic cardiac arrest has a favorable prognosis and prolonged resuscitation and extracorporeal rewarming are indicated. In this article, we give an overview on the pathophysiology and on-site management of avalanche victims.
Topics: Asphyxia; Avalanches; Heart Arrest; Humans; Hypothermia; Rewarming
PubMed: 34639535
DOI: 10.3390/ijerph181910234 -
The Nigerian Postgraduate Medical... 2023Birth asphyxia is one of the three main causes of neonatal mortality in Nigeria. Hypomagnesaemia has been reported amongst severely asphyxiated babies. Despite this, the...
BACKGROUND AND AIMS
Birth asphyxia is one of the three main causes of neonatal mortality in Nigeria. Hypomagnesaemia has been reported amongst severely asphyxiated babies. Despite this, the prevalence of hypomagnesaemia amongst newborns with birth asphyxia has not been well researched in Nigeria. This study set out to determine the prevalence of hypomagnesaemia in term neonates with birth asphyxia and the relationship (if any) between magnesium levels and the severity of birth asphyxia or encephalopathy.
METHODS
In this cross-sectional analytical study, the serum magnesium levels of consecutive cases of birth asphyxia were compared to that of gestational age-matched healthy term neonates. Babies with Apgar scores <7 in the 5th minute of life were recruited into the study. Blood samples were taken from each baby at birth and 48 h. Serum magnesium was measured using spectrophotometry.
RESULTS
Hypomagnesaemia was found in 36 (35.3%) babies with birth asphyxia and 14 (13.7%) healthy controls; this difference was statistically significant (χ = 18.098, P = 0.001), with an odds ratio of 3.4 (95% confidence interval = 1.7, 6.9). The median (interquartile range) levels of serum magnesium in babies with mild, moderate and severe asphyxia were 0.7 mmol/L (0.5-1.1), 0.7 mmol/L (0.4-0.9) and 0.7 mmol/L (0.5-1.0), respectively (P = 0.316), while those of babies with mild (stage 1), moderate (stage 2) and severe (stage 3) encephalopathy were 1.2 mmol/L (1.0-1.3), 0.7 mmol/L (0.5-0.8) and 0.8 mmol/L (0.6-1.0), respectively (P = 0.789).
CONCLUSION
This study has shown that hypomagnesaemia was more common in babies with birth asphyxia and there was no relationship between magnesium levels and the severity of asphyxia or encephalopathy.
Topics: Humans; Infant, Newborn; Asphyxia; Magnesium; Cross-Sectional Studies; Nigeria; Asphyxia Neonatorum; Brain Diseases
PubMed: 37148120
DOI: 10.4103/npmj.npmj_1_23 -
Molecules (Basel, Switzerland) Apr 2015Perinatal asphyxia is defined as an oxygen deprivation that occurs around the time of birth, and may be caused by several perinatal events. This medical condition... (Review)
Review
Perinatal asphyxia is defined as an oxygen deprivation that occurs around the time of birth, and may be caused by several perinatal events. This medical condition affects some four million neonates worldwide per year, causing the death of one million subjects. In most cases, infants successfully recover from hypoxia episodes; however, some patients may develop HIE, leading to permanent neurological conditions or impairment of different organs and systems. Given its multifactor dependency, the timing, severity and outcome of this disease, mainly assessed through Sarnat staging, are of difficult evaluation. Moreover, although the latest newborn resuscitation guideline suggests the use of a 21% oxygen concentration or room air, such an approach is still under debate. Therefore, the pathological mechanism is still not clear and a golden standard treatment has yet to be defined. In this context, metabolomics, a new discipline that has described important perinatal issues over the last years, proved to be a useful tool for the monitoring, the assessment, and the identification of potential biomarkers associated with asphyxia events. This review covers metabolomics research on perinatal asphyxia condition, examining in detail the studies reported both on animal and human models.
Topics: Animals; Asphyxia; Biomarkers; Disease Models, Animal; Female; Humans; Infant, Newborn; Metabolome; Metabolomics; Pregnancy
PubMed: 25898414
DOI: 10.3390/molecules20047000 -
Journal of Forensic Sciences Sep 2020Finland has one of the highest homicide rates in Western Europe, and almost every tenth homicide is caused by asphyxiation. Reliable statistics, a strict legislation,...
Finland has one of the highest homicide rates in Western Europe, and almost every tenth homicide is caused by asphyxiation. Reliable statistics, a strict legislation, and an exceptionally high medico-legal autopsy rate formed a base for a nationwide analysis of asphyxia homicides (n = 383) during 30 years. The cases were identified through multiple records, and all the forensic pathology case files were studied in detail. In more than one out of five cases, there were indications of staging, and the homicide was revealed first at autopsy in close to one in ten cases. The vast majority of the homicides took place in private locations and involved persons known to each other. Every third victim was an intimate partner, and every tenth a child. Almost half of the victims died from manual strangulation, one in three from ligature strangulation. Smothering, choking, neck compression with a firm object, and thoracic compression were more rare methods. Drownings were excluded from this study material. Of all the victims, 7% had no observable external injuries. Petechiae were recorded in approximately in 61%, laryngohyoid fractures in 47%, and vocal cord hemorrhages in 16% of the cases. Every tenth female victim had genital injuries. Toxicological analyses were performed in close to all of the cases, and almost three out of four victims tested positive for blood alcohol. The various aspects of the demographics and autopsy findings covered in this study contribute reliable and accurate data to further strengthen the spectrum of observable medico-legal characteristics of asphyxia homicides.
Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Asphyxia; Blood Alcohol Content; Child; Child, Preschool; Crime Victims; Female; Finland; Forensic Medicine; Fractures, Bone; Fractures, Cartilage; Genitalia, Female; Hemorrhage; Homicide; Humans; Hyoid Bone; Infant; Infant, Newborn; Laryngeal Cartilages; Male; Middle Aged; Motivation; Purpura; Retrospective Studies; Sex Distribution; Substance Abuse Detection; Vocal Cords; Young Adult
PubMed: 32602942
DOI: 10.1111/1556-4029.14458 -
Fa Yi Xue Za Zhi Apr 2020Mitochondria are the special organelle in eukaryotic cells. Their main functions are to synthesize energy required for cell activity by oxidative phosphorylation. Most... (Review)
Review
Mitochondria are the special organelle in eukaryotic cells. Their main functions are to synthesize energy required for cell activity by oxidative phosphorylation. Most of the oxygen absorbed by the body is consumed in the mitochondria. The precise diagnosis of mechanical asphyxia is one of the difficulties in forensic pathology practice. Forensic pathologists have been trying to find a reliable and sensitive marker for the diagnosis of mechanical asphyxia. Mitochondria are very sensitive to hypoxic environments, and the markers of mitochondrion damage can be used as a basis for the diagnosis of mechanical asphyxia. The purpose of this paper is to review the research progress on mitochondrial damage in hypoxic environments and to explore the possibility of using markers of mitochondrion damage in forensic pathological practice.
Topics: Asphyxia; Forensic Pathology; Humans; Hypoxia; Mitochondria; Oxygen
PubMed: 32530175
DOI: 10.12116/j.issn.1004-5619.2020.02.018