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Medicolegal autopsies in children: Experience of a department of Legal Medicine in Brazil

Forensic Medicine and Anatomy Research 2013年第3期1卷 40-46页

作者： Manoel Eugenio dos Santos Modelli Marco Agassiz de Almeida Vasques Riccardo Pratesi Institute of Legal Medicine of Federal District Brasília Brazil University of Brasilia Brasilia Brazil

Purposes: The purpose of this study was to determine the pattern of mortality in children’s Federal District. Knowledge of the epidemiology of injuries is essential for planning, implementation and evaluation of preventive measures. Methods: We analyzed the forensic examination documents of all children under 12 years sent to the IML-DF, during 2010. The data analyzed included age, gender, cause of death (*** or external), mechanism of death (traffic accident, asphyxia, firearm injuries, poisoning, heat injuries) and the medical cause of death. Results: A large number of children (n = 123 total;n = 71 males, n = 52 females) were examined in the IML-DF, Brasília, Brazil. Mean age was 37.96 months, with a median of 12 months, and 21% of children were younger than 1 month. There were 62 cases (33 males and 29 female) classified as natural deaths. The average age for natural deaths was 18.72 months. Most cases of natural death occurred in the first year of life (n = 50), being prevalent in the first month of life (n = 24). Among the 62 cases analyzed, six were stillborns, 13 suffered intrauterine fetal distress (e.g. placental insufficiency, prematurity and meconium aspiration), 36 had lung problems (e.g. Acute respiratory distress syndrome (ARDS), bronchopneumonia, pulmonary hemorrhage, interstitial pneumonitis and infant respiratory distress syndrome (IRDS)), five had neurologicalproblems (e.g. hydrocephalus, hydranencephaly,convulsive seizures and meningitis) and two had undetermined cause of death. There were also isolated cases of heart disease, leukemia, diabetic ketoacidosis, peritonitis causedby acute appendicitisand amniotic bandsyndrome. There were 61 cases of deaths from external causes, as a consequence of the following: blunt instrument, firearm, physical agent (***), physicochemical agent (***) and chemical agent (***). Conclusions: The profile of deaths from external causesin this developing country follows a trend similar

关键词： Forensic autopsies Violent Deaths Children Mortality Developing Country Patterns of Mortality

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High prevalence of hepatic steatosis and vascular thrombosis in COVID-19:A systematic review and meta-analysis of autopsy data

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World Journal of Gastroenterology 2020年第48期26卷 7693-7706页

作者： Luis Antonio Díaz Francisco Idalsoaga Macarena Cannistra Roberto Candia Daniel Cabrera Francisco Barrera Alejandro Soza Rondell Graham Arnoldo Riquelme Marco Arrese Michael D Leise Juan Pablo Arab Department of Gastroenterology Escuela de MedicinaPontificia Universidad Católica de ChileSantiago 8320000Chile Department of Internal Medicine Pontificia Universidad Católica de ChileSantiago 8320000Chile School of Medicine Pontificia Universidad Católica de ChileSantiago 8320000Chile Facultad de Ciencias Médicas Universidad Bernardo O'HigginsSantiago 8320000Chile Department of Laboratory Medicine and Pathology Mayo Clinic RochesterMinnesotaMN 55902United States Católica de Chile Santiago 8320000Chile Division of Gastroenterology and Hepatology Mayo Clinic RochesterMinnesotaMN 55905United States

BACKGROUND Coronavirus disease 2019(COVID-19)disease can frequently affect the *** on hepatic histopathological findings in COVID-19 is *** To characterize hepatic pathological findings in patients with *** We conducted a systematic review with meta-analysis registered on PROSPERO(CRD42020192813),following PRISMA *** trials were those including patients of any age and COVID-19 diagnosis based on a molecular *** reports from deceased COVID-19 patients undergoing autopsy or liver biopsy were *** including less than ten patients were *** were pooled using random-effects models.Q statistic and I2 were used to assess heterogeneity and levels of evidence,*** We identified 18 studies from 7 countries;all were case reports and case series from *** the patients were over 15 years old,and 67.2%were *** performed a meta-analysis of 5 studies,including 116 *** prevalence estimates of liver histopathological findings were hepatic steatosis 55.1%[95%confidence interval(CI):46.2-63.8],congestion of hepatic sinuses 34.7%(95%CI:7.9-68.4),vascular thrombosis 29.4%(95%CI:0.4-87.2),fibrosis 20.5%(95%CI:0.6-57.9),Kupffer cell hyperplasia 13.5%(95%CI:0.6-54.3),portal inflammation 13.2%(95%CI:0.1-48.8),and lobular inflammation 11.6%(95%CI:0.3-35.7).We also identified the presence of venous outflow obstruction,phlebosclerosis of the portal vein,herniated portal vein,periportal abnormal vessels,hemophagocytosis,and *** We found a high prevalence of hepatic steatosis and vascular thrombosis as major histological liver *** frequent findings included portal and lobular inflammation and Kupffer cell hyperplasia or *** studies are needed to establish the mechanisms and implications of these findings.

关键词： Pathology SARS-CoV-2 COVID-19 autopsies Liver Liver biopsies

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A Comparison between Premortem and Postmortem Diagnosis in Trauma Cases

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Forensic Medicine and Anatomy Research 2015年第4期3卷 89-94页

作者： Dua Sumeyra Demirkiran Ibrahim Ortanca Mustafa Sahan Adnan Celikel Muhammet Mustafa Arslan Department of Forensic Medicine Medical Faculty of Mustafa Kemal University Serinyol Hatay Turkey Department of Emergency Medicine Medical Faculty of Mustafa Kemal University Serinyol Hatay Turkey

This study evaluated the comparison of premortem and postmortem diagnoses of trauma cases that died during treatment and then autopsied. We had analyzed the autopsy reports of forensic deaths retrospectively which occurred between 2013 and 2014. The cases that died because of trauma and which had complete medical reports were included the study. Totally 626 cases were autopsied and 307 cases records were examined from them. The mean age was found to be 28.11. According the treatment period, it was detected that 116 (37.8%) cases died within the first 24 hours. Discrepancies between premortem and postmortem diagnoses were determined in 20.6% of cases. 5.9% had a main diagnostic discrepancy and 14.7% were of second lethal diagnoses. The discrepancies were observed mostly in the multiple injury cases. In our study, diagnostic discrepancy rate was higher in multiple injury cases especially who died by explosion. When clinicians focus on the treatment according to their main diagnosis, they overlook the fatal injuries in other parts of the body. This study shows that autopsy is the most reliable method for the confirmation of the clinical diagnosis in trauma patients. Therefore, particularly surgery physicians should compare the results of the autopsy diagnoses to their own diagnosis.

关键词： Clinical Diagnosis autopsies Trauma

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