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Protocol of Investigation on sudden death at Autopsy, Including Molecular, Genetic and Toxicology Testing

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World Journal of Cardiovascular Surgery 2024年第6期14卷 78-86页

作者： Gaetano Thiene Donata Favretto Department of Cardiac Thoracic Vascular Sciences and Public Health University of Padua Padova Italy

The role of the autopsy: 1) Whether the death is ascribable to a natural or unnatural cause and when natural, if cardiac or extra-cardiac;2) The nosology of the cardiac diseases and the mechanism of cardiac death, whether arrhythmic or mechanical;3) If the cardiac disease is inherited, screening and counselling of the next of kin is required. About 30% of sudden deaths is ascribable to genetically determined morbid entities, mostly transmissible with the autosomal dominant pattern of inheritance, so that 50% of the first degree relatives are genetically affected (“carriers”) and exposed at risk;4) If toxic or illicit drug abuse was involved.

关键词： Family Screening Genetics Inheritance Molecular Autopsy sudden death Toxicology

sudden death in the southern region of Saudi Arabia:A retrospective study

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World Journal of Clinical Cases 2023年第20期11卷 4843-4851页

作者： Ahmed Mohamed Ahmed Al-Emam Abdulrahman Dajam Mohammed Alrajhi Waleed Alfaifi Mubarak Al-Shraim Ahmed Mohamed Helaly Department of Pathology College of MedicineKing Khalid UniversityAsir 61421Saudi Arabia Forensic Medicine and Clinical Toxicology Mansoura UniversityMansoura 35516Egypt Medical School King Khalid UniversityAsir 61421Saudi Arabia Clinical Science Faculty of MedicineYarmouk UniversityIrbid 21163Jordan

BACKGROUND sudden death is unanticipated,non-violent death taking place within the first 24 h after the onset of *** is a major public health problem ***,the effects of living at moderate altitude on mortality are poorly *** To retrospectively report the frequency and the main causes of sudden deaths in relation to total deaths at Asir Central Hospital,2255 m above sea level,in the southern region of Saudi Arabia over a period of 4 years from 2013 to *** The medical records of 1821 deaths were examined and showed 353 cases(19.4%)of sudden *** The highest incidence of sudden death was among the elderly(51%),whereas,the lowest was among children and adolescents(6.5%).With regard to gender,the incidence of sudden death was higher in males(54.4%)compared to 45.6% in *** this study,we found that the most common direct causes of sudden death were cardiovascular diseases(29.2%),respiratory disease(22.7%),infectious disease(12.2%),cancer(9.4%)and hematological diseases(6.2%).With respect to seasonal variation,the highest incidence was during winter(31.32%)followed by summer(25.8%).CONCLUSION The results of this study will help emergency physicians and health care providers to exercise due care to reduce the incidence of sudden death and raise public awareness about the impact of sudden death.

关键词： sudden death High altitude Cardiovascular Gender distribution Age Seasonal variation

Robustness of quantum discord to sudden death in nuclear magnetic resonance

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Chinese Physics B 2012年第4期21卷 60-66页

作者：胥建卫陈起辉 Key Laboratory for Radiation Physics and Technology Institute of Nuclear Science and TechnologySichuan UniversityChengdu 610065China Physics Department Sichuan UniversityChengdu 610065China

We investigate the dynamics of the entanglement and quantum discord of two qubits in liquid state homonuclear nuclear magnetic resonance. Applying a phenomenological description for nuclear magnetic resonance under a relaxation process, and taking a group of typical parameters of nuclear magnetic resonance, we show that when a zero initial state experiences a relaxation process, its entanglement disappears completely after a sequence of so-called sudden deaths and revivals, while the quantum discord retains remarkable values after a sequence of oscillations. That is to say, the quantum discord is more robust than entanglement.

关键词： quantum discord nuclear magnetic resonance concurrence sudden death

Multi-phase post-mortem CT-angiography： a pathologic correlation study on cardiovascular sudden death

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Journal of Geriatric Cardiology 2016年第10期13卷 855-865页

作者： Emanuela Turillazzi Paola Frati Natascha Pascale Cristoforo Pomara Giampaolo Grilli Rocco Valerio Viola Vittorio Fineschi Section of Forensic Pathology Department of Clinical and Experimental Medicine University of Foggia Foggia Italy Department of Anatomy Histology Forensic Medicine and Orthopaedics Sapienza University of Rome Rome Italy Depariment of Anatomy University of Malta Malta Operative Unit of Radiodiagnostics Ospedali Riuniti Foggia Italy

Multi-phase post-mortem CT-angiography （MPMCTA） has the great potential to increase the quality of the postmortem investigation, especially in the area of sudden death; however, its role as routine complement to the pathology toolbox is still questioned as it needs to be further standardized. The aim of this study is to investigate the contribution of MPMCTA in cases of sudden unexplained death in adults and in particular in sudden cardiovascular death. Sixty-eight sudden unexpected deaths of adults were investigated at our institution between 2012 and 2013. Ten cases underwent MPMCTA and autopsy and were included in the study. Before the angiographic step by complete filling of the vascular system, prior to any manipulation of the body, a non-contrast CT-scan was carried out. Image reconstructions were performed on a CT workstation （Vitrea） and two radiologists experienced with post mortem imaging interpreted the MPMCTA findings. In all 10 cases, we could state a good correlation between combination of post-mortem CT and MPMCTA and autopsy procedures, confirming a high diagnostic sensitivity. With this case series we want to illustrate the advantages offered by performing MPMCTA when facing a sudden death, regardless of specific suspicion for acute coronary syndrome or other vascular or ischemic disease.

关键词： Angiography Imaging sudden death

Prediction of sudden death in elderly patients with heart failure

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Journal of Geriatric Cardiology 2018年第2期15卷 185-192页

作者： Ana Ayesta Helena Martinez-Sellest Antonio Bayes de Luna Manuel Martinez-Selles Cardiology Department Hospital Universitario del Sureste Arganda del Rey Madrid Spain Universidad Complutense Madrid Spain Fundacio lnvestigacio Cardiovascular ICCC Hospital de Sant Pau Barcelona Spain Cardiology Department Hospital General Universitario Gregorio Maranon CIVERCK Universidad Europea Madrid Spain

Most heart failure （HF） related mortality is due to sudden cardiac death （SCD） and worsening HF, particularly in the case of reduced ejection fraction. Predicting and preventing SCD is an important goal but most works include no or few patients with advanced age, and the prevention of SCD in elderly patients with HF is still controversial. A recent reduction in the annual rate of SCD has been recently described but it is not clear if this is also true in advanced age patients. Age is associated with SCD, although physicians frequently have the perception that elderly patients with HF die mainly of pump failure, underestimating the importance of SCD. Other clinical variables that have been associated to SCD are symptoms, New York Heart Association functional class, ischemic cause, and comorbidities （chronic obstructive pulmonary disease, renal dysfunction and diabetes）. Some test results that should also be considered are left ventricular ejection fraction and diameters, natriuretic peptides, non-sustained ventricular tachycardias and autonomic abnormalities. The combination of all these markers is probably the best option to predict SCD. Different risk scores have been described and, although there are no specific ones for elderly populations, most include age as a risk predictor and some were developed in populations with mean age 〉 65 years. Finally, it is important to stress that these scores should be able to predict any type of SCD as, although most are due to tachyarrhythmias, bradyarrhythmias also play a role, particularly in the case of the elderly.

关键词： Heart failure Prediction Risk sudden death The elderly

sudden death in Goldenhar Syndrome

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Journal of Forensic Science and Medicine 2023年第1期9卷 84-87页

作者： Basappa Subhas Hugar Jayanth SHosahally Kalpana Kumari Samiya Chisti Department of Forensic Medicine MS Ramaiah Medical CollegeBengaluruKarnatakaIndia Department of Forensic Medicine Dr.Chandramma Dayananda Sagar Institute of Medical Education and ResearchDayananda Sagar UniversityBengaluruKarnatakaIndia Department of Forensic Pathology MS Ramaiah Medical CollegeBengaluruKarnatakaIndia

Goldenhar syndrome(GS)is a rare congenital disorder that is characterized by incomplete development of the ear,eye,nose,soft palate,lip,and *** is also called oculo-auriculo-vertebral syndrome of Goldenhar,the name describes the common structural problems seen with the eyes,ears,and *** outlook for children with GS varies but is generally very *** children can expect to live a healthy life once treatments have been ***,certain congenital heart defects seen in this syndrome such as ventricular septal defect(VSD),persistence of arterial conduct,tetralogy of Fallot,and big vessel transposition can lead to sudden death during *** defects are usually diagnosed during intrauterine life by means of fetal echography,leading to termination of such pregnancy or necessary corrective measures after the birth of such *** such a child dies,it will be certified by the treating ***,an autopsy pathologist rarely comes across such *** such case of a 45-day-old female infant suffering from craniofacial deformity who became breathless,cyanotic,and died on the way to the hospital is being discussed *** right ventricle showed double outlets,arising from it were the pulmonary artery and aorta.A small subaortic VSD was *** hypoplasia of all internal viscera on the right side was observed.

关键词： Congenital heart defects forensic medicine forensic pathology Goldenhar syndrome sudden death

sudden death of entanglement of a quantum model

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Chinese Physics B 2007年第7期16卷 1855-1857页

作者：张国锋 Department of Physics School of Sciences Beijing University of Aeronautics and Astronautics (BUAA) Beijing 100083 China

In this paper the so-called sudden death effect of entanglement is investigated in a quantum model. The results show that one can expect the resurrection of the original entanglement to occur in a periodic way following each sudden death event. The length of the time interval for the zero entanglement depends not only on the degree of entanglement of the initial state but also on the initial state.

关键词： entanglement sudden death

Unexpected sudden death in pregnancy–arrhythmogenic right ventricular cardiomyopathy/dysplasia:a case report

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Forensic Sciences Research 2017年第3期2卷 161-163页

作者： Amal Nishantha Vadysinghe Rankothge Pemasiri Jayasooriya G.Keerthi Kumara Gunatilake Murugupillai Sivasubramanium Department of Forensic Medicine University of PeradeniyaPeradeniyaSri Lanka Forensic Unit General Hospital GampahaGampahaSri Lanka Forensic Unit Teaching Hospital KandyKandySri Lanka

Cardiovascular disease is an important contributor to maternal mortality in both developing and developed *** search for cardiac disease is usually not performed during pregnancy despite hypertensive disease,undiagnosed pulmonary hypertension and cardiomyopathies being recognized as major health problems in these *** article reported a 27-year-old female who was normal on clinical examination and basic investigations,and on an antenatal visit was found collapsed in the toilet of her house and was pronounced dead on admission to *** was found to be in the 11th week of pregnancy and had no history of significant illness in the *** did not reveal any obvious macroscopic pathology except for a significant amount of epicardial fat infiltrating into myocardium of right *** histopathological examination of the heart demonstrated fibro-fatty replacement of the heart *** cause of death was arrhythmogenic right ventricular cardiomyopathy/dysplasia(ARVC/D).ARVC/D can cause unexpected sudden death during ***,it is recommended that an ECG and echocardiogram be included as screening tests during antenatal follow-up to minimize preventable cardiac deaths like ARVC/D.

关键词： Forensic science sudden death pregnancy arrhythmogenic right ventricular cardiomyopathy/dysplasia(ARVC/D)

sudden death as the Outcome of Cardiac Arrest,in a Portuguese Region:Where Do Resuscitation Manoeuvres Stand?

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World Journal of Cardiovascular Diseases 2015年第8期5卷 227-232页

作者： Rosa Henriques de Gouveia Adriana Martins Duarte Nuno Vieira Forensic Pathology Department Delegacao do CentroInstituto Nacional de Medicina Legal e Ciencias ForensesCoimbraPortugal Medical Faculty Coimbra UniversityCoimbraPortugal

Cardiac Arrest (CA) is a major health problem, due to short and long-term sequel? and to associated mortality. Despite the improvement of out-of-hospital and in-hospital resuscitation manoeuvres, unexpected sudden fatal events occur. The authors reported the features of a series of sudden death (SD) cases where cardiopulmonary resuscitation (CPR) was performed. Files of 1053 medico-legal autopsies, from victims aged ≥18 years-old, were reviewed. Cardiac Arrest leading to sudden death were found in 477 cases (45.3%), but only 199 (42%) of these had been submitted to resuscitation manoeuvres. There was an elderly male predominance. Both non-cardiac and cardiac CA/SD causes were present, despite the higher coronary artery disease incidence. Both out-of-hospital and in-hospital events took place. Age, severity of the disease, comorbidities and predominance of out-of-hospital CA were obstacles to successful CPR, leading to SD. Knowing the population characteristics may help to improve Emergency Assistance.

关键词： Cardiac Arrest Resuscitation Manoeuvres sudden death Portugal