Search

This study investigated the relationship between the cause of death stated on a post-mortem (medical) examination report and the subsequent cause of death given in a finding by a legal or judicial coroner (non-medical). A review of causes of death provided by forensic pathologists in their reports found the majority of cases (89%) were given in the traditional death certificate format, but were transformed to a sentence format in just over two thirds of coronial findings (68.5%). There was no evidence that converting the format of the cause of death statements caused a delay in finalizing the case. Of note, the post-mortem examination report provided an indefinite cause of death in 3.8% of cases and around a quarter (25.3%) of these were converted to a definite cause of death in the coronial finding (for example, by removing the word 'probable'). Where the post-mortem examination did not determine a cause of death (5.2% of cases), most remained undetermined in the coronial finding. It is suggested that pathologists could work with coroners to ensure the cause of death provided on post-mortem examination reports are in the preferred style for their jurisdiction. [ABSTRACT FROM AUTHOR]

Abstract Background The objective of this study was to examine the inter-relationships between pig farm management and facilities (as assessed by questionnaire) and post-mortem lung lesion (lung score assesment), which are the result of respiratory infections. The relationships between carcass characteristics and post-mortem lung lesion scores were also investigated. Results Questionnaire responses were collected from 22 self-selecting pig farmers about their farm facilities/management and health condition of the respiratory system of pigs, including the occurrence of clinical respiratory signs, results of laboratory testing for respiratory pathogens, and the use of respiratory vaccines. When fatteners were sent to the abattoir, their carcasses (n = 1,976) were examined for evidence of respiratory disease by lung lesion (pleuritis pneumonia-like (PP-like) and enzootic pneumonia-like (EP-like) lesions) scoring and the Actinobacillus pleuropneumoniae Index (APPI) was calculated. Carcass characteristics were recorded and, retrospectively, the prevalence of cachectic pigs was calculated. Using these variables, the relationships between farm facilities/management and lung lesions scores and the relationships between the latter and carcass characteristics and cachexia were explored. The key findings relating farm facilities and management to lung lesions were: slatted floors were associated with significantly higher EP-like lesions scores than litter bedding in weaners, single-stage fattening in the same building was associated with significantly higher EP-like lesions scores than two-stage fattening, but herd size, stocking density, use of all-in/all-out (AIAO) rule, technological break duration and variation in daily temperature did not affect lung lesions scores. The key findings relating lung lesion scores to carcass characteristics were: a significant, negative correlation between EP-like scores and carcass weight but not with other carcass characteristics, a significant positive correlation between PP-like scores and carcass meat content and prevalence of cachectic carcasses and a significant positive correlation between lung APPI and prevalence of cachectic carcasses. Conclusions It can be concluded that both farm facilities and management affect lung lesions scores and that the latter affect carcass characteristics. Lung lesion scoring is an inexpensive technique suitable for rapid monitoring of large numbers of carcasses that can be performed after animal slaughter. It provides useful information to inform producers about possible deficits in farm facilities or management and is a predictor of economic loss due to poorer quality carcasses.

Background: The objective of this study was to examine the inter-relationships between pig farm management and facilities (as assessed by questionnaire) and post-mortem lung lesion (lung score assesment), which are the result of respiratory infections. The relationships between carcass characteristics and post-mortem lung lesion scores were also investigated. Results: Questionnaire responses were collected from 22 self-selecting pig farmers about their farm facilities/management and health condition of the respiratory system of pigs, including the occurrence of clinical respiratory signs, results of laboratory testing for respiratory pathogens, and the use of respiratory vaccines. When fatteners were sent to the abattoir, their carcasses (n = 1,976) were examined for evidence of respiratory disease by lung lesion (pleuritis pneumonia-like (PP-like) and enzootic pneumonia-like (EP-like) lesions) scoring and the Actinobacillus pleuropneumoniae Index (APPI) was calculated. Carcass characteristics were recorded and, retrospectively, the prevalence of cachectic pigs was calculated. Using these variables, the relationships between farm facilities/management and lung lesions scores and the relationships between the latter and carcass characteristics and cachexia were explored. The key findings relating farm facilities and management to lung lesions were: slatted floors were associated with significantly higher EP-like lesions scores than litter bedding in weaners, single-stage fattening in the same building was associated with significantly higher EP-like lesions scores than two-stage fattening, but herd size, stocking density, use of all-in/all-out (AIAO) rule, technological break duration and variation in daily temperature did not affect lung lesions scores. The key findings relating lung lesion scores to carcass characteristics were: a significant, negative correlation between EP-like scores and carcass weight but not with other carcass characteristics, a significant positive correlation between PP-like scores and carcass meat content and prevalence of cachectic carcasses and a significant positive correlation between lung APPI and prevalence of cachectic carcasses. Conclusions: It can be concluded that both farm facilities and management affect lung lesions scores and that the latter affect carcass characteristics. Lung lesion scoring is an inexpensive technique suitable for rapid monitoring of large numbers of carcasses that can be performed after animal slaughter. It provides useful information to inform producers about possible deficits in farm facilities or management and is a predictor of economic loss due to poorer quality carcasses. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Acute type A aortic dissection (ATAAD) remains a highly life-threatening condition. This study investigates factors associated with fatal ATAAD prior to surgical treatment. METHODS We reviewed autopsy reports of ATAAD decedents who died before surgical intervention and underwent postmortem examination at our clinic from 1994 to 2022. RESULTS Among 94 eligible cases, 50 (53.2%) decedents had DeBakey type I dissection, and 44 (46.8%) had DeBakey type II dissection. Most were males, 63 (67%), and 72 (77%) had a history of hypertension. The median age was 70.5 years, and the type II group was a decade older than the type I group (P  < 0.001). Decedents in the type II group predominantly died during the first hour after symptoms onset 16 (52%), while in the type I group, fatalities occurred between 1 h and 1 day, 27 (66%). The most common site of the intimal tear was the midportion of the ascending aorta, 45 (48%). The median ascending aorta size was 5 cm for the entire cohort, 5.2 cm for type I and 4.6 cm for type II (P  < 0.045). CONCLUSIONS In this autopsy study of fatal acute aortic dissection, the median aortic size was below the current guideline threshold for elective repair. Type II acute aortic dissections were found more frequently than expected and were characterized by older age, advanced aortic atherosclerosis, smaller aortic size, a shorter interval from symptom onset to death and a higher frequency of syncope compared to type I dissection. [ABSTRACT FROM AUTHOR]

Objectives: Post-mortem interval (PMI) estimation has long been relying on sequential post-mortem changes on the body as a function of extrinsic, intrinsic, and environmental factors. Such factors are difficult to account for in complicated death scenes; thus, PMI estimation can be compromised. Herein, we aimed to evaluate the use of post-mortem CT (PMCT) radiomics for the differentiation between early and late PMI. Methods: Consecutive whole-body PMCT examinations performed between 2016 and 2021 were retrospectively included (n = 120), excluding corpses without an accurately reported PMI (n = 23). Radiomics data were extracted from liver and pancreas tissue and randomly split into training and validation sets (70:30%). Following data preprocessing, significant features were selected (Boruta selection) and three XGBoost classifiers were built (liver, pancreas, combined) to differentiate between early (< 12 h) and late (> 12 h) PMI. Classifier performance was assessed with receiver operating characteristics (ROC) curves and areas under the curves (AUC), which were compared by bootstrapping. Results: A total of 97 PMCTs were included, representing individuals (23 females and 74 males) with a mean age of 47.1 ± 23.38 years. The combined model achieved the highest AUC reaching 75% (95%CI 58.4–91.6%) (p = 0.03 compared to liver and p = 0.18 compared to pancreas). The liver-based and pancreas-based XGBoost models achieved AUCs of 53.6% (95%CI 34.8–72.3%) and 64.3% (95%CI 46.7–81.9%) respectively (p > 0.05 for the comparison between liver- and pancreas-based models). Conclusion: The use of radiomics analysis on PMCT examinations differentiated early from late PMI, unveiling a novel image-based method with important repercussions in forensic casework. Clinical relevance statement: This paper introduces the employment of radiomics in forensic diagnosis by presenting an effective automated alternative method of estimating post-mortem interval from targeted tissues, thus paving the way for improvement in speed and quality of forensic investigations. Key Points: • A combined liver-pancreas radiomics model differentiated early from late post-mortem intervals (using a 12-h threshold) with an area under the curve of 75% (95%CI 58.4–91.6%). • XGBoost models based on liver-only or pancreas-only radiomics demonstrated inferior performance to the combined model in predicting the post-mortem interval. [ABSTRACT FROM AUTHOR]

There is increasing evidence of cardiac involvement in COVID-19 cases, with a broad range of clinical manifestations spanning from acute life-threatening conditions such as ventricular dysrhythmias, myocarditis, acute myocardial ischemia and pulmonary thromboembolism to long-term cardiovascular sequelae. In particular, acute myocarditis represents an uncommon but frightening complication of SARS-CoV-2 infection. Even if many reports of SARS CoV-2 myocarditis are present in the literature, the majority of them lacks histological confirmation of cardiac injury. Here, we report a case of a young lady, who died suddenly a few days after testing positive for SARS-CoV-2, whose microscopic and genetics features suggested a direct cardiac involvement compatible with fulminant myocarditis. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to provide an overview of the psychological autopsy (PA) research method, including its methodology, uses, limitations, and ethical considerations. Materials and Methods: The study conducted a PA investigation on 35 cases of suicide. Information was collected from multiple sources and reliable informants, including family members, friends, medical and mental health professionals, and other relevant individuals. Qualitative and quantitative research methods were used to analyze the collected information. Results: The results indicated that several factors were associated with suicide, including mental health problems, life stressors, interpersonal conflicts, substance abuse, and history of previous suicide attempts. The findings have important implications for suicide prevention strategies, emphasizing the significance of addressing mental health issues and providing social support. Conclusion: The PA is a valuable research method for investigating and understanding suicide. Despite challenges such as recall biases and methodological limitations, it provides insights into the psychological factors associated with suicide and informs suicide prevention strategies. However, conducting psychological autopsies requires careful consideration of ethical issues. Further research is needed to replicate and extend the findings of this study [ABSTRACT FROM AUTHOR]

In recent years, the number of patients with a cardiac implantable electronic device (CIED) has been steadily increasing. Implantable cardioverter-defibrillators (ICDs) are currently one of the primary methods of preventing sudden cardiac death (SCD) in patients at risk. A post-mortem CIED examination, which these days is performed very rarely, as well as the analysis of the recordings may provide key information regarding the circumstances of the patient's death. This applies to both the potential impact of a defect or damage to the device in an event of the owner's death and the forensic analysis of the circumstances of death, especially when traditional post-mortem diagnostics do not provide a clear diagnosis. In addition, using the data stored on the device, it is possible to identify the corpse and precisely determine the time of death, which is crucial for the conducted expertise. Since it is a quick, cheap and widely available procedure, CIED analysis should be incorporated as a routine element of post-mortem diagnostics. [ABSTRACT FROM AUTHOR]

Introduction: Injuries due to burns is the fourth most common type of trauma worldwide. In India 7 million people suffer from burn injury, out of which 7 lakh need hospital admission and 2.4 lakh become disabled. Burn injuries have varied aetiological factors. Aims: To study the demographic profile of fatal burn deaths, brought to the mortuary of the District Hospital, Kalaburagi and to find preventive and remedial measures to bring down the incidence. Methodology: The present study is a retrospective study of autopsies performed at District hospital Kalaburagi from January 2018 to December 2018 to assess the pattern of deaths due to burns. Data was analyzed with respect to the age, gender, manner of death, total body surface area involved, survival period and the cause of death. Results: In this study, the majority of deaths due to burns were observed in the age group between 20-40 years maximum cases were in the age group between 21-30 years (50.9%), followed by 31-40 years (27.6%). Female preponderance was seen with 90.2% cases as compared to males with 9.8%.Accidental burning was seen in 21.6% cases followed by suicidal (78.4%).Maximum 51% cases showed total body surface area involvement between 50 – 70%.Maximum survival period was between 24-72hours with 26 cases (51%).The major cause of death was Hypovolaemic shock and Toxaemia 62%cases, followed by Septicemia (21.6%), neurogenic shock in 13.7%, and multi-organ failure in 1.9% cases. Conclusion: The present study helps to provide preventive strategies which should address the hazards for specific burn injuries, education for vulnerable populations and training of communities Burn injuries are a serious public health problem with alarmingly high mortality and morbidity. These injuries are preventable through design and promotion of more aggressive prevention programs especially for flame injuries occurring in the home environment.

Abstract Background The investigation into sudden unexpected and unnatural deaths supports criminal justice, aids in litigation, and provides important information for public health including surveillance, epidemiology, and prevention programs. The use of mortality data to convey trends can inform policy development and resource allocations. Hence, data practices/management systems in Forensic Medicine are critical. This study scoped literature and described the body of knowledge on data management and practice systems in Forensic Medicine. Methods Five steps of the methodological framework of Arksey and O’Malley guided this scoping review. A combination of keywords, Boolean terms, and Medical Subject Headings was used to search PubMed, EBSCOhost (CINAHL with full text and Health Sources), Cochrane Library, Scopus, Web of Science, Science Direct, WorldCat, and Google Scholar from the 18th to 24th of June 2020 and updated in November 2021 for peer review papers. This study included articles involving unnatural deaths, focused on data practice or data management systems, relating to Forensic Medicine, all study designs, and published in English. Screening and selection and data extraction were conducted by two reviews. Thematic analysis was conducted, and the results were reported using both quantitatively and qualitatively. Results Of the 23,059 articles, 16 met this study’s inclusion criteria. The included articles were published between 2008 and 2019. Eight of the 16 articles were published between 2017 and 2019. Most of the included studies were conducted in the USA (5) and Australia/New Zealand (4). Only two publications were from lower- and middle-income countries (Nigeria, Mexico), and the remaining 14 were from high-income countries (Italy, Denmark, USA, Australia, and New Zealand, Japan, Switzerland, Canada). The data management systems found in this study were as follows: Virtopsy, Canadian Coroner and Medical Examiner Database, Infant Injury Database, Fatal injury surveillance system, Medical Examiners and Coroners Alert System, National Violent Deaths Reporting System, AM/PM Database, Tokyo CDISC/ODM, and National Coronial Information System. Conclusions This study’s results revealed limited articles relating to data management and practice systems in Forensic Medicine, particularly in LMICs through literature indicating there is a prevalence of unnatural deaths in LMICs. This study, therefore, recommends research on data management and practice systems relating to forensic medicine in LMICs to inform policy decisions.

Abstract Background Animal health surveillance is important in ensuring optimal animal health and welfare. Monitoring of diagnostic submissions, including post-mortem examination of carcasses, at the Department of Agriculture Food and the Marine laboratories, provides the basis for this type of passive surveillance in Ireland. The process requires engagement from veterinarians and farmers from all sectors of the agricultural spectrum. This study aims to identify the reasons why farmers engaged in dairy, beef, sheep, and mixed farming enterprises submit carcasses or not to the Regional Veterinary Laboratories. Results Surveys were distributed in hard copy format at Regional Veterinary Laboratories, and fifty Teagasc facilitated farmer discussion groups. There were 1179 responses collected in 54 locations. The top reasons participants submitted to the laboratories were 1) to guide treatment/ vaccination, 2) fear of a contagious disease, and 3) if their veterinarian advised them to. The top reasons for not submitting were 1) the vet making a diagnosis on the farm, 2) the distance from the laboratory, and 3) lack of time and labour. Implementation of vaccination protocols was the main change implemented based on results, followed by management changes and the use of different treatments, e.g., switching from antibiotic to parasite treatment. Sheep enterprises were more likely than dairy to choose distance and cost as a reason not to submit. Dairying enterprises were more likely than other enterprise types to submit if they feared a contagious or zoonotic disease. Conclusion Positively, this survey shows the desire of participants to submit to the laboratories to guide treatment and vaccination protocols, potentially indicating that positive engagement between stakeholders and the RVLs will help promote optimal animal health and promote responsible antimicrobial use. Results also show the critical role of veterinarians in continued disease surveillance on farms. Maintaining engagement with all farming sectors will be essential in promoting successful animal health surveillance.

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Determining the time of death plays a crucial role in a forensic post-mortem examination. Many methods for the time of death (TOD) determination have been developed. However, most are not applicable during the first hours after death and produce large post-mortem interval (PMI) ranges. Eye examination makes it possible to precisely determine the time of death during the initial period after death with half-hour accuracy. In recent years methods for estimating the time of death by measuring the changes in the eye have made great strides. Those methods use the changes in the reaction to drugs and macroscopically visible morphological changes. Experimental studies also produced equations that can estimate the post-mortem interval using biochemical, electrochemical and thermal changes within the eye. [ABSTRACT FROM AUTHOR]

Life is incredibly valuable, and the unexpected death of an individual raises significant concerns for both family members and investigating officers. This case study focuses on a 71-year-old man who was admitted to two different hospitals due to chest discomfort and a reported history of traumatic chest injuries sustained 10 days prior to his death. Determining the presence and extent of severe chest trauma in this case posed a considerable challenge, alongside evaluating the manner and cause of death. The post-mortem investigation ultimately ruled out the likelihood of severe physical chest trauma. It identified the cause of death as "cardiac tamponade due to rupture of the infarcted myocardial wall," with the manner of death determined to be "natural." Additionally, the histopathological investigation revealed an unusual finding of "miliary tuberculosis of the heart." This case underscores the crucial role of thorough post-mor tem examinations in clarifying the cause of death and addressing allegations of trauma. [ABSTRACT FROM AUTHOR]

Determining the time of death plays a crucial role in a forensic post-mortem examination. Many methods for the time of death (TOD) determination have been developed. However, most are not applicable during the first hours after death and produce large post-mortem interval (PMI) ranges. Eye examination makes it possible to precisely determine the time of death during the initial period after death with half-hour accuracy.. In recent years methods for estimating the time of death by measuring the changes in the eye have made great strides. Those methods use the changes in the reaction to drugs and macroscopically visible morphological changes. Experimental studies also produced equations that can estimate the post-mortem interval using biochemical, electrochemical and thermal changes within the eye.

The exact incidence and outcomes of acute occlusive arterial mesenteric ischaemia (AMI) are unclear as most studies include only patients diagnosed correctly while alive. The aim of this study was to assess the incidence, mortality, and diagnostics of AMI by also including patients diagnosed post-mortem. This retrospective study comprised patients diagnosed with AMI either alive or post-mortem between 2006 and 2015 within a healthcare district serving 1.6 million inhabitants. Key exclusion criteria were venous or non-obstructive ischaemia. A total of 470 patients were included in the study of which 137 (29%) were diagnosed post-mortem. The most common misdiagnoses on those not diagnosed alive were unspecified infection (n = 19, 17%), gastrointestinal bleeding (n = 13, 11%), and ileus (n = 13, 11%). Of those diagnosed alive (n = 333), 187 (56%) underwent active surgical or endovascular treatment. During the 2006 – 2015 period, the overall incidence of AMI was 3.05 (95% CI 2.78 – 3.34)/100 000 person years and 26.66 (95% CI 24.07 – 29.45) for those aged 70 years or more. The mean autopsy rate during the study period was 29% for the overall population (32% during 2006 – 2010 and 25% during 2011 – 2015) and 18% for those aged 70 years or more. Overall, the 90-day mortality was 83% in all patients. The ninety day mortality decreased, being 87% during the first period (2006 – 2010) and 79% during the second period (2011 – 2015) (p =.029), while at the same time the proportion of patients diagnosed alive rose from 71% to 80% (p =.030) and the number of endovascular revascularisations rose from 1% to 5% (p =.022). A significant proportion of patients with AMI are not diagnosed alive, which is reflected in the mortality rates. Post-mortem examinations and autopsy rate data continue to be key factors in epidemiological studies on AMI. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Public Law / Zeitschrift für Öffentliches Recht is the property of Verlag Oesterreich GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: "Nuvan" is a trading name for Dichlorvos (DDVP) organophosphate insecticide. Nuvan contains 76% DDVP and is accessible in India. Nuvan Insecticide is highly misused as orally ingested in suicide attempts and is one of the leading causes of poisoning deaths in Indian rural areas. Methods: In this case study, we have diagnosed the four poisoning deaths by Nuvan-dichlorvos insecticide through Post-Mortem examination and toxicological analysis. The gastro-intestinal tract (GIT) was grossly examined. The solvent extraction method is used for withdrawing pesticide content from GIT. Toxicological analyses were performed using thin-layer chromatography (TLC) using a spraying reagent Results: A Fluorescent turquoise blue liquid content was found throughout the stomach to the small intestine. Content had a notable odor of volatile organic compounds (VOCs). The mucosal walls of the stomach were highly congested and hemorrhagic. Toxicological analyses done for all four cases showed a confirmatory detection of dichlorvos. Conclusions: The simple gross examination of gastrointestinal viscera during post-mortem is supporting diagnostic evidence for orally administered Nuvan insecticide. Solvent extraction method is a suitable technique for the extraction of pesticides from aqueous biological matrices. Thin Layer Chromatography is a simple and inexpensive technique for chemical confirmation and DDVP was detected. [ABSTRACT FROM AUTHOR]

There is increasing evidence of cardiac involvement in COVID-19 cases, with a broad range of clinical manifestations spanning from acute life-threatening conditions such as ventricular dysrhythmias, myocarditis, acute myocardial ischemia and pulmonary thromboembolism to long-term cardiovascular sequelae. In particular, acute myocarditis represents an uncommon but frightening complication of SARS-CoV-2 infection. Even if many reports of SARS CoV-2 myocarditis are present in the literature, the majority of them lacks histological confirmation of cardiac injury. Here, we report a case of a young lady, who died suddenly a few days after testing positive for SARS-CoV-2, whose microscopic and genetics features suggested a direct cardiac involvement compatible with fulminant myocarditis.

Background: The investigation into sudden unexpected and unnatural deaths supports criminal justice, aids in litigation, and provides important information for public health including surveillance, epidemiology, and prevention programs. The use of mortality data to convey trends can inform policy development and resource allocations. Hence, data practices/management systems in Forensic Medicine are critical. This study scoped literature and described the body of knowledge on data management and practice systems in Forensic Medicine. Methods: Five steps of the methodological framework of Arksey and O'Malley guided this scoping review. A combination of keywords, Boolean terms, and Medical Subject Headings was used to search PubMed, EBSCOhost (CINAHL with full text and Health Sources), Cochrane Library, Scopus, Web of Science, Science Direct, WorldCat, and Google Scholar from the 18th to 24th of June 2020 and updated in November 2021 for peer review papers. This study included articles involving unnatural deaths, focused on data practice or data management systems, relating to Forensic Medicine, all study designs, and published in English. Screening and selection and data extraction were conducted by two reviews. Thematic analysis was conducted, and the results were reported using both quantitatively and qualitatively. Results: Of the 23,059 articles, 16 met this study's inclusion criteria. The included articles were published between 2008 and 2019. Eight of the 16 articles were published between 2017 and 2019. Most of the included studies were conducted in the USA (5) and Australia/New Zealand (4). Only two publications were from lower- and middle-income countries (Nigeria, Mexico), and the remaining 14 were from high-income countries (Italy, Denmark, USA, Australia, and New Zealand, Japan, Switzerland, Canada). The data management systems found in this study were as follows: Virtopsy, Canadian Coroner and Medical Examiner Database, Infant Injury Database, Fatal injury surveillance system, Medical Examiners and Coroners Alert System, National Violent Deaths Reporting System, AM/PM Database, Tokyo CDISC/ODM, and National Coronial Information System. Conclusions: This study's results revealed limited articles relating to data management and practice systems in Forensic Medicine, particularly in LMICs through literature indicating there is a prevalence of unnatural deaths in LMICs. This study, therefore, recommends research on data management and practice systems relating to forensic medicine in LMICs to inform policy decisions. [ABSTRACT FROM AUTHOR]

Simple Summary: Alpacas have a quite recent history in Europe. Only in the 1990's were a considerable number of alpacas imported into the UK and then into continental Europe, where the number of animals increased significantly. This development has necessitated a more thorough knowledge of infectious diseases in alpaca husbandry. One of the most serious infectious diseases in alpacas is caseous lymphadenitis (CLA), which is caused by Corynebacterium (C.) pseudotuberculosis. As shown by the post-mortem examinations in this study, CLA is characterized by the formation of multiple, visible abscesses, particularly affecting the lungs and liver as the pathogen spreads throughout the body. While post-mortem examinations and isolation of the pathogen are pivotal for a proven diagnosis, serological examinations are the basis of epidemiological and monitoring studies. We examined 232 alpacas living in three independent herds for this current study. C. pseudotuberculosis was able to be isolated in several alpacas. All of the alpacas were tested serologically using a commercially available ELISA, an in-lab ELISA, and, in select animals, immunoblot. The immunoblot showed the highest sensitivity in the early phase of the infection in alpacas proven to be infected with C. pseudotuberculosis. Testing for antimicrobial susceptibility based on minimal inhibitory concentration using the broth microdilution method revealed uniform susceptibility to aminopenicillins, cephalosporines, macrolides, enrofloxacin, florfenicol, tetracycline, sulfonamid/trimethoprime, tiamulin, gentamicin, neomycin, spectinomycin, and vancomycin, but resistance to colistin, nitrofurantoin, and oxacillin. The present study shows that C. pseudotuberculosis poses an imminent health risk for alpaca husbandry. Laboratory diagnostics based on post-mortem, bacteriological and serological examinations are valuable tools for implementing specific measures as a basis for tackling this infectious disease in alpaca herds. Alpacas are the major camelid species in Europe held for hobbies, animal-aided therapy, and commercial reasons. As a result, health-related issues associated with alpacas are of growing significance. This especially holds true for one of the most serious infectious diseases, caseous lymphadenitis, which is caused by the bacterial pathogen Corynebacterium (C.) pseudotuberculosis. Our study focuses on post-mortem examinations, the laboratory diagnostic tool ELISA, and the immunoblot technique for the detection of specific antibodies against C. pseudotuberculosis and detection of the causative pathogen in alpaca herds. We examined a total of 232 alpacas living in three herds. Four of these alpacas were submitted for post-mortem examination, revealing abscesses, apostematous and fibrinous inflammation in inner organs, pleura, and peritoneum. Serological investigation using a commercial ELISA based on phospholipase D (PLD) as antigen and an in-lab ELISA based on whole cell antigens (WCA) revealed an overall seroprevalence of 56% and 61.2%, respectively. A total of 247 alpaca sera originating from 232 animals were tested comparatively using the in-lab and the commercial ELISA and showed a substantial degree of agreement, of 89.5% (Cohen's kappa coefficient of 0.784), for both tests. Further comparative serological studies using the two ELISAs and the immunoblot technique were carried out on selected sera originating from 12 breeding stallions and six breeding mares for which epidemiological data and partial C. pseudotuberculosis isolates were available. The results showed the immunoblot to have a sensitivity that was superior to both ELISAs. In this context, it should be emphasized that evaluation of these investigations and the epidemiological data suggest an incubation period of one to two months. Antibiotic susceptibility testing of 13 C. pseudotuberculosis isolates based on the determination of minimal inhibitory concentrations using the broth microdilution method revealed uniform susceptibility to aminopenicillins, cephalosporines, macrolides, enrofloxacin, florfenicol, tetracycline, sulfonamid/trimethoprime, tiamulin, gentamicin, neomycin, spectinomycin, and vancomycin, but resistance to colistin, nitrofurantoin, and oxacillin. [ABSTRACT FROM AUTHOR]

A post-mortem examination is a reliable method to reveal possible hidden causes of death. However, due to the stigma associated with drug use, mortality data related to drug use is a neglected topic in local health in Palestine. Therefore, we aimed to describe post-mortem examination cases' mortality data and investigate the occurrence of death-related drug use in the West Bank in a retrospective study, 2011-2021. Homicide was more prevalent among males (32.9%) than females (20.9%), with increased risk in young adults (OR=2.8) and the summer season (OR=1.9). Moreover, Palestinian refugees were three times more likely to commit homicide than urban (OR=30.3). Most suicide cases were males and with increased risk in children (OR=4.9) and young adults (OR=8.7) than age group>40 years (p-value<0.05). In mortality data related to intoxication, organophosphates were the leading cause of death in suicidal cases and multidrug misuse in unintentional death. Amphetamines were the most drugs found in combination with other drugs. Most of the deaths related to drug use were male prominent and from villages. In conclusion, age-related increases in homicide and suicide rates highlighted the vital role of raising national health awareness and improving the health care system in rural areas and refugee camps. Moreover, the increased percentages of suicide and accidental death related to drug use, the age of victims, and the polydrug tested in these cases indicate a hidden population of multidrug users in young Palestinian adults and children, which designates drug use in Palestine has reached an alarming situation. [ABSTRACT FROM AUTHOR]

Knowledge gaps surrounding animal welfare assessment in hunted terrestrial wild mammals and seals were highlighted in the reviews by Knudsen (2005) and EFSA (2007). Following these reviews, the present paper aims to report on developments in the quantitative assessment of welfare outcomes in wild mammals killed via rifle shooting, and modern explosive harpoon grenades used in the killing of whales. Time to death (TTD) and instantaneous death rate (IDR) are widely accepted ante-mortem variables for assessing the duration of suffering during the killing process. The addition of post-mortem assessments allows for validation of TTD and IDR, thus providing a more accurate appraisal of animal welfare during hunting. While this combined assessment for large cetaceans has been implemented since the 1980s in the Norwegian minke whale (Balaenoptera acutorostrata) hunt, we report that this approach has been implemented in studies of the Icelandic minke and fin whale (Balaenoptera physalus) hunts, as well as the Canadian and Norwegian commercial harp seal (Pagophilus groenlandicus) hunts. Additionally, this approach has been incorporated into welfare studies in terrestrial herbivore management programmes. Quantitative welfare assessment during hunts is capable of effectively evaluating the weapons used and judging modifiable variables such as projectile choice, optimal shooting procedure, as well as identifying areas for improvement in hunter training. In moving towards a standardised approach for welfare outcome assessment, an established framework can effectively allow all hunts to be contrasted and allow for identification of optimal strategies that minimise animal suffering.

Simple Summary: Wildlife disease surveillance can be considered an essential tool for providing important information about the health status of the population and for protecting human health. Between 2000 and 2020, 284 chamois carcasses from the entire home range of the species in Slovenia were examined using comprehensive necropsy and other laboratory tests. The results indicate a wide range of chamois diseases, but none of the identified diseases can be considered a significant health threat to other wildlife species and/or to humans. In this paper, we provide an overview of the causes of death of Alpine chamois (Rupicapra r. rupicapra) diagnosed in the national passive health surveillance of chamois in Slovenia. From 2000 to 2020, 284 free-ranging chamois provided by hunters were necropsied at the Veterinary Faculty, University of Ljubljana, Slovenia. Depending on the results of complete necropsy, histopathological, bacteriological, parasitological, and virological examinations, a descriptive data analysis was performed. The most common causes of death in chamois were infectious diseases (82.2%), followed by non-infectious diseases (11.8%). Of all the causes of death, parasitic infections accounted for 70.3%, trauma for 9.7%, and bacterial infections for 9.3% of all cases. Less common diseases were viral infections, neoplasms, winter starvation, and metabolic disorders. [ABSTRACT FROM AUTHOR]

• Most respondents had experienced euthanizing a horse, but few were offered a necropsy. • Respondents had higher familiarity with the term autopsy compared to necropsy. Respondents were more comfortable using the terms body and mortality versus carcass. • Veterinary recommendation was positively associated with performing a necropsy. In recent years, the number of horses submitted for necropsy has been in decline. This study aimed to identify the perceptions and barriers of equine necropsy through an online survey of horse owners. The data were analyzed by multivariate models for associations and factors that influenced decision making regarding necropsy. The survey yielded 1,366 usable responses. Respondents had higher familiarity with the term "autopsy" compared to "necropsy" (P < 0.001) and showed a greater level of comfort using the terms "body" and "mortality" compared to "carcass" (P < 0.001). Most respondents (82 %) had experienced euthanizing a horse, but few (27 %) were offered a necropsy. Of those offered a necropsy, a majority (81 %) opted to perform one. When asked about their reasons for choosing to have a necropsy performed, recommendations from veterinarians (77.87 OR, 95 % CI: 49.3, 127.5) and already knowing the cause of death (1.85 OR, 95 % CI: 1.2, 30) were positively associated while a benefit to herd health was negatively associated (0.55 OR, 95 % CI: 0.3, 1.0). Owning horses for use as competition animals (1.44 OR, 95 % CI: 0.9, 2.2), the desire for personal closure (1.76 OR, 95 % CI: 1.1, 2.9), and the goals to protect human health (1.29 OR, 95 % CI: 1.0, 1.6) and to improve herd health (1.43 OR, 95 % CI: 1.1, 1.9) were positively associated with a likelihood of choosing to have a necropsy performed or recommending necropsies in the future. This research highlights the need for education of horse owners about the option and benefits of necropsy, and the use of more societally accepted language. [ABSTRACT FROM AUTHOR]

The loss of an apparently healthy infant is confronting for any family, puzzling for a clinician and challenging for the pathologist charged with the task of demonstrating a cause for death. The term "cot death" evolved to "sudden infant death syndrome" [SIDS] and now "sudden unexpected death in infancy [SUDI]" as the epidemiology and pathology of infant death changed. Community interventions were successful in changing sleep practices for young babies. The current research focus is on understanding genetic predispositions to unexpected death in early childhood. Whilst much has been achieved in reducing the infant mortality rate from SUDI by between 50%, and 80% in some countries, over the last 30 years, there remain challenges for improving rates of accurate diagnosis and reaching out to more vulnerable families with clearly modifiable risk factors for SUDI. These challenges directly involve the clinician through taking a systematic and detailed history and better standardised death scene evaluations with specifically accredited assessors. Better knowledge regarding circumstances of SUDI cases will help Coroners and researchers provide answers for grieving families now, and in the future contribute to further reductions in the rate of SUDI in communities across the world. [ABSTRACT FROM AUTHOR]

Abstract Background Microbiological examination of lesions found in slaughtered animals during meat inspection is an important part of public health protection as such lesions may be due to zoonotic agents that can be transmitted by meat. Examination of inflamed lymph nodes also plays a particular important role, as lymphadenitis may reflect a more widespread infection. Such lesions in sheep are mainly caused by pyogenic bacteria but also mycobacteria are occasionally found. Meat inspection data from 2017 to 2018 from southern Poland, especially from the Małopolska region, indicate that purulent or caseous lymphadenitis involving the mediastinal and tracheobronchial lymph nodes (MTLNs) is a common finding. The primary aim of the current study was to determine the aetiology of these lesions. Furthermore, it was investigated how presence of lesions was correlated with age and grazing strategy of affected sheep. Results Post-mortem examination revealed purulent or caseous lymphadenitis in the MTLNs of 49 out of 284 animals (17.3%). Subsequent microbiological examination revealed the presence of Corynebacterium pseudotuberculosis (34.7%), Streptococcus dysgalactiae subsp. equisimilis (34.7%), Staphylococcus aureus (8.2%), Enterococcus spp. (2.0%), Trueperella pyogenes (2.0%), and β-haemolytic strains of Escherichia coli (2.0%). Mycobacterium spp. and Rhodococcus equi were not detected. In older sheep, the probability of the presence of purulent or caseous lymphadenitis was higher than in younger, and the risk was increasing by 1.5% with each month of life. Sheep grazing locally had 4.5-times greater risk of having purulent or caseous lymphadenitis than individuals summer grazing in the mountains. Conclusion The most common aetiological agents of purulent or caseous lymphadenitis in the MTLNs of sheep in the Małopolska region were C. pseudotuberculosis and S. dysgalactiae subsp. equisimilis. Particular attention during post-mortem examination should be paid to the carcasses of older sheep and sheep grazing on permanent pastures, as they seem more prone to develop purulent or caseous lymphadenitis.

Abstract Background A high rate of euthanized and spontaneously dead sows causes production losses and likely indicates underlying welfare problems. Identification of predisposing factors to on-farm deaths requires a thorough understanding of the causes. Post-mortem examination is needed for a proper diagnosis. The aims of this descriptive study were to determine causes of spontaneous deaths and euthanasia in sows in a convenience sample of Finnish herds and to describe pathological findings in the locomotor system and in teeth and gums. Results This study described post-mortem findings in 65 sows found dead or euthanized on 15 farms. All but one of the sows presented with two or more pathological findings. The majority of primary pathologic-anatomic diagnoses (PAD-1) were inflammatory. The most prevalent diagnoses were arthritis and peritonitis (9% of sows each). The locomotor system was the body part most commonly affected by lesions. Findings in the locomotor system unassociated with death were present in 85% of the animals, additionally 29% of PAD-1 s concerned the locomotor system. The prevalence for both degenerative joint disease and tooth wear was 71%. Farmers had noted clinical signs within 30 days of death in every euthanized sow and in half of the spontaneously dead ones. The farmer’s impression of the cause of death agreed at least partly with the PAD-1 in 44% of the cases. Conclusion Multiple pathologies were the norm in the present animals. This may indicate an extended course of illness and therefore also an unnecessary delay in medical treatment or euthanasia. The prevalence and clinical relevance of the most common disorders, including degenerative joint disease and tooth wear, need to be elucidated.

Background: Knowing the cause of stillbirth is of paramount importance for bereaved parents and fetal autopsy is one of the key investigations aimed at providing explanation about the fetal death. However, parents often manifest concerns in autopsy acceptance. Barriers against fetal autopsy can be related to caregivers’ disinformation and misconceptions. Our aim was to investigate the knowledge about fetal autopsy in a third level Italian University care Center. Methods: We investigated the knowledge of caregivers (n = 60) about fetal autopsy collecting data from an on-line anonymous questionnaire. We investigated about dismemberment, disfigurement and whether the parents can see their baby after the autopsy. Results: We obtained 34/60 (56.7%) answers, highlighting the discomfort of health care providers about addressing this issue. Only half of the responders knows that the baby will not be dismembered during the autopsy and only one third of caregivers knows that the baby will not be disfigured after the autopsy and parents can see their baby after the post-mortem investigation if they wish. More than 30% of health care providers reported that they did not know technical details about the autopsy procedures, and they did not know answers to some common questions about autopsy such as whether the fetus would be disfigured or dismembers and whether the remains could be viewed following completion of the autopsy. Conclusions: To overcome some barriers about fetal autopsy, it is of paramount importance that both caregivers and parents are aware that the baby will not be dismembered, and the face, hands, feet, and limbs of the baby are untouched during the full autopsy investigation. Deleting caregivers’ misconceptions is a crucial point for improving parents’ autopsy acceptance.

• Data on COVID-19-related sudden deaths occurring in the community are lacking • Forensic autopsies of sudden community deaths show undiagnosed COVID-19 deaths • Pulmonary thromboembolism due to COVID-19 is a major morbitity of these deaths • Underlying risk factors of sudden COVID-19 community deaths need definition Data from Africa regarding sudden and unexpected COVID-19 community deaths and underlying pathological, demographic, and co-morbidity features require definition. We performed a case series of COVID-19-related deaths seen at Forensic Post-Mortem examination of sudden and unexpected Community Deaths in Lusaka, Zambia, Africa. Whole-body Post-Mortem examinations were performed according to Standard Operating Procedures. Patient demographics, history, co-morbidities, pathological gross and microscopic findings, and cause(s) of death were recorded. Variables were grouped as frequencies and percentages. Comparison of data was made with autopsy findings of hospital COVID-19 deaths. Of 21 COVID-19 decedents, 14/21 (66.7%) were male; 18/21, (85.7%) were below 55 years of age (mean age, 40 ± 12.3; range, 20-73). The median duration of symptoms was 1 day (range 0-2); 9/21 (42.9%) had co-morbidities, with hypertension and obesity being the most common. Main post-mortem findings were diffuse alveolar damage (DAD) (80.9%), saddle and shower emboli (38.1%, respectively), and pneumonia (14.3%). Pulmonary thromboembolism (76.2%), DAD (14.3%), and SARS-CoV-2 pneumonia (9.5%) were common causes of death. COVID-19 is an important cause of death to consider in forensic investigations of sudden and unexpected community deaths. Risk factors for the younger age of COVID-19 deaths and thromboembolism need to be identified. [ABSTRACT FROM AUTHOR]

Autopsy is an important quality assurance indicator and a tool to advance medical knowledge. This study aims to compare the premortem clinical and postmortem pathology findings in patients who died in the Intensive Care Unit (ICU), to analyze if there are any discrepancies between them, and to compare the results to two similar studies performed in our institution in 2004 and 2007. Between January 1, 2016, and December 31, 2018, 888 patients died in the ICU and 473 underwent post-mortem examination (PME) of whom 437 were included in the present study. Autopsies revealed discrepancies between clinical diagnosis and pathologic findings according to in 101 cases (23.1%) according to Goldman classification. Forty-eight major discrepancies (class I and class II) were identified in 44 cases and the most frequent identified discrepancies were pulmonary embolism (3/12) as class I and malignancies (13/35) as class II. They were more frequent in patients hospitalized for less than 10 days then in the group with more than 10 days of hospitalization (13.8% vs 4.5%; p = 0.002). No statistical difference has been noticed concerning age, gender, and ICU stay. We observed an increase of performed autopsies and a total discrepancy rate similar to the studies performed in the same institution in 2004 (22.5%) and 2007 (21%). In conclusion, discrepancies between clinical and PME diagnoses persist despite the medical progress. Secondly, the autopsy after a short hospital stay may reveal unexpected findings whose diagnosis is challenging even if it may be suspected by the intensivist. [ABSTRACT FROM AUTHOR]

Background: Alcohol is well-established risk factors for road traffic deaths around the world. Method: This is a cross-sectional study to assess the prevalence of alcohol consumption among the victims of fatal road traffic accidents in Imphal, Manipur. A detailed post-mortem examination was carried out among 160 victims and blood alcohol concentration was assessed by Cavett test and then quantified by gas liquid chromatography. Result: A total of 40 (25%) cases were found to be positive for alcohol in the blood. Most of the cases 11(27.5%) occurred in age group of 21-30 years and 41- 50 years, respectively. Maximum number of cases 13(32.5%) showed blood alcohol concentration of 90-120 mg% while 7(17.5%) cases showed readings above 180 mg%. Conclusion: This study found that driving under the influence of alcohol, exponentially increases the risk of having an accident which could be fatal in its outcome. [ABSTRACT FROM AUTHOR]

Measles and rubella are targeted for elimination in the WHO region Europe. To reach the elimination goal, vaccination coverage of 95% must be achieved and sustained, the genotype information has to be provided for 80% of all outbreaks and transmission chains of a certain variant must not be detected for >12 months. The latter information is collected at Germany's National Reference Center Measles, Mumps, Rubella (NRC MMR). We describe here an outbreak of measles occurring in Hildesheim. The outbreak comprised 43 cases and lasted 14 weeks. Surprisingly, a high number of vaccination failures was observed since 11 cases had received two doses of the MMR vaccine and 4 additional cases were vaccinated once. A 33-year-old woman passed away during the outbreak. She was the mother of 5 children between 4 and 16 years of age. Two schoolchildren contracted measles and passed it on to the rest of the family. Due to delivery bottlenecks, the vaccination of the mother was delayed. She developed measles-like symptoms 3 days after vaccination and was found dead on the morning of day 8 after vaccination. A post-mortem examination was done to identify the cause of death. Moreover, molecular characterization of the virus was performed to analyze whether she was infected by the wildtype virus circulating at that time in Hildesheim or whether the vaccine may have been a concomitant and aggravating feature of her death. The result showed that the samples taken from her at the time of death and during necropsy contained the wildtype measles virus variant corresponding to MVs/Gir Somnath.IND/42.16 (WHO Seq-ID D8–4683) that fueled the Hildesheim outbreak and circulated in Germany from March 2018 to March 2020. The vaccine virus was not detected. Moreover, two aspects uncovered by the post-mortem examination were remarkable; the woman died from giant cell pneumonia, which is a complication seen in immune-suppressed individuals and she was actively using cannabis. THC is known to influence the immune system, but literature reports describing the effects are limited. • The district of Hildesheim experienced a measles outbreak in 2019, leading to 43 cases (15 of them with prior vaccination). • During this period, a 33-year-old woman died after she had contracted measles virus from their children. • The post-mortem investigation demonstrated a giant cell pneumonia, a complication seen typically in immune-suppressed individuals. • Genotyping of measles virus revealed wildtype virus D8-4683 associated with the Hildesheim outbreak. • Prior vaccination or rapid post-exposition prophylaxis would have probably saved her life. [ABSTRACT FROM AUTHOR]

In this paper, we provide an overview of the causes of death of Alpine chamois (Rupicapra r. rupicapra) diagnosed in the national passive health surveillance of chamois in Slovenia. From 2000 to 2020, 284 free-ranging chamois provided by hunters were necropsied at the Veterinary Faculty, University of Ljubljana, Slovenia. Depending on the results of complete necropsy, histopathological, bacteriological, parasitological, and virological examinations, a descriptive data analysis was performed. The most common causes of death in chamois were infectious diseases (82.2%), followed by non-infectious diseases (11.8%). Of all the causes of death, parasitic infections accounted for 70.3%, trauma for 9.7%, and bacterial infections for 9.3% of all cases. Less common diseases were viral infections, neoplasms, winter starvation, and metabolic disorders.

Objectives: The main objective of this study was to evaluate the accuracy of prenatal ultrasound to diagnose corpus callosum alterations, compared to prenatal magnetic resonance imaging (MRI), postnatal image techniques (ultrasound and/or MRI), and post-mortem examination in terminated pregnancies.Methods: Retrospective review of 86 cases of prenatal ultrasound diagnosis of corpus callosum anomalies between January 2007 and December 2015 at a third level Maternal Fetal Medicine center. The study reviewed the findings of prenatal ultrasound and MRI, post-mortem examination in cases of termination of pregnancy (TOP) or stillbirths and postnatal ultrasound, and MRI in neonates. The anomalies of corpus callosum (CC) were classified as complete agenesis of the corpus callosum (ACC), partial ACC, or dysgenesis of CC.Results: Fifty-eight (67.4%) cases resulted in TOP, 26 (30.2%) cases opted to continue with the pregnancy and two (2.3%) cases were lost to follow up. Among the 26 cases that continued with the pregnancy, 24 (92.3%) were live births and two (7.7%) were stillborn. All cases in which a third trimester MRI was performed (n = 46) confirmed the prenatal ultrasound diagnosis of CC anomaly. In seven (15.2%) of them, the MRI found additional intracranial findings and in three cases (6.5%) the type of CC anomaly (complete, partial, or dysgenesis) was reclassified (Kappa index: 0.86, 95% CI: 0.71-1.00). CC anomalies were confirmed in 46 (95.8%) of the 48 cases in which a post-mortem examination was available, the type of anomaly being reclassified in three cases (6.3%) (Kappa index: 0.88, 95% CI: 0.75-1.00). Among the 10 cases in which a postnatal ultrasound was performed, the CC anomaly was confirmed in all and the type of anomaly was reclassified in 1 (10%) of them (Kappa index: 0.75, 95% CI: 0.32-1.00).Conclusion: Corpus callosum agenesis can be detected on the routine mid-trimester ultrasound scan. Prenatal ultrasound and MRI can accurately classify the type of CC abnormality. Moreover, third trimester MRI can detect additional intracranial anomalies in 15% of cases. [ABSTRACT FROM AUTHOR]

Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The concealment of the body following a homicide undermines different moments of the forensic and medico-legal investigations. The aim of the present study is to provide an overview of the literature and the forensic casuistry of the Institute of Legal Medicine of Padova for analyzing and discussing diverse methodological approaches for the forensic pathologist dealing with covered-up homicides. Material and methods: A literature review, updated until September 2019, was performed, and a literature pool of forensic cases was built. In-house cases were included by conducting a retrospective analysis of the forensic caseworks of Padova of the last 20 years. Data regarding epidemiology, methodology of assessment, methods of concealment, and answers to medico-legal issues were extracted for both data sets. Results and discussion: Seventy-eight papers were included in the literature review (78.2% being case reports or case series, 17% retrospective studies, and 6% experimental studies or reviews). Literature and in-house data sets consisted of 145 and 13 cases, respectively. Death scene investigation, radiology, toxicology, and additional analyses were performed in 20–54% of literature and 62–77% of in-house cases. Cover-up by multiple methods prevailed. Death was caused by head trauma in about 40% of cases (both data sets), strangulation in 21% of literature, and 7% of in-house cases, and was undetermined in 17% of literature and 7% of in-house cases. Conclusions: The methodology of ascertainment should be case-specific and based on a multidisciplinary and multimodal evaluation of all data, including those gained through novel radiological and/or analytical techniques. [ABSTRACT FROM AUTHOR]

The evolution of a permanent separation of the upper respiratory and digestive tract is one of the adaptions cetaceans evolved for their aquatic life. Generally, it prevents odontocetes from choking on either saltwater or foreign bodies during ingestion under water. Nevertheless, several sporadic single case reports from different parts of the world show that this separation can be reversed especially by overly large items of prey. This incident can have a fatal outcome for the odontocetes. The German federal state of Schleswig-Holstein has a year-round, permanent and systematic stranding network that retrieves stranded marine mammals from its shorelines and constantly enables post-mortem examinations. In 2016, with nine affected animals, a high incidence of fatal pharyngeal entrapment of flatfish in harbour porpoises (Phocoena phocoena) occurred during spring and early summer on the German North Sea island of Sylt. All flatfish were identified as common sole (Solea solea). A retrospective post-mortem data analysis over a 30-year period from the North and Baltic Sea revealed similar yearly and seasonally case accumulations on the same island in the 1990s as well as several single case events over the whole timespan. All cases except one were caused by flatfish. When flatfish speciation was performed, only common sole was identified. From 1990 to 2019, of all examined harbour porpoises, 0.3% (2/713) from the Baltic Sea and 5.5% (45/820) from the North Sea died due to fish entrapped in the pharynx. On the North Sea coast, the occurrence of fatal obstruction shows high yearly variations from 0 to 33.3%. Years that stand out are especially 1990 to 1992, 1995, as well as 2016. The majority of all cases generally occurred between April and July, indicating also a seasonality of cases. This study evaluates the occurrence of fatal pharyngeal entrapment of fish in two geographically separated harbour porpoise populations. Additionally, common sole is clearly identified as a potentially risky item of prey for these small odontocetes.

Objectives: The aim of this study was to compare post-mortem CT findings with necropsy findings in domestic cats. Methods: Post-mortem CT and necropsies were performed in 20 cadavers of domestic cats. The sensitivity, specificity and agreement between the post-mortem CT and necropsy findings were determined. Results: There were a total of 315 post-mortem findings; 183 were identified by post-mortem CT and 132 were identified by necropsy. Post-mortem CT demonstrated a higher sensitivity to identify the findings mainly in bones. The higher indices of agreement between post-mortem CT and necropsy were related to abnormalities of pleural space, bones and joints. Conclusions and relevance: This study demonstrated that post-mortem CT and necropsy provided different information. Thus, their use in conjunction with each other might improve the understanding of the cause of death and the identification of post-mortem lesions. [ABSTRACT FROM AUTHOR]

Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundSynthetic cannabinoid receptor agonists (SCRAs) have become the largest group of new psychoactive substances monitored by the European Union Early Warning System. Despite the wide diffusion on the market, data regarding effects, toxicities, and mechanisms as well as toxic/lethal doses are still scarce.MethodsA comprehensive literature search for articles published up to January 2019 was performed in multiple electronic databases. Only cases of death in which toxicological analyses revealed the presence of SCRAs in blood or urine and at least an external examination was performed, including those occurred in emergency departments, were included.ResultsOf 380 studies identified, 354 were excluded, while 8 additional manuscripts were included through the screening of relevant references cited in the selected articles. A total number of 34 manuscripts (8 case series and 26 case reports) were included.ConclusionsTypical toxic ranges for SCRAs have not been so far identified, and the results of toxicological analyses should be interpreted with caution. In death cases involving SCRAs, a thorough post-mortem examination is a prerequisite to assess the role of the substance use in the deceased and to identify a probable mechanism of death. Even after a comprehensive analysis of clinical, circumstantial, toxicological, and autoptic data, the cause and manner of death remain unclear in some cases.

Background: The external post-mortem examination (EPME) is an important medical, legal and socio-economic task with far-reaching relevance; however, due to discrepancies between findings from EPMEs and actual cause of death, improvements in accuracy and quality are needed. Objectives: To investigate knowledge, competencies and attitudes regarding EPME in general practitioner (GP) post-graduate trainees. Methods: Before four post-graduate training courses on the EPME for general practitioner trainees, organized in 2014 in the German federal state of Baden-Wuerttemberg, a questionnaire on the EPME was distributed by the lecturer, completed by the GP post-graduate trainees and returned to the lecturer. The questionnaire consisted of 19 items related to three main categories: knowledge, competencies and attitudes. Results: Out of 380 GP post-graduate trainees, 128 completed and returned the questionnaire (response rate 33.7%). Less than 18% felt adequately confident in identifying a natural cause of death and less than 5% felt adequately confident in identifying an unnatural cause of death. Only 33% consistently fully uncover the corpse for the EPME. Conclusion: We found an important uncertainty in GP post-graduate trainees regarding their EPME knowledge and competencies.

Evidence of hearing impairment was identified in a harbour porpoise (Phocoena phocoena) on the basis of scanning electron microscopy. In addition, based on histopathology and immunohistochemistry, there were signs of unrelated cerebral toxoplasmosis. The six-year old individual live stranded on the Dutch coast at Domburg in 2016 and died a few hours later. The most significant gross lesion was multifocal necrosis and haemorrhage of the cerebrum. Histopathology of the brain revealed extensive necrosis and haemorrhage in the cerebrum with multifocal accumulations of degenerated neutrophils, lymphocytes and macrophages, and perivascular lymphocytic cuffing. The diagnosis of cerebral toxoplasmosis was confirmed by positive staining of protozoa with anti-Toxoplasma gondii antibodies. Tachyzoites were not observed histologically in any of the examined tissues. Ultrastructural evaluation of the inner ear revealed evidence of scattered loss of outer hair cells in a 290 µm long segment of the apical turn of the cochlea, and in a focal region of ~ 1.5 mm from the apex of the cochlea, which was compatible with noise-induced hearing loss. This is the first case of concurrent presumptive noise-induced hearing loss and toxoplasmosis in a free-ranging harbour porpoise from the North Sea.