Interpreting a myocardial inflammation as causal,contributory or as of no significance at all in the cause of death can be challenging,especially in cases where other pathologic and/or medico-legal findings are also p...Interpreting a myocardial inflammation as causal,contributory or as of no significance at all in the cause of death can be challenging,especially in cases where other pathologic and/or medico-legal findings are also present.To further evaluate the significance of myocardial inflammation as a cause of death we performed a retrospective cohort study of forensic and clinical autopsy cases.We revised the spectrum of histological inflammatory parameters in the myocardium of 79 adult autopsy cases and related these to the reported cause of death.Myocardial slides were reviewed for the distribution and intensity of inflammatory cell infiltrations,the predominant inflammatory cell type,and the presence of inflammation-associated myocyte injury,fibrosis,edema and hemorrhage.Next,the cases were divided over three groups,based on the reported cause of death.Group 1(n=27)consisted of all individuals with an obvious unnatural cause of death.Group 2(n=29)included all individuals in which myocarditis was interpreted to be one out of more possible causes of death.Group 3(n=23)consisted of all individuals in which myocarditis was reported to be the only significant finding at autopsy,and no other cause of death was found.Systematic application of our histological parameters showed that only a diffuse increase of inflammatory cells could discriminate between an incidental presence of inflammation(Group 1)or a potentially significant one(Groups 2 and 3).No other histological parameter showed significant differences between the groups.Our results suggest that generally used histological parameters are often insufficient to differentiate an incidental myocarditis from a(potentially)significant one.展开更多
Deaths or other legal disputes caused by novel coronavirus pneumonia(COVID-19)may require forensic pathological autopsy or forensic clinical identification.During daily forensic identification of cases in which indivi...Deaths or other legal disputes caused by novel coronavirus pneumonia(COVID-19)may require forensic pathological autopsy or forensic clinical identification.During daily forensic identification of cases in which individuals died of infectious diseases,forensic identification agencies and experts should be fully aware of the risk of infection when dissecting and examining such cadavers.Furthermore,forensic identification personnel should always adopt eflfective protective measures.As a novel infectious disease,research and information on COVID-19 are updated rapidly.Therefore,guidelines should be carefully selected for forensic identification.In addition to the above aspects,this paper has also discussed other common issues during the forensic autopsy of patients who died of infectious diseases,such as professional ethics,informed consent,insurance claims,and environmental protection.展开更多
文摘Interpreting a myocardial inflammation as causal,contributory or as of no significance at all in the cause of death can be challenging,especially in cases where other pathologic and/or medico-legal findings are also present.To further evaluate the significance of myocardial inflammation as a cause of death we performed a retrospective cohort study of forensic and clinical autopsy cases.We revised the spectrum of histological inflammatory parameters in the myocardium of 79 adult autopsy cases and related these to the reported cause of death.Myocardial slides were reviewed for the distribution and intensity of inflammatory cell infiltrations,the predominant inflammatory cell type,and the presence of inflammation-associated myocyte injury,fibrosis,edema and hemorrhage.Next,the cases were divided over three groups,based on the reported cause of death.Group 1(n=27)consisted of all individuals with an obvious unnatural cause of death.Group 2(n=29)included all individuals in which myocarditis was interpreted to be one out of more possible causes of death.Group 3(n=23)consisted of all individuals in which myocarditis was reported to be the only significant finding at autopsy,and no other cause of death was found.Systematic application of our histological parameters showed that only a diffuse increase of inflammatory cells could discriminate between an incidental presence of inflammation(Group 1)or a potentially significant one(Groups 2 and 3).No other histological parameter showed significant differences between the groups.Our results suggest that generally used histological parameters are often insufficient to differentiate an incidental myocarditis from a(potentially)significant one.
基金Supported by the Key Project of National Social Science Foundation of China,“Research on Ethical Thinking and Legal Regulation of Medical Behaviors in China from the Perspective of Doctor-patient Relationship(No.15AZD065).”。
文摘Deaths or other legal disputes caused by novel coronavirus pneumonia(COVID-19)may require forensic pathological autopsy or forensic clinical identification.During daily forensic identification of cases in which individuals died of infectious diseases,forensic identification agencies and experts should be fully aware of the risk of infection when dissecting and examining such cadavers.Furthermore,forensic identification personnel should always adopt eflfective protective measures.As a novel infectious disease,research and information on COVID-19 are updated rapidly.Therefore,guidelines should be carefully selected for forensic identification.In addition to the above aspects,this paper has also discussed other common issues during the forensic autopsy of patients who died of infectious diseases,such as professional ethics,informed consent,insurance claims,and environmental protection.
