Tumor metastático espinocelular de cérvix uterino para coração: diagnóstico ante mortem

Mulher de 63 anos com história pregressa de câncer de útero e queixa de fadiga e dispnéia aos pequenos esforços. Ao exame, apresentava-se hipertensa e com estertores de bases pulmonares. O ecocardiograma transtorácico mostrou massa de pouca mobilidade em ventrículo direito. A paciente foi levada para cirurgia, ocasião em que se encontrou uma massa envolvendo a parede anterior da artéria pulmonar, valva tricúspide, átrio direito e parede posterior do ventrículo direito. A artéria pulmonar e o ventrículo direito foram reconstruídos com patch de pericárdio bovino e a valva tricúspide foi substituída por prótese biológica número 31. O exame anatomopatológico demonstrou metástase de células escamosas com áreas bem diferenciadas e infiltrativas. A paciente recebeu alta hospitalar um mês após a cirurgia. Quatro meses após, entretanto, foi readmitida em estado terminal, confirmando o prognóstico reservado da doença neste estágio.

Postmortale Darstellung der Koronararteriendurchmultiphasische Ganzkörper-CT-Angiographie : Vergleich mit Ante-mortem-Koronarangiographien

Die Diagnostik des plötzlichen Herztods durch bildgebende Techniken ist bislang unzureichend evaluiert. Als Validierungsoption für postmortale koronarangiographische Methoden steht der Sektionsbefund zur Verfügung. Sequenziell postmortal durchgeführte alternative angiographische Methoden sind denkbar. Schließlich bietet die ante mortem durchgeführte Koronarangiographie (CA) - ggf. In Verbindung mit der perkutanen transluminalen Koronarangioplastie (PTCA) - weitere Vergleichsmöglichkeiten. Neben deskriptiven sind hier auch potenziell funktionelle Aussagen zum Stenosegrad möglich.

Influência do banho de aspersão ante-mortem na contaminação microbiana da carne bovina

To determine the effects of the pre-slaughter showering on some meat quality parameters, the bacterial changes in the Longus colli muscle and the contamination of the meat surface at three different points of the slaughter line were studied. Sixteen Nelore steers were slaughtered in a commercial slaughterhouse. Eight animals were submitted to pre-slaughter showering; a control group of eight animals were slaughtered without showering. Aseptic samples were collected for evaluations in the muscle depth, in the anterior portion of Longus colli muscle, just before chilling. The swab method was used for sampling carcass surface right after dressing, before carcasse washing, and at the beginning of chilling. Longus colli muscle samples were used to determine bacteria total count, psychrotrophic count and Enterobacteriaceae count, after 5, 24 and 48 hours from slaughtering, and in carcass surface, bacteria total count and psychrotrophic count. Multivariate methods were used to evaluate bacterial data the use of pre-slaughter showering did not affect the bacteria total counts, in the deep tissue. A significant growth of psychrotrophic bacteria was detected in both treatments. No significant differences (P>.05) were found in bacteria total count and psychrotrophic count between treatments. Also, no differences (P>.05) were detected between counts taken at different momments at the kill floor: skinning, before carcasse washing, and at the cooler, before chilling.

Influência do banho de aspersão ante-mortem na eficiência da sangria e em parâmetros bioquímicos da carne bovina

To determine the effects of the pre-slaughter showering on some meat quality parameters, the biochemical changes in the Longus colli muscle and the bleeding efficiency were studied. Thirty-six Nelore steers were slaughtered in a commercial slaughterhouse. Eighteen animals were submitted to pre-slaughter showering; a control group of eighteen animals were slaughtered without showering. Samples were collected for evaluations in the muscle depth, in the anterior portion of longus colli muscle,just before chilling. Bleeding efficiency was evaluated through the ratio of muscle haemoglobin/blood haemoglobin using blood samples taken five seconds after bleeding, and muscle sample taken before chilling. Longus colli muscle samples were also used to determine glycogen, glucose, pH and acidity, 5, 24 and 48 hours after slaughtering. Multivariate methods were used to evaluate biochemical data and the bleeding efficiency data analysis followed the randomized block design. Haemoglobin retained in the muscle and bleeding efficiency were not affected (P > .05) by pre-slaughter showering. The pre-slaughter showering did not affect (P > .05) the glycolysis. There was a significant effect of time in glycogen, glucose, pH and acidity, in the first 24 hours.

Differentiation of ante-mortem and post-mortem fractures with MRI: a case report

We describe a case of a fatal speed flying accident in which the victim was electrocuted, burned and fell from a great height. Post-mortem imaging revealed acute appearing fractures on CT, without bone marrow oedema on MRI. Based on the known clinical imaging findings of bone marrow oedema in acute fractures, we concluded that the speed flyer died from electrocution rather than the fall and that the fractures occurred post-mortem. Radiological imaging augmented the reconstruction of the peri-mortem events. Further research is needed to assess whether bone marrow oedema in acute fractures is a reliable vital sign.

Post-mortem radiological CT identification based on classical ante-mortem X-ray examinations

Radiological identification is important in forensic medicine. Identification using comparison of individualising structures with ante- and post-mortem conventional radiographs has been known for a long time. New radiological procedures such as computed tomography (CT) and magnetic resonance imaging (MRI) are being increasingly used for identification. In this paper, a new comparative approach using various radiological methods is described and its application demonstrated. This new approach is the comparison of ante-mortem conventional radiographs with projected images calculated from post-mortem CT data. The identification procedure will be illustrated with reference to the frontal sinus and the pelvis.

Virtopsy: fatal stab wounds to the skull--the relevance of ante-mortem and post-mortem radiological data in case reconstructions

Homicides with a survival of several days are not uncommon in forensic routine work. Reconstructions of these cases by autopsy alone are very difficult and may occasionally lead to unsatisfying results. For the medico-legal reconstruction of these cases, ante-mortem and post-mortem radiological imaging should always be included in the expertise. We report on a case of fatal penetrating stab wounds to the skull in which a case reconstruction was only possible by combining the radiological ante- and post-mortem data with the autopsy findings.

Quomodo singularis illa Jesu anxietas et tristitia ante mortem, quam Lucas [agōnian] vocat, sit explicanda, nec non cum ipsius virtute et auctoritate divina concilianda /

Text in Latin, Greek, and Hebrew.

Post-mortem use of wealth, including a consideration of ante-mortem gifts;

Mode of access: Internet.

The medico-legal importance of establishing human identity by palatal rugoscopy: evaluation of the immutability and individuality of palatal rugae under the influence of ante mortem orthodontic treatment

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Estratègies prèvies al sacrifici que poden afectar el benestar animal i la qualitat de la carn de porcs de diferent genotip RYRI

The main objective of this thesis was to study (i) the effect of the fasting and lairage on carcass and technological meat quality and (ii) the inclusion of magnesium (MgCO3 and MgSO4) and/or tryptophan during 5 days before slaughtering pigs as a strategy to decrease stress levels and improve meat quality, with two different porcine RYR1 genotypes (NN and nn). An adequate combination of fasting and lairage period is recommended. A supplement of MgCO3 or Trp did not improve meat quality under minimal stressful ante mortem conditions; and MgSO4 had a laxative effect on pigs supplemented with it. When including nn pigs to the herd, it is recommended to consider the supplements’ combination of tryptophan and a source of Mg (avoiding MgSO4) to alleviate the negative effect of the stress and to improve technological meat quality.

Sensitivity and specificity of NT-proBNP to detect heart failure at post mortem examination.

NT-proBNP, a marker of cardiac failure, has been shown to be stable in post mortem samples. The aim of this study was to assess the accuracy of NT-proBNP to detect heart failure in the forensic setting. One hundred sixty-eight consecutive autopsies were included in the study. NT-proBNP blood concentrations were measured using a chemiluminescent immunoassay kit. Cardiac failure was assessed by three independent forensic experts using macro- and microscopic findings complemented by information about the circumstances of body discovery and the known medical story. Area under the receiving operator curve was of 65.4% (CI 95%, from 57.1 to 73.7). Using a standard cut-off value of >220 pg/mL for NT-proBNP blood concentration, heart failure was detected with a sensitivity of 50.7% and a specificity of 72.6%. NT-proBNP vitreous humor values were well correlated to the ones measured in blood (r (2) = 0.658). Our results showed that NT-proBNP can corroborate the pathological findings in cases of natural death related to heart failure, thus, keeping its diagnostic properties passing from the ante mortem to the post mortem setting. Therefore, biologically inactive polypeptides like NT-proBNP seem to be stable enough to be used in forensic medicine as markers of cardiac failure, taking into account the sensitivity and specificity of the test.

Detection of hemorrhage source: the diagnostic value of post-mortem CT-angiography.

The aim of this study was to compare the diagnostic value of post-mortem computed tomography angiography (PMCTA) to conventional, ante-mortem computed tomography (CT)-scan, CT-angiography (CTA) and digital subtraction angiography (DSA) in the detection and localization of the source of bleeding in cases of acute hemorrhage with fatal outcomes. The medical records and imaging scans of nine individuals who underwent a conventional, ante-mortem CT-scan, CTA or DSA and later died in the hospital as a result of an acute hemorrhage were reviewed. Post-mortem computed tomography angiography, using multi-phase post-mortem CTA, as well as medico-legal autopsies were performed. Localization accuracy of the bleeding was assessed by comparing the diagnostic findings of the different techniques. The results revealed that data from ante-mortem and post-mortem radiological examinations were similar, though the PMCTA showed a higher sensitivity for detecting the hemorrhage source than did ante-mortem radiological investigations. By comparing the results of PMCTA and conventional autopsy, much higher sensitivity was noted in PMCTA in identifying the source of the bleeding. In fact, the vessels involved were identified in eight out of nine cases using PMCTA and only in three cases through conventional autopsy. Our study showed that PMCTA, similar to clinical radiological investigations, is able to precisely identify lesions of arterial and/or venous vessels and thus determine the source of bleeding in cases of acute hemorrhages with fatal outcomes.

Uso de métodos complementares na inspeção post mortem de carcaças com suspeita de tuberculose bovina

O objetivo foi utilizar métodos complementares de diagnóstico (histopatológicos, bacteriológicos e moleculares), no julgamento de lesões suspeitas de tuberculose observadas durante a inspeção post mortem de rotina em abatedouros. Foi acompanhado o abate e a inspeção de 41.193 bovinos, sadios ao exame ante mortem, em sete abatedouros no estado de Mato Grosso. Carcaças de 198 (0,48%) animais apresentaram lesões, sendo 182 (92,0%) classificadas como granulomatosas ou piogranulomatosas na avaliação histopatológica. Entretanto, na baciloscopia, não foi evidenciada a presença de bacilo álcool-ácido resistente (BAAR). Mycobacterium bovis foi isolado em três (1,5%) lesões, provenientes de linfonodos retrofaringeanos de bovinos com até três anos de idade. Quando usado a PCR múltipla (m-PCR) diretamente nos fragmentos de tecido, detectou-se a presença de DNA de M. bovis em 14 (7,0%) lesões, incluindo as três amostras identificadas na análise bacteriológica. O julgamento das lesões pelo exame macroscópico concordou em 93,0% (184/198) com os resultados obtidos por meio da PCR. A fim de evitar equívocos durante a avaliação, principalmente das lesões paucibacilares, como as encontradas neste estudo, recomenda-se a utilização de testes complementares rápidos e confirmatórios. A m-PCR, associada à inspeção post mortem de rotina, demonstrou ser uma técnica promissora para a vigilância da tuberculose bovina em abatedouros, contribuindo para o sucesso do programa de erradicação da tuberculose bovina.