Autopsy Research Articles

Child Neurology: Severe GMPPB-Related Congenital Muscular Dystrophy With Rapidly Progressive Encephalopathy Leading to Infantile Death.

Pathogenic variants in GMPPB cause congenital muscular dystrophy through hypoglycosylation of alpha-dystroglycan (OMIM #615350). The established phenotypic spectrum of GMPPB-related disorders includes recurrent rhabdomyolysis, limb-girdle muscular dystrophy, neuromuscular transmission abnormalities, and congenital muscular dystrophy with variable brain and eye anomalies. We report a 9-month-old male infant with congenital muscular dystrophy, infantile spasms, and compound heterozygous pathogenic variants (c.624T>G and c.1000G>A) in GMPPB who presented acutely in status epilepticus progressing to refractory hemodynamic instability and multiorgan failure leading to death 20 days after admission. Brain MRI showed a pattern of symmetric diffusion restriction consistent with possible vigabatrin toxicity and progressive cerebral volume loss. Postmortem neuropathology examination confirmed features of dystroglycanopathy including patchy loss of dystroglycan staining of muscle. This report of infantile death in an individual with a GMPPB-related disorder raises concern for potential risk of early mortality possibly exacerbated by vigabatrin toxicity.

Current Controversies in Prenatal Diagnosis 2: Conventional Postmortem Examination Remains the Gold Standard for the Anatomical Examination of Fetal Loss.

A comprehensive postmortem examination is an essential component of a work-up after stillbirth. Its findings can support accurate counseling of parents about causes and risk of recurrence. It also supports providers' decisions about most appropriate testing and management plans for future pregnancy to prevent recurrence. Informing parents about fetal autopsy and obtaining their consent is challenging, and conducting a fetal autopsy requires expertise that is, not universally available. Newer non-invasive or minimally invasive methods such as postmortem MRI and targeted biopsies can replace or supplement autopsies, but one must recognize that expertise in these methods is likewise not broadly available. This prompts the question whether a conventional postmortem examination should remain the gold standard for the anatomical examination of fetal loss. This report summarizes the "for" and "against" arguments made by two experts during a debate at the 28th International Conference on Prenatal Diagnosis and Therapy. Arguments favoring comprehensive fetal autopsy include the need to obtain the most complete and accurate information about the cause of the stillbirth. Arguments in favor of less invasive post-mortem examinations using other technologies include sufficiency in many instances and a more equitable and cost-effective approach to postmortem examination. While both debaters weighed the balance of these conflicting arguments differently, they agreed that more research in this area is needed.

Epidemiological profiles and causes of sudden deaths of various ages in Ethiopia: an autopsy-based study

Background Sudden death is an important global public health issue. An autopsy is an important source of epidemiological data, as the considerable causes of sudden death remain hermetic until postmortem examination. This study is devoted to evaluating the sociodemographic, behavioral, clinical and pathological characteristics of sudden deaths of various ages in Ethiopia. Methods This is an observational, prospective, descriptive study that included all sudden deaths observed over 1 year at St. Paul’s Hospital and Millennium Medical College, Addis Ababa, Ethiopia. Results Sudden death (n = 568) accounted for 11.5% (95% CI: 10.6-12.4) of all autopsied cases. There were 482 males and 86 females (M:F ratio of 5.6:1) and a mean age of 44.8±17.349. The peak age group was the fourth and fifth decades, accounting for 43.9% of the cases. Chronic substance abuse and a history of prior illness were declared in 40.1% and 38% of cases of sudden death, respectively. Cardiovascular (36.1%), respiratory (32.6%), and gastrointestinal system (19.5%) pathologies were the most common causes. The leading underlying causes of sudden death were ischemic heart disease and pneumonia. Most (86.6%) sudden deaths occurred outside of a hospital setting. Conclusions Most of the causes of sudden death in Ethiopia can be prevented and treated. The majority of sudden deaths are silent without preexisting symptoms. Therefore, it is vital to develop public health measures that will help educate the community about the importance of recognizing the manifestation of various clinical conditions and the need to seek immediate clinical help. Furthermore, efforts should be made to make healthcare facilities accessible and affordable with adequate diagnostic and management capacity. Documentation of autopsy-based data could provide important epidemiological information to guide medical services, prevention efforts, and control measures.

Prevalence of pulmonary anthracosis in household dogs in southwest states in Nigeria: a sentinel for environmental pollution.

Nigeria, stemming from vehicular traffic, generator sets, industrial sources, residential combustion, and road dust. Pulmonary anthracosis, the accumulation of carbon particles in the lungs, is a known risk factor for cancer. While this condition has been observed in stray dogs, data on its prevalence in household dogs is limited. This study aimed to determine the prevalence of pulmonary anthracosis in household dogs within three southwestern states of Nigeria over a decade (2011-2020) and to analyze the histopathological features of pulmonary anthracosis observed in canine lung tissue samples submitted for post-mortem examination. Lung tissue samples from 472 dog carcasses submitted to the Federal University of Agriculture, Abeokuta, and the University of Ibadan for post-mortem examination were analyzed in this study. Lesions suggestive of pulmonary anthracosis were identified through gross examination and further analyzed histologically to confirm their characteristics. The findings were presented using tables, charts, and chi-square to determine association between breed, age, and sex considering p < 0.05 as significant. Out of total lungs sampled, 150 (31.8%) were positive for pulmonary anthracosis. No significant association was found between breed (p = 0.95) or sex (p = 0.98) and anthracosis, but age was statistically significant (p = 0.01). Histopathological findings included bronchiolar smooth muscle hypertrophy (90%), severe fibrosis (80%), and bronchiolar epithelial hyperplasia (50%). The study concluded that pulmonary anthracosis is prevalent among household dogs in the region. The pathological changes highlighted the adverse effects associated with the condition in affected organs and that black carbon as a major air pollutant that poses health risks to humans and animals.

Computational forensic identification of deceased using 3D bone segmentation and registration.

The identification of deceased with unknown identity is a key task in forensic investigations. Current radiologic identification approaches are often elaborative, lack statistical evidence, and are dependent on the examiner's experience and expertise. Thus, the aim of this work was to develop a 3D computational and thus, more objective identification approach. An anonymised antemortem (AM) dataset consisting of 90 computed tomography (CT) scans containing the sternal bone and the fifth thoracic (T5) vertebra, as well as an anonymised postmortem (PM) dataset consisting of 40 CT scans containing the sternal bone and the T5 vertebra were included in this work. The PM data had corresponding AM data within the AM dataset. A custom-made python script was established to automatically perform 3D segmentation of the sternal bones and the T5 vertebrae, respectively, and to register the AM data to the PM data. The similarity between the registered AM data and the PM data was assessed via the Dice coefficient. The highest Dice score was intended to indicate a match. An accuracy of 86.7 % was achieved for the sternal bone, and 88.9 % for the T5 vertebra, respectively. In some cases, insufficient CT quality and altered bone morphology due to surgical interventions hindered correct matching. However, by combining the sternal bone and T5 vertebra for identification, the accuracy was increased to 97.8 %. Hence, the presented tool seems to be a promising 3D computational approach for objective identification of unknown deceased, which could be further adapted for other bone structures. The final tool is publicly available.

Foetal Achondroplasia: Prenatal Diagnosis, Outcome and Perspectives

Achondroplasia, due to a specific pathogenic variant in FGFR3, is the most common viable skeletal dysplasia and the diagnosis is mostly done in the prenatal period. Since 2021, the use of Vosoritide, a specific treatment for achondroplasia, validated in phase 3 placebo-controlled trials, has been recommended to significantly increase the height of children and infants. In the light of these new therapeutic prospects, a complete understanding of the pathophysiology of skeletal damages occurring from foetal life is required. To describe foetal imaging and the antenatal and postnatal management of pregnancies complicated by a diagnosis of foetal achondroplasia. A retrospective and descriptive study, including all pregnant women with a prenatal diagnosis of achondroplasia, was conducted in the prenatal unit of Necker Hospital (Paris, France) between 2009 and 2022. Maternal and obstetric characteristics and foetal imaging (ultrasound and bone CT) were collected. Pregnancy outcomes, paediatric follow-up in the case of live births, and post-mortem examination (PME) data in the case of termination of pregnancy were reported. In addition, we have prospectively developed a specific research protocol using foetal brain MRI to assess the anatomy of the foramen magnum, following the same approach currently recommended in the postnatal period. 29 cases of achondroplasia were included. Median gestational age at referral was 31+2 weeks', about 1 week after the suspected diagnosis on routine ultrasound. Shortening of the femoral length and of all the other long bones, macrocephaly, facial abnormalities, increased metaphyseal-diaphyseal angle and tapering of the proximal femoral bone were the five most prevalent ultrasound signs. Foetal diagnosis was done by the identification of the foetal FGFR3 mutation and/or by CT scans (n = 15) where specific abnormalities of the long bones, platyspondyly and abnormal profile have been described in 100 % of cases. PME revealed: i) on external examinations (n = 7) that all fetuses had very short long bones, moderate platyspondyly, small iliac wings with internal spines, macrocrania, and narrow thorax, ii) on internal examination (n = 5) all had severe abnormalities in the growth plate and particularities in the temporal cortex and hippocampal region. One foetal MRI was performed at 33 weeks' and revealed tight stenosis of the foramen magnum and compression of the spinal cord. Of the live-born infants for whom follow-up was known (n = 6), 2/6 (including the case who had a foetal MRI) required neurosurgical intervention in the first few months of life for spinal cord compression due to severe stenosis of the foramen magnum. A complete mapping of the skeletal features present in foetuses with achondroplasia is reported here, providing a better understanding of the pathophysiology of this condition. New tools such as foetal MRI, to assess the risk of postnatal severe neurological complications, could help improve the care pathway of the affected neonates.

Sudden cardiac death associated with fatty liver disease.

Fatty liver disease or steatotic liver disease (SLD) affects 25% of the global population and has been associated with heart disease. However, there is a lack of postmortem studies in the context of sudden cardiac death (SCD). To investigate the relationship between SLD and SCD. A post-mortem case-case study was conducted in victims of SCD from an ongoing community-based study in Southern California (Ventura, CA, 2015-2023). Diagnosis of SLD was determined from post-mortem liver histopathology reports. For each patient, demographic variables, laboratory values, and presence of co-morbidities were ascertained from medical records and were compared between patients with and without SLD. Of 162 individuals with SCD, there were 101 SLD cases and 61 without SLD. Individuals with SLD were found to have higher BMI (31.6±7.6 vs. 26.7±5.7, p<0.001), higher prevalence of heavy drinking (28% vs. 12%, p=0.008), heavier liver weights (2433.6g±940.6 vs 1934.7g±505.3, p<0.001), and were more often Hispanic (37 vs. 18%, p=0.01). Patients with SLD had lower prevalence of coronary artery disease (CAD) (49% vs. 70%). Multivariable logistic regression analysis showed that CAD was a negative predictor of SCD with SLD (OR = 0.35, 95% CI 0.14 - 0.83). Among adults with SCD, SLD was associated with higher prevalence of Hispanic ethnicity and lower prevalence of CAD. Given the major rise in SLD burden, these ethnicity-based differences as well as the specific nature of non-ischemic SCD etiologies warrant urgent further investigation.

Unearthing the Unexpected: First Report of Ossa Cordis in a Human Heart.

The ossa cordis (OC), or cardiac bone, is a bony structure within the cardiac skeleton of mammals, believed to maintain heart shape during systole and enhance contraction efficiency. Found in large mammals, especially ruminants, and has recently been described in chimpanzees; however, OC has not previously been described in humans. Herein, we present an incidental finding of OC in the heart of a 39-year-old man who suffered a stab wound to chest. A thorough postmortem examination revealed a 0.8 × 0.6 × 0.4-cm, well-defined, boomerang-shaped, bony structure embedded in atrioventricular node location in the right atrium within the triangle of Koch. The heart showed cardiomegaly and moderate atherosclerosis in the left anterior descending and right coronary arteries but was otherwise normal, without fibrosis, valvular abnormalities, or degenerative changes. Histological analysis revealed mature bone with trilineage hematopoietic elements. This finding highlights anatomical similarities between human hearts and other species, raising questions about whether OC in humans and primates is linked solely to degenerative cardiac disorders or represents a normal aspect of mammalian heart development and aging. To our knowledge, this is the first reported case of an OC in a human.

Silent witnesses: unveiling the epidemic of femicides in North-west Tshwane, South Africa – a decade of analysis

BackgroundFemicides, defined as the gender-based killing of women, are a pressing public health issue worldwide, with South Africa experiencing some of the highest rates globally. This study focuses on the North-west region of Tshwane, particularly the Garankuwa area, aiming to address gaps in understanding the epidemiology, demographics, circumstances, and pathology associated with femicides. The Garankuwa mortuary serves as the primary site for this investigation, providing a detailed analysis over a ten-year period, shedding light on contributing risk factors in the context of systemic gender inequality.ObjectivesThe study had four main objectives: to analyse the demographics and incidence rates of femicides in the North-west Tshwane area, to examine the circumstances surrounding femicides (including the time, location, and demographic risk factors), to identify the causes and pathological characteristics of femicides; and to observe trends in femicide rates over the ten-year study period.MethodsThis study was a retrospective cross-sectional descriptive analysis, focusing on all deceased females admitted to the Garankuwa mortuary from 2009 to 2018. The inclusion criteria comprised female cases at autopsy, with a suspected homicidal manner of death. Excluded were cases classified as suicides, accidents, or natural deaths after further examination. Data was collected through the National Injury Mortality Surveillance System (NIMSS) and cross-verified with post-mortem reports, police data and death registers.ResultsOver the ten-year period, the Garankuwa mortuary admitted an annual average of 1131 bodies, with approximately 23.5% (266) being female. Of these, 17.5% were identified as femicides. The average incidence rate of femicides was 11.2 per 100,000 female population, showing a general decline over the study period, except for notable increases in 2013 and 2016. The study found that the most common months for femicides were September and December, with most incidents occurring at home, followed by residential areas and medical facilities. The geographic analysis identified Temba, Rietgat, and Akasia as the areas with the highest number of femicide cases. Demographically, the majority of femicide victims were black, with the most affected age group being 18–39 years. The leading causes of death were gunshot wounds, sharp force injuries and blunt force trauma, with significant incidences of strangulation and asphyxial deaths, primarily affecting the neck and head regions.ConclusionThis study highlights the high incidence and distinct characteristics of femicides in the North-west Tshwane area, underscoring the role of socio-economic disparities and racial demographics. The findings emphasize the necessity for targeted prevention programs, stricter firearm control measures, and community-based violence prevention strategies. The demographic data indicate that young black women are particularly vulnerable, necessitating protective and educational initiatives tailored to this group.

Validating the Accuracy of Parkinson's Disease Clinical Diagnosis: A UK Brain Bank Case-Control Study.

Despite diagnostic criteria refinements, Parkinson's disease (PD) clinical diagnosis still suffers from a not satisfying accuracy, with the post-mortem examination as the gold standard for diagnosis. Seminal clinicopathological series highlighted that a relevant number of patients alive-diagnosed with idiopathic PD have an alternative post-mortem diagnosis. We evaluated the diagnostic accuracy of PD comparing the in-vivo clinical diagnosis with the post-mortem diagnosis performed through the pathological examination in 2 groups. In this retrospective case-control study, patients and healthy subjects who consented to the post-mortem pathological diagnosis at the UK Brain Bank were consecutively enrolled from the UK Brain Bank. Medical records were reviewed to classify participants and performance metrics were further calculated using neuropathological diagnosis as the gold standard. Four thousand five hundred seventy one subjects were eligible for the study. The clinical diagnosis group was: 1,048 Parkinson's patients and 1,242 healthy subjects. Pathology diagnosis group were: 996 Parkinson's patients and 1,288 subjects with no post-mortem abnormality. For the group of clinical diagnosis, PD diagnosis showed: sensitivity of 99%, specificity of 86%, accuracy of 90.96%, F1-Score 0.89, and a receiver operating characteristics area under the curve (ROC AUC) 0.925 (SE ± 0.006) [95% confidence interval [CI]: 0.913, 0.937], 𝑝<0.001. In this group, the most frequent pathology diagnosis among clinically misdiagnosed PD (false positive) patients was dementia with Lewy bodies (19.4%). Conversely, the most frequent clinical diagnosis among PD missed clinical diagnosis (false negative) patients was Alzheimer's disease (18.5%). Our findings confirm a still significant diagnostic error and emphasize the need for more fine and homogeneous criteria to classify idiopathic Parkinson's patients correctly. ANN NEUROL 2025.

Hyperosmolar Coma: Diagnostic Difficulties on the Clinical Example

Hyperosmolar hyperglycemic state is an acute complication of diabetes mellitus, the mortality rate of which reaches 50 %. One of the reasons for the unfavorable outcome is untimely diagnosis, which is often due to insufficient awareness of doctors regarding the features of clinical and laboratory manifestations of this diabetic complication. Hyperosmolar state often develops in older patients with polymorbidity, and neurological symptoms predominate in the clinical picture, which also complicates diagnosis and causes diagnostic errors. The article presents a clinical case of hyperosmolar hyperglycemic state, the diagnosis of which caused difficulties at all stages, including postmortem pathological examination. Initially, acute cerebrovascular accident was assumed, then the patient’s severe condition was associated with acute myocardial infarction, and based on the results of the pathological examination, a conclusion was made about sepsis and septic shock. Review of the patient’s medical history showed that the most probable diagnosis was hyperosmolar state, which developed as a result of decompensation of diabetes mellitus against the background of the inflammatory process. Severe dehydration of the patient, as the cause of her soporous state, was confirmed by the data of examination and laboratory and instrumental examination: dry skin and mucous membranes, small amount of urine, signs of blood thickening and prerenal acute renal failure. At the same time, the absence of obvious focal neurological disorders, clinically significant changes in the cardiovascular system, fever and hemodynamic disturbances did not allow, in our opinion, to associate the patient’s severe condition with acute cerebrovascular accident, myocardial infarction or septic shock. Dehydration was complicated by the development of disseminated vascular coagulation syndrome, gastrointestinal bleeding and hemorrhagic shock with a fatal outcome. This clinical case demonstrates that in differential diagnostics of diseases a more reliable approach is the analysis of the clinical picture from the point of view of the pathogenesis of disorders. Analysis of such clinical situations can serve as an aid for doctors in diagnosing hyperosmolar state.

Value of anatomopathological examination in goats with a positive comparative intradermal tuberculin test as part of a tuberculosis control programme.

Caprine tuberculosis is a chronic infectious disease caused by Mycobacterium bovis and Mycobacterium caprae. A tuberculosis control programme has been implemented using the comparative intradermal tuberculin (CIT) test. However, infection with Corynebacterium pseudotuberculsis and infection with or vaccination against Mycobacterium avium subspecies paratuberculosis (MAP) may have a negative impact on specificity. Therefore, a postmortem examination is necessary to verify the tuberculosis status of each animal where positive predictive value is low. Thirty-seven CIT-positive goats from 14 herds with a previously tuberculosis-free status were slaughtered between 2015 and 2020, and postmortem examination was carried out at the School of Veterinary Medicine of Murcia. Anatomopathological examination ruled out the presence of tuberculosis lesions. In 23 of the goats, the anatomopathological examination revealed the presence of the paucibacillary form of paratuberculosis (associated with MAP infection), and in another six goats, Corynebacterium pseudotuberculosis infection was confirmed. Positive reactors have not reappeared in any of the herds in the annual CIT tests up to the year 2023. Only those herds that sent their positive animals to the veterinary school were included in the study. Participation in the postmortem analysis was not mandatory for farmers. Anatomopathological examination is a useful, rapid and economically viable tool to determine the tuberculosis status of goat herds.

Perception, Attitude and Knowledge about Medico-Legal Post Mortem Examination: A Study on Para-Clinical Medical Students

Background: Medico-Legal Post-Mortem Examination (MLPME) is generally perceived negatively by the common population including medical students either due to their religious beliefs or due to their pre-conceived fear. Considering the preconceptions, this study is aimed to assess the attitude, perception and knowledge among the para-clinical medical students. Materials and methods: A cross sectional survey was conducted on 200 paraclinical medical students of Chattagram Maa-O-Shishu Hospital Medical College. A pretested questionnaire was used and data analyzed by SPSS22. Results: Among 200 para-clinical medical students, all attended MLPME but 96% not performed. 49% students first knew about this from TV news and from movies. 62.5% didn’t think doing MLPME was disrespectful to the body. 95.5% agreed that MLPME was necessary in medical education. 77.5% agreed that medical students should perform MLPME. 75.5% of participants felt that the MLPME they witnessed were not enough. 40.5% students were not confident on independently performing the MLPME after completion of their graduation but 39.5% were not sure. 90.5% thought MLPME necessary for all unnatural deaths. In MLPME, 94.5% knew that both external and internal examinations were done. 96.5% knew preserving viscera was necessary during MLPME on suspected case of poisoning. 77.5% thought that saturated salt solution used as preservative. Conclusion: Overall data analysis indicated that para-clinical medical students had reasonable knowledge and positive attitude on MLPME but they felt their exposure on MLPME insufficient. Chatt Maa Shi Hosp Med Coll J; Vol.23 (1); January 2024; Page 24-28

DOP031 Anti-IL-7 receptor plus anti-IL12/23 combination induces complete histological normalization in chronic colitis

Abstract Background The signaling networks perpetuating chronic inflammatory bowel disease remain unclear. Interleukin-7 (IL-7) has been previously reported to trigger the expansion of effector Th17 cells and anti-IL-7 receptor (IL-7R) antagonism to render IL23-differentiated Th17 cells susceptible to apoptosis1. We previously reported that IL-7R pathway is locally dysregulated and over-expressed in the colon mucosa of severe IBD patients and reproducibly associated with unresponsiveness to anti-TNF or anti-α4β7 integrin therapies2. We developed a humanized anti-IL7R lusvertikimab with a good PK/PD and tolerance profile in healthy volunteers3 and recently announced positive phase 2 efficacy results in ulcerative colitis after a 10 week-induction treatment period (randomized placebo-controlled CoTikiS study: NCT04882007). Methods Here, we investigated at preclinical level the additive effect of blocking IL-7R in combination with anti-IL12/23 antagonist antibody in an anti-TNF refractory adoptive T cell transfer chronic colitis mouse model as well as in-vitro on human Th17 cell differentiation in combination with anti-IL23 antibody. Results T cell-recipient mice developed a colitis characterised by the development of diarrhoea and body weight loss with post-mortem examination confirming epithelial hyperplasia and inflammatory cell infiltration into the mucosa. Anti-IL7R monotherapy at this dose was suboptimal in this model. Anti-IL-12/23 blockade in monotherapy was efficient but not enough alone to achieve complete remission at macroscopic and histological level. In contrast, administration of anti-IL-7R in combination with anti-IL12/23 mAb was associated with a strong and significant reduction in all measured colitis symptoms, macroscopic large bowel changes and all histopathological endpoints (hyperplasia, colitis severity, inflammation). When mice were treated in combination, the group was statistically different from the anti-IL12/23 monotherapy group and no statistical difference have been measured with the non-colitis group, illustrating this combination achieved complete remission including at histological mucosal healing. In vitro, we confirmed that IL-7 drives human Th17 differentiation despite IL23 blockade and that combining IL7R and IL23 blockade was efficient to prevent Th17 generation in the presence of both IL7 and IL23. Conclusion Our findings show that anti-IL-7R is well tolerated in combination with anti-IL12/23 mAb in mice and act in synergy to achieve a profound control of chronic colitis and complete histological normalization compared to monotherapy.

Genetic diversity and antigenic variability of foot-and-mouth disease virus strains in Egypt.

Foot-and-mouth disease (FMD) continues to pose a significant threat in Egypt, necessitating thorough analyses of FMD virus (FMDV) outbreaks. This study analyzed 144 suspected FMD cases across 52 animal collections during the years 2017-2018 and 2022. Recurrent FMD outbreaks in vaccinated dairy cattle were investigated. Clinical observation, postmortem examination, and histopathological analysis were conducted. Samples were subjected to reverse transcription polymerase chain reaction (RT-PCR) using group-specific in addition to serotype-specific primers, along with direct gene sequencing of the VP1 gene from positive samples, followed by phylogenetic analysis. Signs, postmortem and histopathological lesions consistent with FMD were found. Molecular identification confirmed the presence of serotype A (G-IV topotype), O (O/EA3 topotype), and serotype SAT2 (SAT2/VII/Lib-03 topotype). All detected topotypes were distinct from currently available vaccine strains. Variations in amino acid in the epitopes of the structural protein VP1 were detected. The study highlights the genetic and antigenic variability of FMDV strains circulating in Egypt, indicating potential challenges for vaccine effectiveness.

The Impact of Short-Term Formalin Fixation on Weight and Ventricular Dimensions in the Hearts of Cats and Small-to-Medium-Sized Dogs.

Organ weight and size are important data collected during post-mortem examination not only in neoplastic diseases but also in other conditions, like cardiomyopathies. As post-mortem cardiac examination is challenging, it should be performed by experienced specialists. Nonetheless, the low number of referral centres in veterinary medicine requires the shipment of formalin-fixed specimens to perform detailed post-mortem cardiac examinations. Data regarding other tissues suggest that even short-term formalin fixation can influence the organ's size and/or weight. Presently, no data are available on the impact of formalin fixation on heart weight and size in dogs and cats. The aim of this study was to evaluate the impact of short-term formalin fixation on cardiac weight and ventricular dimensions in cats and small-to-medium-sized dogs in the context of the usefulness and accuracy of referral examination. The study was conducted on 134 hearts (95 feline and 39 canine) obtained during necropsy. Each heart was dissected, cleaned, dried, and immersed in a 7% formalin solution for over 72 h. Weighing of the whole heart and measuring of the ventricular diameters was performed prior to fixation, after 24, 48, 72, and over 72 h of fixation. The study showed that in cats and small-to-medium-sized dogs, heart weight and ventricular dimensions are not significantly influenced by formalin fixation (p > 0.05). Nonetheless, the process of cleaning and drying the heart affects the organ weight significantly (p < 0.0001). The hearts of cats and small-to-medium-sized dogs can be shipped in formalin fixative for a referral opinion, as the fixation does not affect the obtained measurements.

Haematobiochemical alterations and lesion characterization induced by haemonchosis in slaughtered sheep at Gondar ELFORA abattoir, Ethiopia

Haemonchosis is a major gastrointestinal parasitic infection in sheep caused by H. contortus. An abattoir-based cross-sectional study was conducted from January to September 2024 to assess the haematobiochemical alterations and lesion characterization induced by haemonchosis in slaughtered sheep at Gondar ELFORA abattoir. The study involved 60 male local breed sheep, divided into 30 infected and 30 non-infected controls. The selection process involved postmortem examination of the abomasum tissues, incision, palpation, and visual inspection. Blood samples were taken for haematology and serum biochemical profiles, and a three cm tissue sample with typical H. contortus lesions was also taken. The study found significant reductions in hemoglobin, hematocrit, corpuscular volume, hemoglobin, and red blood cell counts in the infected group compared to the non-infected group. However, white blood cells, monocytes, neutrophils, and eosinophils were significantly higher in the infected group. Biochemical parameters showed significant reductions in total protein, albumin, globulin, and albumin-to-globulin ratio in the infected group. Erythrocyte indices indicated microcytic normochromic anemia. Gross examination revealed hemorrhages, dark brown abomasal contents, blood streaks, and a nodular lesion. Microscopic analysis revealed tissue-dwelling worms, submucosal hemorrhage, mucosal gland hyperplasia, thickened muscularis, and hyperplastic abomasal glands. The alterations in haematobiochemical parameters support the findings from gross and microscopic lesions. Thus, integrating haematobiochemical analysis with gross and microscopic lesion characterization improves the diagnosis of haemonchosis. Due to hypoproteinemia observed, it is advisable to supplement helminth-infected animals with protein-rich feeds, such as legumes.

The medico-legal interpretation of diatom findings for the diagnosis of fatal drowning: a systematic review.

The diagnostic use of the diatom test for drowning has been under investigation for more than a century. Despite continuing research, its true usefulness remains controversial and under debate. Data regarding the extent to which diatoms can penetrate the lungs and other organs of drowning victims are conflicting; similar discrepancies exist as to the presence of diatoms in the organs of living individuals; and as to the occurrence of postmortem (PM) contamination. To shed light on current understanding, we conducted a systematic review based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) to investigate how the presence of diatoms PM may be interpreted during medico-legal investigations of drowning. Following sequential screening of records based on our predetermined eligibility criteria, we assessed scientific evidence and risk of bias by use of the SPICOT framework. A total of 17 studies reporting diatom concentrations in victims of drowning, in non-drowned controls, and in non-drowned immersed controls were eligible for this review. Our findings suggest that diatom testing may be of use in medico-legal investigations, although its evidentiary value remains uncertain because both quantitative and qualitative results from the literature are insufficiently comparable. Variations in study design, methodology and reporting approach also fail to provide a comprehensive understanding of the significance of false-positive and false-negative results. Further research is warranted on antemortem and PM contamination, and on standardized autopsy and laboratory procedures, as well as on automated and certified diatom-counting and -identification systems. Moreover, since diatom taxonomy lies outside the specialty of forensic medicine, we underscore that collaboration with expert diatomologists is necessary for analysis and interpretation. Until these issues are adequately addressed, the evidentiary value of diatom testing for the diagnosis of drowning will continue to remain elusive and contentious.

Victim Verification with the Use of Deep Metric Learning in DVI System Supported by Mobile Application

This paper presents the design of a system to support the identification of victims of disasters and terrorist attacks. The system, called ID Victim (IDV), is a web application using a mobile app and data server. The DVI (Disaster Victim Identification) procedure, an international standard developed by Interpol, is used. The purpose of the IDV system is to facilitate and expedite the process of determining victims’ identities. A neural identification module was developed and trained on approximately 13,000 images from the LFW dataset and fine-tuned using 400 simulated PostMortem (PM) and AnteMortem (AM) images. Postmortem data include photographs of victims while antemortem data consist of pre-disaster photos of potential victims. The module generates a hypothesis, linking PM to AM, which is then verified. The module achieved test identification accuracy of up to 60% for 25 sample PM and AM sets. The system partially automates photo comparisons by DVI teams, improving efficiency, reducing identification time, and limiting the exposure of operators to graphic images. Implementing the system as a mobile application accelerates the process by enabling direct data entry during victim examinations on-site.

Bladder Wash: A Proof of Concept as an Alternative Specimen for Postmortem Toxicology.

In postmortem forensic investigation cases where the bladder is voided or dehydrated prior to autopsy, it is possible to wash the bladder with saline and collect the 'bladder wash' and any residual urine for toxicological analysis. While not conventional, this study aims to determine the use of bladder washes as alternative specimens in postmortem forensic toxicology. Comprehensive drug and alcohol analysis was performed on blood, urine, vitreous humor and bladder wash samples. Control studies consisted of matched bladder wash and urine samples for comparison. Authentic applicability studies were performed on bladder wash samples in cases where only blood or no urine samples were available. Bladder wash testing via the routine urine methodology were shown to have the appropriate sensitivity and specificity to serve as an alternative specimen. Specificity of the applicability studies was further improved when comparisons were corrected by evaluating individual analytes jointly with their related parent drug or metabolites. Individual and corrected sensitivity and specificity rates of above 99% were typically observed in both comparisons against urine and blood paired samples. Following drug analysis of 31 cases in which only a bladder wash was available, 57 detections from 23 different analytes were detected that otherwise would have not been obtained. This study demonstrates that standardized collection of the easily accessible bladder wash for postmortem toxicological analysis serves forensic toxicologists and pathologists with invaluable information where urine or other biological specimens are not available.