Autopsy Research Articles

Temporal dynamics in gastrointestinal helminth infections of sympatric mouse lemur species (Microcebus murinus and Microcebus ravelobensis) in Northwestern Madagascar

Madagascar's lemur populations are declining in dwindling habitats due to anthropogenic expansion and changing climatic conditions. Gastrointestinal parasites can be important indicators to assess the health status of threatened species. However, parasites, hosts and the environment are connected in complex interactions. The present study aimed to disentangle the impact of seasonal and several host-specific factors (sex, species, age, reproductive status, and body mass) on endoparasitism in two small-bodied, co-occurring lemur species (Microcebus murinus and Microcebus ravelobensis) in the Ankarafantsika National Park. Helminth prevalence and egg shedding intensity was investigated via copromicroscopic examination of 810 fecal samples that were obtained from 178 individuals across an 11-month period with a longitudinal approach via repeated captures in a 30.6 ha forest area. Both mouse lemur hosts shed seven morphologically distinct egg types (assigned to Subulura baeri, unidentified Enterobiinae, Spirura sp., Lemuricola sp., two Hymenolepididae spp., one unidentified ascarid). Postmortem examination of two deceased individuals enabled assignment of adult worms to egg morphotypes of S. baeri, Spirura sp. and one Hymenolepididae sp., supported by molecular analysis. A significant seasonal variation was observed in the occurrence of the three most common helminth species S. baeri (total prevalence 71%), unidentified Enterobiinae (46%) and Spirura sp. (38%), with a higher likelihood of infection with advancing dry season. Neither host species, sex nor reproductive status had a significant effect on gastrointestinal helminth infections. Host body mass showed pronounced seasonal changes but did not differ significantly between infected and non-infected individuals. The pathogenic effects of gastrointestinal helminths therefore likely remained within compensable limits in the studied mouse lemur populations. Our findings highlight the prominent influence of seasonal changes on helminth communities. The results of combined morphologic and genetic approaches can furthermore help to overcome limitations of parasite identification via copromicroscopy by linking egg morphology to DNA sequences.

Prevalence of Cystic Echinococcosis in Cattle Slaughtered in Kastamonu Slaughterhouse and Its Importance in Turkish Economy

This study was carried out to determine the prevalence of cystic echinococcosis (CE) in cattle slaughtered in the slaughterhouse of Kastamonu Municipality, where cattle breeding is common and to determine the economic loss in the country's economy due to this disease. A total of 5511 bovine livers were examined postmortem for CE between January and December 2021. Of the 5511 cattle, 3872 are male and 1639 are female. In the postmortem examination, the livers of the animals were examined and the number of animals with CE was calculated to be 524 and the preva-lence of the disease was 9.51%. In animals, the highest monthly prevalence was observed in July with 14.85% and the lowest prevalence in December with 3.94%. CE was the lowest with 4.94% in winter and the highest with 13.68% in summer. CE was found to be the lowest in male animals with 4.44% in winter and the highest prevalence in summer with 12.70%. The prevalence of the disease in female animals was 6.79% in winter and 21.32% in summer. Livers with CE were destroyed regardless of infection intensity. As a result of this study, with the destruction of 524 livers, 136240 TL (13859 USD) was lost to the Turkish economy. It has been stated that CE is common in Kastamonu as in Turkey and causes great economic losses.

Cognitive Decline and Other Late-Stage Neurologic Complications in Cockayne Syndrome.

Cockayne syndrome (CS) is an ultra-rare, autosomal recessive, premature aging disorder characterized by impaired growth, neurodevelopmental delays, neurodegeneration, polyneuropathy, and other multiorgan system complications. The anatomic aspects of CS neurodegeneration have long been known from postmortem examinations and MRI studies, but the clinical features of this neurodegeneration are not well characterized, especially at later stages of the disease. This was a retrospective observational study in which individuals with CS who survived beyond 18 years were ascertained at 3 centers in the United States, France, and the United Kingdom. Medical records were examined to determine the frequencies and features of the following neurologic complications: neurocognitive/neuropsychiatric decline (8 symptoms), tremors, neuropathy, seizures, and strokes. Among 18 individuals who met inclusion criteria, all but one (94.4%) experienced at least one symptom of neurocognitive/neuropsychiatric decline, with most individuals experiencing at least half of those symptoms. Most participants experienced tremors and peripheral neuropathy, with a few experiencing seizures and strokes. For individuals with available data, 100.0% were reported to have gait ataxia and neuroimaging showed that 85.7% had generalized cerebral atrophy on MRI while 78.6% had white matter changes. Symptoms of neurocognitive/neuropsychiatric decline are nearly universal in our cohort of adults with CS, suggesting that these individuals are at risk of developing neurocognitive/neuropsychiatric decline, with symptoms related to but not specific to dementia. Considering the prominent role of DNA repair defects in CS disease mechanisms and emerging evidence for increased DNA damage in neurodegenerative disease, impaired genome maintenance may be a shared pathway underlying multiple forms of neurocognitive/neuropsychiatric decline. Components of the DNA damage response mechanism may bear further study as potential therapeutic targets that could alleviate neurocognitive/neuropsychiatric symptoms in CS and other neurodegenerative disorders.

Further exploration of cardiac channelopathy and cardiomyopathy genes in stillbirth.

To explore genetic variation including whole genome copy number variation and sequence analysis of 98 genes associated with pediatric or adult cardiomyopathies, cardiac channelopathies, and sudden death in an unexplained intrauterine fetal death cohort. The study population included 55 stillbirth cases that remained unexplained after thorough postmortem examination, excluding maternal, fetal, and placental causes of stillbirth. Molecular karyotyping was performed in 55 cases and the trio exome sequencing approach was applied in 19 cases. The analysis revealed six rare variants with predicted effects on protein function in six genes (CASQ2, DSC2, KCNE1, LDB3, MYH6, and SCN5A) previously reported in cases of stillbirth or severe early onset pediatric cardiac related phenotypes. When applying strict American College of Genetics and Genomics classification guidelines, these are still variants of uncertain significance. Several potentially stillbirth-related genetic variants were detected in our cohort, adding to the growing literature on cardiac phenotype gene variation in stillbirth. However, the mechanisms of action, gene-gene interaction, and contribution of the uterine environment are still to be deciphered. In order to advance our knowledge of the genetics of unexplained fetal death, there is an evident need for international collaboration and field standardization.

Clinicopathologic Characterization of 2 Individuals With TBK1 Variants-1 Novel Splice Variant, 2 Proteinopathies: A Case Series.

Here, we report detailed clinicopathologic evaluation of 2 individuals with pathogenic variants in TBK1, including one novel likely pathogenic splice variant. We describe the striking diversity of clinical phenotypes among family members and also the brain and spinal cord neuropathology associated with these 2 distinct TBK1 variants. Two individuals with pathogenic variants in TBK1 and their families were clinically characterized, and the probands subsequently underwent extensive postmortem neuropathologic examination of their brains and spinal cords. Multiple affected individuals within a single family were found to carry a previously unreported c.358+3A>G variant, predicted to alter splicing. Detailed histopathologic evaluation of our 2 TBK1 variant carriers demonstrated distinct TDP-43 pathologic subtypes, but shared argyrophilic grain disease (AGD) tau pathology. Although all pathogenic TBK1 variants are associated with TDP-43 pathology, the clinical and histologic features can be highly variable. Within one family, we describe distinct neurologic presentations which we propose are all caused by a novel c.358+3A>G variant. AGD is typically associated with older age, but it has been described as a copathologic finding in other TBK1 variant carriers and may be a common feature in FTLD-TDP due to TBK1.

Jean-Martin Charcot: Pioneer of Neurology.

Jean-Martin Charcot, born on November 29, 1825, in Paris, France, is known as the father of neurology. During a time when neurology was not yet a recognized medical specialty, Charcot's pioneering contributions significantly advanced the field. Charcot's use of the anatomo-clinical method, which correlates clinical symptoms with anatomical findings, led to the discovery and characterization of numerous neurological conditions, including multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), Charcot's joint, and Charcot-Marie-Tooth (CMT) disease. His methodical approach to documenting clinical signs and conducting post-mortem examinations revolutionized neurological research and diagnosis, laying the groundwork for modern neurology. The anatomo-clinical methods continue to be a vital tool in neurological research and practice today. Charcot's work extended beyond clinical practice, influencing the study of neurology through his role as an educator and mentor to many, including Sigmund Freud. Despite some controversies and a reputation for being difficult to work with, Charcot's legacy endures, with his initial discoveries fostering greater awareness and the development of therapies for various neurological disorders.

Complex neural tube and skeletal malformations, resembling Chiari malformations, in two calves.

Two 1-day-old full-term female calves from different farms located in the Brazilian state of Rio Grande do Sul were unable to stand due to paresis of the pelvic limbs. Both calves had spina bifida on the spinal lumbar segment and were submitted to euthanasia due to poor prognosis. Postmortem examination revealed cerebellar herniation, caudal displacement of the brainstem, rostral deviation of the cranial nerves, caudal extension of occipital lobes, absence of dorsal lamina of lumbar vertebrae with exposed spinal cord, myelodysplasia, kyphosis, segmental spinal agenesis, renal fusion, muscular atrophy, and arthrogryposis. Histology highlighted myelodysplasia (syringomyelia and diplomyelia) and muscular atrophy. The reverse transcription-polymerase chain reactions for ruminant pestivirus were negative. Based on these lesions, the diagnosis of complex neural tube and skeletal malformations was made. A review of previous publications on calves diagnosed with these malformations, originally called Chiari or Arnold-Chiari malformations, revealed a wide range of nervous system and skeletal lesions. These variations amplified the uncertainty regarding whether all cases represent the same disorder and reinforced the importance of reconfiguring the terminology.

Safety evaluation of recombinant Newcastle disease virus expressing IBV multi-epitope chimeric live vaccine.

Newcastle Disease (ND) and Infectious Bronchitis (IB) are two significant diseases that pose threats to the poultry industry, caused by Newcastle disease virus (NDV) and Infectious bronchitis virus (IBV), respectively. Currently, the control and prevention of these diseases primarily rely on vaccination. However, commercial ND and IB vaccines face challenges such as poor cross-protection of inactivated IBV strains and interference from live vaccines when used together, leading to immunization failures. Previously, we reported the successful rescue of a recombinant NDV expressing multiple epitopes of IBV, named rNDV-IBV-T/B, which showed promising immunoprotective efficacy against both NDV and IBV. This study focuses on the biosafety of the genetically modified recombinant vaccine candidate rNDV-IBV-T/B. Immunization was performed on day-old chicks, ducklings, goslings, and ICR mice. Observations were recorded on clinical symptoms, body weight changes, and post-mortem examination of organs, as well as histopathological preparations of tissue samples. The results indicated that the rNDV-IBV-T/B vaccine candidate had no adverse effects on the growth of targeted animals (chickens) and non-target species (ducks, geese) as well as in mammals (mice). Additionally, histopathological slides confirmed that the vaccine is safe for all tested species. Further studies evaluated the potential of rNDV-IBV-T/B to spread horizontally and vertically post-immunization, and its environmental safety. The findings revealed that the vaccine candidate lacks the capability for both horizontal and vertical transmission and does not survive in the environment. In conclusion, the rNDV-IBV-T/B strain is safe and holds potential as a new chimeric live vaccine for ND and IB.

Exploring the Risks of Copulatory Trauma in Immunocompromised NOD SCID Mice

This report documents a sudden and fatal case of copulatory breeding trauma in a 7-month old NOD SCID male breeder mouse. While similar injuries in other mouse strains typically result in recovery, the immunocompromised status of NOD SCID mice significantly impairs their healing abilities and heightens their susceptibility to infections. The mouse exhibited acute lethargy, gastrointestinal distress, and penile discharge, leading to death within a few hours. Postmortem examination revealed a significantly distended bladder with hemorrhagic spots, and urine analysis showed numerous motile sperm-like structures. The findings indicate that copulatory trauma was the primary cause of death, emphasizing the need for careful monitoring and preventive measures in breeding management, particularly for immunocompromised strains.

Clinical, magnetic resonance imaging and histopathological findings of a congenital hypomyelinating leukodystrophy in a Holstein Friesian calf

AbstractA 12‐day‐old, male Holstein Friesian calf was presented to the hospital due to progressive ataxia and tremors since birth. A diffuse central nervous system disorder primarily affecting white matter was suspected based on clinical neurological examination. Blood tests were unremarkable, except for positive serology for Schmallenberg virus. Magnetic resonance imaging of the brain demonstrated severe, diffuse abnormalities primarily affecting the white matter regions of the encephalon and cranial cervical spinal cord, consistent with leukoencephalomyelopathy. Euthanasia was performed at 8 weeks of age after no clinical improvement. A postmortem examination was performed. Histopathological examination of the central nervous system revealed changes compatible with hypomyelinating leukodystrophy, with no signs of infectious agents observed. The disorder was considered most likely to be hereditary, as Schmallenberg virus infections during pregnancy in cattle have not been reported to result in such clinical, magnetic resonance imaging or histopathological findings, and no viral genomic material was identified with polymerase chain reaction.

Enhancing trauma evaluation: Comparative analysis of post-mortem computed tomography and autopsy findings in abdominal stab wounds.

In cases of traumatic deaths, accurate assessment of injuries is essential for both legal and medical purposes. This case report compares the findings of post-mortem computed tomography with conventional autopsy methods in assessing abdominal stab wounds. A 34-year-old woman with multiple stab wounds in the abdomen underwent post-mortem examination, including computed tomography imaging. Computed tomography revealed specific breaches in the skin's continuity and internal injuries, including perforation of the stomach. A conventional autopsy confirmed the presence of multiple stab wounds and associated injuries to internal structures. However, additional injuries to major blood vessels, such as the abdominal aorta and inferior vena cava, were only detected during manual exploration of the peritoneal cavity. This case highlights the complementary roles of post-mortem computed tomography and conventional autopsy in evaluating traumatic injuries. While computed tomography imaging offers non-invasive visualisation of injuries, manual examination remains essential for identifying certain injuries, particularly those affecting major blood vessels. The integration of computed tomography imaging with traditional autopsy methods enhances the accuracy and reliability of forensic assessments in cases of traumatic deaths, particularly in complex cases involving multiple injuries. Understanding the strengths and limitations of these techniques is crucial for improving forensic investigations and ultimately enhancing medico-legal outcomes.

Tension hydrothorax complicating syringopleural shunt for post-traumatic syringomyelia.

Syringomyelia is a rare phenomenon that is typically associated with Chiari malformations. However, they can occur in the setting of post-traumatic spinal injury. Potential diversion treatments include syringopleural (SPS), syringoperitoneal and syringosubarachnoid shunts. Short-term complications have been reported in the literature, however, long term complications are not well documented. This case report is of a 43-year-old woman found deceased in bed. She had a history of a traumatic spinal injury following a motor vehicle accident 15 years prior to death. This was complicated by a syringomyelia/syrinx requiring a SPS insertion. Post-mortem imaging and autopsy findings demonstrated a large right tension hydrothorax with dense fibrosis of the pleural surfaces, contralateral diffuse alveolar damage lung changes histologically and a patent SPS. Her cause of death was registered as "Right tension hydrothorax and diffuse alveolar damage complicating right syringopleural shunt and thoracic syrinx".

Meningoencephalomyelitis and brachial plexitis in a dog infected with louping ill virus.

A foxhound from a hunting kennel in the United Kingdom was euthanized after being hospitalized with progressive neurologic signs, including tremors, seizures, and obtunded mentation. No abnormalities were appreciated on gross postmortem examination. Histologically, severe meningoencephalomyelitis and mild neuritis of the brachial plexus were present. Molecular analysis of brain tissue detected louping ill virus. In addition, louping ill virus-specific antigens were detected in neurons within the brainstem, the entire length of the spinal cord, as well as in rare cells in the brachial plexus using immunohistochemistry. The genetic sequence of the virus appears most closely related to a previously detected virus in a dog from a similar geographic location in 2015. This is the first characterization of the inflammatory lesions and viral distribution of louping ill virus in a naturally infected dog within the spinal cord and brachial plexus.

Swinepox virus: an unusual outbreak in free-range pig farms in Sicily (Italy)

BackgroundTwo outbreaks of swinepox were investigated in free-range domestic pig farms located in the northeastern side of Sicily, Italy. The disease is generally self-limiting with a low mortality rate, but morbidity can reach high rates in case of poor sanitary conditions, improper husbandry practices and ectoparasitic infestation. The presented cases are the first ever reported on the island and part of the few cases reported in domestic pigs.Case presentationCarcasses condemned at the slaughterhouse and deceased pigs from Farm A and Farm B respectively, were referred for post-mortem examination and further investigations, with a strong suspect of SwinePox virus (SWPV) infection. Twelve deceased pigs were examined in total, showing poor body condition and pustular lesions scattered all over the cutaneous surfaces. Moreover, pigs from Farm B showed ocular lesions classified from Grade I to IV (from mild conjunctivitis to severe keratoconjunctivitis with corneal oedema, opacity, and ulcers). Final diagnosis was pursued by the microscopic assessment of skin lesions in both farms, which revealed the typical SWPV-lesion appearance, such as severe and disseminated ulcerative dermatitis and suspected inclusion bodies multifocally observed in the epidermis. Moreover, negative staining Electron Microscopy (nsEM) was performed on skin lesions and ocular swabs from Farm B, revealing in two samples the presence of brick-shaped viral particles, 220 nm long and 160 nm wide, with irregularly arranged surface tubules, identified as SWPV. The gene encoding the 482-bp fragment of the virus late transcription factor–3 was detected by PCR and sequencing revealed 99.79% identity and 100% query-cover with a strain previously isolated in Germany. Field clinical assessment was then performed in Farm B, revealing high overcrowding, poor sanitary conditions and improper husbandry practices, which are relevant risk factors for SWPV transmission.ConclusionsThe present is the first case report of SWPV in free-range pigs raised in Sicily, an island of the Southern coast of Italy, and wants to raise awareness on a neglected disease, and cause of animal health and welfare issues.

Sudden Death in Pediatric Patient With Dilated Cardiomyopathy Due to Founder Variant in NKX2-5: Case Report.

Background: The NKX2-5 gene encodes a transcription factor that plays a role in atrioventricular nodal and myocardial development. Pathogenic variants of NKX2-5 are associated with congenital heart disease and sudden cardiac death. The missense variant in this case is one of the more common ones in Northern Europe and has high penetrance in familial cases. To our knowledge, this is the youngest person who died due to this variant. Case summary: This was a healthy, asymptomatic 14-year-old male with well-managed mild congenital dilated cardiomyopathy who died unexpectedly in his home. Postmortem examination revealed the NKX2-5 pathogenic missense variant, p.Phe145Leu, as the only explicable cause of death. Discussion: We propose that immediate family members of those who die suddenly due to NKX2-5 disease undergo genetic counseling and longitudinal screening to include this gene, as pathogenic variants in the NKX2-5 gene may manifest in a time-dependent manner.

Relation between possible under-diagnosed/treated glucose dysmetabolism, delayed villous maturation, and lethal fetal pneumonia

BackgroundGestational diabetes mellitus (GDM) is a known risk factor for stillbirth (Rosenstein et al., 2012) [1]. Delayed villous maturation (DVM), predominantly seen in term placentas in pregnancies complicated with glucose dysmetabolism, may in part be a consequence of excessive maternal glucose leading to release of fetal insulin and other growth factors that promote excessive placental growth at the expense of villous maturation (Redline, 2012) [2]. CasesWe present three cases of under-diagnosed/treated glucose dysmetabolism in women in their first pregnancies cared for in other hospitals in the United Kingdom (UK) with the fatal fetal/neonatal outcomes and confirmed DVM in the placenta and congenital pneumonia on post-mortem examination in all three cases. ConclusionThis cluster supports a hypothesis that DVM and glucose dysmentabolism may make babies more susceptible to severe perinatal infection. All three cases received the antenatal care in their subsequent pregnancies in our unit and had confirmed glucose dysmetabolism which was treated and resulted in healthy babies.

Zdjęcia online i prawnie chronione tajemnice: możliwe konsekwencje prawne publikowania zdjęć zwłok przez personel sekcyjny

Photographs of human remains, including those captured during post-mortem examinations, are occasionally shared on social media for various reasons, extending beyond purely scientific purposes. critical questions regarding the ethical and legal boundaries concerning the publication of such materials. Notably, there is no overarching legal prohibition on the photography and dissemination of human remains. Consequently, each case demands an individual assessment, grounded in the principles of criminal law, civil liability, and ethics, particularly in the context of medical practices. This article offers a comprehensive analysis of the potential legal frameworks applicable to instances where photographs of corpses, taken during or related to autopsies, are published on social media platforms. The analysis encompasses legal guidelines governing autopsy procedures, regulations protecting the confidentiality of preparatory proceedings, the safeguarding of professional and functional secrets, laws against the desecration of corpses, and the upholding of personal rights.

Virchow's Second Protocol; a 21st-Century Review.

Rudolf Virchow published several autopsy protocols in his 1876 book on postmortem examinations. The protocols demonstrate the application of the 1875 Regulations to medicolegal practice. The book went through several editions and translations throughout the remainder of the 19th century, but the second autopsy protocol was subject to scathing criticism in 1915. This article summarizes the protocol and reviews the criticism, historic context, and conclusions. Application of 21st-century practice principles is also attempted in order to test the durability of Virchow's methods and protocol across centuries.

Profile of unnatural deaths in adult females – A retrospective study conducted at a tertiary care hospital in Haryana

Unnatural deaths, including unintentional and intentional events, require post-mortem examinations to rule out foul play. Women aged 18 to 30 are particularly vulnerable to mental, physical, psychological, and social challenges, including dowry-related deaths and occupational hazards. Unfortunately, female victimization is often underreported and research on the topic is limited. This study took into account 1564 post-mortem records of cases conducted in 5 years and analysed cases of unnatural deaths in adult females aged over 18 years to understand the gravity of female victimization in the region. Of the 204 identified cases, poisoning was the leading cause of death, and suicide was the most common manner of death. Accidental deaths were the second most common manner.: The study highlights the need for policies to address socio-economic and human rights deprivation, domestic violence, and mental health issues that contribute to these deaths. Measures to promote female economic independence and effective prevention and support strategies are necessary to reduce the prevalence of unnatural deaths among women in India.

Brain Abscesses in Domestic Ruminants: Clinicopathological and Bacteriological Approaches.

Brain abscesses in ruminants often arise from primary infection foci, leading to an unfavorable prognosis for affected animals. This highlights the need for comprehensive studies on brain abscesses across different ruminant species. We retrospectively investigated medical records of epidemiological, clinical, neuroimaging, anatomopathological, and bacteriological findings in six ruminants (three goats, two cows, and one sheep) diagnosed with brain abscesses. All animals studied were female. Apathy (50%), compulsive walking (33%), decreased facial sensitivity (33%), head pressing (33%), seizures (33%), semicomatous mental status (33%), strabismus (33%), unilateral blindness (33%), and circling (33%) represented the most common neurologic signs. Leukocytosis and neutrophilia were the main findings in the hematological evaluation. Cerebrospinal fluid (CSF) analysis revealed predominant hyperproteinorrachia and pleocytosis. In three cases, computed tomography or magnetic resonance imaging were used, enabling the identification of typical abscess lesions, which were subsequently confirmed during postmortem examination. Microbiological culture of the abscess samples and/or CSF revealed bacterial coinfections in most cases. Advanced imaging examinations, combined with CSF analysis, can aid in diagnosis, although confirmation typically relies on postmortem evaluation and isolation of the causative agent. This study contributes to clinicopathological aspects, neuroimages, and bacteriological diagnosis of brain abscesses in domestic ruminants.