Journal articles: 'Post-mortem care'

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Hocking, M. "Coroner's post-mortem reports." Emergency Medicine Journal 7, no. 1 (March 1, 1990): 55–56. http://dx.doi.org/10.1136/emj.7.1.55.

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Stoner, Marilyn. "Conceptual Analysis of Post Mortem Care (520)." Journal of Pain and Symptom Management 39, no. 2 (February 2010): 415. http://dx.doi.org/10.1016/j.jpainsymman.2009.11.168.

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Wilson, Keith. "Intermediate Care: From Innovation to… Post‐Mortem?" Journal of Integrated Care 11, no. 6 (December 2003): 4–6. http://dx.doi.org/10.1108/14769018200300052.

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Mort, Thomas C., and Neil S. Yeston. "The relationship of pre mortem diagnoses and post mortem findings in a surgical intensive care unit." Critical Care Medicine 27, no. 2 (February 1999): 299–303. http://dx.doi.org/10.1097/00003246-199902000-00035.

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Petrov, Gennadiy, Marina Erugina, and Irina Krom. "Post-mortem and living donation: ethical and legal issues." Glavvrač (Chief Medical Officer), no. 3 (March 1, 2020): 66–71. http://dx.doi.org/10.33920/med-03-2003-07.

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The article is devoted to ethical and legal issues of organ donation. The authors analyze the main concepts of the Russian legislation concerning health care in relation to living and postmortem organ donors. The results indicate the need to specify legal norms for this type of health care and assess complex issues of organ donation on the basis of sociological approaches.

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Dimopoulos, George, Michael Piagnerelli, Jacques Berré, Isabelle Salmon, and Jean-Louis Vincent. "Post mortem examination in the intensive care unit: still useful?" Intensive Care Medicine 30, no. 11 (October 7, 2004): 2080–85. http://dx.doi.org/10.1007/s00134-004-2448-5.

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Zijlstra, J. G., J. J. M. Ligtenberg, J. E. Tulleken, and T. S. van der Werf. "Post mortem examination in the intensive care unit: still useful?" Intensive Care Medicine 31, no. 2 (December 30, 2004): 311. http://dx.doi.org/10.1007/s00134-004-2526-8.

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Vincent, Jean-Louis, George Dimopoulos, and Isabelle Salmon. "Post mortem examination in the intensive care unit: still useful?" Intensive Care Medicine 31, no. 2 (December 22, 2004): 312. http://dx.doi.org/10.1007/s00134-004-2527-7.

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Rachet-Darfeuille, V. "Lecture des dispositions législatives relatives aux prélèvements scientifiques post mortem." Réanimation Urgences 8, no. 4 (July 1999): 331–34. http://dx.doi.org/10.1016/s1164-6756(99)80090-5.

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Dal Santo, Matthew J. "Philosophy, Hagiology and the Early Byzantine Origins of Purgatory." Studies in Church History 45 (2009): 41–51. http://dx.doi.org/10.1017/s0424208400002400.

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On 8 June 1438, the Council of Ferrara-Florence began proceedings aimed at the reunion of the Eastern and Western Churches. One of the first issues discussed was the Latin doctrine of purgatory. This article examines a particular moment in the divergence of eschatological doctrine between the Latin, Greek and Syriac Churches – indeed, representatives of the West Syrian ‘Jacobites’ and East Syrian ‘Nestorians’ were at Ferrara too. It argues that a debate concerning the post mortem activity of the saints proved crucial for the formation of various Christian eschatological orthodoxies. The catalyst for this debate was the sixth-century revival of Aristotelian philosophy, especially Aristotelian psychology which emphasized the soul’s dependence on the body. This threatened the cult of the saints and the Church’s sacramental ‘care of the dead’. Defenders of the hagiological and cultic status quo rejected Aristotle’s claims and asserted the full post mortem activity of the soul after separation from the body by developing a novel doctrine of immediate post mortem judgement. This led to the formulation of eschatological opinions which, if not normative in their day, came to be considered so by later generations. One of these ideas was post mortem purgation.

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Jonigk, Danny, Bruno Märkl, and Julie Helms. "COVID-19: what the clinician should know about post-mortem findings." Intensive Care Medicine 47, no. 1 (November 3, 2020): 86–89. http://dx.doi.org/10.1007/s00134-020-06302-0.

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Bell, Jeanne E. "Is Post Mortem Practice in Terminal Decline and Should We Care?" Practical Neurology 4, no. 5 (October 2004): 257–59. http://dx.doi.org/10.1111/j.1474-7766.2004.00255.x.

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Joshi, Rajiv, Ashwini Kumar, Gurjeet Singh, Alwin Varghese, Ravdeep Singh, and Harvinder S. Chhabra. "Estimation of Time Since Death from Rigor Mortis - An Autopsy Study in Tertiary Care Hospital of Malwa Region of Punjab state of India." INTERNATIONAL JOURNAL OF ETHICS, TRAUMA & VICTIMOLOGY 7, no. 02 (December 31, 2021): 10–15. http://dx.doi.org/10.18099/ijetv.v7i02.3.

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Background: Postmortem interval estimation is an important tool in forensic medicine. Estimating time since death is extremely important in cases where there is doubt about the period of death. After death, many changes occur in a regular sequence and can be used to arrive at an approximate time since death. When a post-mortem is conducted, doctor conducting the post-mortem examination has to give his opinion about post-mortem interval i.e. the probable time that elapsed between death and post-mortem examination even in cases of decomposed dead bodies. While giving this opinion, we always think we should have some other dependable methods to be more accurate in answering this question. Algor mortis, Rigor mortis, and Livor mortis have been the basis for ascertaining the post-mortem interval collectively. Among them, Rigor Mortis is an important indicator of post-mortem interval. Although it is a dependable tool for estimating post-mortem interval, it is influenced by many endogenous and exogenous factors like nature of death, nature of the body, temperature, humidity etc. Time of death is almost always asked by investigating authorities to connect the crime with criminals. Determining the death time has always been a topic of keen interest amongst forensic pathologists from its inception to date. Many workers in forensic medicine have tried to investigate to determine the time of death based on post mortem findings. To date, it is still an important and fascinating criterion to ascertain the time since death. With this study, we aimed to demonstrate the intricacies of Rigor Mortis with fluctuating temperature and humidity of the local region. We planned to estimate and compare the post-mortem interval based on Rigor Mortis in different body muscles. Materials and Methods: This study was conducted in the Department of Forensic Medicine and Toxicology at G.G.S. Medical College, Faridkot after taking clearance from the institutional ethics committee. Thirty medico-legal autopsy cases were included in the study where the exact time of death was known and included only hospital deaths. The relatives of the deceased were explained the purpose and nature of the study and provided with the patient information sheet and informed consent was taken. The details of the cases were noted from the hospital bed head ticket, relative interview and the police inquest papers. The exact temperature and humidity were noted at the start of autopsy using a digital hygrometer. Results: A total of 30 cases were observed out of which males outnumbered the females by approximately 3:1. Maximum cases consisted of Roadside Accidents (43.3%) followed by poisoning, assault and hanging, in that order. The average temperatures during the study months varied from a maximum of 41.3°C (June) to a minimum of 33.7°C (July). The average humidity varied from a maximum of 62.6% (July) to a minimum of 29.3% (May). The average temperatures during the study months varied from a maximum of 41.3°C (June) and a minimum of 33.7°C (July). The average humidity during the study months varied from a maximum of 62.6 % (July) and a minimum of 29.3% (May). Fully established Rigor Mortis was observed at a minimum of 10 hours and a maximum of 29 hours in May and June.

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Podbregar, M., E. Kralj, R. Čičak, and A. Pavlinjek. "A Triad Algorithm for Analysing Individual Ante- and Post-Mortem Findings to Improve the Quality of Intensive Care." Anaesthesia and Intensive Care 39, no. 6 (November 2011): 1086–92. http://dx.doi.org/10.1177/0310057x1103900617.

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Autopsy is an important source of data for education and quality control. The aim of this study was comparison of ante- to post-mortem findings to detect weak points of intensive care unit (ICU) care. Patients who died in our 14-bed university medical ICU care and underwent an autopsy examination over 20 months (September 2007 to May 2009) were included. Modified Goldman's criteria were used to categorise discrepancies between diagnoses and post-mortem findings. A triad algorithm was constructed to analyse individual ante- to post-mortem findings. One hundred and seventy post-mortem examinations were conducted (45.6% autopsy rate). Major diagnostic discrepancies were detected in 20 patients (11.8%); four class I (2.4%) and 16 class II (9.4%). Massive pulmonary embolism with cardiac arrest was the most common class I discrepancy (75%). Triad analysis of major class I discrepancies showed that all patients had a history of chronic disease; the majority (75%) had a short ICU length of stay. In 75% adequate tests were used to detect disorders. There were interpretation problems of bedside data in complex emergency clinical conditions, especially with less experienced ICU physicians. Inappropriate or incorrectly interpreted diagnostic procedures were performed in more than half of cases with class II discrepancies (9/16, 56%). Abdominal ultrasonography was misleading in 31% (5/16) cases with class II discrepancies. In conclusion, triad algorithm analysis revealed problematic interpretation of bedside diagnostics in emergency cases by inexperienced physicians in class I major discrepancies detected at autopsy. No correct test and wrong interpretation of abdominal ultrasonography were major causes of class II discrepancies.

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Leadbetter, K. Z., Z. A. Vesoulis, F. V. White, R. E. Schmidt, G. Khanna, J. S. Shimony, and A. M. Mathur. "The role of post-mortem MRI in the neonatal intensive care unit." Journal of Perinatology 37, no. 1 (September 22, 2016): 98–103. http://dx.doi.org/10.1038/jp.2016.156.

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Maris, Calliope, Benoît Martin, Jacques Creteur, Myriam Remmelink, Michael Piagnerelli, Isabelle Salmon, Jean-Louis Vincent, and Pieter Demetter. "Comparison of clinical and post-mortem findings in intensive care unit patients." Virchows Archiv 450, no. 3 (January 25, 2007): 329–33. http://dx.doi.org/10.1007/s00428-006-0364-5.

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Camut, Stéphanie, Antoine Baumann, Véronique Dubois, Xavier Ducrocq, and Gérard Audibert. "Non-therapeutic intensive care for organ donation." Nursing Ethics 23, no. 2 (December 8, 2014): 191–202. http://dx.doi.org/10.1177/0969733014558969.

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Background and Purpose: Providing non-therapeutic intensive care for some patients in hopeless condition after cerebrovascular stroke in order to protect their organs for possible post-mortem organ donation after brain death is an effective but ethically tricky strategy to increase organ grafting. Finding out the feelings and opinion of the involved healthcare professionals and assessing the training needs before implementing such a strategy is critical to avoid backlash even in a presumed consent system. Participants and methods: A single-centre opinion survey of healthcare professionals was conducted in 2013 in the potentially involved wards of a French University Hospital: the Neurosurgical, Surgical and Medical Intensive Care Units, the Stroke Unit and the Emergency Department. A questionnaire with multiple-choice questions and one open-ended question was made available in the different wards between February and May 2013. Ethical considerations: The project was approved by the board of the Lorraine University Diploma in Medical Ethics. Results: Of a total of 340 healthcare professionals, 51% filled the form. Only 21.8% received a specific education on brain death, and only 18% on potential donor’s family approach and support. Most healthcare professionals (93%) think that non-therapeutic intensive care is the continuity of patient’s care. But more than 75% of respondents think that the advance patient’s consent and the consent of the family must be obtained despite the presumed consent rule regarding post-mortem organ donation in France. Conclusion: The acceptance by healthcare professionals of non-therapeutic intensive care for brain death organ donation seems fairly good, despite a suboptimal education regarding brain death, non-therapeutic intensive care and families’ support. But they ask to require previously expressed patient’s consent and family’s approval. So, it seems that non-therapeutic intensive care should only remain an ethically sound mean of empowerment of organ donors and their families to make post-mortem donation happen as a full respect of individual autonomy.

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Puntis, J. W. L., and D. I. Rushton. "Pulmonary intravascular lipid at neonatal post mortem: a ten year prospective study." Clinical Nutrition 9 (January 1990): 8. http://dx.doi.org/10.1016/0261-5614(90)90165-o.

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MD, YOEL DONCHIN, AVRAHAM RTVKIND MD, YAACOV BAR ZIV, and MICHAEL DRESCHER MD. "POST MORTEM COMPUTERIZED TOMOGRAPHY IN TRAUMA VICTIMS. A NEW METHOD OF PM DIAGNOSIS." Journal of Trauma: Injury, Infection, and Critical Care 35, no. 1 (July 1993): 161. http://dx.doi.org/10.1097/00005373-199307000-00039.

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Hau, Sofie Olsson, Jasmine Webster, Alexandra Petersson, Jakob Eberhard, David Gisselsson, and Karin Jirström. "Abstract B024: Exploring the temporal dynamics of pancreatic cancer through post-mortem tumor analysis: A pilot case study." Cancer Research 82, no. 10_Supplement (May 15, 2022): B024. http://dx.doi.org/10.1158/1538-7445.evodyn22-b024.

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Abstract Introduction Pancreatic cancer is a lethal disease with an incidence little higher than the mortality rate. Great advances in oncology have been made in recent years with new treatment strategies for many cancers, leading to substantial improvement in patient outcome. The prognosis for pancreatic cancer patients, however, remains dismal and chemotherapy is still standard of care. An increased understanding of the temporal evolution and resistance mechanisms of pancreatic cancer during chemotherapy is necessary to improve patient outcome. To this end, the Chemotherapy, Host response And Molecular dynamics in Periampullary cancer study (CHAMP) was initiated in 2018. It is an ongoing, prospective observational trial in which blood samples are taken from patients at each chemotherapy cycle. Recently, the CHAMP- Extended Tissue Analysis (ETA) study was initiated, wherein selected patients enrolled in the CHAMP-study undergo targeted autopsies. The aim of this study was to compare the expression of selected immunohistochemical (IHC) markers and the quality of DNA in tumor tissue from an ante-mortem resected metastasis to the ileum and post-mortem collected tumor tissue in the first patient enrolled in the CHAMP-ETA study. Methods The autopsy was performed by a senior pathologist in accordance with standard procedure guidelines and all visible tumor was collected for analysis. The post-mortem interval (PMI) was 44 hours. Multiple tissue cores from formalin-fixed paraffin-embedded tumor tissue from the surgical resection and different tumor sites from the autopsy were assembled into a single tissue microarray (TMA) block. DNA was extracted from adjacent tissue cores obtained in parallel with the TMA-construction, and the quality examined by qPCR. IHC staining of standard diagnostic markers CK7, CK20, CDX2 and the proliferation marker Ki67 was performed on the TMA. Results In line with the expected, both normal and tumor tissue in the pancreas displayed a higher degree of autolysis compared to the metastases. Tumor areas surrounded by a more dense stroma tended to be less autolytic. CK20 and CDX2 expression was negative in all samples, both ante-mortem and post-mortem. CK7 was highly expressed in all tumor samples with an ever-stronger intensity in the post-mortem samples. Of note, CK7 was also strongly expressed in the tumor stroma of the post-mortem samples, but not in the pre-mortem samples. Ki67 expression was significantly higher in ante-mortem than in post-mortem samples. The extracted DNA was of sufficient quality in all tested post-mortem samples. Conclusion The results demonstrate that the DNA quality is sufficient after a PMI of 44 hours. The conditions for IHC staining are less optimal but may be sufficient for some markers. Access to post-treatment tumor tissue is an important complement to on-treatment biomarker studies, and of vital importance to understand the molecular events leading to terminal disease. Citation Format: Sofie Olsson Hau, Jasmine Webster, Alexandra Petersson, Jakob Eberhard, David Gisselsson, Karin Jirström. Exploring the temporal dynamics of pancreatic cancer through post-mortem tumor analysis: A pilot case study [abstract]. In: Proceedings of the AACR Special Conference on the Evolutionary Dynamics in Carcinogenesis and Response to Therapy; 2022 Mar 14-17. Philadelphia (PA): AACR; Cancer Res 2022;82(10 Suppl):Abstract nr B024.

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Κηπουρίδου (Kalliopi Kipouridou), Καλλιόπη, and Μαρία Μιλαπήδου (Maria Milapidou). "Το νομοθετικό πλαίσιο της μεταθανάτιας γονιμοποίησης σε Ελλάδα και Σουηδία." Bioethica 4, no. 1 (February 22, 2018): 55. http://dx.doi.org/10.12681/bioeth.19698.

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Post-mortem fertilization is one of the most controversial methods of M.AR., the implementation of which raises a number of legal, religious, moral and social concerns. Therefore the study of the issue deserves particular attention, as the legislator is faced with unprecedented challenges. This method became possible due to cryopreservation of gametes and fertilized eggs.Several arguments have been presented both for and against this particular form of reproductive technique. Under Greek law, post-mortem fertilization is permissible provided that specific strict requirements are met according to the regulatory framework. Failure to comply with legal requirements entails civil, criminal and administrative consequences.On the contrary, the Swedish legislator has chosen to ban post-mortem fertilization, since the basic requirement to perform M.A.R. applications is that the donors of the genetic material to be alive. This restriction even excludes the use of cryoperserved fertilized eggs. However, in Sweden a debate has been developed on whether post-mortem fertilization should be allowed if the use of the method of reproductive care has begun before the death of the father or the mother. In any case, it is necessary to fully clarify all issues that arise in order to ensure legal certainty and children born through this technique are fully protected by enjoying the rights that the other children born either naturally or by using some other form of M.A.R. enjoy.

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Reed, Kate, and Julie Ellis. "Uncovering Hidden Emotional Work: Professional Practice in Paediatric Post-Mortem." Sociology 54, no. 2 (August 28, 2019): 312–28. http://dx.doi.org/10.1177/0038038519868638.

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The concepts of emotional labour and emotion management have been extensively explored across a range of health and social care occupations. Less is known about emotionality in ‘hidden’ and ‘taboo’ realms of health work. Drawing on data from an ethnographic study on fetal and neonatal post-mortem, we explore the ways in which professionals across occupation and status positions both articulate and manage their emotions. Post-mortem involves a range of practices which take place around the edges of life and death, medicine and hospital space. Although often concealed from members of the public (and from some professionals), such practices tend to be highly valued by professionals and parents. Our analysis moves beyond the current sociological focus on occupation, illuminating instead how emotional work is performed across multi-disciplinary teams in this secret context. In doing so we seek to contribute to the conceptual and empirical development of the sociology of emotion work.

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Outin, H., and R. Gay. "Les prélèvements scientifiques post mortem contribuent en 1999 à l'exercice d'une médecine de qualité." Réanimation Urgences 8, no. 4 (July 1999): 327–30. http://dx.doi.org/10.1016/s1164-6756(99)80089-9.

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Michaut, Carine, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, and Xavier Ducrocq. "An assessment of advance relatives approach for brain death organ donation." Nursing Ethics 26, no. 2 (June 23, 2017): 553–63. http://dx.doi.org/10.1177/0969733017708331.

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Background: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. Research design: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called ‘Prélor’. Participants: The study population comprised 460 physicians and nurses in the Neurosurgical, Surgical and Medical Intensive Care Units, the Stroke Units and the Emergency Departments. Ethical considerations: The project was approved by the board of the Lorraine University Diploma in Medical Ethics and the Prélor Network administrators. Main findings: A slight majority of 53.5% of respondents had previously participated in an advance relatives approach: 83% of the physicians and 42% of the nurses. A majority of healthcare professionals (68%) think that the main justification for advance relatives approach is the comprehensive care of the dying patient and the research of his or her most likely opinion (74%). The misunderstanding of the related issues by relatives is an obstacle for 47% of healthcare professionals and 51% think that the answer given by the relatives regarding the most likely opinion of the person regarding post-mortem organ donation really corresponds to the person opinion in only 50% of the cases or less. Conclusion: Time given by advance approach should be employed to help and enable relatives to authentically bear the values and interests of the potential donor in the post-mortem organ donation discussion. Nurses’ attendance of advance relatives approach seems necessary to enable them to optimally support the families facing death and post-mortem organ donation issues.

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Ismet, Zhansila, Kamila Sharmetova, Zhasulan Baymakhanov, Erbol Serikuly, Shokan Kaniev, Aidar Skakbayev, Manas Seisembayev, et al. "Study of public opinion on post-mortem donation in the Republic of Kazakhstan." Journal "Medicine" 9-10, no. 219-220 (January 20, 2021): 2–10. http://dx.doi.org/10.31082/1728-452x-2020-219-220-9-10-2-10.

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Goal. Find out the opinion of the Kazakh population about post-mortem organ donation to save the lives of patients with terminal diseases of organs in need of transplantation. Material and methods. The survey was conducted in the form of an anonymous online questionnaire. Our study involved 1176 people, of these, 309 are male and 867 are female. The survey participants were citizens of different regions of the country and different nationalities, the average age of the participants was 38.7±1 years (18-73 years). Results and discussion. 422 participants (36%) agreed to become a posthumous donor, and 644 (55%) refused to donate. 88 (7.6%) of the participants doubted their choice, the other 22 participants did not answer this question. During the survey, out of 1,176 respondents, 991 (84%) participants know that organ transplantation is being carried out in the country, of which 384 (38.7%) participants agree to post-mortem donation, and 607 (61.2%) participants refuse post-mortem donation. 185 (16%) participants are not informed that organ transplantation is being performed in the country, of which 49 (26.5%) participants agree to post-mortem donation, and 136 (73.5%) participants refuse post-mortem donation. As a result, it was found that informed participants agreed to post-mortem donation in 38.7% of cases, and uninformed participants agreed in only 26.5% of cases. Conclusion. For the development of organ transplantation from a cadaveric donor in Kazakhstan, it is necessary to inform the population about organ transplants carried out in large transplant centers of the country, and with good long-term results, to inform the population about the laws of the Republic of Kazakhstan on organ transplantation. It is very important for the population to guarantee security and huge support from the government of the country. In addition, for the development of organ transplantation from a posthumous donor in Kazakhstan, a lot depends not only on the population of the country itself, but also on social, moral, ethical, economic, and humanitarian support from the state government. Organ transplantation from a post-mortem donor is one of the most complex types of medical care, requiring a high level of professional and material support and coordinated actions at all levels of management. This area cannot develop without the support of society, the government, as well as without a positive view of the population. Keywords: organ transplantation, donor, opinion of the population of Kazakhstan.

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Chaurasia, Zini, Swapnil Agarwal, Renu Gupta, Cheta Singh, and Dishant Kumar Malik. "Analysis of undiagnosed neoplasms identified at post-mortem: A descriptive study." IP International Journal of Forensic Medicine and Toxicological Sciences 6, no. 4 (January 15, 2022): 158–63. http://dx.doi.org/10.18231/j.ijfmts.2021.033.

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Autopsy which is also known as post-mortem examination has been derived from the greek term “autopsia” meaning “to see for one self”. Autopsies performed by the forensic medicine specialists are followed by histopathological examination of various concerned organs for underlying cause of death. histopathological examination of various organs thus always present an interesting plethora of unsuspected findings. These findings could have been present ante mortem with symptoms or completely asymptomatic. The undetectable lesions could have contributed to the death of the person. There fore the alertnesss and inquisitiveness of a pathologist while examining the autopsy cases can contribute significantly towards the subject of pathology and also serve as a learning process for the clinician to establish clinicopathological correlations. This study has been conducted with the following aims & objectives in mind:To analyse the neoplastic lesions detected incidentally on histopathology and correlate with the symptoms if any present ante mortem. Settings and design: this is a retrospective, descriptive study done in the department of pathology, dr. bsa hospital, delhi.A retrospective study of medicolegal autopsies for five years was undertaken in a tertiary care centre to analyse the tumors incidentally detected on histopathological examination. Autopsy records of 663 cases were reviewed and cases where a histopathological diagnosis of tumor was given were included in our study. Gross and histopathologic findings were noted and the salient features were studied. Clinical data of these cases were noted in detail from the forensic post mortem records and tabulated. This study includes 12 cases of tumor out of 663 cases. Most common benign tumor was leiomyoma and most common malignant tumor was adenocarcinoma. An interesting case of hodgkins lymphoma in spleen and liver was also documented. A single case of meningioma, squamous cell carcinoma metastasis to heart and astrocytic tumor were noted.This study highlights the various undetected tumors both benign and malignant. This study also gives a perspective to correlate ante mortem findings with post mortem findings to the clinician and pathologist.

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Mentink, Max G., Bartholomeus G. H. Latten, Frans C. H. Bakers, Casper Mihl, Roger J. M. W. Rennenberg, Bela Kubat, and Paul A. M. Hofman. "Clinical Relevance of Unexpected Findings of Post-Mortem Computed Tomography in Hospitalized Patients: An Observational Study." International Journal of Environmental Research and Public Health 17, no. 20 (October 18, 2020): 7572. http://dx.doi.org/10.3390/ijerph17207572.

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Background and objective: The current literature describing the use of minimally invasive autopsy in clinical care is mainly focused on the cause of death. However, the identification of unexpected findings is equally important for the evaluation and improvement of daily clinical care. The purpose of this study was to analyze unexpected post-mortem computed tomography (PMCT) findings of hospitalized patients and assess their clinical relevance. Materials and methods: This observational study included patients admitted to the internal medicine ward. Consent for PMCT and autopsy was requested from the next of kin. Decedents were included when consent for at least PMCT was obtained. Consent for autopsy was not obtained for all decedents. All findings reported by PMCT were coded with an International Classification of Diseases (ICD) code. Unexpected findings were identified and subsequently categorized for their clinical relevance by the Goldman classification. Goldman class I and III were considered clinically relevant. Additionally, correlation with autopsy results and ante-mortem imaging was performed. Results: In total, 120 decedents were included and evaluated for unexpected findings on PMCT. Of them, 57 decedents also underwent an autopsy. A total of 1020 findings were identified; 111 correlated with the cause of death (10.9%), 508 were previously reported (49.8%), 99 were interpreted as post-mortem changes (9.7%), and 302 were classified as unexpected findings (29.6%). After correlation with autopsy (in 57 decedents), 24 clinically relevant unexpected findings remained. These findings were reported in 18 of 57 decedents (32%). Interestingly, 25% of all unexpected findings were not reported by autopsy. Conclusion: Many unexpected findings are reported by PMCT in hospitalized patients, a substantial portion of which is clinically relevant. Additionally, PMCT is able to identify pathology and injuries not reported by conventional autopsy. A combination of PMCT and autopsy can thus be considered a more comprehensive and complete post-mortem examination.

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Kendall, I. G., S. M. Wynn, and D. N. Quinton. "A study of patients referred from A&E for coroners post-mortem." Emergency Medicine Journal 10, no. 2 (June 1, 1993): 86–90. http://dx.doi.org/10.1136/emj.10.2.86.

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Badder, D., L. Dykes, P. Cutting, and M. Lord. "Are pathologists tarnishing TARN? TARN performance and the precision of post-mortem reports." Emergency Medicine Journal 26, Suppl 1 (September 9, 2009): 8. http://dx.doi.org/10.1136/emj.2009.082081h.

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Rusu, Stefan, Philomène Lavis, Vilma Domingues Salgado, Marie-Paule Van Craynest, Jacques Creteur, Isabelle Salmon, Alexandre Brasseur, and Myriam Remmelink. "Comparison of antemortem clinical diagnosis and post-mortem findings in intensive care unit patients." Virchows Archiv 479, no. 2 (February 13, 2021): 385–92. http://dx.doi.org/10.1007/s00428-020-03016-y.

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AbstractAutopsy 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.

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Jabin, Nashat, KM Moinuddin, Parveen Sultana, Md Ridwanur Rahman, and AM Selim Reza. "Analysis of Post Mortem Findings in Suicidal Hanging- Study in a Tertiary Care Hospital." Journal of Shaheed Suhrawardy Medical College 13, no. 1 (August 4, 2022): 36–40. http://dx.doi.org/10.3329/jssmc.v13i1.60929.

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Background: Suicide is the act of intentionally taking your own life. Hanging is always suicidal unless otherwise proved. It is a from of violent asphyxial death. It produces painless death for the victims so that it is a widely practiced method of suicide. Every year, 8 lac people die for hanging. In Bangladesh hanging in one of the Commonest methods of suicide. Objectives: The objective of this study was to find out Socio-demographic characterizes of victims, common ligature materials used by victims and post mortem findings. Materials and method: A retrospective cross sectional study was done in Shaheed Suhrawardy Medical College mortuary during the period of July 2018 to December 2020. During this period data were collected from 1815 cases of medico legal autopsies by purposive sampling. Results: A total of 1815 medico legal autopsies were analysed of which 818 (45.06%) were deaths due to hanging. out of these 818 cases maximum 395(48.28%) deaths due to hanging were in age group of 21-30 years. Majority of the cases 546(66.74%) were observed in female and others in male 272(33.25%). Majority 425 (51.95%) of victims had used Dopatta (Orna) as a ligature material. Cyanosis of finger tips and nail beds was the commonest 797 (97.43%) finding in cases of asphyxia death due to hanging. Conclusion: In this study all the cases of hanging were suicidal and no case of post-mortem hanging was documented. Majority of the victims were between 21-30 of age (48.28%). Twothirds of them were females. Most frequent occupation was students. More than two thirds belonged to low socio-economic condition and none of the case were from higher socio-economic condition. More than 70% victims were found inside house with locked door. In more than threefourth of the cases, the ligature material was dopatta (orna), apparently because of cost and availability. In most cases the point of suspension was ceiling fan. Complete hanging was most frequent type of hanging. Other external and internal autopsy findings were like book picture. J Shaheed Suhrawardy Med Coll 2021; 13(1): 36-40

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Conley, Carol E. "Student nurses' end-of-life and post mortem care self-efficacy: A descriptive study." Nurse Education Today 121 (February 2023): 105698. http://dx.doi.org/10.1016/j.nedt.2022.105698.

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Hanlon, Samuel, Benjamin Packard, and Marilyn Gugliucci. "SIGNIFICANCE OF SECOND YEAR MEDICAL STUDENTS PARTICIPATING IN THE 48-HOUR HOSPICE HOME IMMERSION PROJECT, 2017–2018." Innovation in Aging 6, Supplement_1 (November 1, 2022): 531–32. http://dx.doi.org/10.1093/geroni/igac059.2024.

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Abstract Medical education on palliative medicine and end-of-life care is generally lacking in the medical curricula. The University of New England College of Osteopathic Medicine (UNECOM) Learning by Living: 48 Hour Hospice Home Immersion Project is an immersion-based learning model whereby UNECOM 2nd year students live in an18-bed acute care hospice house to care for dying patients, provide family support, and conduct post-mortem care. This project determined if and in what ways immersion experiences were valuable in augmenting student medical end-of-life care education during AY 2017-2018.Retrospective ethnographic/autobiographic data were analyzed from the eight randomly selected student hospice immersion journals (approx. 200 pages) who participated during academic year 2017-18. Pre-fieldwork, fieldwork, post-fieldwork journals were reviewed and analyzed using manual content analysis followed by NVivo 12+ analysis. Thematic coding resulted in representative quotes, key words, and native concepts. Inter-rater reliability was established with the use of a codebook and agreed upon thematic definitions. Four key themes included: Subversion of End of life (EOL) Expectations; Character Development/Introspection; Exposure to Diverse Cultural/Spiritual Perspectives; and Skills to Bring into Future Practice. Proximity to death/dying resulted in reflections on values and priorities, and a renewed sense for compassionate patient care. Students developed skills for future practice, including competency in EOL and post-mortem care, navigating difficult, emotionally laden family dynamics, and contributing to an interprofessional staff team even in uncomfortable situations. This immersion positively affected student perspectives about death and end-of-life care; creating life-altering experiences in patient-centered-care. Students stated significant impacts to employ as a physician.

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Marey, Isabelle, Véronique Fressart, Caroline Rambaud, Paul Fornes, Laurent Martin, Sarah Grotto, Yves Alembik, et al. "Clinical impact of post-mortem genetic testing in cardiac death and cardiomyopathy." Open Medicine 15, no. 1 (May 19, 2020): 435–46. http://dx.doi.org/10.1515/med-2020-0150.

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AbstractPost-mortem genetic analyses may help to elucidate the cause of cardiac death. The added value is however unclear when a cardiac disease is already suspected or affirmed. Our aim was to study the feasibility and medical impact of post-mortem genetic analyses in suspected cardiomyopathy. We studied 35 patients with cardiac death and suspected cardiomyopathy based on autopsy or clinical data. After targeted sequencing, we identified 15 causal variants in 15 patients (yield 43%) in sarcomeric (n = 8), desmosomal (n = 3), lamin A/C (n = 3) and transthyretin (n = 1) genes. The results had various impacts on families, i.e. allowed predictive genetic testing in relatives (15 families), planned early therapeutics based on the specific underlying gene (5 families), rectified the suspected cardiomyopathy subtype (2 families), assessed the genetic origin of cardiomyopathy that usually has an acquired cause (1 family), assessed the diagnosis in a patient with uncertain borderline cardiomyopathy (1 family), reassured the siblings because of a de novo mutation (2 families) and allowed prenatal testing (1 family). Our findings suggest that post-mortem molecular testing should be included in the strategy of family care after cardiac death and suspected cardiomyopathy, since genetic findings provide additional information useful for relatives, which are beyond conventional autopsy.

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Qasim, Muhammad, Muhammad Sharjeel Khalid, Muhammad Danyal Amjad, and Mobin Inam Pal. "Analysis of forensic autopsies in year 2018 at forensic medicine department, Faisalabad Medical University, Faisalabad." Professional Medical Journal 27, no. 10 (October 10, 2020): 2199–202. http://dx.doi.org/10.29309/tpmj/2020.27.10.4432.

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Objectives: The study was aimed to audit autopsies in the year 2018 and promoting statistical approach in Forensic Medicine. Also to study the gender based distribution of cases and study shifting trends in weapon of offence. Study Design: Retrospective Study. Setting: Post Mortem Unit of the Department of Forensic Medicine & Toxicology, Faisalabad Medical University, Faisalabad. Period: From 1st January, 2018 to 31st December, 2018. Material & Methods: Autopsy was performed on 248 cases reported to Post Mortem Unit. Study Material was collected from the Post Mortem Unit of Allied Hospital and DHQ Hospital Faisalabad which are referral tertiary care teaching hospitals affiliated with Faisalabad Medical University, Faisalabad. Results: Out of a total 248 autopsies conducted 178 (71.77%) were males and 70 (28.23%) were females. The male to female ratio was 2.54:1. Most used weapon of offence was Firearm. Followed by firearm the second major cause of death was road traffic accidents which were followed by Asphyxia (12.9% of total autopsies). Conclusion: Ban on illegal possession of Firearms - educational lectures to Public and steps to raise the literacy rate along with the improvement of socioeconomic status of the society. Preventive-strategy to create an awareness of safe traveling practices especially among the groups at high risk.

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Gödde, Daniel, Florian Bruckschen, Christian Burisch, Veronika Weichert, Kevin J. Nation, Serge C. Thal, Stephan Marsch, and Timur Sellmann. "Manual and Mechanical Induced Peri-Resuscitation Injuries—Post-Mortem and Clinical Findings." International Journal of Environmental Research and Public Health 19, no. 16 (August 22, 2022): 10434. http://dx.doi.org/10.3390/ijerph191610434.

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(1) Background: Injuries related to resuscitation are not usually systematically recorded and documented. By evaluating this data, conclusions could be drawn about the quality of the resuscitation, with the aim of improving patient care and safety. (2) Methods: We are planning to conduct a multicentric, retrospective 3-phased study consisting of (1) a worldwide literature review (scoping review), (2) an analysis of anatomical pathological findings from local institutions in North Rhine-Westphalia, Germany to assess the transferability of the review data to the German healthcare system, and (3) depending on the results, possibly establishing potential prospective indicators for resuscitation-related injuries as part of quality assurance measures. (3) Conclusions: From the comparison of literature and local data, the picture of resuscitation-related injuries will be focused on and quality indicators will be derived.

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Stark, Anne, and James Scott. "A review of the use of clozapine levels to guide treatment and determine cause of death." Australian & New Zealand Journal of Psychiatry 46, no. 9 (February 10, 2012): 816–25. http://dx.doi.org/10.1177/0004867412438871.

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Objective: To review the literature to examine the use of clozapine levels to (i) guide therapy and prevent toxicity in clinical care and (ii) determine cause of death in post-mortem examination of patients who were treated with clozapine. Methods: MEDLINE was searched in December 2010 using the following keywords: ‘clozapine levels’, ‘clozapine and toxicity’, ‘clozapine and death’, ‘clozapine and mortality’ and ‘post-mortem redistribution’. Data was also collected from the 2010 MIMS Annual. Results: The literature reported significant variation in clozapine levels attained with any given dose, and considerable variability in the clinical response achieved at any given clozapine level. The lowest effective clozapine levels ranged from 250 to 550 µg/L, while the recommended upper limit to prevent toxicity varied from 600 to 2000 µg/L. There was minimal correlation between clozapine levels and side effects, with the exception of sedation, hypotension and seizure activity. The risk of seizures increased with plasma clozapine levels greater than 600 µg/L or rapid upward titration. In addition to prescribed dose, there are many factors that influence plasma clozapine levels. After death, the process of post-mortem drug redistribution resulted in 3.00 to 4.89 times increases in clozapine levels in central blood vessels and 1.5 fold increases in peripheral vessels compared to ante-mortem levels. Conclusions: The exact range of clozapine levels that corresponds to toxicity remains unclear. However, levels between 350 µg/L and 1000 µg/L achieved with gradual upward titration are more likely to be effective and less likely to cause toxicity. Ongoing clozapine level monitoring is indicated, especially when (i) prescribing higher doses (> 600 mg/day) of clozapine, (ii) there has been a change in a patient’s concomitant pharmacotherapy or cigarette use and (iii) there has been a suboptimal response to treatment. The use of post-mortem clozapine levels to determine clozapine toxicity as a cause of death is unreliable.

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Twigg, Steven J., Alastair McCrirrick, and Peter M. Sanderson. "A comparison of post mortem findings with post hoc estimated clinical diagnoses of patients who die in a United Kingdom intensive care unit." Intensive Care Medicine 27, no. 4 (March 14, 2001): 706–10. http://dx.doi.org/10.1007/s001340100903.

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Chainchel Singh, Mansharan Kaur, Mohamad Helmee Mohd Noor, Mohamad Azaini Ibrahim, Sheue Feng Siew, and Poh Soon Lai. "Use of Post-Mortem Computed Tomography During the COVID-19 Pandemic: The Malaysian Experience." Malaysian Journal of Medical Sciences 29, no. 5 (October 28, 2022): 83–92. http://dx.doi.org/10.21315/mjms2022.29.5.9.

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Background: COVID-19 was declared a pandemic by the World Health Organization (WHO). COVID-19 is highly contagious, making it a threat to healthcare workers, including those working in mortuaries. Therefore, it is important to determine if the cause of death (COD) could be identified using limited autopsy, diagnostic tests and post-mortem imaging modalities instead of full autopsy. This study aims to examine the effectiveness of post-mortem imaging, specifically post-mortem computed tomography (PMCT) at determining the COD during a pandemic. Methods: This cross-sectional study included 172 subjects with suspected or unknown COVID-19 status brought in dead to the institute’s mortuary during the pandemic in Malaysia. PMCT images reported by forensic radiologists and their agreement with conventional autopsy findings by forensic pathologists regarding COD were analysed to look at the effectiveness of PMCT in determining COD during a pandemic. Results: Analysis showed that 78.7% (133) of cases reported by forensic radiologists concurred with the COD certified by forensic pathologists. Of these cases, 85 (63.9%) had undergone only external examination and real-time reverse transcriptase polymerase chain reaction (rRT-PCR) COVID-19 testing, meaning that imaging was the sole method used to determine the COD besides history from available medical records and the investigating police officer. Conclusion: PMCT can be used as a complement to medicolegal autopsies in pandemic contexts, as it provides significant information on the possible COD without jeopardising the safety of mortuary health care workers.

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Al Mahdy, Husayn. "Quality of coroner's post-mortems in a UK hospital." International Journal of Health Care Quality Assurance 27, no. 1 (February 4, 2014): 25–35. http://dx.doi.org/10.1108/ijhcqa-07-2012-0073.

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Purpose – The aim of this paper was, principally, to look at the coroner's post-mortem report quality regarding adult medical patients admitted to an English hospital; and to compare results with Royal College of Pathologists guidelines. Design/methodology/approach – Hospital clinical notes of adult medical patients dying in 2011 and who were referred to the coroner's office to determine the cause of death were scrutinised. Their clinical care was also reviewed. Findings – There needs to be a comprehensive approach to coroner's post-mortems such as routinely taking histological and microbiological specimens. Acute adult medical patient care needs to improve. Research limitations/implications – Steps should be taken to ensure that comprehensive coroner's post-mortems are performed throughout the UK, including with routine histological and microbiological specimens examination. Additionally, closer collaboration between clinicians and pathologists needs to occur to improve emergency adult medical patient clinical care. Originality/value – The study highlights inadequacies in coroner's pathology services.

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Siakia, U. N., V. Vishwajeet, R. Kumar, V. Suri, K. Joshi, and B. Radotra. "Disseminated TB in inpatient deaths at a tertiary care centre: an autopsy study over three decades." International Journal of Tuberculosis and Lung Disease 25, no. 4 (April 1, 2021): 271–76. http://dx.doi.org/10.5588/ijtld.20.0802.

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BACKGROUND: One of the most severe forms of TB, disseminated TB (dTB) is associated with significant mortality. A retrospective study was undertaken to assess the proportion of dTB among inpatient deaths and to describe the pathological spectrum of lesions. Associated comorbidities and missed dTB cases ante-mortem were also sought.METHODS: Data on autopsy-confirmed cases of dTB from over three decades (1988–2016) obtained from the departmental archives of the Post Graduate Institute of Medical Education and Research, Chandigarh, India, were reviewed for clinical details, as well as gross and histopathological findings. The proportion of autopsy-confirmed dTB were reported.RESULTS: During this period, a total of 243 autopsy-confirmed cases were retrieved. The organs most commonly involved in these cases were the lungs (90.1%), followed by the liver (72%), spleen (44%), kidneys (37%), bone marrow (17%), adrenals (12.2%), intestine (11.4%), pancreas (8.5%) and reproductive organs (6.9%). The brain was involved in 73.3% cases. In one third of cases, the diagnosis of TB was not suspected ante-mortem. Comorbid conditions were noted in 36.2% cases.CONCLUSION: A significant burden of dTB was noted among hospital inpatient deaths. Due to multi-organ involvement, dTB has atypical symptoms and may remain undiagnosed ante-mortem. Increased awareness and robust screening of TB cases are mandatory, particularly in patients with underlying comorbidities.

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Memon, Abdul Majeed, Sono Mal, Inayatullah Magsi, Aisha Khalid, Sadia Abdul Qayyum, Hafiza Naima Anwar, Abdul Samad, and Ejaz A. Awan. "A Post-Mortem Medicolegal Study of Asphyxial Deaths: An Autopsy Based Study." Pakistan Journal of Medical and Health Sciences 15, no. 8 (August 26, 2021): 2148–50. http://dx.doi.org/10.53350/pjmhs211582148.

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Objective: To assess the medicolegal causes of asphyxial deaths in tertiary care hospital of Hyderabad, Sindh, Pakistan. Study Design: Descriptive, observational and retrospective Place and Duration of Study: Medicolegal Section of Liaquat University Hospital Hyderabad from 1st January 2015 to 31st December 2019. Methodology: Two hundred and nineteen patients were retrieved and died due to other reasons were excluded from the study while no any patient’s age and gender restrictions. Results: There were 157 males and 62 females. Sixty six patients of asphyxial belonged to age 39-48 years. Among 74 patients of suffocation, 51 patients were males and 23 were females. There are 5 reported reasons of asphyxial deaths. Out of 45 hanging patients, 5 patients belonged to 18-28 years, 8 patients belonged to 29-38 years, 9 patients belonged to 39-48 years, 6 patients belong to 49-58 years and 15 patients belonged to ≥59 59 years. Conclusion: Male is the most vulnerable victim of the violent asphyxial deaths. The major contribution in the suicidal deaths is dominant by the hanging and strangulations. The manner of deaths indicates the frustrations and carelessness of the majority of the population. The social awareness and hopefulness contributed by the awareness sessions and education on Individual levels is encouraged for such cases. Keywords: Asphyxial, Post-mortem, Medicolegal causes

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Noh, Gun So, and Myung Kyung Lee. "Development of Nursing Protocol for a Forensic Post-Mortem Care to Preserve Evidence in Medical Facilities." Korean Academy of Scientific Criminal Investigation 14, no. 2 (June 30, 2020): 105–13. http://dx.doi.org/10.20297/jsci.2019.14.2.105.

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Noh, Gun So, and Myung Kyung Lee. "Development of Nursing Protocol for a Forensic Post-Mortem Care to Preserve Evidence in Medical Facilities." Korean Academy of Scientific Criminal Investigation 14, no. 2 (June 30, 2020): 105–13. http://dx.doi.org/10.20297/jsci.2020.14.2.105.

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Sundukov, D. V., V. A. Putintsev, V. V. Shekera, D. V. Bogomolov, and O. L. Romanova. "Use of modern forensic methods for post-mortem diagnosis of blood loss." RUDN Journal of Medicine 25, no. 2 (December 15, 2021): 154–61. http://dx.doi.org/10.22363/2313-0245-2021-25-2-154-161.

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In forensic medical practice, when diagnosing the cause of death from blood loss, it is often necessary to solve questions related to the etiology of loss of circulating blood volume (CBV), the degree and severity of the injury, as well as its role in thanatogenesis and the duration of the terminal (agonal) period. When investigating the cases of death from acute blood loss, the authorities often ask forensic experts to solve issues related to the possibility of performing active targeted actions by the dying person, as well as to assess the timeliness of medical care and the actions of medical personnel. The solution of these issues is often difficult for experts, and it is associated with both objective and subjective reasons. For example, in cases where the circumstances of death are unknown, or there are no medical documents, or they do not contain sufficient information, without which it is impossible to conduct a retrospective clinical and anatomical analysis for the purpose of differential diagnosis between hemolytic shock and post-hemorrhagic anemia. The article deals with the use of new methodological approaches in postmortem morphological diagnostics of blood loss by the rate of its development and its role in thanatogenesis, in forensic medical practice. For example, a particular forensic expertise (case study) shows that the application of two new methods allowed to solve the issues for the investigator related to the cause of death and duration of dying from blood loss. Experts knowledge of new methodological approaches to the forensic diagnosis of acute blood loss will help law enforcement authorities to counteract crimes against the life of citizens, as well as to development the measures to improve the methods for prevention and reduction of mortality from traumatic injuries with blood loss.

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Hancock, Lauren, and Madhuri Kambhampati. "NURS-06. NURSING PROFESSIONALS AND THEIR AID IN RESEARCH BIOBANKING." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii422. http://dx.doi.org/10.1093/neuonc/noaa222.625.

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Abstract Nursing teams play an integral role in the care of patients with brain tumors; however nurses do not often see themselves as essential contributors to translational research. Recent development of nurse-researcher relationships and involvement of the multidisciplinary team have led to successful biobanking strategies. Though there are challenges associated with fostering these relationships, their vital role has significantly enhanced participant recruitment and sample collection at one large urban Children’s Hospital. Researchers at the institution have established a biobank to collect samples from pediatric brain tumor patients at diagnosis, during therapy, and post mortem using conventional methods. However, a collaborative environment between nursing and research teams greatly enhanced the growth of the biobank. We have increased patient recruitment by more than 50% in the past four years and supported different types of specimen collection. Our success entails: 1) development of nurse-researcher relationships, 2) an efficient consent process, 3) streamlined sample collection, and 4) appreciation of the vital role of the nursing team in clinical data collection pertinent to molecular analysis. Additionally, the support of nursing is valuable during post mortem consents and provides emotional support to the family to fulfil their wish to donate. Nurses play a major role in coordination of the post-mortem donation process, and assist in the formation of partnerships within the community to promote this opportunity to families. As biobanking continues to be an important part of bench research, all institutions should recognize and support the vital role that nurses can have in enhancing this endeavor.

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Griffin, Cassandra, Ricardo Vilain, Simon King, Sandy Nixon, Alisha Gooley, Samara Bray, James Lynam, Marjorie M. Walker, Rodney J. Scott, and Christine Paul. "Mind Over Matter: Confronting Challenges in Post-Mortem Brain Biobanking for Glioblastoma Multiforme." Biomarker Insights 16 (January 2021): 117727192110133. http://dx.doi.org/10.1177/11772719211013359.

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Over the past 10 years, there has been limited progress for the treatment of brain cancer and outcomes for patients are not much improved. For brain cancer researchers, a major obstacle to biomarker driven research is limited access to brain cancer tissue for research purposes. The Mark Hughes Foundation Brain Biobank is one of the first post-mortem adult brain banks in Australia to operate with protocols specifically developed for brain cancer. Located within the Hunter New England Local Health District and operated by Hunter Cancer Biobank, the boundaries of service provided by the Brain Bank extend well into the surrounding regional and rural areas of the Local Health District and beyond. Brain cancer biobanking is challenging. There are conflicting international guidelines for best practice and unanswered questions relating to scientific, psychosocial and operational practices. To address this challenge, a best practice model was developed, informed by a consensus of existing data but with consideration of the difficulties associated with operating in regional or resource poor settings. The regional application of this model was challenged following the presentation of a donor located in a remote area, 380km away from the biobank. This required biobank staff to overcome numerous obstacles including long distance patient transport, lack of palliative care staff, death in the home and limited rural outreach services. Through the establishment of shared goals, contingency planning and the development of an informal infrastructure, the donation was facilitated within the required timeframe. This experience demonstrates the importance of collaboration and networking to overcome resource insufficiency and geographical challenges in rural cancer research programmes.

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Waheed, Abdul, Iqbal Ahmed Khan, Abdul Waheed, Hari Ram, Shahid Nezam, and Perwez Alam. "Results of Medicolegal Autopsies Conducted At A Tertiary Care Hospital, Sukkur, Pakistan." ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 27, no. 4 (November 30, 2022): 159–64. http://dx.doi.org/10.58397/ashkmdc.v27i4.581.

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Objective: To describe the results of medicolegal autopsies conducted at mortuary of Ghulam Muhammad Mahar Medical College, Sukkur, Pakistan during a specific period. Methods: Present study is a retrospective descriptive analysis of medicolegal autopsies conducted in the mortuary from a period of January 2018 to December 2020 after acquiring ethical approval from the hospital. A total of 297 medicolegal autopsies were performed during this specific period. Their significant findings such as gender, age, caste, area of residence, cause & manner of death were collected from Post-mortem registers/records, Inquest papers and Post- mortem reports and entered on SPSS version 22 for analysis. Frequency and percentages were calculated for all categorical variables. Results: It was observed that out of 297 medicolegal deaths, maximum number of autopsies conducted were in third decade of life (n=133 cases, 44.78%) followed by 66 (22.22%) in 2nd decade of life. Male cases predominated over female cases, which were (n=193, 65%). Majority of the cases were resident of local areas of Sukkur. Mughals were in majority with 79 cases (26.59%) followed by Sheikhs with 62 cases (20.87%), Baloch 44 (14.81%). Maximum number of deaths were due to road traffic accidents (n=103, 34.68%) followed by firearm injuries (n=73, 24.57 %) and asphyxial deaths (n=11, 3.70%). Accidental was the most common manner of death (n=192, 64.64%) followed by homicidal (n=40, 13.46%). Conclusion: It is observed that majority of cases were in 3rd decade of life and preponderance of male sex is seen over female sex , could be due to more exposure of males to outer world. Most common cause of death found was road traffic accidents probably due to increased frequency of transportation and decreased regulation of traffic control.

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Lebedeva, Anastasia M., Alexei V. Bereznikov, Evgenia A. Berseneva, Yulia O. Onufriychuk, Sergei O. Shkitin, and Nadezhda V. Makarets. "Diagnostics errors as the reasons for the discrepancy between clinical and pathoanatomical diagnoses." RUDN Journal of Medicine 26, no. 1 (March 21, 2022): 88–95. http://dx.doi.org/10.22363/2313-0245-2022-26-1-88-95.

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Relevance. The development of medical science has made it easier for clinicians to diagnose specific diseases, often leading to the reduction of traditional diagnostic methods, including differential diagnosis. As a result, there is an increase in medical errors in diagnosis, the choice of treatment tactics, including in cases with the development of an unfavorable outcome. The aim of the study was to identify typical errors in the differential diagnosis of diseases in cases with a fatal outcome in the departments of both therapeutic and surgical profiles. Materials and Methods. At the first stage of the retrospective cohort study, fatal cases were analyzed for the correctness of the final post-mortem clinical diagnosis and the results of its comparison with the pathoanatomical diagnosis based on the results of the examination of the quality of medical care in compulsory health insurance. Errors in the formulation of the post-mortem clinical diagnosis were identified, and their causes were determined. At the second stage, the scenario method determines three variants of risk realization in the case of divergence of the final clinical and pathoanatomical diagnoses, with an assessment of the frequency of risk variants realization in the surgical and therapeutic profiles . Results and Discussion. When analyzing cases of fatal outcomes with a discrepancy between the final clinical and pathoanatomical diagnoses, the main errors in the formulation of the final clinical diagnosis were identified. In the first variant of risk realization, the reason for the discrepancy is the incorrect formulation of the final post-mortem diagnosis. In the case of the second scenario, violations relate to incorrect diagnostic tactics when a new disease or exacerbation of a chronic disease occurs. In the third scenario, violations are associated with incorrect differential diagnosis: the initial restriction of the range of nosologies for diagnostic search. Conclusion. Typical violations of diagnosis and differential diagnosis leading to a discrepancy between the final clinical and pathoanatomical diagnoses are identified. As part of the provision of medical care in surgical specialties, the second scenario is more often identified: incorrect diagnostic tactics when a new disease appears or a chronic disease worsens. When providing medical care in therapeutic specialties, violations are more often detected in the third scenario: incorrect differential diagnosis, initial restriction of the range of nosologies for diagnostic search. The second and third scenarios create legal risks for the doctor and the medical organization when evaluated by the relevant authorities.

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Lebedeva, Anastasia M., Alexei V. Bereznikov, Evgenia A. Berseneva, Yulia O. Onufriychuk, Sergei O. Shkitin, and Nadezhda V. Makarets. "Diagnostics errors as the reasons for the discrepancy between clinicaland pathoanatomical diagnoses." RUDN Journal of Medicine 26, no. 1 (March 3, 2022): 87–94. http://dx.doi.org/10.22363/2313-0245-2022-26-1-87-94.

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Abstract:

Relevance. The development of medical science has made it easier for clinicians to diagnose specific diseases, often leading to the reduction of traditional diagnostic methods, including differential diagnosis. As a result, there is an increase in medical errors in diagnosis, the choice of treatment tactics, including in cases with the development of an unfavorable outcome. The aim of the study was to identify typical errors in the differential diagnosis of diseases in cases with a fatal outcome in the departments of both therapeutic and surgical profiles. Materials and Methods. At the first stage of the retrospective cohort study, fatal cases were analyzed for the correctness of the final post-mortem clinical diagnosis and the results of its comparison with the pathoanatomical diagnosis based on the results of the examination of the quality of medical care in compulsory health insurance. Errors in the formulation of the post-mortem clinical diagnosis were identified, and their causes were determined. At the second stage, the scenario method determines three variants of risk realization in the case of divergence of the final clinical and pathoanatomical diagnoses, with an assessment of the frequency of risk variants realization in the surgical and therapeutic profiles . Results and Discussion. When analyzing cases of fatal outcomes with a discrepancy between the final clinical and pathoanatomical diagnoses, the main errors in the formulation of the final clinical diagnosis were identified. In the first variant of risk realization, the reason for the discrepancy is the incorrect formulation of the final post-mortem diagnosis. In the case of the second scenario, violations relate to incorrect diagnostic tactics when a new disease or exacerbation of a chronic disease occurs. In the third scenario, violations are associated with incorrect differential diagnosis: the initial restriction of the range of nosologies for diagnostic search. Conclusion. Typical violations of diagnosis and differential diagnosis leading to a discrepancy between the final clinical and pathoanatomical diagnoses are identified. As part of the provision of medical care in surgical specialties, the second scenario is more often identified: incorrect diagnostic tactics when a new disease appears or a chronic disease worsens. When providing medical care in therapeutic specialties, violations are more often detected in the third scenario: incorrect differential diagnosis, initial restriction of the range of nosologies for diagnostic search. The second and third scenarios create legal risks for the doctor and the medical organization when evaluated by the relevant authorities.

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Journal articles on the topic 'Post-mortem care'

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