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Krebs-Drouot L, Karpathiou G, Scolan V, Bidat-Callet C, Boyer B, Péoc'h M. Death due to unsuspected acute myeloid leukaemia: an unusual forensic diagnosis. Forensic Sci Med Pathol 2023; 19:60-66. [PMID: 35984604 DOI: 10.1007/s12024-022-00516-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Abstract
Acute myeloid leukaemia (AML) is a rare haematologic cancer with a rapid increase in blast cells, which need to be rapidly diagnosed and treated. The aim of this report is to analyse the rare phenomenon of AML diagnosed at autopsy after sudden death. We report three cases of AML and perform a literature review using the mesh terms "sudden death" and "leukaemia". We report the cases of three young women diagnosed with AML only after autopsy. We found seven articles which reported sudden death due to AML diagnosed at autopsy. Diagnosis of AML during autopsy is rare but can raise forensic issues. A complete autopsy with pathology analysis is needed.
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Affiliation(s)
- Lila Krebs-Drouot
- Forensic Medicine Department, Grenoble Alpes University Hospital, La Tronche, Grenoble, France.
| | - Georgia Karpathiou
- Pathology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Virginie Scolan
- Forensic Medicine Department, Grenoble Alpes University Hospital, La Tronche, Grenoble, France
| | - Carolyne Bidat-Callet
- Forensic Medicine Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Baptiste Boyer
- Forensic Medicine Department, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Michel Péoc'h
- Pathology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
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Kelly KL, Lin PT, Basso C, Bois M, Buja LM, Cohle SD, d'Amati G, Duncanson E, Fallon JT, Firchau D, Fishbein G, Giordano C, Leduc C, Litovsky SH, Mackey-Bojack S, Maleszewski JJ, Michaud K, Padera RF, Papadodima SA, Parsons S, Radio SJ, Rizzo S, Roe SJ, Romero M, Sheppard MN, Stone JR, Tan CD, Thiene G, van der Wal AC, Veinot JP. Sudden cardiac death in the young: A consensus statement on recommended practices for cardiac examination by pathologists from the Society for Cardiovascular Pathology. Cardiovasc Pathol 2023; 63:107497. [PMID: 36375720 DOI: 10.1016/j.carpath.2022.107497] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022] Open
Abstract
Sudden cardiac death is, by definition, an unexpected, untimely death caused by a cardiac condition in a person with known or unknown heart disease. This major international public health problem accounts for approximately 15-20% of all deaths. Typically more common in older adults with acquired heart disease, SCD also can occur in the young where the cause is more likely to be a genetically transmitted process. As these inherited disease processes can affect multiple family members, it is critical that these deaths are appropriately and thoroughly investigated. Across the United States, SCD cases in those less than 40 years of age will often fall under medical examiner/coroner jurisdiction resulting in scene investigation, review of available medical records and a complete autopsy including toxicological and histological studies. To date, there have not been consistent or uniform guidelines for cardiac examination in these cases. In addition, many medical examiner/coroner offices are understaffed and/or underfunded, both of which may hamper specialized examinations or studies (e.g., molecular testing). Use of such guidelines by pathologists in cases of SCD in decedents aged 1-39 years of age could result in life-saving medical intervention for other family members. These recommendations also may provide support for underfunded offices to argue for the significance of this specialized testing. As cardiac examinations in the setting of SCD in the young fall under ME/C jurisdiction, this consensus paper has been developed with members of the Society of Cardiovascular Pathology working with cardiovascular pathology-trained, practicing forensic pathologists.
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Affiliation(s)
| | | | - Cristina Basso
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health - University of Padua, Padua, Italy
| | | | | | | | | | - Emily Duncanson
- Jesse E. Edwards Registry of Cardiovascular Disease, St. Paul, MN, USA
| | | | | | | | | | | | | | | | | | - Katarzyna Michaud
- University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital and University of Lausanne, Switzerland
| | | | | | - Sarah Parsons
- Victorian Institute of Forensic Medicine, Melbourne, Australia
| | | | - Stefania Rizzo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health - University of Padua, Padua, Italy
| | | | | | - Mary N Sheppard
- St. George's Medical School, University of London, London, United Kingdom
| | | | | | - Gaetano Thiene
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health - University of Padua, Padua, Italy
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Drommi M, Errico S, Barioglio B, Barranco R, Ventura F. Sudden unexpected non-cardiac death in the Genoa Medico-Legal District: A six year study (2014-2019) and literature review. Med Leg J 2021; 89:180-186. [PMID: 34082591 DOI: 10.1177/00258172211010547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sudden death is described as a natural but unexpected death occurring within one hour from the onset of the patient's final symptoms. Despite cardiac disease being recognised as the cause of death in most people, sudden and unexpected death can also be non-cardiac related. Often a natural but sudden death is not subject to an autopsy, but only to an external examination, and this runs the risk of wrongly attributing the death to a cardiac cause. The present review is a retrospective-observational study which looks into the cases of sudden non-cardiac death recorded in the Genoa District (Italy) from 2014 to 2019 and investigated through complete autopsy examinations. Amongst these cases, 39 (31.5%) were attributable to gastrointestinal diseases, mostly due to the rupture of oesophageal varices; 39 (31.5%) to respiratory diseases, especially pulmonary infections; 31 (25%) to peripheral vascular disease, mostly attributable to pulmonary thromboembolisms or the acute dissection of aneurysms whilst the remaining 15 cases (12%) were attributable to intracranial haemorrhages.
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Affiliation(s)
- Martina Drommi
- Department of Forensic and Legal Medicine, University of Genova, Genova, Italy
| | - Stefano Errico
- Department of Forensic and Legal Medicine, University of Genova, Genova, Italy
| | - Bianca Barioglio
- Department of Forensic and Legal Medicine, University of Genova, Genova, Italy
| | - Rosario Barranco
- Department of Forensic and Legal Medicine, University of Genova, Genova, Italy
| | - Francesco Ventura
- Department of Forensic and Legal Medicine, University of Genova, Genova, Italy
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Birngruber CG, Hochscheid C, Dettmeyer RB. Unerkannte letale idiopathische Riesenzellmyokarditis – ein Fallbericht. Rechtsmedizin (Berl) 2020. [DOI: 10.1007/s00194-020-00411-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
ZusammenfassungMyokarditiden stellen nach der hypertrophen Kardiomyopathie und der stenosierenden Koronararteriensklerose die dritthäufigste Ursache des plötzlichen Herztodes dar. Die Klinik der Myokarditis ist wie ihr Verlauf äußerst variabel, und ihr Therapieerfolg hängt stark von der Ätiologie und somit einer umfassenden diagnostischen Abklärung ab. Zum Goldstandard gehört nach wie vor die Endomyokardbiopsie, deren Ergebnisse bedeutenden Einfluss auf die Therapieplanung haben können. Vorgestellt wird der Fall einer 35 Jahre alt gewordenen Frau, bei der zu Lebzeiten eine chronisch aktive lymphozytäre Myokarditis mit Nachweis des humanen Herpesvirus 6 (HHV 6) diagnostiziert wurde. Acht Monate nach der Diagnose verstarb sie unerwartet. Die Obduktion mit nachfolgender histopathologischer Aufarbeitung der Myokardproben erbrachte den Nachweis einer Riesenzellmyokarditis, die als Differenzialdiagnose zu Lebzeiten nicht gestellt worden war. Der Fall verdeutlicht die Problematik der Diagnosestellung zu Lebzeiten, wenn Myokardproben nicht repräsentativ sind zum Nachweis der Grunderkrankung und illustriert die autoptischen Befunde dieser seltenen Form der Myokarditis.
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Charpiat B, Leboucher G, Maire P, Schmitt É. Le potassium injectable concentré, emblématique de l’insécurité médicamenteuse des hôpitaux français. Rech Soins Infirm 2020; 141:78-86. [DOI: 10.3917/rsi.141.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Rapid death following undiagnosed stercoral perforation in a chronic opioid user. Leg Med (Tokyo) 2020; 42:101644. [DOI: 10.1016/j.legalmed.2019.101644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/30/2019] [Accepted: 11/02/2019] [Indexed: 01/14/2023]
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Sanchez O, Campuzano O, Fernández-Falgueras A, Sarquella-Brugada G, Cesar S, Mademont I, Mates J, Pérez-Serra A, Coll M, Pico F, Iglesias A, Tirón C, Allegue C, Carro E, Gallego MÁ, Ferrer-Costa C, Hospital A, Bardalet N, Borondo JC, Vingut A, Arbelo E, Brugada J, Castellà J, Medallo J, Brugada R. Natural and Undetermined Sudden Death: Value of Post-Mortem Genetic Investigation. PLoS One 2016; 11:e0167358. [PMID: 27930701 PMCID: PMC5145162 DOI: 10.1371/journal.pone.0167358] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/11/2016] [Indexed: 12/15/2022] Open
Abstract
Background Sudden unexplained death may be the first manifestation of an unknown inherited cardiac disease. Current genetic technologies may enable the unraveling of an etiology and the identification of relatives at risk. The aim of our study was to define the etiology of natural deaths, younger than 50 years of age, and to investigate whether genetic defects associated with cardiac diseases could provide a potential etiology for the unexplained cases. Methods and Findings Our cohort included a total of 789 consecutive cases (77.19% males) <50 years old (average 38.6±12.2 years old) who died suddenly from non-violent causes. A comprehensive autopsy was performed according to current forensic guidelines. During autopsy a cause of death was identified in most cases (81.1%), mainly due to cardiac alterations (56.87%). In unexplained cases, genetic analysis of the main genes associated with sudden cardiac death was performed using Next Generation Sequencing technology. Genetic analysis was performed in suspected inherited diseases (cardiomyopathy) and in unexplained death, with identification of potentially pathogenic variants in nearly 50% and 40% of samples, respectively. Conclusions Cardiac disease is the most important cause of sudden death, especially after the age of 40. Close to 10% of cases may remain unexplained after a complete autopsy investigation. Molecular autopsy may provide an explanation for a significant part of these unexplained cases. Identification of genetic variations enables genetic counseling and undertaking of preventive measures in relatives at risk.
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Affiliation(s)
- Olallo Sanchez
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Oscar Campuzano
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
- Department of Medical Sciences, School of Medicine, University of Girona, Girona (Spain)
| | - Anna Fernández-Falgueras
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
- Cardiovascular Genetics Unit, Hospital Josep Trueta, Girona (Spain)
| | | | - Sergi Cesar
- Arrhythmia Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona (Spain)
| | - Irene Mademont
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Jesus Mates
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | | | - Monica Coll
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Ferran Pico
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Anna Iglesias
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Coloma Tirón
- Cardiovascular Genetics Unit, Hospital Josep Trueta, Girona (Spain)
| | - Catarina Allegue
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Esther Carro
- Arrhythmia Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona (Spain)
| | - María Ángeles Gallego
- Forensic Pathology Service, Institut Medicina Legal Ciències Mèdiques Catalunya, Barcelona (Spain)
| | | | - Anna Hospital
- Forensic Pathology Service, Institut Medicina Legal i Ciències Forenses de Catalunya, Girona (Spain)
| | - Narcís Bardalet
- Forensic Pathology Service, Institut Medicina Legal i Ciències Forenses de Catalunya, Girona (Spain)
| | - Juan Carlos Borondo
- Histopathology Unit, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona (Spain)
| | - Albert Vingut
- Histopathology Unit, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona (Spain)
| | - Elena Arbelo
- Arrhythmia Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona (Spain)
| | - Josep Brugada
- Arrhythmia Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona (Spain)
- Arrhythmia Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona (Spain)
| | - Josep Castellà
- Forensic Pathology Service, Institut Medicina Legal Ciències Mèdiques Catalunya, Barcelona (Spain)
| | - Jordi Medallo
- Forensic Pathology Service, Institut Medicina Legal Ciències Mèdiques Catalunya, Barcelona (Spain)
| | - Ramon Brugada
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
- Department of Medical Sciences, School of Medicine, University of Girona, Girona (Spain)
- Cardiovascular Genetics Unit, Hospital Josep Trueta, Girona (Spain)
- * E-mail:
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Naneix AL, Périer MC, Beganton F, Jouven X, Lorin de la Grandmaison G. Sudden adult death: An autopsy series of 534 cases with gender and control comparison. J Forensic Leg Med 2015; 32:10-5. [DOI: 10.1016/j.jflm.2015.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/20/2014] [Accepted: 02/07/2015] [Indexed: 12/29/2022]
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Petelska AD, Kotyńska J, Figaszewski ZA. The effect of fatal carbon monoxide poisoning on the equilibria between cell membranes and the electrolyte solution. J Membr Biol 2015; 248:157-61. [PMID: 25416423 PMCID: PMC4300427 DOI: 10.1007/s00232-014-9753-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 11/11/2014] [Indexed: 12/31/2022]
Abstract
The effect of fatal carbon monoxide poisoning on equilibria between cell membranes and surrounding ions was described using a theoretical four-equilibria model. The model was developed to obtain parameters characterizing the interactions between solution ions and erythrocyte or thrombocyte membrane surface. The parameters are the total surface concentrations of both acidic and basic groups C A, C B and their association constants with solution ions K AH, K BOH. These parameters were used to calculate the theoretical values of surface charge density. The model was validated by comparison of these values to experimental data, which were determined from the electrophoretic mobility measurements of the blood cells. The experimental and theoretical surface charge density values agree at pH 2-8, and at higher pH, the deviation was observed.
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Affiliation(s)
- Aneta D Petelska
- Institute of Chemistry, University of Bialystok, Al. J. Pilsudskiego 11/4, 15-443, Białystok, Poland,
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Püschel K, Bajanowski T, Vennemann M, Kernbach-Wighton G, Madea B. Plötzliche und unerwartete Todesfälle aus innerer Ursache. Rechtsmedizin (Berl) 2015. [DOI: 10.1007/978-3-662-43500-7_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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12
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Nielsen TS, Hansen J, Nielsen LP, Baandrup UT, Banner J. The presence of enterovirus, adenovirus, and parvovirus B19 in myocardial tissue samples from autopsies: an evaluation of their frequencies in deceased individuals with myocarditis and in non-inflamed control hearts. Forensic Sci Med Pathol 2014; 10:344-50. [PMID: 24781135 DOI: 10.1007/s12024-014-9570-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2014] [Indexed: 12/18/2022]
Abstract
PURPOSE Multiple viruses have been detected in cardiac tissue, but their role in causing myocarditis remains controversial. Viral diagnostics are increasingly used in forensic medicine, but the interpretation of the results can sometimes be challenging. In this study, we examined the prevalence of adenovirus, enterovirus, and parvovirus B19 (PVB) in myocardial autopsy samples from myocarditis related deaths and in non-inflamed control hearts in an effort to clarify their significance as the causes of myocarditis in a forensic material. METHODS We collected all autopsy cases diagnosed with myocarditis from 1992 to 2010. Eighty-four suicidal deaths with morphologically normal hearts served as controls. Polymerase chain reaction was used for the detection of the viral genomes (adenovirus, enterovirus, and PVB) in myocardial tissue specimens. The distinction between acute and persistent PVB infection was made by the serological determination of PVB-specific immunoglobulins M and G. RESULTS PVB was detected in 33 of 112 (29 %) myocarditis cases and 37 of 84 (44 %) control cases. All of the samples were negative for the presence of adenovirus and enterovirus. Serological evidence of an acute PVB infection, determined by the presence of immunoglobulin M, was only present in one case. In the remaining cases, PVB was considered to be a bystander with no or limited association to myocardial inflammation. CONCLUSION In this study, adenovirus, enterovirus, and PVB were found to be rare causes of myocarditis. The detection of PVB in myocardial autopsy samples most likely represents a persistent infection with no or limited association with myocardial inflammation. The forensic investigation of myocardial inflammation demands a thorough examination, including special attention to non-viral causes and requires a multidisciplinary approach.
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Affiliation(s)
- Trine Skov Nielsen
- Department of Clinical Medicine, Centre for Clinical Research, Vendsyssel Hospital, Aalborg University, Bispensgade 37, 9800, Hjørring, Denmark,
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Hejna P, Janík M. Lipomatous hypertrophy of the interatrial septum: a possibly neglected cause of sudden cardiac death. Forensic Sci Med Pathol 2013; 10:119-21. [DOI: 10.1007/s12024-013-9480-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2013] [Indexed: 12/26/2022]
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Abstract
It has been suggested that the weather may promote some types of death; this study sought to determine if types of death in the region around Adelaide, South Australia, occur in non-random clusters and in relationship to the weather. A Poisson model was used to determine if the occurrence of types of death were random. An exploratory analysis was performed for each death type to see if there was a relationship to weather variables using data supplied by the Bureau of Meteorology. Cases examined at Forensic Science South Australia from 1 January 2008 to 31 December 2009 were reviewed. It was ascertained that cardiovascular deaths were distributed non-randomly; there was statistical evidence to suggest that deaths from ischemic heart disease, pulmonary embolus and drug toxicity had non-random occurrence. Maximum temperatures and increases in temperatures correlated with deaths from natural causes, cardiovascular disease, ischemic heart disease and pulmonary thromboembolus; lower hours of sunlight were statistically significant for deaths due to pulmonary thromboembolus. The distribution pattern of deaths resulting from motor vehicle collision did not fit the Poisson (random) model with variation through the week also being present. Non-random clusters of deaths do occur and weather events, such as increase in temperature, are associated with some types of death. However, analysis indicates that the weather is not responsible for all clustering. With regards to motor vehicle collision deaths temporal variation may be related to social factors, such as holiday periods. Further investigation may assist with health resource planning.
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Kotyńska J, Petelska AD, Szeremeta M, Niemcunowicz-Janica A, Figaszewski ZA. Changes in surface-charge density of blood cells after sudden unexpected death. J Membr Biol 2012; 245:185-90. [PMID: 22527604 PMCID: PMC3345184 DOI: 10.1007/s00232-012-9428-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 04/01/2012] [Indexed: 12/12/2022]
Abstract
The objective of the investigation was evaluation of postmortem changes of electric charge of human erythrocyte and thrombocyte membranes after sudden unexpected death. The surface charge density values were determined on the basis of the electrophoretic mobility measurements of the cells carried out at various pHs of electrolyte solution. The interactions between both erythrocyte and thrombocyte membranes and electrolyte ions were studied. Values of parameters characterizing the membrane--that is, the total surface concentrations of both acidic and basic groups and their association constants with solution ions--were calculated on the basis of a four-equilibria mathematical model. The model was validated by comparison of these values to experimental data. We established that examined electric properties of the cell membranes are affected by sudden unexpected death. Postmortem processes occurring in the cell membranes can lead to disorders of existing equilibria, which in turn result in changes in values of all the above-mentioned parameters.
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Affiliation(s)
- Joanna Kotyńska
- Institute of Chemistry, University of Bialystok, Al. J. Pilsudskiego 11/4, 15-443 Bialystok, Poland
| | - Aneta D. Petelska
- Institute of Chemistry, University of Bialystok, Al. J. Pilsudskiego 11/4, 15-443 Bialystok, Poland
| | - Michał Szeremeta
- Department of Forensic Medicine, Medical University of Bialystok, Waszyngtona St. 13, 15-230 Bialystok, Poland
| | - Anna Niemcunowicz-Janica
- Department of Forensic Medicine, Medical University of Bialystok, Waszyngtona St. 13, 15-230 Bialystok, Poland
| | - Zbigniew A. Figaszewski
- Institute of Chemistry, University of Bialystok, Al. J. Pilsudskiego 11/4, 15-443 Bialystok, Poland
- Laboratory of Electrochemical Power Sources, Faculty of Chemistry, University of Warsaw, Pasteur St. 1, 02-093 Warsaw, Poland
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Abstract
Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds) must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.
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18
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Matejic D, Schönfeld C, Tsokos M. Plötzlicher Tod bei akuter idiopathischer Riesenzellmyokarditis. Rechtsmedizin (Berl) 2010. [DOI: 10.1007/s00194-010-0686-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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