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Jessika C, Anna Laura S, Stefano D, Giuliano GB, Marco B, Riccardo B, Riccardo R, Enrico S. Diagnosing coronary thrombosis using multiphase post-mortem CT angiography (MPMCTA): A case study. MEDICINE, SCIENCE, AND THE LAW 2021; 61:77-81. [PMID: 33591864 DOI: 10.1177/0025802420923175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While post-mortem angiography (PMA) is gradually establishing its role in Forensic Radiology, the available literature in Italy lacks a solid foundation, particularly regarding its use in criminal court proceedings. An illustrative example of multiphase post-mortem CT angiography (MPMCTA) is presented here to encourage the systematic implementation of PMA methods. To demonstrate concordance between MPMCTA and the reference standard (autopsy and histology) in a case of acute coronary thrombosis, we report a case where MPMCTA, autopsy, histological and toxicological analyses were performed on a previously healthy 51-year-old man. MPMCTA detected a right coronary artery filling defect that could be ascribed to coronary thrombosis, which was later confirmed by autopsy and histological examinations.
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Affiliation(s)
- Camatti Jessika
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Santunione Anna Laura
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Draisci Stefano
- Department of Adult and Neonatal-Gynaecological Medical Surgical Sciences, Section of Diagnostic Imaging, University of Modena and Reggio Emilia, Modena, Italy
| | - Gangi Bruno Giuliano
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Bisceglia Marco
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Bini Riccardo
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Renzi Riccardo
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Silingardi Enrico
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Schell-Chaple HM, Liu KD, Matthay MA, Puntillo KA. Rectal and Bladder Temperatures vs Forehead Core Temperatures Measured With SpotOn Monitoring System. Am J Crit Care 2018; 27:43-50. [PMID: 29292274 DOI: 10.4037/ajcc2018865] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Methods and frequency of temperature monitoring in intensive care unit patients vary widely. The recently available SpotOn system uses zero-heat-flux technology and offers a noninvasive method for continuous monitoring of core temperature of critical care patients at risk for alterations in body temperature. OBJECTIVE To evaluate agreement between and precision of a zero-heat-flux thermometry system (SpotOn) and continuous rectal and urinary bladder thermometry during fever and defervescence in adult patients in intensive care units. METHODS Prospective comparison of SpotOn vs rectal and urinary bladder thermometry in eligible patients enrolled in a randomized clinical trial on the effect of acetaminophen on core body temperature and hemodynamic status. RESULTS A total of 748 paired temperature measurements from 38 patients who had both SpotOn monitoring and either continuous rectal or continuous bladder thermometry were analyzed. Temperatures during the study were from 36.6°C to 39.9°C. The mean difference for SpotOn compared with bladder thermometry was -0.07°C (SD, 0.24°C; 95% limits of agreement, ± 0.47°C [-0.54°C, 0.40°C]). The mean difference for SpotOn compared with rectal thermometry was -0.24°C (SD, 0.29°C; 95% limits of agreement, ± 0.57°C [-0.81°C, 0.33°C]). Most differences in temperature between methods were within ± 0.5°C in both groups (96% bladder and 85% rectal). CONCLUSIONS The SpotOn thermometry system has excellent agreement and good precision and is a potential alternative for noninvasive continuous monitoring of core temperature in critical care patients, especially when alternative methods are contraindicated or not available.
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Affiliation(s)
- Hildy M. Schell-Chaple
- Hildy M. Schell-Chaple is a clinical nurse specialist and an associate professor of nursing, University of California, San Francisco Medical Center, San Francisco, California. Kathleen D. Liu is a professor of medicine and Michael A. Matthay is a professor of medicine and anesthesia, University of California, San Francisco School of Medicine, San Francisco, California. Kathleen A. Puntillo is professor emeritus, University of California, San Fran-cisco School of Nursing, San Francisco, California
| | - Kathleen D. Liu
- Hildy M. Schell-Chaple is a clinical nurse specialist and an associate professor of nursing, University of California, San Francisco Medical Center, San Francisco, California. Kathleen D. Liu is a professor of medicine and Michael A. Matthay is a professor of medicine and anesthesia, University of California, San Francisco School of Medicine, San Francisco, California. Kathleen A. Puntillo is professor emeritus, University of California, San Fran-cisco School of Nursing, San Francisco, California
| | - Michael A. Matthay
- Hildy M. Schell-Chaple is a clinical nurse specialist and an associate professor of nursing, University of California, San Francisco Medical Center, San Francisco, California. Kathleen D. Liu is a professor of medicine and Michael A. Matthay is a professor of medicine and anesthesia, University of California, San Francisco School of Medicine, San Francisco, California. Kathleen A. Puntillo is professor emeritus, University of California, San Fran-cisco School of Nursing, San Francisco, California
| | - Kathleen A. Puntillo
- Hildy M. Schell-Chaple is a clinical nurse specialist and an associate professor of nursing, University of California, San Francisco Medical Center, San Francisco, California. Kathleen D. Liu is a professor of medicine and Michael A. Matthay is a professor of medicine and anesthesia, University of California, San Francisco School of Medicine, San Francisco, California. Kathleen A. Puntillo is professor emeritus, University of California, San Fran-cisco School of Nursing, San Francisco, California
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Scansen BA, Simpson EM, López-Alvarez J, Thomas WP, Bright JM, Eason BD, Rush JE, Dukes-McEwan J, Green HW, Cunningham SM, Visser LC, Kent AM, Schober KE. Pulmonary artery dissection in eight dogs with patent ductus arteriosus. J Vet Cardiol 2015; 17:107-19. [PMID: 25596918 DOI: 10.1016/j.jvc.2014.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 12/04/2014] [Accepted: 12/05/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To describe a series of dogs with pulmonary artery dissection and patent ductus arteriosus (PDA). ANIMALS Eight dogs. METHODS Retrospective case series. RESULTS Pulmonary artery dissection was diagnosed in 8 dogs, 3 were Weimaraners. Four dogs presented in left-sided congestive heart failure, 4 presented for murmur evaluation and without clinical signs, and 1 presented in right-sided congestive heart failure. In 7 dogs the dissection was first documented concurrent with a diagnosis of uncorrected PDA. In the other dog, with pulmonary valve stenosis and PDA, the dissection was observed on autopsy examination 17 months after balloon pulmonary valvuloplasty and ductal closure. Median age at presentation for the 7 dogs with antemortem diagnosis of pulmonary artery dissection was 3.5 years (range, 1.5-4 years). Three dogs had the PDA surgically ligated, 2 dogs did not undergo PDA closure, 1 dog failed transcatheter occlusion of the PDA with subsequent surgical ligation, 1 dog underwent successful transcatheter device occlusion of the PDA, and 1 dog had the PDA closed by transcatheter coil delivery 17 months prior to the diagnosis of pulmonary artery dissection. The 2 dogs that did not have the PDA closed died 1 and 3 years after diagnosis due to heart failure. CONCLUSIONS Pulmonary artery dissection is a potential complication of PDA in dogs, the Weimaraner breed may be at increased risk, presentation is often in mature dogs, and closure of the PDA can be performed and appears to improve outcome.
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Affiliation(s)
- Brian A Scansen
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, USA.
| | - Elaine M Simpson
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, USA
| | - Jordi López-Alvarez
- Small Animal Teaching Hospital, School of Veterinary Science, University of Liverpool, Leahurst, Chester High Road, Neston, Cheshire, UK; Department of Clinical Science and Services, Royal Veterinary College, London, UK
| | - William P Thomas
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Janice M Bright
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Bryan D Eason
- Department of Veterinary Clinical Sciences and the Veterinary Teaching Hospital, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - John E Rush
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Joanna Dukes-McEwan
- Small Animal Teaching Hospital, School of Veterinary Science, University of Liverpool, Leahurst, Chester High Road, Neston, Cheshire, UK
| | - Henry W Green
- Department of Veterinary Clinical Sciences and the Veterinary Teaching Hospital, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Suzanne M Cunningham
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Lance C Visser
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, USA
| | - Agnieszka M Kent
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, USA
| | - Karsten E Schober
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, USA
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