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Zhang L, Li K, Yang Q, Lin Y, Geng C, Huang W, Zeng W. Associations between deep venous thrombosis and thyroid diseases: a two-sample bidirectional Mendelian randomization study. Eur J Med Res 2024; 29:327. [PMID: 38877527 PMCID: PMC11177513 DOI: 10.1186/s40001-024-01933-1] [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] [Received: 09/12/2023] [Accepted: 06/09/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Some previous observational studies have linked deep venous thrombosis (DVT) to thyroid diseases; however, the findings were contradictory. This study aimed to investigate whether some common thyroid diseases can cause DVT using a two-sample Mendelian randomization (MR) approach. METHODS This two-sample MR study used single nucleotide polymorphisms (SNPs) identified by the FinnGen genome-wide association studies (GWAS) to be highly associated with some common thyroid diseases, including autoimmune hyperthyroidism (962 cases and 172,976 controls), subacute thyroiditis (418 cases and 187,684 controls), hypothyroidism (26,342 cases and 59,827 controls), and malignant neoplasm of the thyroid gland (989 cases and 217,803 controls. These SNPs were used as instruments. Outcome datasets for the GWAS on DVT (6,767 cases and 330,392 controls) were selected from the UK Biobank data, which was obtained from the Integrative Epidemiology Unit (IEU) open GWAS project. The inverse variance weighted (IVW), MR-Egger and weighted median methods were used to estimate the causal association between DVT and thyroid diseases. The Cochran's Q test was used to quantify the heterogeneity of the instrumental variables (IVs). MR Pleiotropy RESidual Sum and Outlier test (MR-PRESSO) was used to detect horizontal pleiotropy. When the causal relationship was significant, bidirectional MR analysis was performed to determine any reverse causal relationships between exposures and outcomes. RESULTS This MR study illustrated that autoimmune hyperthyroidism slightly increased the risk of DVT according to the IVW [odds ratio (OR) = 1.0009; p = 0.024] and weighted median methods [OR = 1.001; p = 0.028]. According to Cochran's Q test, there was no evidence of heterogeneity in IVs. Additionally, MR-PRESSO did not detect horizontal pleiotropy (p = 0.972). However, no association was observed between other thyroid diseases and DVT using the IVW, weighted median, and MR-Egger regression methods. CONCLUSIONS This study revealed that autoimmune hyperthyroidism may cause DVT; however, more evidence and larger sample sizes are required to draw more precise conclusions.
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Affiliation(s)
- Lifeng Zhang
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jinniu District, Chengdu, 610072, Sichuan, People's Republic of China
| | - Kaibei Li
- Disinfection Supply Center, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jin Niu District, Chengdu, 610072, Sichuan, People's Republic of China
| | - Qifan Yang
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jinniu District, Chengdu, 610072, Sichuan, People's Republic of China
| | - Yao Lin
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jinniu District, Chengdu, 610072, Sichuan, People's Republic of China
| | - Caijuan Geng
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jinniu District, Chengdu, 610072, Sichuan, People's Republic of China
| | - Wei Huang
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jinniu District, Chengdu, 610072, Sichuan, People's Republic of China
| | - Wei Zeng
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jinniu District, Chengdu, 610072, Sichuan, People's Republic of China.
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Systematic Review on Post-Mortem Protein Alterations: Analysis of Experimental Models and Evaluation of Potential Biomarkers of Time of Death. Diagnostics (Basel) 2022; 12:diagnostics12061490. [PMID: 35741301 PMCID: PMC9222196 DOI: 10.3390/diagnostics12061490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022] Open
Abstract
Estimating the post-mortem interval (PMI) is a very complex issue due to numerous variables that may affect the calculation. Several authors have investigated the quantitative and qualitative variations of protein expression on post-mortem biological samples in certain time intervals, both in animals and in humans. However, the literature data are very numerous and often inhomogeneous, with different models, tissues and proteins evaluated, such that the practical application of these methods is limited to date. The aim of this paper was to offer an organic view of the state of the art about post-mortem protein alterations for the calculation of PMI through the analysis of the various experimental models proposed. The purpose was to investigate the validity of some proteins as “molecular clocks” candidates, focusing on the evidence obtained in the early, intermediate and late post-mortem interval. This study demonstrates how the study of post-mortem protein alterations may be useful for estimating the PMI, although there are still technical limits, especially in the experimental models performed on humans. We suggest a protocol to homogenize the study of future experimental models, with a view to the next concrete application of these methods also at the crime scene.
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Aquila I, Boca S, Ricci P, Perozziello G, Candeloro P, Di Fabrizio E, Malara N, Gratteri S, Sacco MA, Francardi M. The use of scanning electron microscopy and energy dispersive X-ray spectroscopy in a case of occupational death. Med Leg J 2020; 88:163-168. [PMID: 32233908 DOI: 10.1177/0025817219891085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Scanning electron microscopy is a technique that provides high-resolution images at the micro- and nano-scale. The combination of scanning electron microscopy and energy dispersive X-ray spectroscopy analysis is developing fast for application in forensic science. In this work, we report a case of work-related traumatic death of a 50-year-old man. The autopsy showed cranial fractures with cerebral haemorrhage. It was more difficult to understand the accident dynamics because the body had been shifted from the accident site to mask what had really taken place. Scanning electron microscopy/energy dispersive X-ray spectroscopy was used to identify the material of the impacting tool and to establish the possible legal responsibility of the employer. In this study, we demonstrate that scanning electron microscopy/energy dispersive X-ray spectroscopy is a useful forensic tool for the analysis of biological samples. Further, for studying the lacerations on the corpse from doubtful blunt tools, scanning electron microscopy/energy dispersive X-ray spectroscopy can assist in demonstrating that the scene has been falsified, as it was in this case.
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Affiliation(s)
- I Aquila
- Institute of Legal Medicine, Magna Græcia, Department of Medical and Surgical Sciences, Institute of Legal Medicine, University of Catanzaro, Catanzaro, Italy
| | - S Boca
- U.O. di Medicina Legale, ASL Torino, Italy
| | - P Ricci
- Institute of Legal Medicine, Magna Græcia, Department of Medical and Surgical Sciences, Institute of Legal Medicine, University of Catanzaro, Catanzaro, Italy
| | - G Perozziello
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - P Candeloro
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - E Di Fabrizio
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - N Malara
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - S Gratteri
- Institute of Legal Medicine, Magna Græcia, Department of Medical and Surgical Sciences, Institute of Legal Medicine, University of Catanzaro, Catanzaro, Italy
| | - M A Sacco
- Institute of Legal Medicine, Magna Græcia, Department of Medical and Surgical Sciences, Institute of Legal Medicine, University of Catanzaro, Catanzaro, Italy
| | - M Francardi
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
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Aquila I, Ricci P, Galassi A, Sacco MA, Malfa O, Gratteri S. Sudden death and Takayasu's arteritis: The role of histopathological investigation. Med Leg J 2019; 87:139-143. [PMID: 31414603 DOI: 10.1177/0025817219862484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
When death is sudden and unexpected, autopsy may not provide sufficient information to be sure of the cause of death. Some causes can only be identified by microscopy. We report a case of sudden death in a woman who suffered from vertigo and hypertension. The autopsy only showed sclerosis of the thoracic aorta, abdominal aorta and coronary arteries, and the toxicological results were negative and did not explain the cause of death. A microscopic and immunohistochemical analysis of samples from various organs was carried out. The histopathological examination revealed eosinophilia in the aortic wall, consistent with a vasculitis such as Takayasu's arteritis. This case emphasises the association between systemic vasculitis and sudden death, as well as the role of histopathological investigation and the importance of post-mortem diagnosis to prevent similar fatal events among family members.
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Affiliation(s)
- Isabella Aquila
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | | | - Matteo Antonio Sacco
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Orazio Malfa
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Santo Gratteri
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
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Aquila I, Ricci P, Oliverio A, Gratteri S. Role of the body mass index in the genesis of ascites in ovarian cancer: a forensic case and review of the literature. BMJ Case Rep 2018; 11:11/1/e226491. [PMID: 30567893 DOI: 10.1136/bcr-2018-226491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The ovarian tumour is the seventh female cancer for incidence. In the advanced stages of cancer, tumour cells nourish on the peritoneal serous causing carcinomatosis and peritoneal function abnormalities with liquid build-up inside it. Ascites from peritoneal carcinomatosis is common in patients with ovarian cancer. An obese woman suffering from ovarian cancer was found dead in her home from secondary cardio-respiratory arrest due to Multiple Organ Failure (MOF). An autopsy was performed. The abdominal incision showed an ascitic fluid outflow about 20 litres in volume and a flood about one metre and half. An association between obesity and intraperitoneal fluid volume secondary to peritoneal carcinomatosis has been demonstrated. This finding could improve the prognosis of patients through actions aimed to reduce body weight.
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Affiliation(s)
- Isabella Aquila
- Institute of Legale Medicine, University Magna Graecia of Catanzaro, Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legale Medicine, University Magna Graecia of Catanzaro, Catanzaro, Catanzaro, Italy
| | - Alessandra Oliverio
- Institute of Legale Medicine, University Magna Graecia of Catanzaro, Catanzaro, Catanzaro, Italy
| | - Santo Gratteri
- Institute of Legal Medicine, AO MaterDomini Catanzaro, Catanzaro, Italy
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Aquila I, Ricci P, Mocciaro R, Gratteri S. A case of suspected illegal abortion: how clinicians may assist the forensic pathologist. BMJ Case Rep 2018; 2018:bcr-2017-220577. [PMID: 29970605 DOI: 10.1136/bcr-2017-220577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Abortion may be performed in a safe or unsafe manner, the latter being a frequent and dangerous event. It can also be performed in countries where abortion is legally recognised but, for various reasons, may be undertaken in an illegal environment. We present a case of a possible illegal abortion. A woman presented to the hospital with a dead fetus, saying that she was the victim of a car accident. Forensic and gynaecological examination of the woman were carried out, along with an autopsy of the fetus. It was discovered that the woman had performed a clandestine abortion. The differential diagnosis between illegal abortion and miscarriage represents a complicated issue and requires both clinical and forensic support. The gynaecologist may be of assistance to the forensic pathologist in confirming whether an illegal abortion has been performed.
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Affiliation(s)
- Isabella Aquila
- Institute of Legale Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legale Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Rita Mocciaro
- Institute of Legale Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Aquila I, Gratteri S, Amirante C, Fineschi V, Frati P, Ricci P. Electric or traumatic injury? The role of histopathological investigations. Med Leg J 2017; 86:85-88. [PMID: 29262767 DOI: 10.1177/0025817217743856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Analysis of wounds is crucial in forensic medicine to prove how an injury was caused. In many cases, microscopic analysis may be decisive. It is often difficult to distinguish macroscopic skin lesions resulting from electrical, mechanical and from thermal trauma where these occur simultaneously and to formulate a correct differential diagnosis. We report two cases in which the injuries found on the bodies and the manner of death raised uncertainty. An autopsy was performed. External examination of the bodies showed skin injuries that needed histopathological analysis to reconstruct the dynamics and the manner of death which has an important role in doubtful cases.
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Affiliation(s)
- Isabella Aquila
- 1 Institute of Legal Medicine, Magna Græcia University, Catanzaro, Italy
| | - Santo Gratteri
- 1 Institute of Legal Medicine, Magna Græcia University, Catanzaro, Italy
| | - Claudio Amirante
- 1 Institute of Legal Medicine, Magna Græcia University, Catanzaro, Italy
| | | | - Paola Frati
- 2 Institute of Legal Medicine, La Sapienza University, Rome, Italy
| | - Pietrantonio Ricci
- 1 Institute of Legal Medicine, Magna Græcia University, Catanzaro, Italy
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Aquila I, Tarzia P, Ricci P, Gratteri S. Sudden death and acute myocarditis: a unique forensic case of double origin of coronary arteries. BMJ Case Rep 2017; 2017:bcr-2017-221791. [DOI: 10.1136/bcr-2017-221791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Aquila I, Gratteri S, Sacco MA, Fineschi V, Magi S, Castaldo P, Viscomi G, Amoroso S, Ricci P. The Biological Effects of Kambo: Is There a Relationship Between its Administration and Sudden Death? J Forensic Sci 2017; 63:965-968. [PMID: 28886207 DOI: 10.1111/1556-4029.13641] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/21/2017] [Accepted: 08/21/2017] [Indexed: 11/30/2022]
Abstract
Kambo is a substance obtained from the skin secretions of a frog, Phyllomedusa bicolor, popular in the Amazon region, which is administered via the transdermal route. We report a case of 42-year-old man found dead in his house. Near the corpse, a plastic box labeled as "Kambo sticks" was found. The man was a chronic consumer of Kambo and no previous pathology or genetic disease emerged in clinical history from the declaration of his general practitioner. Autopsy investigations and toxicological analysis were performed. The histopathological examination showed left ventricular hypertrophy. Toxicological screening was negative for ethanol and other drugs. Phyllocaerulein, phyllokinin, and deltorphin A were isolated from the Kambo sticks but, only deltorphin A was detected in blood sample. We describe the first forensic case of death associated with Kambo administration. We attempt to explain how its use could be related to the cause of sudden death in this case.
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Affiliation(s)
- Isabella Aquila
- Institute of Legal Medicine, University "Magna Graecia", 88100, Catanzaro, Italy.,Institute of Legal Medicine, University "La Sapienza", 00186, Rome, Italy
| | - Santo Gratteri
- Institute of Legal Medicine, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Matteo A Sacco
- Institute of Legal Medicine, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Vittorio Fineschi
- Institute of Legal Medicine, University "La Sapienza", 00186, Rome, Italy
| | - Simona Magi
- Department of Biomedical Sciences and Public Health, School of Medicine, University "Politecnica delle Marche", 60126, Ancona, Italy
| | - Pasqualina Castaldo
- Department of Biomedical Sciences and Public Health, School of Medicine, University "Politecnica delle Marche", 60126, Ancona, Italy
| | | | - Salvatore Amoroso
- Department of Biomedical Sciences and Public Health, School of Medicine, University "Politecnica delle Marche", 60126, Ancona, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, University "Magna Graecia", 88100, Catanzaro, Italy
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