Cause of Death Determined by Full-body Autopsy in Neuropathologically Diagnosed Dementias

AbstractInfection by the new corona virus strain SARS-CoV-2 and its related syndrome COVID-19 has been associated with more than two million deaths worldwide. Patients of higher age and with preexisting chronic health conditions are at an increased risk of fatal disease outcome. However, detailed information on causes of death and the contribution of pre-existing health conditions to death yet is missing, which can be reliably established by autopsy only. We performed full body autopsies on 26 patients that had died after SARS-CoV-2 infection and COVID-19 at the Charité University Hospital Berlin, Germany, or at associated teaching hospitals. We systematically evaluated causes of death and pre-existing health conditions. Additionally, clinical records and death certificates were evaluated. We report findings on causes of death and comorbidities of 26 decedents that had clinically presented with severe COVID-19. We found that septic shock and multi organ failure was the most common immediate cause of death, often due to suppurative pulmonary infection. Respiratory failure due to diffuse alveolar damage presented as immediate cause of death in fewer cases. Several comorbidities, such as hypertension, ischemic heart disease, and obesity were present in the vast majority of patients. Our findings reveal that causes of death were directly related to COVID-19 in the majority of decedents, while they appear not to be an immediate result of preexisting health conditions and comorbidities. We therefore suggest that the majority of patients had died of COVID-19 with only contributory implications of preexisting health conditions to the mechanism of death.

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Clinical Application of Postmortem Magnetic Resonance Imaging in Neonates

Neonatology ◽

10.1159/000512923 ◽

2021 ◽

Vol 118 (1) ◽

pp. 54-63

Author(s):

Eilon Shany ◽

Kyla Marks ◽

Aviva Levitas ◽

Agneta Golan ◽

Ramy Abramsky ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Cause Of Death ◽

Clinical Application ◽

Resonance Imaging ◽

Postmortem Magnetic Resonance Imaging ◽

New Findings ◽

Clinical Diagnoses ◽

Postmortem Examinations ◽

Full Body

Background: Recent reports advocate the use of MRI either as a substitute for postmortem examinations or for a more targeted autopsy. Methods: A full-body postmortem MRI (pMRI) of infants was performed as early as possible after death, and findings were compared to clinical premortem diagnoses. Results: Thirty-one infants were scanned during the study period. Median gestation at birth was 34 weeks (ranges: 24–43). In 3 (10%) cases, no new findings were detected. In 2 (6%), new minor findings not related to the cause of death were detected, and in 17 (55%), new minor findings related to the cause of death were detected. New major findings related to the cause of death were detected in 4 (13%) cases, and new major findings not related to the cause of death were detected in 5 (16%) cases. In 3 (10%), findings thought to alter the perceived cause of death were detected. Overall, in 23 (74%) cases, pMRI findings reinforced the clinical premortem diagnoses. Conclusions: pMRI is a culturally accepted alternative when autopsy is not performed and can either reinforce, refute, or add to premortem clinical diagnoses.

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Death in a Carbon Dioxide Therapy Bath: A Case Report and Review of the Literature

Academic Forensic Pathology ◽

10.1177/1925362119851241 ◽

2019 ◽

Vol 9 (1-2) ◽

pp. 93-96

Author(s):

Julian Samuel ◽

Zhanna Georgievskaya

Keyword(s):

Carbon Dioxide ◽

Case Report ◽

Cause Of Death ◽

Review Of The Literature ◽

Manner Of Death ◽

Chronic Skin ◽

Skin Conditions ◽

Closed Environment ◽

Full Body ◽

At Home

Carbon dioxide (CO2) therapy is the subcutaneous or transcutaneous administration of CO2 for therapeutic purposes. Carbon dioxide therapy is used for localized lipolysis, to treat chronic skin conditions, and is a safe treatment. Full-body CO2 baths are offered in European spa centers, in which the clients are placed into full body bags infused with CO2 at an optimal concentration range between 1000 and 1400 mg/L (516 000-722 500 ppm). Commercially manufactured, air-tight bags and accompanying apparatus designed to provide CO2 baths can be purchased for home use. Few human CO2-related deaths have been reported. They have been mostly accidental, consisting of persons trapped in a closed environment in the presence of “dry ice” or solid CO2. There have been no reported deaths of a human undergoing a CO2 therapy at home. We present a case of a middle-aged male found at home completely inside an air-sealed bag wrapped tightly around his body. The bag was connected to a working pump and a CO2 gas tank. The pump was connected through an inflow and outflow circuit to the bag. The inflow tubing for CO2 gas delivery was partially disrupted, while the outflow tubing was intact. The autopsy and toxicology were unremarkable. The cause of death was determined to be asphyxia by vitiated atmosphere as evident by the displacement of oxygen by CO2 and low pressure created inside a “CO2 therapy bath.” The manner of death was accidental.

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Full Body Exams May Reveal Hidden Cancers

Skin & Allergy News ◽

10.1016/s0037-6337(05)70052-8 ◽

2005 ◽

Vol 36 (3) ◽

pp. 44

Author(s):

DAMIAN MCNAMARA

Keyword(s):

Full Body

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Fast and Effective: Full-Body Examinations Uncover Otherwise Missed Skin Lesions

Family Practice News ◽

10.1016/s1553-3212(05)70971-7 ◽

2005 ◽

Vol 35 (5) ◽

pp. 39

Author(s):

DAMIAN MCNAMARA

Keyword(s):

Skin Lesions ◽

Full Body

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Wiser Reasoning and Less Disgust Have the Potential to Better Achieve Suicide Prevention

Crisis ◽

10.1027/0227-5910/a000709 ◽

2020 ◽

pp. 1-8

Author(s):

Chao S. Hu ◽

Jiajia Ji ◽

Jinhao Huang ◽

Zhe Feng ◽

Dong Xie ◽

...

Keyword(s):

High School ◽

Suicide Prevention ◽

Cause Of Death ◽

Facial Expressions ◽

Emotional Reaction ◽

Suicide Method ◽

University Teachers ◽

Advice Giving ◽

Prevention Techniques

Abstract. Background: High school and university teachers need to advise students against attempting suicide, the second leading cause of death among 15–29-year-olds. Aims: To investigate the role of reasoning and emotion in advising against suicide. Method: We conducted a study with 130 students at a university that specializes in teachers' education. Participants sat in front of a camera, videotaping their advising against suicide. Three raters scored their transcribed advice on "wise reasoning" (i.e., expert forms of reasoning: considering a variety of conditions, awareness of the limitation of one's knowledge, taking others' perspectives). Four registered psychologists experienced in suicide prevention techniques rated the transcripts on the potential for suicide prevention. Finally, using the software Facereader 7.1, we analyzed participants' micro-facial expressions during advice-giving. Results: Wiser reasoning and less disgust predicted higher potential for suicide prevention. Moreover, higher potential for suicide prevention was associated with more surprise. Limitations: The actual efficacy of suicide prevention was not assessed. Conclusion: Wise reasoning and counter-stereotypic ideas that trigger surprise probably contribute to the potential for suicide prevention. This advising paradigm may help train teachers in advising students against suicide, measuring wise reasoning, and monitoring a harmful emotional reaction, that is, disgust.

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Child and Adolescent Suicide Deaths in New Mexico, 1990-1994

Crisis ◽

10.1027//0227-5910.21.1.36 ◽

2000 ◽

Vol 21 (1) ◽

pp. 36-44 ◽

Cited By ~ 9

Author(s):

DD Werenko ◽

LM Olson ◽

L Fullerton-Gleason ◽

AW Lynch ◽

RE Zumwalt ◽

...

Keyword(s):

New Mexico ◽

Cause Of Death ◽

American Indians ◽

Adolescent Suicide ◽

Suicide Attempts ◽

Medical Examiner ◽

Contributing Factors ◽

Targeted Interventions ◽

And Gender ◽

Youth Activity

The suicide death rate in New Mexico is consistently higher than the national rate. Among adolescents, suicide is the third leading cause of death nationally, but in New Mexico it is the second leading cause of death. This study describes the pattern of adolescent suicide deaths in New Mexico. We conducted a retrospective review of all medical examiner autopsies for adolescent suicides (ages 20 years and younger) in New Mexico from 1990-1994. Records were reviewed for demographics and possible contributing factors such as depression, previous attempts, and alcohol and drug use. We identified 184 suicide deaths among children and adolescents ages 9-20 years for an overall rate of 12.9 per 100,000. Our rates for ages 5-9 years (0.2), 10-14 years (3.8), and 15-19 years (22.3) are over twice the U.S. rates. Suicide deaths resulted primarily from firearms (67%), hanging (16%), poisoning (6%), inhalation (4%), and other methods (7%). Method varied by ethnicity (p = .01) and gender (p = .03); males and non-Hispanic Whites were overrepresented among firearm deaths. Firearm ownership was known in 60 (48%) of the firearm deaths. Of these, 53% of the firearms belonged to a family member, 25% to the decedent, and 22% to a friend. Over one-third of decedents (41%) experienced mental disorders, primarily depressed mood and clinical depression. Previous suicide attempts were noted for 15% of the decedents. Some 50% of the decedents had alcohol or drugs present at the time of death; among American Indians/Alaska Natives, 74% had drugs or alcohol present (p = .003). Targeted interventions are needed to reduce adolescent suicide in New Mexico. We suggest raising awareness about acute and chronic contributing factors to suicide; training physicians to look for behavioral manifestations of depression; and involving physicians, teachers, and youth activity leaders in efforts to limit firearm accessibility, such as advising parents to remove firearms from their households.

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