Towards the end of 2019, a novel coronavirus was identified as the culprit for a cluster of pneumonia cases in Wuhan, China. Since then, it has rapidly spread worldwide, affecting more than 43 million people, and in March 2020, the World Health Organization (WHO) declared it a pandemic. The purpose of the study is to present the findings of 15 forensic autopsies performed in Romania, on SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) positive subjects, and to present the case of one SARS-CoV-2 infected patient who experienced a violent death, as established during their autopsy. A total of 11 male and 4 female patients were autopsied, and SARS-CoV-2 infection was diagnosed post-mortem in two cases. The most frequent symptoms before death were dry cough, dyspnoea, and fever. Hypertension, ischemic cardiac disease, and a history of stroke were the most frequent associated diseases. The mean duration from the symptoms’ debut to a RT-PCR positive SARS-CoV-2 test was 3.7 days, while the mean survival time from the RT-PCR positive test was 4.2 days. A histological examination was performed in seven cases and revealed, in most of them, hyaline membranes, and mixed inflammatory cell infiltration of the interstitium, alveoli, and perivascular areas. In addition, all of the examined cases developed small vessel thrombosis. A case of violent death was also reported, regarding a 87-year-old male subject who suffered a femur fracture (domestic fall) and was diagnosed with SARS-CoV-2 infection the following day after surgery. After transfer to a COVID-19 (coronavirus disease-19) support hospital, during an episode of behavioral disorder, the patient jumped from the first floor window. Death occurred a few days later, and the cause was established as bronchopneumonia superimposed on SARS-CoV-2 infection. In conclusion, autopsies should be conducted while providing a safe environment for professionals to perform them, because they are crucial procedures that can help gain a better understanding of the role of SARS-CoV-2 infection in thanatogenesis.
Introduction: Amiodarone, a frequently used antiarrhythmic drug in cardiology, is very effi cient in the treatment of ventricular and supraventricular tachiarrithmyas. The iodine content of amiodarone is 39%. Its chemical structure is similar to tyrosine. It is estimated that 1-23% of patients treated with amiodarone can develop hyperthyroidism. The purpose of this study is to assess and monitor the incidence of hyperthyroidism induced by amiodarone in patients admitted for various types of cardiac dysrhythmias, considering that most of the patients included in the study came from an endemic goitre area. Material and method: One-hundred patients chosen systematically (62 men, 38 women) from 560 patients treated with amiodarone in the January 1 st , 2009 -December 31, 2009 period were assessed (clinically, laboratory fi ndings and imaging studies); their mean age was 64 years (range 50-70 years). In order to identify and diagnose hyperthyroidism, a questionnaire (Newcastle index) was used, also urinary iodine dosage, hormonal dosages (T3, T4, TSH) and thyroid imaging (ultrasound, radioactive iodine uptake test) were used. Results: The incidence of hyperthyroidism induced by amiodarone in this study was 8%. Hyperthyroidism was more frequent in women (6 women vs. 2 men). Conclusions: Thyroid hormonal levels have to be determined and a clinical or thyroid ultrasound examination should be made prior to initiating a treatment with amiodarone. At the end of the study, 8 patients, most of them female, were diagnosed with hyperthyroidism.
Postmortem bacteriology examinations have been a controversial topic over the years, though the value of postmortem bacteriology cultures remains promising. The aim of this study was to review the postmortem bacteriological sampling procedures and results in a single centre in Bucharest over a period of 10 years. Material and methods: The present study was a retrospective, single-center study, performed at the Mina Minovici National Institute of Legal Medicine in Bucharest, Romania, from 2011–2020. Results: Postmortem bacteriology was requested 630 forensic autopsies, 245 female (38.9%) and 385 male (61.1%), age range 0 and 94 years, median age of 52 years. Deaths occurred in hospital for 594 cases (94.3%) and out-of-hospital for 36 cases (5.7%—field case). Blood cultures were requested in the majority of cases, followed by tracheal swabs and lung tissue. In-hospital and out of hospital deaths did not differ significantly regarding the number of microorganisms identified in a positive blood culture. Postmortem bacteriology cultures of the respiratory tract showed a statistically significant association to microscopically confirmed lung infections. Conclusions Postmortem sampling for bacteriology testing in our center in Bucharest is heterogeneous with a high variation of patterns. A positive blood culture result for Staphylococcus species without the identification of a specific microorganism is more likely due to postmortem contamination.
The objective of the current study is to evaluate the complication rates (embolic and hemorrhagic events) in deep venous thrombosis (DVT) patients on different types of oral anticoagulation therapy (OAC): direct oral anticoagulant therapy and vitamin K antagonist therapy.Methods: A number of 62 DVT patients were included and divided in two groups, depending on the type of oral anticoagulation therapy administered. The first group was composed of patients treated with direct oral anticoagulant treatment (Dabigatran, Rivaroxaban) and the second group was composed of patients treated with vitamin K antagonist (Acenocumarol). General data, including BMI and comorbidities were noted. Embolic and hemorrhagic events were noticed.Results: in the first group of patients (DOAC therapy), a number of 34 patients were included (14 of them with BMI higher than 25 kg/m2 and 14 with concomitant atrial fibrillation), while the second group comprised of 28 patients treated with VKA (21 of them with a high BMI and only 3 of them with atrial fibrillation). After a mean period of 36 months of anticoagulant therapy, complications were present in 17 patients, hematuria (8 episodes) and pulmonary embolism (4 cases) were the most frequent, with no difference regarding the treatment applied.Conclusion: No statistically significant difference was encountered regarding embolic and hemorrhagic event rates in our deep vein thrombosis patients.
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