Jonassengotfredsen1865
with COVID-19-related deaths. Cycle threshold values were not correlated with the cause of death or postmortem time. The sensitivity and specificity of the rapid antigen test were 91.67% and 100.00%, respectively. The RT-qPCR positivity rate of forensic cases was higher than the cumulative infection rate for the entire population. SARS-CoV-2 could be detected with the rapid antigen test and RT-qPCR within 216 hours of death. Because the rapid antigen test showed the same sensitivity and specificity as those observed in clinical practice, the test combined with RT-qPCR may be useful for diagnosing COVID-19 even in postmortem specimens.
A 1989 state law in Maryland allows family members to contest cause and manner of death determinations of medical examiners. A previous article described the experience with this law involving 12 appeals over a 3-year period (2012-2015). We now update the experience with the law involving 10 appeals that occurred over a subsequent period (2015 to September 2021) and a resultant change in the law. This unique appellate scheme has proven to be a valuable tool for medical examiners and families and has to date prevented resort to judicial courts. It is a model statutory scheme that is recommended for other jurisdictions to consider.
A 1989 state law in Maryland allows family members to contest cause and manner of death determinations of medical examiners. A previous article described the experience with this law involving 12 appeals over a 3-year period (2012-2015). We now update the experience with the law involving 10 appeals that occurred over a subsequent period (2015 to September 2021) and a resultant change in the law. This unique appellate scheme has proven to be a valuable tool for medical examiners and families and has to date prevented resort to judicial courts. It is a model statutory scheme that is recommended for other jurisdictions to consider.
The incidence of how often a deep vein thrombosis is found in the calves of the legs at coronial postmortem examination is unclear. This study retrospectively examined postmortem examination reports from Australian Coronial investigations of sudden death resulting from pulmonary thromboembolism to determine the likelihood of dissection of the deep veins of calves of the legs revealing the source of a pulmonary thromboembolism. From 450 cases taken from the National Coronial Information System (NCIS) for 2016, the postmortem reports of 327 cases were reviewed to provide demographic details of victims of sudden death from pulmonary thromboembolism. In 235 cases, it was possible to determine in 76.6% a thrombus had been found in the deep veins of the calves of the legs after dissection. In 141 cases, it was documented that both sides had been examined. From these, it was determined there was no statistically significant difference in the prevalence of thrombus in either side. However, it was shown that the preses, it was documented that both sides had been examined. From these, it was determined there was no statistically significant difference in the prevalence of thrombus in either side. However, it was shown that the presence of an abnormality of a lower limb (such as leg or hip infection, burns, surgery and nonoperated fractures, or a larger circumference) increased the likelihood that a deep vein thrombus would be found on that side.
After high-profile events involving firearms, gun violence often becomes the center stage of public discourse with national media attention, overshadowing less common causes of homicidal deaths, such as sharp force injury, blunt trauma, and asphyxia. A retrospective analysis of all cases referred for medicolegal autopsy to the Medical and Forensic Autopsy Division of the Department of Pathology and Laboratory Medicine at the Medical University of South Carolina from 2013 to 2018 documented 793 deaths where the manner was classified as homicide. Of these, 18% (144) of the deaths were caused by non-firearm-inflicted injuries. Nonfirearm homicides were further categorized by method; demographic data including decedent age, race, and sex; and other variables such as incident site, decedent relationship status to the alleged perpetrator, number of other homicide fatalities associated with a homicide event, and the presence of drugs and alcohol in the decedents. Data accrued in this review were compared with natiirearm-inflicted injuries. Nonfirearm homicides were further categorized by method; demographic data including decedent age, race, and sex; and other variables such as incident site, decedent relationship status to the alleged perpetrator, number of other homicide fatalities associated with a homicide event, and the presence of drugs and alcohol in the decedents. Data accrued in this review were compared with national statistics published by the Centers for Disease Control and Prevention and to the overall Medical University of South Carolina firearm-related homicide decedent demographic statistics for this same period. Findings augment existing information available regarding non-gun-related homicides and may be valuable in contributing to the ongoing public and political debate regarding firearm and nonfirearm fatalities.
A 61-year-old woman with an asymptomatic hip presented acutely with a swollen lower limb 15 years after a metal bearing surface total hip replacement (THR). A large intrapelvic pseudotumor was discovered compressing her femoral and iliac vessels. Collaboration between an orthopaedic and vascular surgeon led to a 2-stage surgical procedure with resection of the pseudotumor, followed by revision of the THR implant 3 months later.
This case demonstrates the importance of long-term follow-up of patients with metal bearing surface implants, early recognition of an unusual presentation of a common problem, and the utility of collaboration between orthopaedic and vascular surgeons.
This case demonstrates the importance of long-term follow-up of patients with metal bearing surface implants, early recognition of an unusual presentation of a common problem, and the utility of collaboration between orthopaedic and vascular surgeons.
Despite abortion being a common part of reproductive healthcare, UK undergraduate medical school abortion education varies widely. We therefore aimed to explore medical students' views on their undergraduate abortion education, including whether it prepared them to be a competent practitioner.
We conducted in-depth semi-structured interviews with 19 students from five UK medical schools, all of whom had received abortion teaching. The qualitative research followed a quantitative survey of UK undergraduate abortion education; the five medical schools were purposively sampled to encompass a wide variety of teaching approaches. Interviews were transcribed and data were analysed using an inductive thematic approach.
Dedicated abortion teaching was highlighted as necessary and valuable, as abortion care is so commonly accessed. Participants felt that abortion education should prepare students to be competent practitioners, with inclusion of clinical placements and an emphasis on non-stigmatising care. Most isensitivity of abortion increases the importance of effective teaching that prepares them to provide competent respectful care when they qualify. It is incumbent on medical schools to provide the comprehensive education that students need and the Royal College of Obstetricians and Gynaecologists recommends.
This trial aimed to evaluate effects of structured contraceptive counselling among non-migrants, foreign-born migrants and second-generation migrants.
A cluster randomised controlled trial was conducted in 2017-2019 at abortion, youth and maternal health clinics in Stockholm, Sweden (the LOWE trial). Patients were eligible if they were 18 years or older, could understand Swedish or English (or if assisted by an interpreter), were sexually active or planning to be, and were seeking contraception for pregnancy prevention. We randomised clinics at a 11 allocation ratio to give either structured contraceptive counselling (intervention) or to maintain standard contraceptive counselling (control). Blinding was not deemed feasibile. A study-specific package for structured contraceptive counselling was used and comprised an educational video, an effectiveness chart, four key questions and a box with contraceptive models. Outcomes were effects of the intervention on long-acting reversible contraception (LARC) choiptive counselling increased LARC choice, initiation and use, controlled for participants' migration background. The effectiveness chart was found to be significantly more supportive among foreign-born migrants and second-generation migrants compared to non-migrants when choosing contraceptive methods.
NCT03269357.
NCT03269357.Excessive daytime sleepiness (EDS) is classically viewed as a consequence of insufficient sleep or a symptom of sleep disorders. selleck kinase inhibitor Epidemiological and clinical evidence have shown that patients reporting EDS in tandem with sleep disorders (e.g., obstructive sleep apnoea) are at greater cardiovascular risk than non-sleepy patients. While this may simply be attributable to EDS being present in patients with a more severe condition, treatment of sleep disorders does not consistently alleviate EDS, indicating potential aetiological differences. Moreover, not all patients with sleep disorders report EDS, and daytime sleepiness may be present even in the absence of any identifiable sleep disorder; thus, EDS could represent an independent pathophysiology. The purpose of this review is twofold first, to highlight evidence that EDS increases cardiovascular risk in the presence of sleep disorders such as obstructive sleep apnoea, narcolepsy and idiopathic hypersomnia and second, to propose the notion that EDS may also increase cardiovascular risk in the absence of known sleep disorders, as supported by some epidemiological and observational data. We further highlight preliminary evidence suggesting systemic inflammation, which could be attributable to dysfunction of the gut microbiome and adipose tissue, as well as deleterious epigenetic changes, may promote EDS while also increasing cardiovascular risk; however, these pathways may be reciprocal and/or circumstantial. Additionally, gaps within the literature are noted followed by directions for future research.
Non-invasive high-frequency oscillatory ventilation (nHFOV) is an extension of nasal continuous positive airway pressure (nCPAP) support in neonates. We aimed to compare global and regional distribution of lung volumes during nHFOV versus nCPAP.
In 30 preterm infants enrolled in a randomised crossover trial comparing nHFOV with nCPAP, electrical impedance tomography data were recorded in prone position. For each mode of respiratory support, four episodes of artefact-free tidal ventilation, each comprising 30 consecutive breaths, were extracted. Tidal volumes (V
) in 36 horizontal slices, indicators of ventilation homogeneity and end-expiratory lung impedance (EELI) for the whole lung and for four horizontal regions of interest (non-gravity-dependent to gravity-dependent; EELI
, EELI
, EELI
, EELI
) were compared between nHFOV and nCPAP. Aeration homogeneity ratio (AHR) was determined by dividing aeration in non-gravity-dependent parts of the lung through gravity-dependent regions.
Overall, 228 recordings were analysed.
