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INTRODUCTION: Studies dealing with analysing cases of violent, sudden and unexpected deaths in childhood are very important, as these deaths can be prevented to a high percentage. The aim of this study is to evaluate the results of analysis of cases involving childhood deaths undergoing autopsy at Bratislava medico-legal workplaces within the catchment area of Bratislava and Trnava regions. PATIENTS AND METHODS: There was performed a retrospective analysis of autopsy protocols of death cases in childhood (from 0 to 14 years) at the Institute of Forensic Medicine of the School of Medicine Comenius University and Department of Forensic Medicine of Health Care Surveillance Authority in Bratislava in the period 1999-2008. RESULTS: In the monitored period there were detected 156 childhood deaths from the total number of 10,771 autopsied cases, which accounts for 1.45 %. Violent deaths were determined in 115 cases, i.e. 73.7 %. In 70.5 % of cases there were male children. The most frequent cause of death were injuries caused by a blunt object in 44.2 % of cases, followed by deaths caused by pathological causes (25.7 %), asphyxia (14.7 %), high temperature, intoxication, electrocution, etc. The external cause of death was most frequently traffic accidents in 56 cases (35.9 %), drowning in 13 cases (8.3 %) and homicides together with assaults in 12 cases (7.7 %). There were 45.5 % of the analysed cases in school age. CONCLUSION: The results of our analysis show that Bratislava and Trnava regions fall into regions with relatively low incidence of violent deaths in childhood. Our study has shown that many deaths could have been prevented by better care and higher responsibility of parents in particular, but also those who are responsible for the care and supervision of children.
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Autopsia/estadística & datos numéricos , Adolescente , Causas de Muerte , Niño , Preescolar , Femenino , Patologia Forense , Humanos , Lactante , Masculino , EslovaquiaRESUMEN
INTRODUCTION: Medical examiners frequently examine victims of sudden death. Most often sudden deaths have a cardiovascular cause. determine the diagnosis of sudden cardiac death based only on morphological findings may be often very difficult. Measurement of blood concentrations of cardiac troponin I (cTnl) and atrial natriuretic peptide (pro-ANP) is now in clinical use in adult patients with heart failure caused by myocardial damage. AIM: The aim of the study was the estimation wheather cTnl and/or pro-ANP could be markers of sudden cardiac death. PATIENTS AND METHODS: The study was carried out on 89 necroptic cases, of which 53 were concluded as cardiac-related sudden death, and 36 cases were used as a control group being other than cardiac death cases. Concentrations of markers were determined in blood taken from the left cardiac ventricle and from the right femoral vein. The dependence between the results of biochemical studies and death causes, results of histopathological examination of myocardium, time interval between the death and taking of samples, and resuscitation data was investigated. RESULTS: Concentrations of cTnl as determined in blood samples from the left ventricle were in most cases very high, largely exceeding the cut-off level, and so were concentrations of pro-ANP. The values of both parameters were significantly lower in peripheral blood. No statistically significant dependences were found between the levels of the studied markers and the cause of death, myocardial histopathological findings, time interval between the death and taking of samples, and resuscitation data. CONCLUSION: Based on the results obtained, the study can be concluded that blood is not a suitable medium for determination of biochemical markers of cardial troponin I and atrial natriuretic peptide for post-mortem diagnostics of myocardial damage and for determining the diagnosis of sudden cardiac death in a manner similar to diagnostics of myocardium damage in living patients.
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Factor Natriurético Atrial/sangre , Muerte Súbita Cardíaca , Troponina I/sangre , Biomarcadores/sangre , Muerte Súbita Cardíaca/etiología , HumanosRESUMEN
WHO Classification of Tumours of the Central Nervous System from the 2007 is distinguished from the previous 2000 classification by a few conceptual modifications, changes in the terminology and seven newly codified tumour entities. The text shows a short comparison of both classifications emphasising the most important changes from the surgical neuropathology point of view. The newly codified entities are: angiocentric glioma, pilomyxoid astrocytoma, papillary glioneuronal tumor, rosette-forming glioneuronal tumor of the 4th ventricle, papillary tumour of the pineal region, spindle cell oncocytoma and pituicytoma. Mostly, they are rare tumours already known from the literature. Based on new knowledge from the molecular pathology the paragraphs about tumour genetics were markedly changed. The complexity and diversity of tumours of the nervous system is enormous, and, not surprisingly, some problematic questions of classification and grading remain unresolved.