DOCSLIB.ORG

Management of the Corpse with Suspect, Probable Or Confirmed

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Management of the Corpse with Suspect, Probable Or Confirmed PATHOLOGICA Epub 2020 Mar 26 DOI: 10.32074/1591-951X-13-20 Guidelines Management of the corpse with suspect, probable or confirmed COVID-19 respiratory infection – Italian interim recommendations for personnel potentially exposed to material from corpses, including body fluids, in morgue structures and during autopsy practice Vittorio Fineschi1, Anna Aprile2, Isabella Aquila3, Mauro Arcangeli4, Alessio Asmundo5, Mauro Bacci6, Mariano Cingolani7, Luigi Cipolloni8, Stefano D’Errico9, Ilaria De Casamassimi1, Giulio Di Mizio3, Marco Di Paolo10, Martina Focardi11, Paola Frati1, Mario Gabbrielli12, Raffaele La Russa1, Aniello Maiese10, Federico Manetti1, Massimo Martelloni13, Elena Mazzeo14, Angelo Montana15, Margherita Neri16, Martina Padovano1, Vilma Pinchi17, Cristoforo Pomara15, Pietrantonio Ricci3, Monica Salerno15, Alessandro Santurro1, Matteo Scopetti1, Roberto Testi18, Emanuela Turillazzi10, Giuseppe Vacchiano19 on behalf of the Scientific Society of Hospital Legal Medicine of the National Health System (COMLAS), Filippo Crivelli20, Emanuela Bonoldi21, Fabio Facchetti22, Manuela Nebuloni23 Anna Sapino24,25; on behalf of the Italian Society of Anatomical Received and accepted: March 25, 2020 Pathology and Cytology (SIAPEC) Published online: March 26, 2020 1 Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Correspondence Italy; 2 Department of Molecular Medicine, Legal Medicine, University of Padua, Italy; 3 Institute of Legal Anna Sapino Medicine, University “Magna Graecia” of Catanzaro, Italy; 4 Department of Clinical Medicine, Public Health, Life SC Anatomia Patologica FPO-IRCCS, and Environmental Sciences, University of L’Aquila, Italy; 5 Departmental section of Legal Medicine “G. Martino”, Candiolo (Turin), Italy and Department of University of Messina, Italy; 6 Forensic and Sports Medicine Section, Department of Surgery and Biomedical Medical Sciences, University of Turin, Italy Science, University of Perugia, Italy; 7 Section of Legal Medicine, University of Macerata, Italy; 8 Department E-mail: [email protected] of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D’Avanzo, Foggia, Italy; 9 Department of Legal Medicine, University of Trieste, Italy; 10 Department Conflict of interest statement of Surgical Pathology, Medical, Molecular and Critical Area, University of Pisa, Italy; 11 Department of Health The Authors declare no conflict of interest. Sciences, Section of Forensic Medicine, University of Florence, Italy; 12 Department of Medicine, Surgery and Neuroscience, Santa Maria alle Scotte University Hospital of Siena, Italy; 13 Department of Legal Medicine, Azienda USL Toscana Nordovest, Lucca, Italy; 14 Department of Biomedical Sciences, Legal Medicine, University How to cite this article: Fineschi V, Aprile A, of Sassari, Italy; 15 Department of Medical Science, Surgical Science and advanced Technologies “G.F, Ingrassia”, Aquila I, et al. Management of the corpse with University of Catania, Italy; 16 Department of Morphology, Surgery and Experimental Medicine, Section of Legal suspect, probable or confirmed COVID-19 Medicine and LTTA Centre, University of Ferrara, Italy; 17 Department of Health Sciences, University of Florence, respiratory infection – Italian interim recom- Italy; 18 ASL “Città di Torino”, Regional Center for Prion Diseases (DOMP), Turin, Italy; 19 Department of Law, mendations for personnel potentially exposed Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy; 20 SCA Anatomia to material from corpses, including body flu- Patologica, ASST Valle Olona, Busto Arsizio, Italy; 21 SC Anatomia Istologia Patologica e Citogenetica, Grande ids, in morgue structures and during autopsy Ospedale Metropolitano Niguarda Milan, Italy; 22 UOC di Anatomia Patologica, ASST Spedali Civili di Brescia, practice. Pathologica Epub 2020 Mar 26. Italy; 23 Anatomia Patologica, ASST-FBF-Sacco, Dibic, UNIMI, Italy; 24 SC Anatomia Patologica FPO-IRCCS, https://doi.org/10.32074/1591-951X-13-20 Candiolo (Turin), Italy ; 25 Department of Medical Sciences, University of Turin, Italy © Copyright by Società Italiana di Anatomia Pato- logica e Citopatologia Diagnostica, Divisione Itali- ana della International Academy of Pathology Introduction OPEN ACCESS The COVID-19 (Coronavirus Disease-19) is the most urgent health This is an open access article distributed in accordance emergency worldwide and all professionals are called to give support in with the Creative Commons Attribution Non Commercial the diagnosis and treatment of patients affected by this disease. (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and The Scientific Society of Hospital Legal Medicine of the National Health license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, System (COMLAS) and the Italian Society of Anatomical Pathology and any changes made indicated, and the use is non-commercial. Cytology (SIAPEC) produced this document with the intent of offering a See: http://creativecommons.org/licenses/by-nc/4.0 technical support to professional involved in the autoptic activities during 2 V. Fineschi et al. the Severe Acute Respiratory Syndrome Coronavi- Purpose and field of application rus 2 (SARS-CoV-2) epidemic infection. Coronaviruses are a broad category of viruses known The classification of infectious hazards needs to be to cause diseases ranging from the common cold to periodically reviewed and updated in light of global ep- Middle Eastern Respiratory Syndrome (MERS) and idemiological trends. The categorization of infectious Acute Severe Respiratory Syndrome (SARS). Recent- biological agents provides for the attribution to hazard ly, a novel coronavirus (nCoV) was identified that had groups (Hazard Group 1-4) based on the probability of never previously been found in humans 1-3. causing disease in humans, the probability of spread- The viruses responsible for SARS include SARS- ing the infection in the community, the availability of CoV-2 (Severe Acute Respiratory Syndrome Coro- prophylactic or therapeutic measures 31. navirus 2); the disease caused by the new Corona- The Advisory Committee on Dangerous Pathogens virus is called COVID-19 (Coronavirus Disease-19) (ACDP) in early 2020 established a provisional clas- and represents a cluster of pneumonia that has spread sification of SARS-CoV-2 as an HG3 pathogen (Hazard to China and other countries of the world since 31 De- Group 3). In this regard, it should be emphasized that cember 2019 4-8. HG3 agents can cause serious diseases in humans Initial reports suggest that transmission occurs during and constitute a serious risk for professionals; the agent close contact with an infected subject, mainly through may spread in the community, but effective prophylac- respiratory droplets produced in the act of speaking, tic or therapeutic measures are usually available. The coughing or sneezing 9,10. Droplets can settle on the risks for personnel operating in the morgue facilities, in eyes, nose or mouth, as well as being inhaled by peo- most infections, are minimal when standard universal ple nearby. At present, long-distance aerial transmis- precautions for infection prevention are applied 32-35. sion from person to person is unlikely. The purpose of the operating procedure is, therefore, Common signs of infection include fever, cough and to indicate how to manage the bodies of suspect or breathing difficulties. In severe cases, the infection confirmed cases of COVID-19 in order to minimize the can cause pneumonia, severe acute respiratory risk of environmental contamination and the contagion syndrome, multi-organ dysfunction or failure, and of personnel involved in the process. According to this death 11-16. perspective, the document is intended to recommend: WHO, CDC and ECDC have provided clear details on • the preparation of standard operating procedures measures to prevent the spread of the virus 17-21. Stan- (SOP) for the containment of infectious risk; dard recommendations to prevent the spread of infec- • adequate conduct for carrying out activities and tion include regular hand washing, covering the mouth maneuvers at risk during autopsy checks on cases and nose when coughing or sneezing and avoiding of SARS-CoV-2 infection; close contact 22,23. • personal protective equipment (PPE) to be used in At the Italian national level, the extra- and intra-hos- daily practice; pital path of suspect or confirmed cases of COVID-19 • the optimal evaluation pathways for the diagnosis and the indications relating to the use of personal pro- of SARS-CoV-2 infection. tective equipment (PPE) by healthcare personnel are The present document is mainly aimed at staff serv- extensively defined 24-28. ing in morgues (health professionals, trainees, as In view of the limited scientific knowledge and evi- well as auxiliary, administrative and surveillance staff) dence on SARS-CoV-2 infection, it is therefore con- and must be applied to every death from COVID-19, sidered appropriate to proceed systematically with the whether suspect, probable or confirmed. management of COVID-19 cases 29,30, whether they are suspect, probable or confirmed, accepted at the morgue. Hence the need to condense the available Terms and definitions evidence on biological risk, individual protection and autopsy investigation with the aim of providing a prac-
Load more

Recommended publications
  • Sleuths BEHIND the Scenes for PATHOLOGISTS, the UNUSUAL IS the USUAL
    ON THE COVER sleuths BEHIND THE scenes FOR PATHOLOGISTS, THE UNUSUAL IS THE USUAL. BY HOWARD BELL ennifer Boland’s path to pathology began during her sec- ond year of medical school at Washington University in St. Louis. Boland would take study breaks by looking at Jspecimen slides and images, learning to identify them. “Pathology is a visual science. I found it more enjoyable than memorizing notes,” she recalls. After a surgical pathology elective during her clinical rotations, she was hooked. “In medicine it can be hard to find the field you love,” says Boland, who is now a pathologist at Mayo Clinic. “I was lucky enough to find it.” Boland began practicing at Mayo three years ago, after com- pleting a pathology residency as well as pulmonary and surgical pathology fellowships there. She specializes in pulmonary and bone and soft-tissue pathology. Her particular expertise is in lung and chest sarcomas. “They’re a rare and interesting set of tumors,” she says. “Very few are diagnosed in this country each year.” Like many Mayo pathologists, she spends about half her time evaluating specimens from around the world for Mayo Medical Laboratories and the other half evaluating specimens from Mayo patients. Depending on case complexity, she evaluates around 25 to 50 specimens each day. “I like the mystery-solving of pathol- ogy,” she says. Boland is one of 332 pathologists who practice in Minnesota, according to the Minnesota Board of Medical Practice. Often thought of as either white-coated geeks hunched over microscopes or sexy swashbucklers who spend more time solving crimes than analyzing specimens (thanks to TV), pathologists 20 | MINNESOTA MEDICINE | OCTOBER 2014 ON THE COVER OCTOBER 2014 | MINNESOTA MEDICINE | 21 ON THE COVER are sleuths working behind the scenes to ogy, Boland says, adding that many don’t years for neuropathology).
    [Show full text]
  • Medicolegal Death Investigation Forensic Pathology: Forensic
    Medicolegal Death Investigation Forensic Pathology: Forensic pathology is a specific practice of medicine and subspecialty of pathology that directs its efforts to the examination of dead persons (and sometimes live persons) to provide an opinion concerning the: • cause, mechanism, and manner of disease, injury, or death; • identification of persons; • significance of biological and physical evidence; • correlation and/or reconstruction of wounds, wound patterns, and sequences. Forensic pathology is an integral component of comprehensive medicolegal death investigation. Forensic pathology applies techniques of pathology to the needs and protection of public health, Homeland Security (surveillance and mass disaster operations), public safety, quality assurance, education in medicine, research, jurisprudence, and the administration of justice. The highest goal of forensic pathology is the development of strategies to prevent injury, disease, and death. Forensic Pathologists: Forensic pathologists should be physicians specially trained in forensic pathology and board-certified by the American Board of Pathology or a non- USA trained pathologist with equivalent certification. The practicing forensic pathologist is licensed as a physician in one or more states and is skilled in conducting death investigations, interpreting injuries in both fatal and non-fatal cases, performing medicolegal examinations, determining disease/injury causation to an appropriate degree of medical certainty, and determining cause and manner of death. Forensic pathologists
    [Show full text]
  • Curated Materials
    PATHOLOGY RESOURCES TO DOWNLOAD Looking for more information or mentorship in Pathology? Send an email to: [email protected] for announcements on future pathology open houses hosted by the APC! QUICK LINKS TO DOWNLOAD: PDF RESOURCES WITH MORE LINKS! • Follow Pathology & Pathologists: www.dropbox.com/s/olq2dvuptrxcgli/Pathology_People%2BOrganizations.pdf?dl=0 • Watch Pathology Videos: www.dropbox.com/s/jor8en7g1y4soaf/Pathology_VideosToWatch.pdf?dl=0 • Free Memberships & Awards: www.dropbox.com/s/6erz3nh2ndngi16/Pathology_StudentOpportunities.pdf?dl=0 OTHER DOWNLOADABLE PDF RESOURCES ABOUT PATHOLOGY • Top 5 Pathology Myth Busted Flier (cap.org) https://documents.cap.org/documents/pathology-five-myths-busted-flier.pdf • Pathology 101 for Medical Students (cap.org) https://documents.cap.org/documents/pathology-101-for-medical-students.pdf • Overview of Anatomic and Clinical Pathology (cap.org) https://documents.cap.org/documents/overview-anatomic-clinical-pathology-medical-students.pdf • The Road to Becoming a Biomedical Physician Scientist (asip.org) www.asip.org/ASIP/assets/file/careers/TheRoad.pdf SALARIES, JOB MARKET, WORKFORCE TRENDS, AND CAREERS IN PATHOLOGY From APC’s Journal – Academic Pathology • Pathology: A Satisfying Medical Profession: journals.sagepub.com/doi/full/10.1177/2374289516661559 • Opportunity: Newly Created Physician-Scientist Research Pathway by the American Board of Pathology: journals.sagepub.com/doi/full/10.1177/2374289516632240 • The Pathology Workforce and Clinical Licensure: The Role of the PhD Clinical Laboratorian in the United States: journals.sagepub.com/doi/full/10.1177/2374289518775948 • Entry of Graduates of US Pathology Residency Programs Into the Workforce: Cohort Data Between 2008 and 2016 Remain Positive and Stable: journals.sagepub.com/doi/10.1177/2374289520901833 From ASCP’s Magazine – The Pathologist • Dr.
    [Show full text]
  • Forensic Pathology Large Coroner Offices Function Similar to a and the Type of Cases That Will Be Not Just for Popular TV Shows Medical Examiner Office
    Victor Weedn forensic pathologists, and in some states, on coroners, who often lack training Health & Medicine ︱ coroners are appointed. Typically, a and need not heed the advice of the coroner is not a licensed physician and medical examiner. cannot perform an autopsy, so they act as medicolegal death investigators – HOW RELEVANT ARE but they retain the legal ability to sign MEDICOLEGAL DEATH the death certificate. All coroners are INVESTIGATIONS TODAY? county-based and most are rural. A few State statutes define the type of system Forensic pathology large coroner offices function similar to a and the type of cases that will be Not just for popular TV shows medical examiner office. investigated. Most deaths are natural and wikipedia.org/wiki/Charles_Norris_(medical_examiner) the patient’s doctor will certify the death Medical examiner’s offices are headed without the need for investigation, but Forensic pathology is one orensic pathology is not your implementation of collapsible steering by board-certified forensic pathologist deaths that are not under the care of a of the most exciting and average medical specialty. Made wheel columns. professionals. Forensic pathology requires physician often require a comprehensive fascinating specialties in all of Fpopular by crime scene investigation Charles Norris was the 1st Chief Medical Examiner more training and education than a family medicolegal death investigation for medicine. Dr Victor W. Weedn, TV shows over the decades, from Quincy, THE ORIGINS OF of the City of New York, in office 1918–1935. practitioner. Medical examiner offices may accurate designation of cause and Chief Medical Examiner for M.E. in the 1970s to Coroner in 2019, the FORENSIC PATHOLOGY be at city, county, regional, or state level.
    [Show full text]
  • DUKE UNIVERSITY School of Medicine Pathologists' Assistant
    DUKE UNIVERSITY School of Medicine Pathologists’ Assistant Program Department of Pathology Academic Programs The Department of Pathology at Duke University offers a wide array of training programs to fit individual requirements and goals. The Residency Training program is an ACGME approved program and is available as an Anatomic Pathology/Clinical Pathology combined program, a shorter Anatomic Pathology only program, or an Anatomic Pathology/Neuropathology program. Subspecialty fellowships in Cytopathology, Dermatopathology, Hematopathology, Medical Microbiology, and Neuropathology are also ACGME approved. These programs provide the highest quality of graduate medical education by drawing on the depth and breadth of faculty expertise in the Department in all aspects of anatomic and clinical pathology and the availability of a wide variety of often complex clinical cases seen at Duke University Health System. For medical students interested in a career in Pathology predoctoral fellowships, internships and externships are available. Research Training in Experimental pathology can be obtained through Pre- and postdoctoral fellowships of one to five years. All predoctoral fellows are candidates for the Ph.D. degree in pathology. The Ph.D. is optional in postdoctoral programs, which provide didactic and research training in various aspects of modern experimental pathology. A two year NAACLS accredited Pathologists’ Assistant Program leads to a Master of Health Science degree, certifies graduates to sit for the ASCP Board of Certification examination, and leads to exciting career opportunities in a variety of anatomic pathology laboratory settings. Pathologists’ assistants are analogous to physician assistants, but with highly specialized training in autopsy and surgical pathology. This profession was pioneered in the Duke Department of Pathology more than 45 years ago, and is one of only eleven such programs in existence today.
    [Show full text]
  • Department of Pathology
    DEPARTMENT OF PATHOLOGY 2017 – 2018 HOUSESTAFF HANDBOOK 300 Pasteur Drive, L235 Stanford, CA 94305 http://pathology.stanford.edu 1 Please use the bookmarks as the Table of Contents 2 Training in Pathology at Stanford Overview The Department of Pathology at Stanford University Medical Center seeks to train outstanding candidates for academic, private practice and other leadership positions in pathology. We offer residency training in Anatomic Pathology (AP), Clinical Pathology (CP), and combined AP and CP (AP/CP). The overall goal of our program is to provide in-depth, flexible training, in all aspects of pathology, leading to board certification in AP, CP or AP/CP. We also offer accredited clinical fellowships in Blood Banking/Transfusion Medicine, Breast Pathology, Cytopathology, Dermatopathology, Gastrointestinal Pathology, Gynecologic Pathology, Hematopathology, Neuropathology, Microbiology, Molecular Genetic Pathology, and Surgical Pathology. Combined AP/Neuropathology is also offered, but must be discussed with the Program Directors and appropriate Fellowship Directors prior to pursuing these training avenues. Trainee Selection All eligible applicants will be considered for training in the Pathology Department at Stanford. Applicants must have one of the following qualifications to be eligible for consideration: ● Graduates of medical schools in the United States and Canada accredited by the Liaison Committee on Medical Education (LCME) ● Graduates of colleges of osteopathic medicine in the United States accredited by the American Osteopathic Association (AOA) ● Graduates of medical schools outside the United States and Canada who have received a currently valid certificate from the Educational Commission for Foreign Medical Graduates or have a full and unrestricted license to practice medicine in a U.S.
    [Show full text]
  • The Man in the Iron Coffin: an Interdisciplinary Effort to Name the Past
    Institutional Database of Staff Publications Tennessee Division of Archaeology Title: The Man in the Iron Coffin: An Interdisciplinary Effort to Name the Past. Year: 2006 Name(s): Douglas W. Owsley, Karin S. Bruwelheide, Larry W. Cartmell, Laurie E. Burgess, Shelly J. Foote, Skye M. Chang, and Nick Fielder Source: Historical Archaeology 40(3):89-108. Division of Archaeology • 1216 Foster Ave. • Cole Bldg #3 • Nashville, TN 37243 Tel: 615-741-1588 • Fax: 615-741-7329 • www.tennessee.gov/environment/section/arch-archaeology 89 Douglas W. Owsley the beautification of death (Little et al. 1992). Karin S. Bruwelheide After the War of 1812, interest in preserving Larry W. Cartmell, Sr. the body grew and, at the same time, coffin Laurie E. Burgess making moved from urban cabinetmakers to Shelly J. Foote commercial burial case manufacturing. Although Skye M. Chang many industrial coffin manufacturers introduced Nick Fielder "body preserving" coffins made out of iron, zinc, and clay, one of the most innovative and popular designs was made of cast iron (Crane, The Man in the Iron Coffin: Breed & Co. 1858, 1867). An Interdisciplinary Effort Almond D. Fisk's cast-iron coffin, patented to Name the Past in 1848, was one of the first iron coffins to advertise an airtight environment. The coffin design incorporated protruding flanges encircl ABSTRACT ing both the top and bottom portions that were joined with a lead seal and then bolted together. The examination of a cast-iron coffin from the Mason This created an excellent anaerobic environment family cemetery at Pulaski, Tennessee, offered an exceptional conducive to superior human tissue preservation, opportunity to study relatively well-preserved human remains, which was also being promoted by more sophis associated artifacts, and the coffin itself.
    [Show full text]
  • Curriculum Vitae
    February, 2013 CURRICULUM VITAE Name: Douglas H. Ubelaker Born: August 23, 1946 Horton, Kansas Present Position: Curator, Department of Anthropology National Museum of Natural History Smithsonian Institution Washington, D.C. 20560 Adjunct Positions: Consultant in Forensic Anthropology to the FBI, 1978-present Professorial Lecturer, Department of Anatomy, The George Washington University, Washington, D.C., 1986-present Professorial Lecturer, Department of Anthropology, The George Washington University, Washington, D.C., 1986-present Professor, Department of Anthropology, Michigan State University, East Lansing, Michigan, 2009-present Education: B.A. (honors) University of Kansas, 1968 Ph.D. University of Kansas, 1973 Military Service: U.S. Army, 1969-71 Major Consultant Work: Analysis of human skeletal remains 1976 to present. Over 855 individual cases reported on. Testimonials as expert witness at trials and hearings: September 6, 1978 State of Florida vs. Ludwig Oddo Baglioni Pensacola, Florida March 11, 1981 Commonwealth of Massachusetts vs. Carl Drew Fitchburg, Massachusetts March 2, 1982 State of Washington vs. Michael A. Smith Spokane, Washington June 5, 1985 U.S.A. vs. Buck Duane Walker San Francisco, California 2 September 16, 1985 State of Rhode Island and Providence Plantations vs. Paul Triana Providence, Rhode Island February 7, 1986 U.S.A. vs. Stephanie Stearns San Francisco, California February 21, 1986 State of Nebraska vs. Thomas E. Nesbitt Omaha, Nebraska April 16, 1987 State of New York vs. William Seifert Buffalo, New York April 28, 1987 United States of America vs. Gary Cheyenne Rapid City, South Dakota February 5, 1988 Commonwealth of Massachusetts vs. Christopher Bousquet New Bedford, Massachusetts November 19, 1990 State of Washington vs.
    [Show full text]
  • Increasing the Number, Retention, and Quality
    NATIONAL COMMISSION ON FORENSIC SCIENCE Increasing the Number, Retention and Quality of Board Certified Forensic Pathologists Type of Work Product Policy Recommendation prepared by the Medicolegal Death Investigation Subcommittee. Recommendation The National Commission on Forensic Science requests that the Attorney General of the United States approve policy recommending that: Medical schools and pathology training programs receiving federal funds should be required to assist in the recruitment of forensic pathologists by: (1) in the case of medical schools, providing exposure to forensic pathology, i.e. a minimum of two hours of instruction, during pathology education and offering elective rotations in forensic pathology; and (2) in the case of training programs in anatomical pathology, requiring a one month rotation in a medicolegal office where forensic autopsies are performed. All municipal, county, state or federal entities which receive federal grant money for their police agencies or crime laboratories require that all forensic autopsies performed under their authority be performed by a forensic pathologist. Loan forgiveness for forensic pathologists in full time practice for ten years since completion of their training in forensic pathology, and Forensic pathologist salaries be made competitive with other medical specialties There be recognition that Forensic pathologists operate as autonomous, and neutral scientists separate from law enforcement, and Forensic pathologists be available for prosecuting (or plaintiff) and defense attorneys in both criminal and civil law cases arising from their official death investigation duties as well as on independent consultations. Statement of Issue Forensic pathology is a pathology subspecialty that is largely practiced on behalf of the public. Forensic pathologists support the public health, public safety and criminal justice systems as well as provide critical information to the families of decedents and their treating physicians.
    [Show full text]
  • Forensic and Autopsy Microbiology
    The role of microbiology in forensic science and post-mortem examinations: a special focus on molecular diagnosis Amparo Fernández©- Rodríguezby author Microbiology Laboratory, Biology Service InstitutoESCMID Nacional Online de Toxicología Lecture Library y Ciencias Forenses (INTCF), Madrid, Spain Glamorous forensic medicine is in the media © by author ESCMID Online Lecture Library © by author ESCMID Online Lecture Library At the same time… The existing paradigm of clinical microbiology is changing For more than 100 years, physicians have relied on isolation and characterization of bacteria to understand disease and develop both patient- specific treatment plans Koch’s postulates link specific microorganisms to specific diseases that remain today the “gold standard” in medical microbiology Isolation of a pathogen microorganism in pure culture from a patient: association with infectious disease © by author However, clinical microbiology laboratories are increasingly moving away from primary isolation of pathogensESCMID to culture independent Online diagnostic testingLecture (CIDT)… Library …CIDT provides multipathogen diagnostic panels with remarkably brief turn-around times. Clinical laboratories are increasingly using CIDT methods and are less likely to conduct primary isolation Autopsy microbiology Determining the cause of death Or predisposing factors to death Applications in forensic / clinical pathology Main goals of forensic microbiology ©Is there by aauthor crime? Attribution: who committed a crime? ComparisonESCMID of strains isolated Online in a victim Lecture to those associated Library with the assailant “Autopsies tell communities why people are dying. Take for example West Nile Virus. When eight New Yorkers died of brain infections in 1999, most everyone assumed they had a common virus. But New York City's medical examiners insisted on autopsies.
    [Show full text]
  • Postmortem Changes and Time of Death
    POSTMORTEM CHANGES AND TIME OF DEATH Quotations "The time of death is sometimes extremely important. It is a question almost invariably asked by police officers, sometimes with a touching faith in the accuracy of the estimate. Determining the time of death is extremely difficult, and accuracy is impossible". (Ref. 8 at p. 115.) "No problem in forensic medicine has been investigated as thoroughly as that of determining the time of death on the basis of post mortem findings. Apart from its obvious legal importance, its solution has been so elusive as to provide a constant intellectual challenge to workers in many sciences. In spite of the great effort and ingenuity expended, the results have been meagre". (Ref. 15 at p. 33.) "Repeated experience teaches the investigator to be wary of relying on any single observation for estimating the time of death (or "duration of the post mortem interval"), and he wisely avoids making dogmatic statements based on an isolated observation". (Ref. 12 at p. 151.) "Considering the variables which influence the rate of body heat loss, the best one can say about the reliability of algor mortis as a post mortem clock is that it permits a rough approximation of the time of death. Errors in over-estimating and under-estimating the post mortem interval based on body cooling are common, even in the face of considerable experience by those making the estimate. Body temperature as an indicator of the post mortem interval should be correlated with all other phenomenon and observations utilised in establishing the time of death". (Ref.
    [Show full text]
  • Forensic Pathology
    If you have issues viewing or accessing this file contact us at NCJRS.gov. ~FORENSIC PATHOLOGY A Handbook For 0. Pathologists al Institute of Law Enforcement and Criminal Justice Law Enforcement Assistance Administration U. S. Department of Justice /I O FORENSIC PATHOLOGY A Handbook For Pathologists Edited By NCJ~S ~ RUSSELL S. FISHER, M.D. 8E001 ~rt CHARLES S. PETTY, M.D. &CQUISBTIO-NS. This project was supported by Grant Number NI 71-1lSG awarded to the Co[[ege of American Pathologists by the National Institute of La~v Enforcement and Criminal Justice, Law Enforcement Assist- ance Administration, U.S. Department of Justice, under the Ot~ni- bus Crime Contro[ and Safe Streets .Act of 1968, as amended. Points of view or opinions stated in this document are those of the contributors and do not necessarily represent the official position or po|icies of the U.S. Department of Justice. July 1977 National Institute of Law Enforcement and Criminal Justice Law Enforcement Assistance Administration U. S. Department of Justice For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402 Stock Number 027-000-00541-1 CONTENTS Page Contributors .......... : ................................ v Foreword--Robert Horn, M.D ............................. ix Preface by Editors ...................................... xi Chapter I Forensic Autopsy Procedure--Leslie I. Lukash, M.D .... 1 II Forensic Autopsy: A Procedural Outline--Frank P. Cleveland, M.D ................................. 7 III The Autopsy Protocol--John F. Barton, M.D. and Charles S. Petty, M.D ............................ 10 IV Preservation of Medicolegal Evidence Arthur J. McBay, Ph.D .................................. 17 V Postmortem Chemistry of Blood, Cerebrospinal Fluid and Vitreous Humor--John I.
    [Show full text]