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Oura P, Hakkarainen A, Sajantila A. Forensic neuropathology in the past decade: a scoping literature review. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00672-9. [PMID: 37439948 DOI: 10.1007/s12024-023-00672-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/14/2023]
Abstract
While there has been notable research activity in the field of clinical neuropathology over the recent years, forensic approaches have been less frequent. This scoping literature review explored original research on forensic neuropathology over the past decade (January 1, 2010, until February 12, 2022) using the MEDLINE database. The aims were to (1) analyze the volume of research on the topic, (2) describe meta-level attributes and sample characteristics, and (3) summarize key research themes and methods. Of 5053 initial hits, 2864 fell within the target timeframe, and 122 were included in the review. Only 3-17 articles were published per year globally. Most articles originated from the Europe (39.3%) and Asia (36.1%) and were published in forensic journals (57.4%). A median sample included 57 subjects aged between 16 and 80 years. The most common research theme was traumatic intracranial injury (24.6%), followed by anatomy (12.3%) and substance abuse (11.5%). Key methods included immunotechniques (31.1%) and macroscopic observation (21.3%). Although a number of novel findings were reported, most were of preliminary nature and will require further validation. In order to reach breakthroughs and validate novel tools for routine use, more research input is urged from researchers across the world. It would be necessary to ensure appropriate sample sizes and make use of control groups.
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Affiliation(s)
- Petteri Oura
- Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, P.O. Box 21, Helsinki, FI-00014, Finland.
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, FI-00271, Finland.
| | - Antti Hakkarainen
- Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, P.O. Box 21, Helsinki, FI-00014, Finland
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, FI-00271, Finland
| | - Antti Sajantila
- Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, P.O. Box 21, Helsinki, FI-00014, Finland
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, FI-00271, Finland
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Keane DF, Raimann JG, Zhang H, Willetts J, Thijssen S, Kotanko P. The time of onset of intradialytic hypotension during a hemodialysis session associates with clinical parameters and mortality. Kidney Int 2021; 99:1408-1417. [PMID: 33607178 PMCID: PMC8165353 DOI: 10.1016/j.kint.2021.01.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/17/2020] [Accepted: 01/13/2021] [Indexed: 02/06/2023]
Abstract
Intradialytic hypotension (IDH) is a common complication of hemodialysis, but there is no data about the time of onset during treatment. Here we describe the incidence of IDH throughout hemodialysis and associations of time of hypotension with clinical parameters and survival by analyzing data from 21 dialysis clinics in the United States to include 785682 treatments from 4348 patients. IDH was defined as a systolic blood pressure of 90 mmHg or under while IDH incidence was calculated in 30-minute intervals throughout the hemodialysis session. Associations of time of IDH with clinical and treatment parameters were explored using logistic regression and with survival using Cox-regression. Sensitivity analysis considered further IDH definitions. IDH occurred in 12% of sessions at a median time interval of 120-149 minutes. There was no notable change in IDH incidence across hemodialysis intervals (range: 2.6-3.2 episodes per 100 session-intervals). Relative blood volume and ultrafiltration volume did not notably associate with IDH in the first 90 minutes but did thereafter. Associations between central venous but not arterial oxygen saturation and IDH were present throughout hemodialysis. Patients prone to IDH early as compared to late in a session had worse survival. Sensitivity analyses suggested IDH definition affects time of onset but other analyses were comparable. Thus, our study highlights the incidence of IDH during the early part of hemodialysis which, when compared to later episodes, associates with clinical parameters and mortality.
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Affiliation(s)
- David F Keane
- Research Division, Renal Research Institute, New York, New York, USA; Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
| | - Jochen G Raimann
- Research Division, Renal Research Institute, New York, New York, USA
| | - Hanjie Zhang
- Research Division, Renal Research Institute, New York, New York, USA
| | - Joanna Willetts
- Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, USA
| | - Stephan Thijssen
- Research Division, Renal Research Institute, New York, New York, USA
| | - Peter Kotanko
- Research Division, Renal Research Institute, New York, New York, USA; Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Kumar NT, Liestøl K, Løberg EM, Reims HM, Mæhlen J. Apolipoprotein E allelotype is associated with neuropathological findings in Alzheimer's disease. Virchows Arch 2015; 467:225-35. [PMID: 25898889 DOI: 10.1007/s00428-015-1772-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 02/27/2015] [Accepted: 03/24/2015] [Indexed: 12/01/2022]
Abstract
In a consecutive hospital-based autopsy series, we examined the relationship between apolipoprotein E (apoE) and Alzheimer's disease (AD) and investigated the clinicopathological relationship in AD. The study population included 99 patients (mean age 81 years) with AD-related neuropathological findings at death, of whom 83 were diagnosed with AD according to the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) classification, and a control group of patients without neurodegenerative disease (n = 1429). The patients were apoE genotyped and the density of β-amyloid senile plaques, neuritic plaques and neurofibrillary tangles was estimated in the cortex and hippocampus. The utility of immunohistochemical staining using an antibody directed against apoE4 in paraffin-embedded tissue was also evaluated. Among patients with "definite AD" according to CERAD, 65 % were ε4 carriers, compared to 32 % among controls (p < 0.001). The risk of ε4 carriers to develop AD was higher (odds ratio = 4.65, p = 0.001) than for non-ε4 carriers. The amount of β-amyloid deposition and neurofibrillary pathology differed significantly (p < 0.01) between the genotypes, with increasing densities from ε2 carriers to homozygous ε4 carriers. The effect of ε4 on the presence of clinical symptoms was attenuated and non-significant after adjusting for AD-related neuropathological findings. There was an association between these findings and the presence of clinical symptoms of AD, with neurofibrillary tangles separating patients with and without symptoms of AD markedly better than β-amyloid. In addition, we found a strong relationship between genotype and immunohistochemical apoE4-staining intensity. In conclusion, this Scandinavian autopsy study shows that the apoE polymorphism is associated with the probability of AD and influences the deposition of β-amyloid and neurofibrillary pathology. Our findings suggest that the association between apoE and clinical manifestations of AD is mediated mainly through the neuropathological features of AD. Further, we found a relationship between AD-related findings and clinical symptoms of AD with neurofibrillary tangles associating most strongly with clinical symptoms. Finally, immunohistochemical staining in brain specimens is useful for determining ε4- or non-ε4-carrier status.
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Affiliation(s)
- Neena Theresa Kumar
- Department of Pathology, Oslo University Hospital-Ullevål, P.O. Box 4956, Nydalen, 0424, Oslo, Norway,
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Behnoush B, Sheikhazadi A, Bazmi E, Fattahi A, Sheikhazadi E, Saberi Anary SH. Comparison of UHPLC and HPLC in benzodiazepines analysis of postmortem samples: a case-control study. Medicine (Baltimore) 2015; 94:e640. [PMID: 25860209 PMCID: PMC4554044 DOI: 10.1097/md.0000000000000640] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 02/09/2015] [Accepted: 02/17/2015] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to compare system efficiency and analysis duration regarding the solvent consumption and system maintenance in high-pressure liquid chromatography (HPLC) and ultra high-pressure liquid chromatography (UHPLC). In a case-control study, standard solutions of 7 benzodiazepines (BZs) and 73 biological samples such as urine, tissue, stomach content, and bile that screened positive for BZs were analyzed by HPLC and UHPLC in laboratory of forensic toxicology during 2012 to 2013. HPLC analysis was performed using a Knauer by 100-5 C-18 column (250 mm × 4.6 mm) and Knauer photodiode array detector (PAD). UHPLC analysis was performed using Knauer PAD detector with cooling autosampler and Eurospher II 100-3 C-18 column (100 mm × 3 mm) and also 2 pumps. The mean retention time, standard deviation, flow rate, and repeatability of analytical results were compared by using 2 methods. Routine runtimes in HPLC and UHPLC took 40 and 15 minutes, respectively. Changes in mobile phase composition of the 2 methods were not required. Flow rate and solvent consumption in UHPLC decreased. Diazepam and flurazepam were detected more frequently in biological samples. In UHPLC, small particle size and short length of column cause effective separation of BZs in a very short time. Reduced flow rate, solvent consumption, and injection volume cause more efficiency and less analysis costs. Thus, in the detection of BZs, UHPLC is an accurate, sensitive, and fast method with less cost of analysis.
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Affiliation(s)
- Behnam Behnoush
- From the Department of Forensic Medicine, School of Medicine, Tehran University of Medical Sciences (BB, AS); Tehran University of Medical Sciences, Faculty of Pharmacy, Toxicology and Poisoning Research Centre (AS); Laboratory of Forensic Toxicology, Legal Medicine Research Center of Tehran, Tehran, Iran (EB, AF); School of Nursing & Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran (ES); Health Services Management, Kerman University of Medical Sciences, Kerman, Iran (SHSA)
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Mehrpour O, Karrari P, Sheikhazadi A. Survey of factors related to criminal behavior in a sample of Iranian substance abusers. J Forensic Leg Med 2013; 20:1078-81. [PMID: 24237824 DOI: 10.1016/j.jflm.2013.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 09/26/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Many countries including Iran have a high rate of substance abuse. It is essential for public health and law enforcement strategies to know the causes and consequences of substance abuse and its relation to crimes. METHODS In a prospective case-control study, covering a period of one year starting from March 21, 2010, 125 cases with criminal behavior and 125 cases with no history of criminal behavior were studied. RESULTS Eight percent of our studied population had a previous history of psychological disorder. Most of our cases were cigarette users (78.4%). Forty-two cases had a history of alcohol abuse (16.8%). Modern drugs were the most common type of drugs (56%) being used. Multivariate analysis using logistic regression revealed that criminal behavior was correlated with divorce (RR = 5.35; 95% CI = 1.59-16.01; P = 0.023), history of alcohol use (RR = 2.63; 95% CI = 1.11-6.22; P = 0.027), history of psychological disorder (RR = 4.97; 95% CI = 1.44-17.20; P = 0.011), Modern drug use (RR = 4.86; 95% CI = 2.01-11.76; P = 0.001) and starting drug abuse at an early age (RR = 0.94; 95% CI = 0.88-0.99; P = 0.03). CONCLUSIONS Risk factors for criminal behavior among substance abusers include being divorced, history of alcohol abuse, history of psychological disorder, modern drug abuse and starting drug abuse at an early age.
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Affiliation(s)
- Omid Mehrpour
- Medical Toxicology and Drug Abuse Research Group, Birjand University of Medical Sciences, Birjand, Iran; Department of Clinical Toxicology and Forensic Medicine, Faculty of Medicine, Birjand University of Medical Sciences, Ghaffari Avenue, Birjand 97175-379, Iran
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Akhlaghi M, Sheikhazadi A, Khosravi N, Pournia Y, Saberi Anary SH. The value of the anthropometric parameters of the tibia in the forensic identification of the Iranian population over the age of 20. J Forensic Leg Med 2011; 18:257-63. [PMID: 21771556 DOI: 10.1016/j.jflm.2011.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 04/16/2011] [Accepted: 05/04/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Tibia is one of the bones which can be applied in sex determination in addition to its successful role in determination of stature. The aim of this study was to investigate the value of anthropometric parameters of the tibia in forensic identification. MATERIALS AND METHODS Cross-sectional analysis of anthropometric parameters of the tibia was done by Legal Medicine Organization of Tehran, Iran studying Iranian population over the age of 20 during 2009 and 2010. RESULTS This study covered four aspects of tibias of 80 fresh Iranian cadavers, 40 men and 40 women, including the maximum lateromedial length, medial length, proximal width, and the distal width. The study showed that genders can be distinguished using the lateromedial length with 90% sensitivity and 80% specificity, the medial length with 90% sensitivity and 85% specificity, the proximal width with 85% sensitivity and 87.5% specificity, and the distal width with 67.5% sensitivity and 75% specificity. CONCLUSION In order to determine the relationships between the diverse aspects of tibia, the correlations between different dimensions of tibia were examined, resulting in the regression equations between its length and width.
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Affiliation(s)
- Mitra Akhlaghi
- Department of Forensic Medicine, School of Medicine, Tehran University of Medical Sciences, Poursina St., Keshavarz Blvd., Tehran 1417613151, Iran
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