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von Stillfried S, Freeborn B, Windeck S, Boor P, Böcker J, Schmidt J, Tholen P, Röhrig R, Majeed R, Wienströer J, Bremer J, Weis J, Knüchel R, Breitbach A, Bülow RD, Cacchi C, Wucherpfennig S, Märkl B, Claus R, Dhillon C, Schaller T, Sipos E, Spring O, Braun G, Römmele C, Kling E, Kröncke T, Wittmann M, Hirschbühl K, Heppner FL, Meinhardt J, Radbruch H, Streit S, Horst D, Elezkurtaj S, Quaas A, Göbel H, Friemann J, Hansen T, Titze U, Lorenzen J, Reuter T, Woloszyn J, Baretton G, Hilsenbeck J, Meinhardt M, Pablik J, Sommer L, Holotiuk O, Meinel M, Esposito I, Crudele G, Seidl M, Mahlke N, Hartmann A, Haller F, Eichhorn P, Lange F, Amann KU, Coras R, Ingenwerth M, Rawitzer J, Schmid KW, Theegarten D, Gradhand E, Smith K, Wild P, Birngruber CG, Schilling O, Werner M, Acker T, Gattenlöhner S, Franz J, Metz I, Stadelmann C, Stork L, Thomas C, Zechel S, Ströbel P, Fathke C, Harder A, Wickenhauser C, Glatzel M, Matschke J, Krasemann S, Dietz E, Edler C, Fitzek A, Fröb D, Heinemann A, Heinrich F, Klein A, Kniep I, Lohner L, Möbius D, Ondruschka B, Püschel K, Schädler J, Schröder AS, Sperhake JP, Aepfelbacher M, Fischer N, Lütgehetmann M, Pfefferle S, Jonigk D, Werlein C, Domke LM, Hartmann L, Klein I, Schirmacher P, Schwab C, Röcken C, Langer D, Roth W, Strobl S, Rudelius M, Delbridge C, Kasajima A, Kuhn PH, Slotta-Huspenina J, Weichert W, Weirich G, Stock K, Barth P, Schnepper A, Wardelmann E, Evert K, Evert M, Büttner A, Manhart J, Nigbur S, Bösmüller H, Fend F, Granai M, Klingel K, Warm V, Steinestel K, Umathum VG, Rosenwald A, Vogt N, Kurz F. [Update on collaborative autopsy-based research in German pathology, neuropathology, and forensic medicine]. Pathologie (Heidelb) 2022; 43:101-105. [PMID: 36114379 PMCID: PMC9483541 DOI: 10.1007/s00292-022-01117-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Autopsies are a valuable tool for understanding disease, including COVID-19. MATERIALS AND METHODS The German Registry of COVID-19 Autopsies (DeRegCOVID), established in April 2020, serves as the electronic backbone of the National Autopsy Network (NATON), launched in early 2022 following DEFEAT PANDEMIcs. RESULTS The NATON consortium's interconnected, collaborative autopsy research is enabled by an unprecedented collaboration of 138 individuals at more than 35 German university and non-university autopsy centers through which pathology, neuropathology, and forensic medicine autopsy data including data on biomaterials are collected in DeRegCOVID and tissue-based research and methods development are conducted. More than 145 publications have now emerged from participating autopsy centers, highlighting various basic science and clinical aspects of COVID-19, such as thromboembolic events, organ tropism, SARS-CoV‑2 detection methods, and infectivity of SARS-CoV-2 at autopsy. CONCLUSIONS Participating centers have demonstrated the high value of autopsy and autopsy-derived data and biomaterials to modern medicine. The planned long-term continuation and further development of the registry and network, as well as the open and participatory design, will allow the involvement of all interested partners.
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Affiliation(s)
- Saskia von Stillfried
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Benita Freeborn
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Svenja Windeck
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Peter Boor
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Medizinische Klinik II (Nephrologie und Immunologie), Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Elektronenmikroskopische Einrichtung, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
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Klein A, Edler C, Fitzek A, Fröb D, Heinemann A, Meißner K, Mushumba H, Püschel K, Schröder AS, Sperhake JP, Ishorst-Witte F, Aepfelbacher M, Heinrich F. [The first COVID-19 hotspot in a retirement home in Hamburg]. Rechtsmedizin (Berl) 2020; 30:325-331. [PMID: 32836898 PMCID: PMC7335629 DOI: 10.1007/s00194-020-00404-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background Coronavirus disease 2019 (COVID-19), a disease caused by the new coronavirus (SARS-CoV-2), is a particular threat to old people. At the end of March 2020, the first and so far largest outbreak of the disease occurred in a retirement home in Hamburg. Methods Analysis of procedures in dealing with a residential unit affected by SARS-CoV‑2, accommodating a risk group of 60 seniors with dementia is presented as well as a detailed presentation of post-mortem examination results of all 8 deceased tested positive for SARS-CoV‑2. Results Out of 60 residents, 39 were infected by SARS-CoV‑2. Due to preventive procedures it was possible to stop further spreading of the infection to other residential areas. In all 8 fatal cases, the autopsy diagnosis was death due to COVID-19. Autopsies revealed all COVID-19 patients to have a fatal (broncho)pneumonia and signs of relevant pre-existing cardiac, renal and pulmonary conditions in all cases. In 75% (n = 6) of the cases a fresh venous thrombosis was found. In 66.7% (n = 4) of the cases thrombotic events were combined with peripheral pulmonary artery thromboembolisms. Conclusion The cohort of SARS-CoV‑2 infected residents of a nursing home is characteristic for clinical and epidemiological features of the new coronavirus disease. Due to a centralized evaluation of all fatalities at the Institute of Legal Medicine in Hamburg, a detailed examination of all deceased positive for SARS-CoV‑2 was possible. Thereby, increased case fatality rates of approximately 20% could in all cases be assigned to a relevant number of pre-existing comorbidities of multiple organ systems, which was consistent with the clinical data available.
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Affiliation(s)
- A Klein
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - C Edler
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - A Fitzek
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - D Fröb
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - A Heinemann
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - K Meißner
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - H Mushumba
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - K Püschel
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - A S Schröder
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - J P Sperhake
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - F Ishorst-Witte
- Bezirksamt Wandsbek, Schloßstraße 60, 22041 Hamburg, Deutschland
| | - M Aepfelbacher
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Deutschland
| | - F Heinrich
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
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Fitzek A, Sperhake J, Edler C, Schröder AS, Heinemann A, Heinrich F, Ron A, Mushumba H, Lütgehetmann M, Püschel K. Evidence for systematic autopsies in COVID-19 positive deceased: Case report of the first German investigated COVID-19 death. Rechtsmedizin (Berl) 2020; 30:184-189. [PMID: 32836897 PMCID: PMC7247437 DOI: 10.1007/s00194-020-00401-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Forensic medicine and pathology involve specific health risks, whereby health workers are dealing with microorganisms, cells or parasites, which are referred to as biological agents. Biological agents are divided into four categories according to § 3 of the Biological Agents Ordinance. The newly identified coronavirus, severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2) that has spread rapidly around the world is placed into category 3 of the Biological Agents Ordinance, meaning pathogens that can cause serious illnesses in humans and may pose a risk to workers. The Robert Koch Institute, the German government’s central scientific institution in the field of biomedicine issued the announcement, that aerosol-producing measures (including autopsies) of SARS-CoV‑2 infected bodies should be avoided, despite the fact that autopsies are an important source of understanding the pathomorphological course of new diseases. The first German case of death due to a proven SARS-CoV‑2 infection is presented with global multifocal reticular consolidation in the post-mortem computed tomography (CT) scan, a macroscopic and microscopic viral pneumonia and viral RNA of SARS-CoV‑2 in pharyngeal mucosa and lung tissue.
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Affiliation(s)
- A Fitzek
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Sperhake
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Edler
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A S Schröder
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Heinemann
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Heinrich
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Ron
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Mushumba
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Lütgehetmann
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Püschel
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Abstract
The pharmacokinetics of 2-pivaloylindan-1,3-dione (Pival) after administration of a single dose was investigated in dogs. The plasma concentration graph can be described by a one compartment open model. The drug is fairly well adsorbed (67%) and the excretion is extremely slow with a half-life of nearly five days. These kinetics can be explained by the physiochemical properties of the drug, such as strong binding to canine plasma protein, high lipophility and the lack of transformation to polar metabolites. A single oral dose of 5 mg/kg must be regarded as lethal to dogs and the LD50 is assumed to be approximately 4 mg/kg in this species.
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Frey HH, Fitzek A, Wintzer HJ, Baumgärtel E. Use of bumetanide, a potent diuretic, to obtain urinary samples for dope testing in horses. Am J Vet Res 1976; 37:1257-60. [PMID: 984555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Use of the potent, high-ceiling diuretic bumetanide made it possible to obtain urinary samples for dope testing of trotters within the 1st hour after the race. The drug was injected intravenously at a dose level of 10 mug/kg during the cold season of the year, but on warm days, a dose of 20 mug/kg was more reliable. These doses did not produce any side-effects and did not interfere with the detection of doping drugs, since bumetanide is not metabolized to a detectable degree and the unchanged drug appears only in extracts from acidic urine. By enhancing the clearance of drugs used for doping, bumetanide even provides favorable conditions for detection of such drugs.
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Wintzer HJ, Frey HH, Fitzek A. [Studies on diffusion of local anesthetic solutions from the hoof-joint in the bursa podotrochlearis in the horse]. SCHWEIZ ARCH TIERH 1976; 118:233-8. [PMID: 968475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Reisch J, Fitzek A. [Photolysis of 4-amino-, 4-alkoxy- and 4-Hydroxy-2,3-dimethyl-1-phenyl-3-pyrazolin-5-ones (author's transl)]. Arch Pharm (Weinheim) 1976; 309:215-21. [PMID: 962524 DOI: 10.1002/ardp.19763090308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Fitzek A, Henning A. [Distribution of thallium in the organism of a pregnant domestic cat]. Dtsch Tierarztl Wochenschr 1976; 83:66-8. [PMID: 765095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Fitzek A. [Direct colorimetric determination of thallium in the urine]. Berl Munch Tierarztl Wochenschr 1975; 88:111-2. [PMID: 1120065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Reisch J, Fitzek A. [Photolysis of 3-methyl- and 3-phenyl-4-amino-2-methyl-1-phenyl-3-pyrazolin-5-one (author's transl)]. Arch Pharm (Weinheim) 1974; 307:211-8. [PMID: 4849393 DOI: 10.1002/ardp.19743070308] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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