scholarly journals Sudden Death without a Clear Cause after Comprehensive Investigation: An Example of Forensic Approach to Atypical/Uncertain Findings

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 886
Author(s):  
Simone Grassi ◽  
Mònica Coll Vidal ◽  
Oscar Campuzano ◽  
Vincenzo Arena ◽  
Alessandro Alfonsetti ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Sudden Death ◽  
Histopathological Examination ◽  
Missense Variant ◽  
Current Evidence ◽  
Fatty Tissue ◽  
Myocardial Area ◽  
Unknown Significance ◽  
The Subject ◽  
The Right

Sudden death (SD) is defined as the unexpected natural death occurred within an hour after the onset of symptoms or from the last moment the subject has been seen in a healthy condition. Brugada syndrome (BrS) is one of the most remarkable cardiac causes of SD among young people. We report the case of a 20-year-old man who suddenly died after reportedly having smoked cannabis. Autopsy, toxicology, and genetic testing were performed. Autopsy found a long and thick myocardial bridging (MB) at 2 cm from the beginning of the left anterior descending coronary artery. Furthermore, at the histopathological examination, fibrosis and disarray in myocardial area above the MB, fatty tissue in the right ventricle and fibrosis of the sino-atrial node area were found. Toxicology testing was inconclusive, while genetic testing found a rare missense variant of the TTN gene, classified as likely benign, and a variant of unknown significance in the SLMAP gene (a gene that can be associated with BrS). Hence, despite several atypical features were found, no inference on the cause of the death could be made under current evidence.

scholarly journals Elastofibroma Dorsi, a Rare Condition, with Challenging Diagnosis. Case Report and Literature Review

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 370
Author(s):  
Octavian Neagoe ◽  
Cosmin Ioan Faur ◽  
Mihaela Ionică ◽  
Flavia Baderca ◽  
Roxana Folescu ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Histopathological Examination ◽  
Rare Condition ◽  
Surgical Excision ◽  
High Rate ◽  
Biological Entity ◽  
Fatty Tissue ◽  
Oncologic Surgery ◽  
Elastofibroma Dorsi ◽  
The Right

Elastofibroma dorsi (ED) is known as a particular clinical and biological entity. We report a case of a bilateral elastofibroma dorsi (ED) in a 65-year-old female who presented to the Department of General and Oncologic Surgery of Emergency Clinical Municipal Hospital Timisoara, Romania. The patient was symptomatic on the right side, presenting pain in the interscapulothoracic region associated with a variable tumoral mass, dependent on the position of the right arm. Imaging studies revealed a well-defined, bilateral tumoral mass with alternation of the muscular and fatty tissue. The initial diagnosis of lipoma was taken into consideration based on the CT scan and clinical findings. Surgical excision of the right subscapular tumor was performed without any postoperative complications. Microscopic examination of hematoxylin and eosin, Masson’s trichrome, and orcein stained slides revealed the diagnosis of ED. Considering the high rate of reported postoperative complications and the asymptomatic presentation of the contralateral subscapular mass, the patient underwent clinical and imagistic monitoring for the contralateral tumor. Due to its rare nature, ED is a difficult preoperative diagnosis that can, however, be suggested by its specific location and may require an accurate histopathological examination for a final diagnosis.

The Postmortem Interpretation of Cardiac Genetic Variants of Unknown Significance in Sudden Death in the Young: A Case Report and Review of the Literature

2020 ◽  
Vol 10 (3-4) ◽  
pp. 166-175
Author(s):  
Saleh Fadel ◽  
Alfredo E. Walker
Keyword(s):  
Genetic Testing ◽  
Sudden Death ◽  
Traumatic Event ◽  
Screening Tests ◽  
Polymorphic Ventricular Tachycardia ◽  
Unique Challenge ◽  
Variants Of Unknown Significance ◽  
Prophylactic Measures ◽  
Unknown Significance ◽  
Qt Syndrome

Sudden cardiac death (SCD) in adolescents and young adults is a major traumatic event for families and communities. In these cases, it is not uncommon to have a negative autopsy with structurally and histologically normal heart. Such SCD cases are generally attributed to channelopathies, which include long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. Our understanding of the causes for SCDs has changed significantly with the advancements in molecular and genetic studies, where many mutations are now known to be associated with certain channelopathies. Postmortem analysis provides great value in informing decision-making with regard to screening tests and prophylactic measures that should be taken to prevent sudden death in first degree relatives of the decedent. As this is a rapidly advancing field, our ability to identify genetic mutations has surpassed our ability to interpret them. This led to a unique challenge in genetic testing called variants of unknown significance (VUS). VUSs present a diagnostic dilemma and uncertainty for clinicians and patients with regard to next steps. Caution should be exercised when interpreting VUSs since misinterpretation can result in mismanagement of patients and their families. A case of a young adult man with drowning as his proximate cause of death is presented in circumstances where cardiac genetic testing was indicated and undertaken. Eight VUSs in genes implicated in inheritable cardiac dysfunction were identified and the interpretation of VUSs in this scenario is discussed.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

Clinical Application and Results of the Assessment of Coronary Blood Flow by the Regional Precordial Xenon Residue Detection Technique

1978 ◽  
Vol 17 (04) ◽  
pp. 161-171
Author(s):  
H.-J. Engel ◽  
H. Hundeshagen ◽  
P. R. Lichtlen
Keyword(s):  
Wall Motion ◽  
High Flow ◽  
Detection Technique ◽  
Fatty Tissue ◽  
Technical Aspects ◽  
Residue Detection ◽  
High Affinity ◽  
Artery Disease ◽  
The Right ◽  
Drug Interventions

Methodological and technical aspects as well as application and results of the precordial Xenon-residue-detection technique are critically reviewed. The results concern mainly normal flow in various regions of the heart esp. in the free wall of the right and left ventricle, poststenotic flow in patients with coronary artery disease in relation to the degree of proximal nar-rowings as well as wall motion of the corresponding LV segment, bypassgraft flow and flow after drug interventions esp. nitrates, betablockers, the calcium-antagonist Nifedipine and the coronary dilator Dipyridamole. In spite of its serious limitations (high affinity of Xenon for fatty tissue, geometrical problems in the assessment of flow and its relation to anatomy, gas exchange in situations of high flow etc.), the technique is found to be a usefull investigatory tool. Due to its technical display and the related high costs routine application is, however, prohibitive.

Contemporary Machiavellian theses "The strategy of the role of the absurd state as a model"

2020 ◽  
pp. 3
Author(s):  
Ali Hussein Hameed ◽  
Saif Hayder AL.Husainy
Keyword(s):  
International Relations ◽  
Decision Maker ◽  
Turning Point ◽  
Information Revolution ◽  
Main Hypothesis ◽  
The Subject ◽  
Area Of Influence ◽  
The Right ◽  
Modern Technologies

In the anarchism that governs the nature and patterns of international relations characterized by instability and uncertainty in light of several changes, as well as the information revolution and the resulting developments and qualitative breakthroughs in the field of scientific and advanced technological knowledge and modern technologies.  All of these variables pushed toward the information flow and flow tremendously, so rationality became an indispensable matter for the decision maker as he faces these developments and changes. There must be awareness and rationality in any activity or behavior because it includes choosing the best alternative and making the right decision and selecting the information accurately and mental processing Through a mental system based on objectivity, methodology, and accumulated experience away from idealism and imagination, where irrationality and anarchy are a reflection of the fragility of the decision-maker, his lack of awareness of the subject matter, his irresponsibility, and recklessness that inevitably leads to failure by wasting time and Effort and potential. The topic acquires its importance from a search in the strategies of the frivolous state and its characteristics with the ability to influence the regional, and what it revealed is a turning point in how to adapt from the variables and employ them to their advantage and try to prove their existence. Thus, the problem comes in the form of a question about the possibility of the frivolous state in light of the context of various regional and international events and trends. The answer to this question stems from the main hypothesis that (the aim which the frustrating state seeks to prove is that it finds itself compelled to choose several strategies that start from the nature of its characteristics and the goals that aim at it, which are centered in the circle of its interests in the field of its struggle for the sake of its survival and area of influence).

Strategi Humas Partai Gerindra dalam Membangun Citra Partai pada Pemilu 2014

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Rialdo Rezeky ◽  
Muhammad Saefullah
Keyword(s):  
Data Collection ◽  
Public Relations ◽  
Media Relations ◽  
Executive Board ◽  
The Public ◽  
Community Or ◽  
The Subject ◽  
Main Components ◽  
The Right ◽  
Participatory Observation

The approach of this research is qualitative and descriptive. In this study those who become the subject of research is an informant (key figure). The subject of this study is divided into two main components, consisting of internal public and external public that is from the Board of the Central Executive Board of Gerindra Party, Party Cadres, Observers and Journalists. The object of this research is the behavior, activities and opinions of Gerindra Party Public Relation Team. In this study used data collection techniques with interviews, participatory observation, and triangulation of data. The results of this study indicate that the Public Relations Gerindra has implemented strategies through various public relations programs and establish good media relations with the reporters so that socialization goes well. So also with the evaluation that is done related to the strategy of the party. The success of Gerindra Party in maintaining the party’s image in Election 2014 as a result of the running of PR strategy and communication and sharing the right type of program according to the characteristics of the voting community or its constituents.Keywords: PR Strategy, Gerindra Party, Election 2014

PENILAIAN AUTENTIK PADA MATAPELAJARAN PENDIDIKAN AGAMA ISLAM

Edupedia ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 77-85
Author(s):  
Mohamad Aso Samsudin ◽  
Ukhtul Iffah
Keyword(s):  
Islamic Education ◽  
Authentic Assessments ◽  
Measurement Tools ◽  
The Subject ◽  
The Right

Teaching is an art means that the art of managing people who have a variety of different characters. The teacher should be able to recognize these different characters so that he can easily master them so that the subject is easily mastered by them. However, the teacher is not easy to do that. It is no less difficult in learning to do assessment, because when assessment teachers are required to be careful and meticulous so that the results are not wrong, be careful in determining appropriate measurement tools as measured, or careful in operating the right tools, especially teachers are required able to do a complete assessment (authentic) in three domains (cognitive, psychomotor, and affective). This article reviews how to carry out authentic assessments in Islamic Education (Pendidikan Agama Islam) learning.

Right and Wrong from the Standpoint of G. W. Hegel

2020 ◽  
Vol 9 ◽  
pp. 5-13
Author(s):  
V. V. Ershov ◽  
Keyword(s):  
The Subject ◽  
The Right

The subject of the article is the right and «wrong» from the standpoint of G. W. Hegel and other researchers. H. W. Hegel refers the «wrong» to the «unreal» right, which should «gradually disappear». In the article, first of all, legal and individual regulators of legal relations are distinguished. Secondly, the «wrong» refers to a type of individual regulators of legal relations, which have distinctive objective features from the right.

Successful Control of a Co-Infection Caused by Candida albicans and Pseudomonas aeruginosa in Keratitis

2020 ◽  
Vol 20 ◽  
Author(s):  
Debarati Paul ◽  
Suman Saha ◽  
Neelam Singh ◽  
Jayansgu Sengupta ◽  
Santi M. Mandal
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Candida Albicans ◽  
Histopathological Examination ◽  
Specific Interaction ◽  
Major Threat ◽  
Effective Combination ◽  
Male Farmer ◽  
Successful Control ◽  
The Right ◽  
Corneal Button

Introduction: Nowadays, co-infection by interspecific organisms is major threat in infection control. To identify the effective combination of drugs to control the keratitis caused by Candida albicans with Pseudomonas aeruginosa are attributed in this study. Materilas and Methods: The patient of a 47 years old male farmer with infection in the right eye which showed redness and watering was treated with fortified cefazolin and fortified tobramycin before referral. No pigmentation or vascularisation was noted. The excised corneal button was also subjected to microbiological and histopathological examination. Results: A rare case of keratitis caused by co-infection of Candida albicans with Pseudomonas aeruginosa was identified. Results confirmed the inter-specific interaction of the two microorganisms. Conclusion: Cases of co-infection by Candida and Pseudomonas are not abundantly reported and difficult to treat. In this case, treatment involved Amphotercin-B and ciprofloxacin, effectively eradicated the infection. This therapy may be successfully implied for such cases of co-infection in future.

Patent Foramen Ovale, the Role of Antiplatelet Therapy Alone or Anticoagulant Therapy Alone Versus Device Closure for Cryptogenic Stroke: A Review of the Literature and Current Recommendations

2020 ◽  
Vol 18 (2) ◽  
pp. 135-150
Author(s):  
Harsha S. Nagarajarao ◽  
Chandra P. Ojha ◽  
Archana Kedar ◽  
Debabrata Mukherjee
Keyword(s):  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Narrow Channel ◽  
Paradoxical Embolism ◽  
Current Evidence ◽  
Foramen Ovale ◽  
The Right ◽  
The Relationship ◽  
Current Guidelines

: Cryptogenic stroke and its relation to the Patent Foramen Ovale (PFO) is a long-debated topic. Recent clinical trials have unequivocally established the relationship between cryptogenic strokes and paradoxical embolism across the PFO. This slit-like communication exists in everyone before birth, but most often closes shortly after birth. PFO may persist as a narrow channel of communication between the right and left atria in approximately 25-27% of adults. : In this review, we examine the clinical relevance of the PFO with analysis of the latest trials evaluating catheter-based closure of PFO’s for cryptogenic stroke. We also review the current evidence examining the use of antiplatelet medications versus anticoagulants for stroke prevention in those patients with PFO who do not qualify for closure per current guidelines.

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