The role of PMCT for the assessment of the cause of death in natural disaster (landslide and flood): a Sicilian experience

Mondello, Cristina; Baldino, Gennaro; Bottari, Antonio; Sapienza, Daniela; Perri, Fabrizio; Argo, Antonina; Asmundo, Alessio; Spagnolo, Elvira Ventura

doi:10.1007/s00414-021-02683-z

Cited by 7 publications

(3 citation statements)

References 21 publications

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“…The explicit potential economic benefits of the PMCT (magnetic resonance imaging-MRI) have not been assessed recently [38,57]; despite its numerous advantages, this method still exhibits the problem of a significant rate of diagnostic discrepancies [58,59]. Nevertheless, PMCT has 79% sensitivity and 92.1% specificity for the detection of the source of bleeding [60].…”

Section: Options For Traditional Autopsymentioning

confidence: 99%

Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers

Šoša

2023

Forensic Sciences

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Many tools of clinical medicine, such as clinical chemistry and diagnostic imaging, are prioritized for clinical diagnosis over post mortem diagnosis. Indeed, it is reasonable that the assessment of a patient’s functional status should take priority over the post mortem, cross-sectional use of diagnostic tests and laboratory equipment. In addition, these tools are sometimes expensive, and their use does not always have a reasonable cost–benefit ratio. However, some post mortem observations, such as inflammation, pulmonary edema, or infiltration and cerebral swelling, cannot be explained without using immunohistochemical markers for post mortem diagnosis. Introducing blood-based biomarkers into post mortem care could significantly reduce the rates of inconclusive post mortems and discrepancies in autopsy findings and clinical diagnoses. This is particularly relevant in relation to vascular pathology, considering the significant burden that vascular diseases represent for overall mortality. Expanding traditional autopsies with blood-based (circulating) biomarkers to avoid invasive post mortem examination would have cultural, religious, and potentially economic advantages. All of the target molecules were discussed in the context of the processes they up-regulate or down-regulate, which turned out to be the final cause of death. Ultimately, it is evident that further studies are needed to provide concrete validation for using a combination of markers for each case to reach a post mortem diagnosis with or without clinical records.

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Section: Options For Traditional Autopsymentioning

confidence: 99%

Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers

Šoša

2023

Forensic Sciences

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“…Generally, the exact cause of death is an information available only in research carried out by forensic surgeons, which is performed in cases of FATLAN with a limited number of victims. Therefore, in landslides with many victims, medical investigations such as postmortem computed tomography might be an alternative to an autopsy and would allow us to assess the cause of death, providing fast information on the type and distribution of lesions [38].…”

Section: The Clinical Causes Of Deathmentioning

confidence: 99%

Landslide Fatality Occurrence: A Systematic Review of Research Published between January 2010 and March 2022

Petrucci

2022

Sustainability

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Landslides triggered by rainfall kill people worldwide, and frequent extreme events that are expected to be an effect of climate change could exacerbate this problem. This review aims to identify recent research, highlighting both the dynamics of landslide accidents and the characteristics of victims. From SCOPUS and WOS databases, using the PRISMA (preferred reporting items for systematic reviews and meta-analysis) approach, 25 articles written in English, published in the January 2010–March 2022 period and focused on landslide fatalities, were mined. The selected articles recognized a worldwide underestimation of landslide fatalities and analyzed landslide mortality from three perspectives, indicating the importance of this topic for a multidisciplinary research community. The papers focused on (a) fatal landslides and their geographic distribution, seasonality, trends, and relationships with socioeconomic indicators; (b) landslide fatalities and their behaviors and the dynamics of accidents; and (c) clinical causes of death or injury types, aiming to improve emergency rescue procedures. The gaps that emerged include (a) the insufficient reuse of valuable fatality databases; (b) the absence of simple take-home messages for citizens, practitioners, schoolteachers, and policymakers, aiming to set educational campaigns and adaptation measures; and (c) the lack of joint research projects between researchers working on landslides and doctors treating victims to provide complete research results that would be able to actually reduce landslide mortality.

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“…Although autopsy is well established as the gold standard technique for investigating the cause of death, the use of a less invasive radiological approachwhenever appropriate-might be preferable in some circumstances, especially in cases of cultural or religious oppositions to the internal examination of the body [3][4][5][6][7]. Since they allow a better visualization of bone structures, gas/fluid spaces and foreign bodies, also providing an enhanced resolution thanks to 3D volume rendering techniques, postmortem CT (PMCT) methodologies are most suited for the investigation of traumatic deaths, acute hemorrhages, lung parenchyma diseases, calcifications (stones, atherosclerosis), pneumothorax and pathological conditions associated with free air, as well as for personal identification [3,5,6,[8][9][10][11]. Compared to PMCT, postmortem Magnetic Resonance (PMMR), although less used, provides useful information on the cause of death as well, proving superior in the study of soft tissues [3,5].…”

Section: Introductionmentioning

confidence: 99%

State of the Art on the Role of Postmortem Computed Tomography Angiography and Magnetic Resonance Imaging in the Diagnosis of Cardiac Causes of Death: A Narrative Review

et al. 2022

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The need of a minimally invasive approach, especially in cases of cultural or religious oppositions to the internal examination of the body, has led over the years to the introduction of postmortem CT (PMCT) methodologies within forensic investigations for the comprehension of the cause of death in selected cases (e.g., traumatic deaths, acute hemorrhages, etc.), as well as for personal identification. The impossibility to yield clear information concerning the coronary arteries due to the lack of an active circulation to adequately distribute contrast agents has been subsequently overcome by the introduction of coronary-targeted PMCT Angiography (PMCTA), which has revealed useful in the detection of stenoses related to calcifications and/or atherosclerotic plaques, as well as in the suspicion of thrombosis. In parallel, due to the best ability to study the soft tissues, cardiac postmortem MR (PMMR) methodologies have been further implemented, which proved suitable for the detection and aging of infarcted areas, and for cardiomyopathies. Hence, the purpose of the present work to shed light on the state of the art concerning the value of both coronary-targeted PMCTA and PMMR in the diagnosis of coronary artery disease and/or myocardial infarction as causes of death, further evaluating their suitability as alternatives or complementary approaches to standard autopsy and histologic investigations.

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The role of PMCT for the assessment of the cause of death in natural disaster (landslide and flood): a Sicilian experience

Cited by 7 publications

References 21 publications

Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers

Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers

Landslide Fatality Occurrence: A Systematic Review of Research Published between January 2010 and March 2022

State of the Art on the Role of Postmortem Computed Tomography Angiography and Magnetic Resonance Imaging in the Diagnosis of Cardiac Causes of Death: A Narrative Review

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