An analysis was carried out of 222 medical records and autopsies from patients with inflammatory diseases of the large intestine, the immediate causes of death of whom were different disorders. The incidence of hepatitis running an active course correlated with age of patients and came up to 58.8% in the group of subjects 20 to 40 years old. In age group running between 40 to 60 and 60 to 80 years there prevailed colorectal carcinoma (18.3% and 42.5% respectively).
Repeated epidemiologic study of atherosclerosis in males on the basis of autopsy material with 25-year interval (1963-66 and 1985-89) has been performed in 7 European cities (Malmö, Praha, Riga, Tallinn, Tartu, Kharkov, Yalta) and 4 Asia cities (Ashkhabad, Bishkek, Irkutsk, Yakutsk). Accelerated development of atherosclerosis in the 2nd study has been revealed in males in the majority of cities except Malmö and Praha. No significant differences in atherosclerosis of aorta and coronary arteries were found in these two cities. An increase of the calcinosis surface in the coronary arteries combined with a higher incidence of coronary stenosis was typical for the 2nd study. Atherosclerosis was less pronounced in the indigenous population of Ashkhabad, Bishkek and Yakutsk in both studied than in non-indigenous populations. There was a positive correlation in males between lethality of coronary heart disease and other cardiovascular diseases and the degree of coronary atherosclerosis. Thus, the course of atherosclerosis can change within the life of one generation.
Over the recent 20 years the incidence of amyloidosis did not undergo any noticeable changes, accounting for 1.48% of the total number of autopsies in 1964-1968 and for 1.52% in 1984-1988 (P less than 0.5). The number of cases of the clinically unrecognized amyloidosis increased from 37.5% in the first period to 52.18% in the second one. In most cases amyloidosis affects the kidneys (94.9%), spleen (58.2%), liver (48%) and then, in the descending order, there follow adrenals, intestine, heart, pancreas and other organs (the total data for both the periods).
Analysis of statistical data on forensic chemical studies carried out in the Perm Regional Bureau of Forensic Medical Expert Evaluations in 1997-2000 indicates an increased number of expert evaluations with positive results. The specific share of expert evaluations with positive results for Perm was 66.6% of the total number of evaluations. The absolute number of the detected agents in combinations with other agents increased more than 2-fold over the studied period. The number of detected agents increased 1.8 times, the rate of detection of narcotics increased sharply (6.5 times).
A statistical analysis of the main causes of death and assessment of the quality of outpatient diagnosis have been performed on the basis of 1843 autopsies of patients who died at home. The causes of misdiagnosis were due in 5.3% of cases to objective and in 94.7% of cases to subjective factors. The criteria of three categories of discrepancy between pathological and outpatient diagnosis are suggested. A positive role of a pathological examination as an additional factor in improving the quality of the outpatient service is shown.
Autopsy data and dispensary records were analyzed for 1843 outpatients who had died at home. Main causes of death were defined. Misdiagnosis was attributed to objective and subjective factors in 5.3% and 94.7% of the cases, respectively. Criteria of discrepancy arising between postmortem and dispensary diagnosis are suggested. Necessity of postmortem examinations is grounded.
The findings from 4359 autopsies made in 4 Moscow hospitals during 1986 were analyzed with two proposed tables. The primary materials were processes with a computer. Table 1 includes data on the total number of unrecognized cases by the main disease, major complications, concomitant and underlying diseases in terms of their category and cause of diagnosis discrepancy. The rate of the discrepancy between clinical and postmortem diagnoses averaged 21.6 +/- 4.7% by the main disease, that of unrecognized fatal complications and major concomitant and underlying diseases was found to be 7.6 and some 2%, respectively. By the categories, the analysis of diagnosis discrepancy indicated 35, 58.6, and 6.4% in Categories I, II, and III, respectively. Table 2 (combined correlational one) makes it possible to study the range of diagnostic errors in various diseases and to find typical mistakes made by clinicians. Analyzing the quality of clinical diagnosis according to the given pattern is of advantage in routine practice to obtain comparable consistent data, to make a thorough examination, and to generalized discrepancy cases of clinical and postmortem diagnoses.
To assess trends in the use of antidepressants among young suicides after the warning that these drugs might increase the risk of suicide.
Individual data of all 845 suicides in the 10- to 19-year age group in Sweden in the time period 1992-2003 (baseline), and in 2004-2010 (after the warning). Outcome data are prescriptions of antidepressants prior to death and detections of antidepressants in post-mortem toxicology.
After the warning, suicide in this age group increased for five consecutive years (60.5%). The increase occurred among individuals not treated with antidepressants.
This study provides further support for the hypothesis that the warning, contrary to its intention, may have increased young suicides by leaving a number of suicidal young persons without treatment with antidepressants.
All forensic autopsy cases in southern Sweden in 1986-89 in which antidepressant drugs were found in the blood were assessed and the findings related to the sales of antidepressants as expressed as defined daily doses per 1,000 inhabitants per day. There was a total of 272 antidepressant-positive cases, which were divided in three groups: 1. suicide or possible suicide caused by antidepressant drugs, 2. suicide or possible suicide caused by other means (including other drugs and other toxic agents), and 3. other deaths. Amitriptyline was the agent most commonly involved in suicide or possible suicide caused by antidepressants, and it was also the most commonly sold antidepressant. When corrected for sales, trimipramine was most frequently involved as the causal agent. Conversely, despite frequent sales, lofepramine appeared only rarely to be involved. This may be related to lower toxicity of lofepramine, reduced lofepramine absorption at overdose and/or to differences in the administration of various antidepressant drugs to patients with differing degrees of risk of suicide.
6170 autopsy protocols have been analysed and the conclusion is made that alcoholic liver cirrhosis is predominating in the structure of liver diseases. Viral liver cirrhosis is less important by its incidence than alcoholic one. Liver tumors are of importance against the background of alcoholic and viral cirrhosis. Primary liver tumors, autoimmune and metabolic diseases occur rarely. The material confirms the fact that alcohol is a principal etiological factor in development of liver diseases.