Search Results (39)

Background: Cancer-related cachexia remains a significant cause of death, particularly for undiagnosed or untreated malignancies. Lymphomas, especially in uncommon locations, may go unrecognized until their advanced stages. Methods: We report the case of a 34-year-old woman who died from cancer-related cachexia due to undiagnosed, untreated cervical non-Hodgkin lymphoma. Four months postpartum, she reported having excluded malignancy through medical investigations, which were later confirmed to have never been performed. The Judicial Authority ordered an autopsy to determine the cause of death. A narrative literature review was conducted via PubMed using the terms “Non-Hodgkin Lymphoma” and “Autopsy,” limited to English-language human studies published between January 2000 and February 2025. Results: At autopsy, marked fat depletion and a 1350 g cervical mass were found, with significant anatomical distortion and airway narrowing due to epiglottic edema. Microscopic examination identified a diffuse large B-cell lymphoma of germinal center origin. A literature review on lymphoma-related autopsy findings identified common diagnostic challenges, including nonspecific symptoms, rapid clinical deterioration, the rarity of certain subtypes, and a lack of medical compliance. Conclusions: Early recognition and proper investigation of lymphoproliferative disorders are crucial to prevent fatal outcomes. Postmortem findings can offer valuable insights into missed diagnoses and inform strategies to reduce diagnostic delay. Full article

The lion’s paw scallop (Nodipecten subnodosus) is a commercially valuable pectinid whose postharvest quality strongly depends on storage and handling conditions. This study investigated the combined effects of seasonality, postmortem time, and storage temperature on energy metabolism in the adductor muscle, focusing on metabolites associated with rigor mortis and freshness. Adult scallops (~10 cm shell height) were harvested in four seasons (spring, summer, autumn, winter), transported under commercial conditions for approximately 2 h, and stored at 0, 5, and 10 °C for 48 h. Muscle samples were collected every 8 h and analyzed for ATP, ADP, AMP, glycogen, arginine phosphate (Arg-P), and free arginine using HPLC and enzymatic assays. In addition, the adenylate energy charge (AEC) was determined in freshly harvested and post-transport specimens. Initial ATP concentrations ranged from 4.2 to 6.5 µmol/g, with higher levels in winter, while Arg-P varied from 3.1 to 4.8 µmol/g. Seasonality significantly influenced all metabolites except arginine, and transport markedly reduced ATP and AEC, particularly in spring and autumn. Storage at 0 °C resulted in rapid ATP depletion (<1.0 µmol/g within 12 h) and AMP accumulation (>3.0 µmol/g), indicating accelerated energy collapse. In contrast, scallops stored at 5 and 10 °C maintained ATP levels above 2.5 µmol/g for up to 24 h, delaying rigor mortis, reducing postmortem contraction, and preserving muscle texture and appearance. Overall, these findings demonstrate that moderate refrigeration represents a physiologically suitable and technologically advantageous strategy to optimize scallop postharvest handling, extend shelf life, and enhance product quality for the fresh seafood market. Full article

Lipids and polar metabolites are emerging as promising indicators of the brain’s molecular phenotype in both clinical and fundamental research. However, the impact of postmortem delay on these compounds, unavoidable in human brain studies, remains insufficiently understood. In this study, we examined the postmortem stability of lipids and polar metabolites over a 48-h interval in the brains of three species: humans, rats, and mice. We show that the abundance levels of 23% of the 867 studied lipids and 75% of the 104 studied polar metabolites were affected significantly by postmortem delay in at least one species. The postmortem effects correlated positively and significantly among the species, while showing an approximately tenfold slower rate in humans compared to rodents. The only exception to the postmortem rates deceleration was a group of oxidized fatty acids, which accumulated at similar speed in both humans and rodents. These findings provide valuable insights for improving reproducibility and refining the interpretation of human and rodent brain lipidome and metabolome data in future studies. Full article

Background: Accurate estimation of the postmortem interval (PMI) is critical in forensic death investigations. Traditional signs of death—algor mortis, livor mortis, and rigor mortis—are generally reliable only within the first two to three days after death, with their accuracy decreasing as decomposition progresses. This paper presents a systematic review conducted in accordance with PRISMA guidelines, aiming to evaluate and compare current methods for estimating the PMI. Specifically, the study identifies both traditional and modern techniques, analyzes their advantages, limitations, and applicable timeframes, critically synthesizes the literature, and highlights the importance of combining multiple approaches to improve accuracy. Methods: A systematic search was conducted in the PubMed, Scopus, and Web of Science databases, following the PRISMA guidelines. The review included original articles and reviews that evaluated PMI estimation methods (through thanatological signs, entomology, microbial succession, molecular, imaging, and omics approaches). Extracted data included study design, methodology, PMI range, and accuracy information. Out of the 1245 identified records, 50 studies met the inclusion criteria for qualitative synthesis. Results: Emerging methods, such as molecular markers, microbial succession, omics technologies, and advanced imaging show improved accuracy across extended postmortem intervals. RNA degradation methods demonstrated higher accuracy within the first 72 h, while entomology and microbial analysis are more applicable during intermediate and late decomposition stages. Although no single method is universally reliable, combining traditional and modern approaches tailored to case-specific factors improves overall PMI estimation accuracy. Conclusions: This study supports the use of an integrative, multidisciplinary, and evidence-based approach to improve time-since-death estimation. Such a strategy enhances forensic outcomes by enabling more precise PMI estimates in complex or delayed cases, increasing legal reliability, and supporting court-admissible expert testimony based on validated, multi-method protocols. Full article

Background: Human metapneumovirus (hMPV) is a respiratory pathogen that causes illness ranging from mild upper respiratory tract infections to severe pneumonia, particularly in individuals with comorbidities. Fatal cases of hMPV-induced hemorrhagic pneumonia are rare and likely under-reported. Diagnosis is often delayed due to overlapping symptoms with other respiratory viruses and the rapid progression of the disease. Case presentation: We report the case of a 55-year-old man with a complex medical history, including liver cirrhosis and diabetes mellitus, who developed acute viral pneumonia. Initial symptoms appeared three days before a sudden clinical deterioration marked by shortness of breath, hemoptysis, and respiratory failure. A nasopharyngeal swab taken on the third day of illness tested positive for hMPV by qRT-PCR. The patient died the following day. Postmortem molecular testing confirmed hMPV in lung tissue and alveolar contents. Autopsy revealed bilateral hemorrhagic pneumonia with regional lymphadenopathy. Histopathological examination showed alveolar hemorrhage, multinucleated cells, neutrophilic infiltration, activated autophagy in macrophages, and numerous cytoplasmic eosinophilic viral inclusions. Conclusions: This is the first documented case of fatal hMPV pneumonia in Armenia. It highlights the potential severity of hMPV in adults with chronic health conditions and emphasizes the need for timely molecular diagnostics. Postmortem identification of characteristic viral inclusions may serve as a cost-effective histopathological marker of hMPV-associated lung pathology. Full article

Background:Envenomation by poisonous creatures is a major global cause of mortality. Its concomitant impact on the postmortem corpse decomposition and associated insect succession pattern is still poorly understood. Purpose of the study: This study comparatively investigates the impact of envenomization with the venoms of the snake Walterinnesia aegyptia L. versus the scorpion, Androctonus crassicauda L., on rabbit corpse decomposition and beetle succession. Methods: Three groups of rabbits (five animals each) were injected with the snake venom, the scorpion venom, or 0.9% saline (control) prior to euthanasia with CO₂. The corpse decomposition stages and beetle succession were monitored over 11 days. Results: Four stages of decomposition with venom-dependent duration variation were observed. The scorpion-envenomized corpses showed a longer decay stage and a delayed dry stage. A total of 1094 beetles belonging to 27 species of 14 families were reported. Histeridae, Dermestidae, Scarabaeidae, and Tenebrionidae were the most diversified and prevalent families. Chrysomelidae, Elateridae, Hybosoridae, and Ptinidae were incidentally attracted to control corpses, while Nitidulidae and Zopheridae were only found on control and snake-envenomized ones. Four species belonging to the families Anthicidae, Histeridae, Scarabaeidae, and Tenebrionidae were predominant on all corpses. Four species belonging to the families Chrysomelidae, Curculionidae, Elateridae, and Hybosoridae were distinctively associated with the control corpses. Conclusions: These findings provided evidence that envenomation impacted the decomposition process and beetle succession in a venom-dependent manner, which could be significant for forensic investigations. Full article

In aquaculture, pre-slaughter fasting reduces stress and improves muscle quality. Fasting periods of 55–58 degree days (°C d) enhance muscle structure and post-mortem biochemistry in rainbow trout (Oncorhynchus mykiss), although optimal durations vary with temperature. This study investigated the effects of fasting from none to extended durations on 495 rainbow trout under summer (22 °C) and winter (8 °C) conditions. In summer, elevated temperatures increased muscle glycogen, leading to lower pH and delayed rigor mortis (RM), especially in fasted groups, where RM peaked at 24 h post-mortem. In winter, RM occurred earlier. Prolonged fasting increased acetylcholinesterase (AChE) activity, with high baseline levels in non-fasted summer fish. Muscle lightness at 0 h post-mortem was highest in non-fasted winter fish but declined to summer levels in fasted groups. Antioxidant enzyme activity (glutathione-S-transferase, glutathione peroxidase) increased with fasting in winter, while summer heat masked responses. The expression of genes for mineralocorticoid receptors and heat shock proteins remained stable in warm conditions. Summer delayed metabolic decline due to higher glycogen-triggered excessive AChE activity from heat stress. Winter supported faster metabolic adjustment and more regulated enzyme activity. These findings highlight the need to adjust fasting strategies seasonally to optimize muscle traits, especially under thermal variations. Full article

The consumption of canned fish as an affordable and shelf-stable food product having high nutritional value is steadily growing in many parts of the world. An important and often overlooked factor that influences the quality of canned fish is the freshness of raw materials used in the production process. It has been shown previously that the freshness status of fish can be assessed using fast proteins and metabolite liquid chromatography (FPMLC) detecting the relative content of post-mortem adenosine triphosphate (ATP) metabolites. The aim of this study is to evaluate the applicability of FPMLC to evaluate the quality of canned fish. Eighteen samples of various canned fish from different manufacturers were acquired from local supermarkets. FPMLC chromatograms of the samples were processed with the compact optoelectronic chromatographic sensor using PD-10 gel columns as a separation medium. The sensor has a photometric detector based on a deep UV LED emitting at 255–265 nm. All chromatograms showed two combined peaks: the first one was related to proteins and the second one was formed by adenosine ATP metabolites. The delay time between the peaks (the Time index) varied in a range from 138 s to 193 s. It was suggested that the higher the Time index, the fewer fresh raw fish materials were used for production. For additional verification of the FPMLC technique, four samples chosen as the most representative were analyzed by high-performance liquid chromatography (HPLC) and nuclear magnetic resonance (NMR) spectroscopy. The Time index was in good correlation with the well-established nucleotide-based K and K_I indices (quality factors) estimated from the HPLC chromatograms and NMR spectra, which confirms the fact that FPMLC can be used to assess the freshness of raw materials in thermally processed fish products. The correct interpretation of the Time index and other nucleotide-based indicators applied to canned food requires taking into account the effects of nutritional nucleotide thermal degradation that occur during high-temperature sterilization. Full article

Myotonia congenita is a hereditary, non-dystrophic skeletal muscle disorder associated with muscle stiffness due to delayed muscle relaxation after contraction. We review myotonia congenita in domesticated animals and humans and investigated suspected myotonia congenita in a flock of Merino sheep in Australia. In 2020, a property in New South Wales reported a four-year history of lambs that would fall on disturbance before rapidly recovering, with 13 affected sheep identified in 2020. Episodes were associated with a short period of tetanic spasms and a stiff gait upon rising. Lambs were otherwise normal between episodes, although over time, lost body condition and occasionally died from misadventure. An inherited condition was considered from limited pedigree information and a preliminary diagnosis of myotonia congenita was made based on clinical presentation. Biochemistry from four sheep found variable, but typically mild increases in creatine kinase (CK) and aspartate aminotransferase (AST). Modified electromyography on six affected sheep found irregular electrical activity within the muscle. For four sheep, there were no consistent significant abnormalities on post mortem examination and histopathology—typical for this condition. A review of the Online Mendelian Inheritance in Man (OMIM) and Online Mendelian Inheritance in Animals (OMIA) databases was conducted to summarise information about myotonia congenita in humans and eight non-human species of animals. Comparing the characteristic clinical presentation, pathology and electromyography data of affected Merino sheep to similar conditions in other species assisted the identification of likely candidate genes. Whole genome sequencing of two affected lambs detected a missense variant in CLCN1 (NC_056057.1:g.107930611C>T; XM_004008136.5:c.844C>T; XP_004008185.4:p.(P282S)), with a predicted deleterious effect on protein function. An SNP genotyping assay was developed, and the variant segregated with the disease in 12 affected sheep and obligate carrier rams under an assumed recessive mode of inheritance. Identifying a likely causal variant and developing a diagnostic test allows screening of suspected affected or carrier Merino sheep for early intervention to reduce propagation of the variant within flocks. Full article

In this time series study, the temporal sequences of postmortem changes in brains kept at different temperatures were investigated in different areas of mouse brains. Fixation of tissues kept at different storage temperatures (4 °C, 22 °C, 37 °C) was delayed for four time points (24, 120, 168, 336 h). Histological and immunohistochemical investigations were carried out to determine how postmortem autolysis may affect the cellular morphology and the expression of neural cell epitopes. Results showed that the autolytic changes started earlier in brains at 22 °C and 37 °C and in the grey matter compared to the white matter, with the cerebellum and hippocampus showing the earliest postmortem changes. The cellular antigens were differently affected by the autolytic process overtime: NeuN and Olig2 immunoreactivity was gradually lost at the nuclear site and diffused into the cytoplasm; increased background staining was observed with SMI-32; GFAP showed an increase in immunolabeling, whereas 2F11 immunoreactivity decreased. This study suggests that the morphological analysis and immunohistochemical investigation of the brain tissue could be satisfactorily applied to forensic cases, providing useful data for the estimation of the postmortem interval. Full article

Background: Rapunzel syndrome is a rare and severe form of trichobezoar, characterized by the presence of hair masses in the stomach that often extend into the bowel, resembling the legendary “Rapunzel’s” long hair. Methods: This review examines the clinical, diagnostic, forensic, and post-mortem aspects associated with Rapunzel syndrome, with a focus on cases resulting in mortality or those at high risk of death due to complications. In particular, the review systematically analyzes the existing literature on fatal cases of Rapunzel syndrome, emphasizing insights into risk factors, clinical manifestations, diagnostic methods, autopsy findings, and preventive measures to provide a focused understanding of these critical aspects. Results: The syndrome predominantly affects young females with a history of trichotillomania (hair-pulling) and trichophagia (hair-eating), often associated with underlying psychiatric conditions. Clinically, Rapunzel syndrome presents with non-specific gastrointestinal symptoms, including abdominal pain, vomiting, and malnutrition, which may complicate timely diagnosis. Diagnosis typically involves imaging techniques such as ultrasound, CT scans, and endoscopy, but cases often go unrecognized until complications like intestinal obstruction, perforation, or even fatal outcomes occur. Forensically, Rapunzel syndrome presents unique challenges, as misdiagnosis or delayed intervention can lead to fatalities that may raise questions in medico-legal investigations. Post-mortem investigations, particularly autopsies, have proven instrumental in elucidating rare complications and advancing understanding of the syndrome’s long-term effects. Conclusions: Increased awareness, timely diagnosis, and comprehensive evaluation, including autopsy studies, are essential to improve patient outcomes and reduce the potential for life-threatening complications in this rare yet serious condition. Full article

Pterygium is often associated with chronic ultraviolet (UV) radiation exposure and characterized by the overgrowth of conjunctiva and extracellular matrix (ECM) remodeling. Notably, several studies in the skin have demonstrated that chronic UV radiation can upregulate Granzyme B (GrB) expression and increase ECM degradation. The aim of this study was to compare GrB expression between pterygium and healthy controls and to further link this GrB expression to mast cells. Post-mortem pterygium tissues and conjunctival tissues from age-matched controls were used to assess GrB expression via immunofluorescence and microscopy. We found a significantly higher density of GrB+ cells from pterygium specimens compared to healthy controls. Furthermore, many of the GrB+ cells in pterygium specimens co-expressed tryptase, a mast cell marker. These findings suggest a role for conjunctival mast cell-secreted GrB in the pathogenesis of pterygium and highlight GrB as a possible therapeutic target in delaying or halting pterygium progression. Full article

Temporal and spatial epigenetic modifications in the brain occur during ontogenetic development, pathophysiological disorders, and aging. When epigenetic marks, such as histone methylations, in brain autopsies or biopsy samples are studied, it is critical to understand their postmortem/surgical stability. For this study, the frontal cortex and hippocampus of adult rats were removed immediately (controls) or after a postmortem delay of 15, 30, 60, 90, 120, or 150 min. The patterns of unmodified H3 and its trimethylated form H3K9me3 were analyzed in frozen samples for Western blot analysis and in formalin-fixed tissues embedded in paraffin for confocal microscopy. We found that both the unmodified H3 and H3K9me3 showed time-dependent but opposite changes and were altered differently in the frontal cortex and hippocampus with respect to postmortem delay. In the frontal cortex, the H3K9me3 marks increased approximately 450% with a slow parallel 20% decrease in the unmodified H3 histones after 150 min. In the hippocampus, the change was opposite, since H3K9me3 marks decreased steadily by approximately 65% after 150 min with a concomitant rapid increase of 20–25% in H3 histones at the same time. Confocal microscopy located H3K9me3 marks in the heterochromatic regions of the nuclei of all major cell types in the control brains: oligodendrocytes, astrocytes, neurons, and microglia. Therefore, epigenetic marks could be affected differently by postmortem delay in different parts of the brain. Full article

For fresh meat consumers, eating satisfaction is of utmost importance and tenderness is one of the most important characteristics in this regard. Our study examined beef of different animal biotypes of the autochthonous breed “Asturiana de los Valles” (AV) to determine if early postmortem oxidative and proteolytic processes may influence the final tenderness of the product. This meat-specialized breed shows different biotypes depending on the frequency of a myostatin mutation “mh” that induces double-muscling or muscular hypertrophy (mh/mh, mh/+, +/+). Samples from the longissimus dorsi muscles of yearling bulls were analyzed during the first 24 h postmortem. Changes in the redox balance of muscle cells were significant in the first hours after slaughter; total antioxidant activity was higher in the mh/mh biotype and it followed the shortening of the sarcomeres, a key parameter in understanding meat tenderness. The two proteolytic systems studied (proteasome and lysosome) followed distinct patterns. Proteasome activity was higher in the (mh/+) biotype, which correlated with higher protein damage. Lysosome proteolysis was increased in the more tender biotypes (mh genotypes). Autophagic activation showed significant differences between the biotypes, with (mh/mh) showing more intense basal autophagy at the beginning of the postmortem period that decreased gradually (p < 0.001), while in the normal biotype (+/+), it was slightly delayed and then increased progressively (p < 0.001). These results suggest that this type of catalytic process and antioxidant activity could contribute to the earlier disintegration of the myofibers, particularly in the mh/mh biotypes, and influence the conversion of muscle into meat. Full article

There is accumulating evidence that vitamin A (VA) deficiency contributes to the pathogenesis and progression of Alzheimer’s disease (AD). All-trans retinoic acid (ATRA), a metabolite of VA in the brain, serves distinct roles in the human hippocampus. Agonists of retinoic acid receptors (RAR), including ATRA, promote activation of the non-amyloidogenic pathway by enhancing expression of α-secretases, providing a mechanistic basis for delaying/preventing amyloid beta (Aβ) toxicity. However, whether ATRA is actually deficient in the hippocampi of patients with AD is not clear. Here, using a publicly available human transcriptomic dataset, we evaluated the extent to which ATRA-sensitive genes are dysregulated in hippocampal tissue from post-mortem AD brains, relative to age-matched controls. Consistent with ATRA deficiency, we found significant dysregulation of many ATRA-sensitive genes and significant upregulation of RAR co-repressors, supporting the idea of transcriptional repression of ATRA-mediated signaling. Consistent with oxidative stress and neuroinflammation, Nrf2 and NfkB transcripts were upregulated, respectively. Interestingly, transcriptional targets of Nrf2 were not upregulated, accompanied by upregulation of several histone deacetylases. Overall, our investigation of ATRA-sensitive genes in the human hippocampus bolsters the scientific premise of ATRA depletion in AD and that epigenetic factors should be considered and addressed as part of VA supplementation. Full article