Comparison between postmortem computed tomography and autopsy in the detection of traumatic head injuries.

INTRODUCTION: The aim of this study was to assess the agreement between postmortem computed tomography (PMCT) and autopsy in detecting traumatic head injuries. MATERIALS AND METHODS: Consecutive cases of death that underwent both unenhanced PMCT and conventional autopsy were collected from our institution database during a period of 3 years and reviewed retrospectively. PMCT images were reviewed for the presence of fractures (cranial vault, skull base, facial bones and atlas/axis) and intracranial hemorrhage. Kappa values were calculated to determine the agreement between PMCT and autopsy reports. RESULTS: 73 cases were included, of which 44 (60%) had head trauma. Agreement between PMCT and autopsy was almost perfect (κ = 0.95) for fractures and substantial (κ = 0.75) for intracranial hemorrhage. PMCT was superior to autopsy in detecting facial bone and upper cervical spine fractures, and intraventricular hemorrhage. However, in some cases thin extra-axial blood collections were missed on PMCT. CONCLUSIONS: The agreement between PMCT and autopsy in detecting traumatic head injuries was good. Using a combination of both techniques increases the quality of postmortem evaluation because more lesions are detected.

[Evaluation of the analytical performance characteristics of NT-proBNP immunoassay on dimension RxL-HM (Dade Behring)]. / Evaluation des performances analytiques du dosage du NT-proBNP sur automate d'immunoanalyse Dimension RxL-HM (Dade Behring).

BACKGROUND: Plasma B-type natriuretic peptide (BNP) and N terminal prohormone (NT-proBNP) are promising markers for the diagnosis, prognosis and follow up of heart failure. Elevated levels have been associated with adverse long-term outcome in patients with acute coronary syndromes. METHOD: The analytical performance of a new automated NT-proBNP assay on Dimension-HM system (Dade Behring) and comparison with the results obtained with the Roche Diagnostics NT-proBNP assays using the Elecsys instrument have been evaluated according to the Valtec protocol. RESULTS: Total imprecision (CV) was below 9% for NT-proBNP concentrations between 100 and 10,000 pg/mL using quality control samples and pooled patients' plasma. Analytical sensitivity was found 9.8 pg/mL the day of calibration and 10.1 pg/mL ten days later. Dilution linearity showed overall recovery between 98.4 and 104.7%. No hook effect was observed for NT-proBNP concentration up to 96,000 pg/mL. The interference of turbidity was below 4%. Hemoglobin interfered negatively with assay upper 240 micromol/L but less than 10%. A precision profile demonstrated a total imprecision of 10% CV at a NT-proBNP concentration of 70 pg/mL and 20% at 30 pg/mL. Dimension results highly correlated (r = 0.99) with Roche Elecsys NT-proBNP.