Histological analysis of forearm superficial veins structure.

BACKGROUND: The connection between the basilic and cephalic veins of the forearm shows considerable interindividual variation. Depending on its form, the most common types of venous connections are M-, N- or Y-shaped. This study aims to compare the metric traits of the basilic and cephalic veins and the relative content of smooth muscle/collagen fibers/elastic fibers in their walls and to determine the differences between the forearm venous systems. MATERIALS AND METHODS: The study was performed on 42 veins collected from 26 deceased individuals between the ages of 19 and 50 years. Vein sections were fixed, embedded in paraffin blocks and used to prepare histological slides, stained according to pentachrome Movat's method. Venous metrics were assessed and the percentage of muscle, elastic and collagen fibers was determined using the Trainable Weka segmentation. Statistical analysis compared the M-type vein with the Y- and N-types, which were combined into one category. RESULTS AND CONCLUSIONS: Analysis showed a greater tunica media thickness in the M-type vein, with a greater lumen circumference in the Y/N types. Correlation analysis showed a correlation of vein metrics with elastic fibre content and a weak inverse correlation with the tunica media thickness. It can be hypothesized that the increased performance of N- and Y-types may be related to elastic fibers content.

Unpacking the Complexity of COVID-19 Fatalities: Adverse Events as Contributing Factors-A Single-Center, Retrospective Analysis of the First Two Years of the Pandemic.

In a retrospective analysis of 477 fatal COVID-19 cases hospitalised at a single medical centre during the period from 6 March 2020 to 30 June 2022, several factors defining those patients at admission were assessed, as well as the course of the hospitalisation and factors contributing to death. There was a predominance of men (59.3% (283)) burdened by comorbidities, with increased inflammation at admission. Patients aged ≥ 81 years were significantly more likely to be admitted to and die in infectious diseases units (IDU) due to respiratory failure, their hospital stays were shorter, and they were most likely not to receive specialist treatment. The most common COVID-19 complications included acute kidney injury in 31.2% (149) patients and thromboembolic complications in 23.5% (112). The course of hospitalisation was complicated by healthcare-associated infections (HAI) in 33.3% (159) of cases, more often in those treated with baricitinib (p < 0.001). The initial use of an antibiotic, although common (94.8% (452)), was unwarranted in almost half of the cases (47.6% (215)). Complications of hospitalisation (46.1% (220)) and adverse events involving staff (49.7% (237)) were found in almost half of the patients. In 88.7% (423) of the cases, death was due to respiratory failure in the course of SARS-CoV-2 infection. Adverse events during hospitalisation should be considered as an additional factor that, in addition to the infection itself, may have influenced the death of patients.

COVID-19-related excess mortality - an overview of the current evidence.

Analysis of excess deaths, defined as the difference in the total number of deaths in an emergency compared to the number of deaths expected under normal conditions, allows a more reliable assessment of the impact on health systems caused by the global threat of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2). So far, data for the two years of the pandemic (2020-2021) indicates the occurrence of 14.9 million excess deaths according to WHO (World Health Organization) estimates. The purpose of the analysis conducted was to define the concept and identify the causes of excess mortality during the COVID-19 pandemic. Inconsistent and unreliable death registration systems; overburdened health systems in low- and middle-income countries; reduced access to medical services for patients with health problems other than COVID-19; the introduction of social distancing and lockdown rules, which translated into increased deaths from psychiatric illnesses and addictions; political considerations and media messages that interfered with vaccination acceptance and adherence; and the additional impact of other natural disasters (hurricanes, floods, drought) were identified as the most important reasons for excess deaths occurrence. The correct identification of country-specific factors and the correct response and countermeasures taken appear crucial in terms of limiting the negative impact of the current pandemic, but also of future threats of a similar nature, in order to reduce excess deaths.

The hero of American and Polish nations: a molecular look at Thaddeus Kosciuszko's cause of death suggests a contribution of endocarditis caused by Cutibacterium acnes infection.

The remains of the heart tissue of Thaddeus Kosciuszko have been investigated as the possible cause of disease and death of the hero of Polish and American nations. Three specimens, DNA isolated from scrappings of wax surface, from the surface of a wooden plate, and from the linen cloth that have had contact with the object were subjected to nanosequencing. From the first two, among all reads identified, only one classified as Propionibacterium acnes (synonymous current name Cutibacterium acnes), had a purported clinical significance. The observed identity between the P. acnes sequences and reference was 89-90% consistent with the hypothesis that the identified reads represent the ancient P. acnes DNA (aDNA), which underwent fragmentation and sequence changes caused by its long-time presence in the environmental conditions conducive to degradation. We present a reasonable and entirely new hypothesis that the analyzed samples could reflect the presence of the bacteria in the original Kosciuszko's heart tissue and that the process of C. acnes infection was progressing inside the organ (endocarditis), not on its surface (pericarditis) leading to rapid deterioration of health and eventually death. We again point out that normal skin and mucosal membranes commensal, a causative agent of common skin acne, may be associated with various severe organ infections posing a threat to health and life.

Determination of Mifepristone (RU-486) and Its Metabolites in Maternal Blood Sample after Pharmacological Abortion.

The aim of the study was the development and validation of the UHPLC-QqQ-MS/MS method for the determination of mifepristone in human blood as well as the identification and quantification of its metabolites after self-induced pharmacological abortion. The metabolic pathway in humans was proposed after examination of an authentic casework. The fast and simple preanalytical procedure was successfully applied (pH9, tert-butyl-methyl ether). The validation parameters of the method were as follows: limit of quantification: 0.5 ng/mL; coefficients of determination: >0.999 (R2), intra- and inter-day accuracy and precision values did not exceed ± 13.2%. The recovery and matrix effect were in the range of 96.3−114.7% and from −3.0 to 14.7%, respectively. Toxicological analysis of the mother's blood (collected the day after the pregnancy termination) revealed the presence of five compounds: mifepristone (557.4 ng/mL), N-desmethyl-mifepristone (638.7 ng/mL), 22-OH-mifepristone (176.9 ng/mL), N,N-didesmethyl-mifepristone (144.5 ng/mL) and N-desmethyl-hydroxy-mifepristone (qualitatively). To our knowledge, the study presented in this paper is the first report on the concentrations of mifepristone and its metabolites in maternal blood samples after performing a self-induced abortion. The established UHPLC-QqQ-MS/MS method is suitable for forensic toxicological analysis as well as in terms of clinical toxicology in future investigations (examination of pharmacokinetics, bioavailability and metabolism of RU-486).

EASIX, Modified EASIX and Simplified EASIX as an Early Predictor for Intensive Care Unit Admission and Mortality in Severe COVID-19 Patients.

COVID-19 receives a lot of attention due to its threat to global public health. Research is ongoing to find universal methods to assess the baseline health status of a patient to determine prognosis and management strategies. This study aims to assess the predictive potential of the EASIX (Endothelial Activation and Stress Index) and two of its modifications (mEASIX and sEASIX) in terms of the need for admission to the ICU (intensive care unit), the use of IMV (invasive mechanical ventilation) and death due to COVID-19. The medical data of 370 severely ill patients hospitalised in the COVID-19 departments of the Regional Specialist Hospital in Wroclaw (Poland), including the ICU, were analysed retrospectively. The mortality rate in the group studied was 65.7% (243 cases). In the case of all three indices, EASIX, mEASIX and sEASIX, there was a statistically significant correlation between the need for admission to the ICU (p = 0.026, p = 0.019, p = 0.001, respectively) and the risk of death (p < 0.001). In terms of the risk of death, the high values of the assessed indices (EASIX ≥ 2.36, mEASIX ≥ 704.03, sEASIX ≥ 3.81) were characterised by low sensitivity (≤40%), high specificity (approximately 90%) and low NPV (negative predictive value) (approximately 40%) with high PPV (positive predictive value) (approximately 80%). Due to the ease of implementation and the low cost of performing basic laboratory tests, the above-mentioned indices can be used as an additional, but not universal tool for the initial assessment of the health condition of patients admitted to the hospital.

"Salt mummification" - atypical method of embalming a corpse.

It is extremely rare for table salt to be used to preserve a dead body in criminal cases. In the case presented here, after the death of his 85-year-old mother, a son kept her body preserved in table salt for about 2 years to extort social benefits (pension). Before her death, the woman had been hospitalised twice due to chronic diseases. The case has been examined by the multi-disciplinary team. The unusual conditions in which the corpse was stored influenced its good condition (close to mummification), with limited colonisation of the corpse by necrophagous insects and insects involved in soft tissue biolysis (i.e. selected Diptera or Coleoptera). The use of table salt inhibited the growth of most fungi which would normally be present on a corpse stored in ambient conditions, and the corpse's surface was colonised by halophilic fungus (Scopulariopsis brevicaulis).

SARS-CoV-2 Viral RNA Is Detected in the Bone Marrow in Post-Mortem Samples Using RT-LAMP.

Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2019, viral RNA has been detected in several different human tissues and organs. This study reports the detection of SARS-CoV-2 RNA in the bone marrow. Post-mortem samples were taken in a sterile manner during two forensic autopsies from the nasopharyngeal region, vitreous humor, cerebrospinal fluid, and bone marrow. SARS-CoV-2 was subsequently diagnosed via Genomtec® SARS-CoV-2 EvaGreen® RT-LAMP CE-IVD Duo Kit. In both postmortem patients, SARS-CoV-2 RNA was detected in bone marrow samples. However, both the vitreous humor and cerebrospinal fluid from the same patients gave negative results using the same test system. The evidence of viral RNA in the bone marrow, along with other reports supports the thesis that SARS-CoV-2 infections are systemic in nature, the consequences of which would profoundly influence both the testing and survival of patients.

The dark side of social media: Two deaths related with chloroform intoxication.

A suicide pact is an agreement between people to commit suicide together, which usually takes place at the same time, in the same place, by using the same method. Social media serve as a way of communication between people. Thus, they use such platforms to find potential suicide pact partners. Chloroform, although being regarded to as a slightly forgotten poison, is still linked to homicide and suicide cases. Death due to an acute chloroform ingestion may be a result of central nervous system depression. In this paper, we present application of headspace gas chromatographic method using a dual column/dual flame ionization detector (HS-GC-FID/FID) for the determination of chloroform in two fatal intoxication cases, as well as chloroform stability study. Analysis of biological samples revealed chloroform concentrations of 135.8, 16.1, 8.1, and 37.1 µg/ml in blood, urine, vitreous humor, and bile, respectively. Kidney, liver, and muscle specimens contained 119.5, 99.6, and 28.4 µg/g of chloroform, respectively. The results of stability studies indicate the highest decrease of chloroform in room temperature, so it is advised to store samples in a freezer. The addition of sodium fluoride is recommended as in blood samples collected to the test tubes without any preservative agent, the detection of chloroform after 91 days is almost impossible. It is important to emphasize that even old poisons can cause a lot of concerns today, as here described cases are linked to chloroform intoxication, as well as with possible danger which social media bring about nowadays.

Development of a procedure involving artifact examination to determine the species affiliation of its biological material, as illustrated by an attempt to demystify an alleged Nazi lampshade made from human skin.

Objectives: The main purpose of the study was to identify the species origin of the material from which the incriminating lampshade bought at a flea market had been made. Methods: The histological and molecular biology methods commonly used in forensic genetics were selected to achieve this goal. The DNA for the research was isolated using a QIAamp DNA Mini Kit (Qiagen) according to the manufacturer's protocol for tissues. The quantitative and qualitative evaluation of genetic material was carried out by the real-time PCR method with a Quantifiler Duo DNA Quantification Kit (Applied Biosystems). Specific genetic markers of mtDNA of cattle, equines, deer, wild boar, and sheep were selected to identify species. Results: Histological tests showed that the lampshade had been made from intestinal flaps. The DNA from sample tested positive for cattle. The test results dispelled the suspicion that the researched lampshade had been made from human skin.-hour journey. The second case is a 55-year-old male assaulted with double punches in his chest and declared dead on arrival at the hospital after 30 minutes. A medicolegal autopsy and thorough investigation, in both cases, revealed cardiac tamponade due to ventricular rupture with no underlying pathology. Conclusion: The proposed testing method can be used to verify the origin of the artifacts misleadingly described as made from human skin. To our knowledge, such artifacts can be found in museums and private collections. Further-more, it has been widely believed until now that human-skin products, mainly lampshades, were mass-produced in Nazi concentration camps, mainly in Buchenwald.

Dermestes (s.str.) haemorrhoidalis (Coleoptera: Dermestidae)-The Most Frequent Species on Mummified Human Corpses in Indoor Conditions? Three Cases from Southwestern Poland.

Beetles of the family Dermestidae, especially of the genus Dermestes Linnaeus, 1758, are often identified on corpses in late stages of decomposition. They usually feed on remains devoid of organs and soft tissues or when the corpses undergo mummification. In Europe, eight species from two subgenera Dermestes and Dermestinus Zhantiev, 1967, have so far been identified on human corpses. Despite the relatively frequent presence of Dermestes sp. in experimental studies conducted in Poland, no reports concerning Dermestes directly collected from human corpses have been published to date. This article again describes observations of Dermestidae collected from human corpses found in indoor conditions in Wroclaw, the capital of the Dolnoslaskie Voivodeship. For the second time, there is evidence of the presence of Dermestes (s.str.) haemorrhoidalis on human corpses-a species considered to be relatively rare, as evidenced by faunistic data published from Poland, as well as the results of ongoing experiments of forensic interest.

Neuropathological Changes in the Brains of Suicide Killers.

BACKGROUND: Homicide combined with subsequent suicide of the perpetrator is a particular form of interpersonal violence and, at the same time, a manifestation of extreme aggression directed against oneself. Despite the relatively well-described individual acts of homicide and suicide, both in terms of psychopathology and law, acts of homicide and subsequent suicide committed by the same person are not well-studied phenomena. The importance of emotional factors, including the influence of mental state deviations (psychopathology), on this phenomenon, is discussed in the literature, but still there is relatively little data with which to attempt neuropathological assessments of the brains of suicide killers. This paper is dedicated to the issue based on the neuropathological studies performed. METHODS: We analyzed a group of murder-suicides using histochemical and immunohistochemical methods. RESULTS: The results of our research indicate the presence of neurodegenerative changes including multiple deposits of ß-amyloid in the form of senile/amyloid plaques and perivascular diffuse plaques. CONCLUSIONS: Neurodegenerative changes found in the analyzed brains of suicide killers may provide an interesting starting point for a number of analyses. The presence of neurodegenerative changes at such a young age in some murderers may suggest preclinical lesions that affect cognitive functions and are associated with depressed moods.

When Conventional Oxygen Therapy Fails-The Effectiveness of High-Flow Nasal Oxygen Therapy in Patients with Respiratory Failure in the Course of COVID-19.

High-flow nasal oxygen (HFNO) is recommended as a first-line treatment in patients with acute hypoxemic respiratory failure due to COVID-19. We assessed the effectiveness of HFNO and predictors of failure and death. The medical records of 200 consecutive adult patients treated with HFNO were analysed. Ninety-two patients (46%) were successfully cured, 52 (26%) required noninvasive ventilation, and 61 (30.5%) received intubation. Overall mortality was 40.5%. Risk factors of HFNO ineffectiveness were: SpO2 ≤ 90% with conventional oxygen therapy (HR 0.32, 95% CI 0.19-0.53, p < 0.001), SpO2 ≤ 74% without oxygen therapy (HR 0.44, 95% CI 0.27-0.71, p < 0.001), an age ≥ 60, comorbidities, biomarkers (C-reactive protein, procalcitonin, creatinine, lactate dehydrogenase), duration of symptoms before admission to hospital ≤ 9 days, start of treatment with HFNO ≤ 4 days. The multivariate logistic regression models (age ≥ 60, comorbidities, C-reactive protein concentration and SpO2 with oxygen therapy) revealed a high predictive value of death and HFNO failure (AUC 0.851, sensitivity 0.780, specificity 0.802; AUC 0.800, sensitivity 0.776, specificity 0.739, respectively). HFNO is a safe method for treating acute hypoxemic respiratory failure, with effectiveness reaching nearly 50%. Low values of SpO2 without and during oxygen therapy seem to be good diagnostic tools for predicting death and HFNO failure.

The chest radiographic scoring system in initial diagnosis of COVID-19: Is a radiologist needed?

BACKGROUND: Lung imaging, next to a polymerase chain reaction (PCR) test, is a key diagnostic tool in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The degree of abnormalities correlates with clinical outcome. Imaging of the lungs using chest radiography (CXR) at the peak of a pandemic is considered a basic diagnostic tool at the triage stage. The CXR images are less characteristic than computed tomography (CT) and should be interpreted with a combination of clinical findings. OBJECTIVES: Comparison of the usefulness of 2 CXR severity scores to evaluate the presence/severity of inflammation in the course of COVID-19 and the possibility of a non-radiologist to interpret the image independently. MATERIAL AND METHODS: Retrospective analysis of the medical records of 152 consecutive patients (aged 19-96, 73 men), infected with SARS-CoV-2, confirmed using real-time PCR (RT-PCR). Five-point and twelve-point CXR severity scoring systems were used (independently by a radiologist and a referring physician) to assess the severity of inflammation. RESULTS: In 77 of 152 cases, the CXR revealed features of inflammation. Bilateral abnormalities were found in 48/77 (62.3%) cases. Statistically, the lower lobes were involved more often than the upper ones (p < 0.001) and the left lobe more often than the right one (p < 0.001). The intensity of the abnormalities using both scales correlated with the persistence of symptoms (p = 0.0133 and p = 0.0403). A positive and statistically significant correlation was found between both scales and dyspnea, decreased oxygen saturation, elevated C-reactive protein (CRP), ferritin, D-dimer, lactate dehydrogenase, and alanine aminotransferase activity. The interobserver agreement analysis did not show a statistically significant difference in the CXR severity score using the five-point (B = 0.8345, kappa = 0.82; p = 0.1480) or the twelve-point scale (B = 0.8219, kappa = 0.77; p = 0.0502). CONCLUSIONS: The CXR severity score is a useful tool to assess the inflammation in the initial diagnosis of coronavirus disease 2019 (COVID-19). Quantifying lung abnormalities accurately may be performed by a referring physician. Both CXR severity scales correlate well with clinical parameters.

Molecular profiling of the intestinal mucosa and immune cells of the colon by multi-parametric histological techniques.

The impact of the post-mortem interval (PMI) on the optical molecular characteristics of the colonic mucosa and the gut-associated lymphoid tissue (GALT) were examined by multi-parametric measurements techniques. Inflammatory cells were identified by immunohistochemical staining. Molecular parameters were estimated using the Raman spectroscopy (RS) and Fourier Transform Infrared (FTIR) spectroscopic imaging. The 3D refractive index (3D-RI) distributions of samples were determined using the digital holographic tomography. The distribution of immune cells between post-mortem (PM) and normal controls did show significant differences for CD4 (P = 0.0016) or CD8 (P < 0.0001), whose expression level was decreased in PM cases. No association was found between individual PMI values and inflammatory cell distribution. However, there was a tendency for a negative correlation between CD4+ cells and PMI (r = - 0.542, P = 0.032). The alterations ongoing in post-mortem tissue may suggest that PMI has a suppressive effect on the effector properties of the cell-mediated immunity. Moreover, it was confirmed that spectroscopic and digital holotomographic histology are also a useful technique for characterization of the differences in inflammation of varying intensity and in GALT imaging in a solid tissue. Anatomical location of immune cells and methods of tissue fixation determine the molecular and optical parameters of the examined cases.

Value of quantitative analysis in lung computed tomography in patients severely ill with COVID-19.

INTRODUCTION: Quantitative computed tomography (QCT) is used to objectively assess the degree of parenchymal impairment in COVID-19 pneumonia. MATERIALS AND METHODS: Retrospective study on 61 COVID-19 patients (severe and non-severe; 33 men, age 63+/-15 years) who underwent a CT scan due to tachypnea, dyspnoea or desaturation. QCT was performed using VCAR software. Patients' clinical data was collected, including laboratory results and oxygenation support. The optimal cut-off point for CT parameters for predicting death and respiratory support was performed by maximizing the Youden Index in a receiver operating characteristic (ROC) curve analysis. RESULTS: The analysis revealed significantly greater progression of changes: ground-glass opacities (GGO) (31,42% v 13,89%, p<0.001), consolidation (11,85% v 3,32%, p<0.001) in patients with severe disease compared to non-severe disease. Five lobes were involved in all patients with severe disease. In non-severe patients, a positive correlation was found between severity of GGO, consolidation and emphysema and sex, tachypnea, chest x-ray (CXR) score on admission and laboratory parameters: CRP, D-dimer, ALT, lymphocyte count and lymphocyte/neutrophil ratio. In the group of severe patients, a correlation was found between sex, creatinine level and death. ROC analysis on death prediction was used to establish the cut-off point for GGO at 24.3% (AUC 0.8878, 95% CI 0.7889-0.9866; sensitivity 91.7%, specificity 75.5%), 5.6% for consolidation (AUC 0.7466, 95% CI 0.6009-0.8923; sensitivity 83.3%, specificity 59.2%), and 37.8% for total (GGO+consolidation) (AUC 0.8622, 95% CI 0.7525-0.972; sensitivity 75%, specificity 83.7%). The cut-off point for predicting respiratory support was established for GGO at 18.7% (AUC 0.7611, 95% CI 0.6268-0.8954; sensitivity 87.5%, specificity 64.4%), consolidation at 3.88% (AUC 0.7438, 95% CI 0.6146-0.8729; sensitivity 100%, specificity 46.7%), and total at 23.5% (AUC 0.7931, 95% CI 0.673-0.9131; sensitivity 93.8%, specificity 57.8%). CONCLUSION: QCT is a good diagnostic tool which facilitates decision-making regarding intensification of oxygen support and transfer to an intensive care unit in patients severely ill with COVID-19 pneumonia. QCT can make an independent and simple screening tool to assess the risk of death, regardless of clinical symptoms. Usefulness of QCT to predict the risk of death is higher than to assess the indications for respiratory support.

Quantification of methadone and its metabolites: EDDP and EMDP determined in autopsy cases using LC-MS/MS.

The paper presents a method for the determination of methadone, EDDP, and EMDP in postmortem biological materials using liquid-liquid extraction with ethyl acetate (pH9) and UHPLC-MS/MS technique. Methadone-d9 and EDDP-d3 were used as the internal standards. The method validation results for blood and urine were as follows: linearity: 0.5-1000 ng/ml; R2  > 0.9993 for methadone, EDDP and R2  > 0.9944 for EMDP. Intra- and inter-day precision: 0.1%-7.5% and 0.3%-8.6%, respectively; intra- and inter-day accuracy: -11.8% to 13.9% and -9.3 to 14.8%, respectively; recovery: 91.5%-123.0%; matrix effect: 83.5%-123.9%. This study also describes 18 postmortem cases, where methadone concentrations ranged 2.3-1180 ng/ml in blood (n = 17), from 11.0 to >10,000 ng/ml in urine (n = 13) and 135.2-409.0 in vitreous humor (VH, n = 3). EDDP concentrations ranged from not detectable to 180 ng/mL in blood, from 42.4 to >10,000 ng/ml in urine and 18.3-36.5 in VH. EMDP concentrations were found in four cases in blood from below LLOQ to 1.8 ng/ml and in seven cases in urine, ranged 2.1-243.0 ng/ml. EMDP was not detected in VH samples. The EDDP/methadone ratios and blood/urine ratios for methadone and EDDP in EMDP-positive and negative cases were performed. The paper presents mass spectra of other methadone metabolites, than EDDP and EMDP (ring hydroxylated methadone, ring hydroxylated EDDP, ring hydroxylated EMDP, methadol, and DDP). Simultaneous determination of methadone and its metabolites in order to unequivocally interpret the results of toxicological tests seems to be useful in cases related to prescription/illicit use of methadone.

Unidentified human remains discovered within Polish territory: Traces of the difficult history of the twentieth century.

Poland, due to its geographical location, has been a place where the interests of neighbouring countries have converged. As a result, Polish territory has been the site of hostilities, totalitarian terror, and acts of genocide. Following the end of World War II, Poland became part of the so-called Eastern Bloc. A movement known as the anti-communist underground arose within Polish territory with the aim of conducting partisan warfare and political and propaganda activities against the occupiers. Partisans were victims of campaigns of liquidation; they lost their lives during interrogations, died in prisons, were sentenced to death by Polish courts, and were subsequently buried at unknown sites throughout the country. In connection with war and post-war events within Polish territory, the remains of victims of both World War II and post-war political repressions are being found to this day. In addition, remains derived from historical populations are being discovered as well as present-day remains belonging to missing persons or victims of criminal offences. A portion of the remains resulting from military operations and the post-war history of Poland are discovered by chance, but discovery of the burial sites of victims of communist crimes is often preceded by many years of research. International agreements and Polish legal regulations make it possible to search for victims of armed conflicts of various nationalities within the country. The process of identifying victims of armed conflicts, political terror and genocide can be carried out thanks to routine procedures for handling unidentified remains. Given the diversity (various historical periods, various nationalities) of the discovered remains, the elaborated procedures enable their dignified burial.

Histology of Liver of the Deceased Due to Harmful Use of Alcohol.

AIM: To study types and incidence of histological changes in liver of people deceased due to harmful use of alcohol. METHODS: A retrospective review of medico-legal autopsy of 236 adults who died in the years 2015-2016 due to harmful use of alcohol was done. Histopathological liver samples taken during autopsies were evaluated. Blood alcohol content was analyzed. Serological tests for hepatitis B surface antigen and anti-hepatitis C virus (HCV) were performed. RESULTS: The most common liver pathology (83.1%) was steatosis, mainly mixed type (50%); 66.9% had high-grade steatosis. Liver fibrosis was detected in 39.4% of cases, with fibrosis of higher than or equal to third grade in 14%, hepatitis in 44.5% and steatohepatitis in 19.1%. Toxic hepatocyte injury features (ballooning degeneration, Mallory-Denk bodies) were found in 20.8% cases and degenerative-damage changes in 41.1%. The correlation between the grade of steatosis and fibrosis (P = 0.0005), toxic injury (0.00000101) and degenerative-traumatic changes (P = 0.00000741) was found. The correlation was found between hepatitis and higher than or equal to third grade steatosis (P = 0.037), cholestasis (P = 0.0139), toxic injury features (P = 2.58 × 10-13), degenerative-damage changes (P = 7.9 × 10-12) and presence of anti-HCV (P = 0.00723) and between progression of fibrosis and presence of toxic injury features (2.28 × 10-19), degenerative-damage changes (P = 4.25 × 10-11) and anti-HCV (P = 0.0263). CONCLUSIONS: Spectrum of histopathological liver changes is broad regardless of sex, and various traits are present in various patterns. Comorbidities have strong influence on the picture of changes in the liver. Exact evaluation how often and what histopathological changes will develop in alcohol liver disease is not possible by reason of variability of external factors.