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- Autopsy in adults with congenital heart disease (ACHD)Publication . Angelini, Annalisa; di Gioia, Cira; Doran, Helen; Fedrigo, Marny; Henriques de Gouveia, Rosa; Ho, Siew Yen; Leone, Ornella; Sheppard, Mary N; Thiene, Gaetano; Dimopoulos, Konstantinos; Mulder, Barbara; Padalino, Massimo; van der Wal, Allard CThe adult congenital heart diseases (ACHD) population is exceeding the pediatric congenital heart diseases (CHD) population and is progressively expanding each year, representing more than 90% of patients with CHD. Of these, about 75% have undergone surgical and/or percutaneous intervention for palliation or correction. Autopsy can be a very challenging procedure in ACHD patients. The approach and protocol to be used may vary depending on whether the pathologists are facing native disease without surgical or percutaneous interventions, but with various degrees of cardiac remodeling, or previously palliated or corrected CHD. Moreover, interventions for the same condition have evolved over the last decades, as has perioperative myocardial preservations and postoperative care, with different long-term sequelae depending on the era in which patients were operated on. Careful clinicopathological correlation is, thus, required to assist the pathologist in performing the autopsy and reaching a diagnosis regarding the cause of death. Due to the heterogeneity of the structural abnormalities, and the wide variety of surgical and interventional procedures, there are no standard methods for dissecting the heart at autopsy. In this paper, we describe the most common types of CHDs that a pathologist could encounter at autopsy, including the various types of surgical and percutaneous procedures and major pathological manifestations. We also propose a practical systematic approach to the autopsy of ACHD patients.
- Mast cells: Promoters of myocardial fibrosis in hypertensive heart disease?Publication . Henriques de Gouveia, Rosa
- Polymethyl methacrylate balls: an unexpected and surprising finding during an autopsyPublication . Coutinho, Eduardo; Henriques de Gouveia, Rosa; Pinheiro, João Emanuel Santos
- Mortality due to respiratory infections: an alert study before COVID-19 pandemicPublication . Gi, Andreia; Henriques de Gouveia, Rosa; Corte Real, Francisco; Carvalho, LinaObjective. Respiratory tract infections remain a common problem in clinical practice with high morbidity and mortality worldwide. In Portugal, pneumonia was the third leading death cause in 2018. Due to COVID-19 pandemic, there is a growing concern about the burden of respiratory diseases and preventable risk factors. The present study started before the pandemic and its aim was to determine the occurrence of pneumonia/bronchopneumonia in a postmortem series and to characterize its circumstantial context. Methods. A retrospective anatomopathological study was performed on cases with acute pneumonia/bronchopneumonia at the Medicolegal Portuguese Institute (2011-2017). Results. In an autopsy series of 737 patients, 521 were male and 675 presented comorbidities. The mean age was 63.87 ± 19.8 years. The most common acquisition site was community (65.1%), as natural death (65.5%). Concerning the manner of death, most cases (48.0%) were sudden deaths, followed by accidents (29.2%). A statistically significant association was observed between the medicolegal etiology and the place of infection acquisition, with higher prevalence of natural obitus (91.0%) in community-acquired pneumonia/bronchopneumonia versus higher prevalence of violent obitus in hospitalacquired pneumonia/bronchopneumonia (82.1%) (p < 0.001). Conclusions. Forensic anatomopathological postmortem data may contribute to better understand community and hospital pulmonary infections.
- Sudden cardiac death and valvular pathologyPublication . Henriques de Gouveia, Rosa; Corte Real, FranciscoSudden death due to valvular heart disease is reported to range from 1% to 5% in native valves and around 0.2%-0.9%/year in prosthesis. The nature of the diseases is varied, from heritable, congenital to acquired. It may affect both genders in multiple age groups. The authors show and comment examples of the major nosologic aetiologies underlying unexpected exitus letalis of valvular nature.
- Chorangioma and John ClarkePublication . Henriques de Gouveia, Rosa; Simoes Da Silva, Beatriz; Corte Real, F.
- Dental abscess and “unexpected death”...Publication . Costa, Margarida; Henriques de Gouveia, Rosa; Simoes Da Silva, Beatriz; Monsanto, Paula Venâncio; Cordeiro, Cristina; Corte Real, F.Even though we are living in an era of major technical-scientific advances and effective antimicrobial and antiviral therapy,dental infections are still the most important predisposing factors for head and neck infections. Odontogenic infections can cause severe complications, e.g. compromised airways, tissue necrosis, deep neck infections, mediastinitis, endocarditis and sepsis. These severe odontogenic infections can be potentially life-threatening. Usually odontogenic infections respond well to a combination of surgical treatment (incision, rainage) and antibiotic therapy. However, especially when the medico-surgical therapy is installed late, cases may evolve unfavourably and be fatal. The authors report a case of a 30-year-old man who was observed on three consecutive occasions by the General Practitioner in a District Hospital, for a decayed tooth with abscess and was, then, referred to a Central Hospital. There, he was examined for the fourth time, this one by a Stomatologist at the Emergency Department, where he died. The post mortem examination revealed bacterial (Gram +) acute neutrophilic (purulent) infection of soft tissues of the mandibular region and neck with para-tracheal extension, as well as thrombosis ofthe left jugular vein. Circumstantial clinical information, post mortem findings, pathophysiology (including complications andprogression of the disease to death) are discussed, highlighting the relevance of accurate and timely diagnosis and treatmentto avoid malpractice and mortality.
- Intraventricular brain tumor: report of three casesPublication . Costa, Margarida; Henriques de Gouveia, Rosa; Simoes da Silva, BeatrizIntroduction: Colloid cysts are considered congenital non invasive benign lesions, enlarging very slowly. They account for less than 1% of symptomatic brain tumors, being the most common tumor of the 3rd ventricle (...)