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American Journal of Forensic Medicine and Pathology

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https://www.readbyqxmd.com/read/29309279/is-the-garden-gun-flobert-9-mm-capable-of-inducing-fatal-injury-literature-review-and-comparative-presentation-of-two-cases
#1
Pavlos Pavlidis, Maria-Valeria Karakasi, Maria Kouroupi, Efthimia Theodoropoulou, Theodossios A Birbilis
This article presents both a fatal suicide incident by Flobert 9 mm-type smoothbore weapon with a single-shot projectile and a nonfatal case of a suicide attempt by the same weapon type with a dispersion cartridge from the authors' forensic record. A retrospective study was conducted examining 84 cases involving cases of headshots inflicted by all kinds of weapons deriving from the broader region of Eastern Macedonia and Thrace (Northern Greece) between 2000 and 2015, among which only 1 involved lethal wounding by a Flobert 9 mm (1...
January 5, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29293100/cortical-expression-of-the-polysialylated-isoform-of-the-neural-cell-adhesion-molecule-on-brain-tissue-to-recognize-drug-related-death-an-exploratory-analysis
#2
Vito Cirielli, Luca Cima, Chiara Chindemi, Olivia Danzi, Claudio Ghimenton, Albino Eccher, Silvestro Mauriello, Federica Bortolotti, Domenico De Leo, Matteo Brunelli, Franco Tagliaro
The polysialylated isoform of the neural cell adhesion molecule (PSA-NCAM) has been shown to be a key player in neuroplastic changes and is expressed in various disorders. We investigated the PSA-NCAM expression on brain cortical tissue in a cohort of drug-related deaths. Brains from 25 drug abusers and 10 control subjects were removed at autopsy, and 2 samples of the right parietal lobe of each case were obtained. The polysialylated isoform of NCAM was evaluated on formalin-fixed and paraffin-embedded tissues...
December 29, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29278540/a-case-of-fatal-cerebral-air-embolism-after-blunt-lung-trauma-postmortem-computed-tomography-and-autopsy-findings
#3
Isabella Mercurio, Daniele Capano, Riccardo Torre, Aldo Taddei, Gianmarco Troiano, Michele Scialpi, Mario Gabbrielli
Cerebral air embolism is caused by gas bubbles in the vascular system. These bubbles can cause cerebral ischemia by obstructing encephalic blood vessels. It is frequently associated with blunt and penetrating chest trauma as well as iatrogenic interventions. Lung trauma involving laceration of the respiratory tract, lung parenchyma, and blood vessels may result in direct communication of these structures, driving air or gas into the pulmonary venous system. We report a case of a blunt chest trauma that led to massive arterial air embolism that was possible to recognize with the help of postmortem computed tomographic scan examination...
December 22, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29278539/a-rare-case-of-fatal-bowel-obstruction-secondary-to-a-colonic-bezoar
#4
Fiorella Caputo, Rosario Barranco, Alessandro Bonsignore, Giulio Fraternali Orcioni, Francesco Ventura
A bezoar is a mass of undigested, or partially digested, material forming in the lumen of the gastroenteric tract, causing occlusive or subocclusive events. The most frequent types of bezoars are those composed of vegetable fibers, also called phytobezoars, which, by virtue of their high content in cellulose, hemicellulose, and lignin, remain undigested in the stomach and intestines and, from there, can migrate and occlude the narrowest portions of the bowel. The areas that are most frequently affected by occlusive phenomena related to the presence of bezoars are the stomach and the small intestine, although colic localizations are extremely rare...
December 22, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29278538/a-fire-extinguisher-death-the-macklin-effect
#5
Ryan Blumenthal, Brigitte Hänert-van der Zee
We present the case of an adult white man found dead in a psychiatric institution with fine white powder (monoammonium phosphate) deposited over the entire face after he insufflated the contents of a dry chemical fire extinguisher. Fine white powder was present within the mouth and sinuses and lined the upper airways. On opening the thoracic cavity, approximately 500 g of fine white powder was present within the right thoracic cavity. The esophagus was ruptured. Traumatic emphysema of the posterior sternum wall was present (pneumomediastinum)...
December 22, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29232215/pulmonary-tumor-thrombotic-microangiopathy-case-report-and-review-of-literature
#6
Josh Curtis Hutchinson, James W Fulcher, Jeff Hanna, Michael E Ward
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare rapidly progressive fatal disease that is difficult to diagnosis antemortem. Activation of the coagulation cascade and fibrocellular intimal thickening caused by embolism of tumor cells into pulmonary vasculature leads to extensive pulmonary hypertension and eventually death. We describe a case of PTTM with association of a presumed lung adenocarcinoma primary. Although rare in nature, PTTM should be a considered diagnosis with chronic dyspnea of unknown origin, severe pulmonary hypertension coupled with right-side heart failure, in the absence of pulmonary embolism...
December 11, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29227295/an-unusual-presentation-of-pituitary-gland-apoplexy-with-noninfectious-meningitis
#7
Margaret LaPorte, Jenna Pollock, Michael Ward, James Fulcher
Pituitary adenomas make up 10% of intracranial tumors, but because of their location, they may go undetected for long periods. In this article, we report the case of a 68-year-old white man found deceased in his residence, who died of acute pituitary tumor apoplexy. He was known to have severe symptoms including acute headache, vision loss, and altered behavior. When found, his home was in extreme disarray, mimicking a possible assault. At autopsy, the decedent had multiple superficial abrasions about the upper and lower extremities, as well as a 2...
December 7, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29194055/hinged-lids-and-fatal-head-entrapment-in-early-childhood
#8
Roger W Byard, Allan D Cala
Young children are at risk of head entrapment because they often do not understand potentially dangerous situations or have the intellectual or physical capabilities to self-extricate. Two cases of head entrapment due to hinged lids are presented to demonstrate another rare lethal situation specific to the very young. Case 1 was a 14-month-old boy found suspended by his neck in a semikneeling position under a toilet seat. A horizontal linear bruise measuring 0.6 × 20 mm was present on the right side of the neck with petechial hemorrhages of the forehead...
December 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29194054/a-rare-vehicle-assisted-ligature-hanging-suicide-at-the-wheel
#9
Rosario Barranco, Fiorella Caputo, Alessandro Bonsignore, Giulio Fraternali Orcioni, Francesco Ventura
Suicide by hanging inside a motor vehicle is a rare occurrence. A 48-year-old woman suffering from major depression was found having agonal breathing inside her automobile. A 20-mm diameter blue nylon rope was wrapped tightly around her neck, with its other end tied to a nearby wooden fence post. Despite resuscitation attempts, she was declared deceased after several minutes. The vehicle was located in an area with a slight downward slope. The motor was off. It was in neutral gear, with the parking brake disengaged...
December 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29194053/cervical-injuries-in-drowning-cases-a-case-report-and-a-review-of-literature
#10
Maroua Boussaid, Mohamed Amin Mesrati, Yosra Mahjoub, Nidhal Haj Salem, Abdelfateh Zakhama, Ali Chadly, Adnen Moussa, Abir Aissaoui
Discovery of bruises in the muscles of the neck and a fracture of the hyoid bone in a body recovered from water makes the diagnosis and the determination of the manner of death difficult.The aims of this work are to report a case of a drowned body with cervical injuries and to highlight the importance of interpreting these findings accurately.A 39-year-old woman was found dead face down in a 6-m deep well with a 3-m water level. She was mentally disturbed and had a history of suicide attempts. In fact, she had previously attempted to jump into that well in an attempt to put an end to her life...
December 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29210711/an-autopsy-case-of-sudden-death-in-neurofibromatosis-type-1-with-pheochromocytoma-and-myocarditis
#11
Masataka Takamiya, Hisae Niitsu, Kiyoshi Saigusa
An autopsy case of sudden death in a 33-year-old man with neurofibromatosis type 1 (von Recklinghausen disease), pheochromocytoma, and myocarditis is reported. The decedent was found in his bedroom in cardiopulmonary arrest. Polypoid, elastic dermal papules on the neck, chest, abdomen, and back, and flat dark-brown macules on the chest and abdomen were observed. Flat, ovoid, dark-brown freckles were present in both axillae. Examination of the right adrenal gland revealed a tumor measuring 5 cm × 5 cm × 3 cm...
November 28, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29140804/exploration-of-predictive-biomarkers-for-sudden-unexplained-cardiac-death-in-nonelderly-people-a-case-control-study-with-biochemical-parameters-related-to-heart-failure
#12
Sakai Kentaro, Iwadate Kimiharu, Matsumoto Sari, Takasu Shojiro, Kanto Yuko
Sudden unexplained cardiac death (SUCD) can occasionally occur in nonelderly patients with epilepsy, psychiatric disorders, or no medical history. This study was conducted to aim to analyze whether values of the biomarkers for heart failure are associated with the SUCD. Serum concentrations of N-terminal probrain natriuretic peptide, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor α were analyzed in 57 nonelderly patients with SUCD who was diagnosed at medicolegal autopsy. The subjects were divided into 3 subgroups according to the medical history: (1) epilepsy, (2) psychiatric disorders, and (3) no specific medical history...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29140803/use-of-postmortem-computed-tomography-to-detect-bowel-obstruction-and-its-relationship-to-the-cause-of-death
#13
Dominic Gascho, Sarah Schaerli, Lucile Tuchtan-Torrents, Michael J Thali, Guillaume Gorincour
Bowel distension frequently indicates bowel obstruction, which is a common diagnosis in clinical radiology. Typically, symptoms and complaints lead to radiological examinations and the detection of the etiology. Untreated intestinal obstructions can lead to a fatal outcome through cardiac failure due to septic shock. Certain of these cases undergo medicolegal investigations depending on the case history, the condition of the decedent, the location of the finding, or recent visits to medical professionals. Computed tomography (CT) is a recommended method in clinical radiology for the detection of bowel obstruction, which is indicated by bowel distension and further radiological signs (eg, the whirl sign, which indicates a volvulus)...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29140802/characterization-with-scanning-electron-microscopy-energy-dispersive-x-ray-spectrometry-of-microtraces-from-the-ligature-mean-in-hanging-mechanical-asphyxia-a-series-of-forensic-cases
#14
Francesca Maghin, Salvatore Ambrogio Andreola, Michele Boracchi, Guendalina Gentile, Francesca Maciocco, Riccardo Zoja
The authors applied scanning electron microscopy with energy-dispersive x-ray spectrometry to the furrow derived from hanging means. The study was conducted with the purpose to detect possible extraneous microtraces, deriving from the ligature, that could have had an interaction with the cutaneous biological matrix, thanks to a transfert mechanism, in the proximities of the lesion.Fifteen cutaneous samples of the furrow and an equal number of fragments of graphite tape, directly positioned on the lesion produced by the ligature mean and used as a "conductor" of possible traces, were analyzed using scanning electron microscopy with energy-dispersive x-ray spectrometry...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29135492/decline-in-2-serial-postmortem-tryptase-measurements-beyond-72-hours-after-death-in-an-antibiotic-related-anaphylactic-death
#15
Rexson Tse, Jack Garland, Yeri Ahn
Anaphylaxis can be difficult to diagnose in the postmortem setting. Postmortem tryptase is a widely used ancillary test in aiding the diagnosis in which an elevation supports a death from anaphylaxis. Postmortem tryptase can be difficult to interpret, and the effects of postmortem kinetics are not fully understood. Clinically, mast cell tryptase returns to baseline 24 to 72 hours after an anaphylactic stimulus. We report another anaphylactic death from antibiotic administration in which 2 serial postmortem total tryptase measurements at 3 days (72 hours) and 6 days (144 hours) after death declined from 522 μg/L to 300 μg/L (baseline, 5...
November 10, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29120874/unusual-suicide-by-a-speargun-shot-through-the-mouth-a-case-report
#16
Youssef Nouma, Sami Krimi, Karama Regaieg
We report an unusual case of suicide committed with a speargun shot through the mouth, causing a penetrating brain injury. The special features of the present case are not only related to the method chosen for the purpose but also to the difficulties encountered in confirming the diagnosis. Although this type of suicide has been previously reported, this case is particularly interesting in terms of the shooting mechanism and manner of death. Because of the length of the weapon, which was apparently used and found at the scene, a suicidal manner of death first seemed unlikely and the possibility of a simulated suicide was raised...
November 9, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29120873/a-rare-case-of-isolated-atrial-myocarditis-causing-death-with-no-post-mortem-computed-tomography-scan-correlation
#17
Rexson Tse, Jack Garland, Kilak Kesha, Yvonne Triggs, Lucy Modahl, David Milne, Zhi Yap, Simon Stables
Acute myocarditis is a potentially fatal cardiac pathology that is thought to cause sudden death through arrhythmia and cardiac failure. Of the different subtypes, lymphocytic myocarditis is the most common form. The pathophysiology of myocarditis can be generally diffuse or focally involve the ventricles, but less frequently affects the atria. Although the clinical literature reports isolated atrial myocarditis as a cause of atrial fibrillation and enlargement, there is scant postmortem literature on the findings of this pathology...
November 9, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29120872/a-rare-case-of-hemopericardium-from-a-ruptured-dissecting-pulmonary-artery-aneurysm-postmortem-computed-tomography-scan-and-autopsy-findings
#18
Rexson Tse, Jack Garland, Yvonne Triggs, Simon Stables
Nontraumatic hemopericardium is a potentially fatal pathology that is most commonly caused by myocardial wall rupture, ruptured aortic dissection, aortic aneurysm rupture, or a neoplastic process. A rare potential cause of hemopericardium is pulmonary artery dissection, with less than 100 reported cases in the literature. Pulmonary artery dissection is associated with pulmonary artery aneurysm, pulmonary artery hypertension, and congenital heart disease. We report a fatal case of nontraumatic hemopericardium caused by a ruptured dissecting pulmonary artery aneurysm in a 16-year-old girl with patent ductus arteriosus...
November 9, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29099394/nontraumatic-convexal-subarachnoid-hemorrhage-accompanied-by-sylvian-hematoma-an-autopsy-case-of-ruptured-distal-middle-cerebral-artery-aneurysm
#19
Kenji Ninomiya, Maki Fukasawa, Yuka Kawakami, Chiaki Fuke, Tetsuji Miyazaki
We describe an autopsy case of nontraumatic convexal subarachnoid hemorrhage (cSAH) accompanied by sylvian hematoma. A woman in her 50s was found dead in her house. On autopsy, massive cSAH accompanied by sylvian hematoma was observed. Because of the absence of subarachnoid hemorrhage (SAH) in the basal cistern, initial suspicion was that of a traumatic SAH. After a detailed investigation, a ruptured cerebral aneurysm of the distal middle cerebral artery was found in the hematoma, and the cSAH in this case was confirmed to be endogenous...
November 2, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29095703/sudden-death-due-to-cystic-tumor-of-the-atrioventricular-node-and-fibromuscular-dysplasia-involving-branches-of-the-coronary-arteries
#20
Silvia Farkašová Iannaccone, Daniel Farkaš, Alžbeta Ginelliová, Marián Švajdler, Ján Laco, Ivo Šteiner, Lucia Fröhlichová
In this paper, we report the autopsy findings of a 42-year-old White male who was found deceased at his home by his brother in the early morning hours with a history of excessive alcohol consumption 1 day before his death. A medical record review revealed chronic alcohol use with alcohol dependence syndrome, hypertension, and cardiac arrhythmias by electrocardiogram 2 years prior. External examination revealed only a single bruise on the forehead. Internal examination revealed changes associated with chronic alcohol abuse and mild atherosclerosis...
November 2, 2017: American Journal of Forensic Medicine and Pathology
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