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American Journal of Forensic Medicine and Pathology

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https://www.readbyqxmd.com/read/30624242/a-case-of-bilateral-extracranial-internal-carotid-artery-dissection-due-to-the-helmet-strap-after-motorcycle-crash
#1
Sara Gioia, Lisa Franceschetto, Massimo Lancia, Mauro Bacci, Fabio Suadoni
The authors report a case of a man who developed stroke symptoms a few days after a road accident on his motorcycle. Radiographic examinations revealed the presence of bilateral dissection of the extracranial internal carotid arteries with signs of involvement of the brain parenchyma.The location, timing, and presentation lead to the conclusion that the carotid lesions were secondary to the motorcycle collision; in particular, we suppose that it is due to the pressure exerted by the helmet strap worn. Although helmets have undoubtedly prevented serious injuries, this report highlights that the helmets themselves may cause injuries, especially to cervical soft tissues and vessels...
January 7, 2019: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30624241/fatal-intestinal-obstruction-in-a-patient-with-fetal-alcohol-syndrome
#2
Cassandra Maria Wygant, Stephen D Cohle
We describe an 8-year-old white boy with a history of fetal alcohol syndrome and pica, who was found dead on the floor by his mother. The child died from massive intestinal dilatation causing asphyxia. We discuss the potential pathogenetic mechanisms of intestinal dilation in patients with fetal alcohol syndrome.
January 7, 2019: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30586338/applied-force-during-prone-restraint-is-officer-weight-a-factor
#3
Mark W Kroll, Michael A Brave, Scott R Kleist, Mollie B Ritter, Darrell L Ross, Steven B Karch
INTRODUCTION: It has been suggested that law enforcement officer (LEO) weight on the backs of prone subjects may cause asphyxia. METHODS: Law enforcement officers used their agency-trained "local" single- and double-knee techniques, the "Wisconsin" 3-Point Ground Stabilization, and the Human Factor Research Group Inc single-knee tactical handcuffing techniques, and the weight force was measured. RESULTS: Forty-one LEOs (36 men, 5 women) participated, aged 38...
December 20, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30570520/a-descriptive-and-geospatial-analysis-of-environmental-factors-attributing-to-sudden-unexpected-infant-death
#4
Stacy A Drake, Dwayne A Wolf, Yijiong Yang, Sherhonda Harper, Jennifer Ross, Thomas Reynolds, Eileen Girandio
This study examined medicolegal death investigation records and autopsy reports of a medical examiner's office to identify the circumstances surrounding sudden unexpected infant deaths (SUID) and geospatial analyses to pinpoint areas of infant death concentration. Analysis of 732 records of SUID deaths occurring in a 10-year span resulted in the conclusion that environmental factors associated with the sudden death were to some extent modifiable. Co-sleeping (sharing a sleeping surface, or bed-sharing) on various surfaces (mattress, pallet, couch) occurred in 53...
December 18, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30562178/neonatal-death-caused-by-interrupted-aortic-arch-associated-with-22q11-2-deletion-syndrome-an-autopsy-case-report
#5
Norihiro Shinkawa, Masatoshi Yamaguchi, Mamoru Ozaki, Nobuhiro Yukawa
A case of clinically unsuspected fatal interrupted aortic arch (IAA) is described. A 17-day-old Japanese girl unexpectedly entered respiratory arrest at home. On autopsy, the heart was hypertrophic, with no apparent connection between the ascending and descending aortas. The ascending aorta branched into common carotid and right subclavian arteries, whereas the left subclavian artery arose from the descending aorta, which was supplied by the ductus arteriosus, indicating type B IAA. In addition, ventricular septal defect, bicuspid aortic valve, patent foramen ovale, and thymic aplasia were identified...
December 17, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30550379/gunshot-suicide-cherry-red-discoloration-of-the-temporal-muscle-beneath-the-exit-wound
#6
Milenko Bogdanović, Tatjana Atanasijević, Vesna Popović, Tijana Durmić, Bojana Radnić
The article describes a case of gunshot suicide to the head in a 51-year-old man. The entrance wound was located in the left temple and exit wound in the right temple. The entrance wound had the characteristics of a hard-contact gunshot wound. The most interesting finding in this case was cherry-red discoloration of the right temporal muscle surrounding the exit wound. This finding could make the determination of the entrance versus exit gunshot wound challenging, especially if the wounds are of atypical appearance...
December 14, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30531211/a-fatal-case-of-acute-renal-failure-from-envenoming-syndrome-after-massive-bee-attack-a-case-report-and-literature-review
#7
Rhome L Hughes
Envenoming syndrome is a systemic toxic reaction to the inoculation of large volume of insect venom, typically after a swarm attack from bees. Africanized honey bees are notorious for their aggressive nature, and human deaths resulting from Africanized honey bee attacks are consistently reported. Whereas anaphylaxis is the most common lethal mechanism of injury, delayed deaths can also occur as a consequence of severe venom toxicity with resultant end organ damage. Acute renal failure complicating massive envenomation is a rare but potentially fatal outcome after Africanized honey bee attack and may be heralded by laboratory evidence of rhabdomyolysis...
December 6, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30531210/symmetrical-apophyses-on-the-posterior-margins-of-the-thyroid-cartilage-a-previously-undescribed-anatomical-variation-with-potential-forensic-implications
#8
Andrea Porzionato, Veronica Macchi, Cristina Mazzarolo, Aldo Morra, Jose Sanudo, Raffaele De Caro
Differential diagnosis between normal/variant anatomy and pathological/traumatic findings represents one of the main matters of investigation of the so-called forensic clinical anatomy. In the literature, many anatomical variations of the laryngeal thyroid cartilage have been reported, with potential implications in forensic pathology. They include triticeal cartilages, foramen thyroideum, asymmetry, segmentation or agenesis of the superior thyroid horns, bone connections with the hyoid bone, absence of cricothyroid facets, hypertrophy of the inferior thyroid tubercle, and asymmetries in the thyroid notch, isthmus, or length of the inferior horn...
December 6, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30507618/depressions-of-dermestes-maculatus-coleoptera-dermestidae-on-bones-could-be-pupation-chambers
#9
Noelia Inés Zanetti, Adriana Alicia Ferrero, Néstor Daniel Centeno
Dermestes maculatus DeGeer beetles feed and can leave marks on bones. This species is of medical, veterinary, and forensic importance. The aim of this work was to determine if the depressions produced on bones by these beetles could be product of pupation. We studied under controlled conditions the behavior of D. maculatus larvae maintained at 24°C ± 3°C, 52.7% average relative humidity, and a 12:12-hour light/dark cycle and fed on pig carcasses. Observations were made, and photographs were taken. The results indicated that depressions produced by D...
November 29, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30507617/supervised-classification-of-cyp2d6-genotype-and-metabolizer-phenotype-with-postmortem-tramadol-exposed-finns
#10
Frank R Wendt, Nicole M M Novroski, Anna-Liina Rahikainen, Antti Sajantila, Bruce Budowle
Cytochrome p450 family 2, subfamily D, polypeptide 6 (CYP2D6) may be used to infer the metabolizer phenotype (MP) of an individual as poor, intermediate, extensive/normal, or ultrarapid. Metabolizer phenotypes may suggest idiosyncratic drug responses as contributing factors to cause and/or manner of death in postmortem investigations. Application of CYP2D6 has used long-range amplification of the locus and restriction enzyme digestion to detect single-nucleotide variants (SNVs) associated with MPs. This process can be cumbersome and requires knowledge of genotype phase...
November 29, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30489283/embolization-of-endocardial-vegetation-with-stroke-presentation
#11
George W Birsic, James W Fulcher, Steven E Fiester
This case report details the unique cause of death of a 37-year-old Caucasian woman with a history significant for intravenous drug abuse. Before her death, she complained of extremity weakness and pain. Although her death was discovered to be the result of endocarditis, her symptoms were similar to that of a stroke. Autopsy revealed a large endocardial vegetation infecting both the tricuspid and mitral valves and a patent foramen ovale. The subsequent embolization of this vegetation caused blockages in the lungs, liver, and brain...
November 27, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30475235/biochemical-differences-between-vitreous-humor-and-cerebral-spinal-fluid-in-a-death-from-diabetic-ketoacidosis
#12
Jack Garland, Winston Philcox, Kilak Kesha, Sinead McCarthy, Leo Lam, Cristian Palmiere, Toni OʼRegan, Simon Stables, Rexson Tse
Biochemical analysis of cerebrospinal fluid (CSF) and vitreous humor (VH) forms an important diagnostic ancillary test at autopsy. Cerebrospinal fluid can be sampled from the ventricular system (VA) and from lumbar puncture (LP), whereas VH can be sampled from the orbits. Biochemical electrolytes seem to vary between VH and CSF collected from different sites, but whether there is any difference in glucose and β-hydroxybutyrate is unclear. We present a case report of a 21-year-old man who died of diabetic ketoacidosis confirmed at autopsy...
November 20, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30475234/neisseria-meningitidis-isolated-in-vitreous-humor-in-a-5-month-old-infant-death-from-meningococcal-sepsis
#13
Jack Garland, Winston Philcox, Kilak Kesha, Veronica Playle, Shanika Perera, Toni OʼRegan, Simon Stables, Rexson Tse
Diagnosing sepsis at postmortem is challenging. With respect to meningococcal sepsis, the postmortem microbiological identification of Neisseria meningitidis is nearly always due to true infection, including in cases of decomposition. Previous case series and case reports were able to isolate N. meningitidis in vitreous humor in adult deaths from meningococcal sepsis when blood and/or cerebrospinal fluid was unavailable. It was suggested that vitreous humor polymerase chain reaction (PCR) may be useful in the diagnosis of meningococcal sepsis...
November 20, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30475233/three-dimensional-printing-technology-combined-with-postmortem-computed-tomography-angiography-as-new-form-of-forensic-evidence-a-case-report
#14
Zhuoqun Wang, Lei Wan, Yu Shao, Donghua Zou, Ningguo Liu, Yijiu Chen
Postmortem computed tomography (PMCT) and PMCT angiography are increasingly used in forensic practice. However, their application in court is still limited because they need professional equipment or software to be displayed. In this article, the authors introduce 3-dimensional (3D) printing technology as a new approach to provide evidence in court. A 67-year-old woman suffered from severe sick sinus syndrome, and she was fitted with a ventricular demand inhibited pacemaker. The operation failed as the doctor accidentally perforated her heart with an electrode wire...
November 20, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30451715/suicide-decapitation-by-a-detonating-cord-a-case-report
#15
Maliha Khara, Jayantha C Herath
In the field of forensic pathology, suicides consist of a considerable portion of the workload. Among the many methods used to commit suicide, using a detonation cord explosive is quite unique. We report the case of a man who committed suicide by detonation cord resulting in decapitation. This case report highlights the fact that the injury patterns observed in explosion-related deaths can be highly variable and that in cases with isolated injuries postmortem imaging and histology are an important adjunct to the standard death investigation...
November 16, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30422823/scurvy-characteristic-features-and-forensic-issues
#16
Roger W Byard, Hamish Maxwell-Stewart
Scurvy is a multisystem condition that arises from vitamin C deficiency. As humans cannot synthesize vitamin C, serum and tissue levels depend on bioavailability, utilization, and renal excretion. Deficiencies result in defective collagen formation with swelling of gums, leg ulceration, and bleeding manifestations. Death most often results from infection and hemorrhage. In a forensic context, scurvy may mimic inflicted injuries and may be responsible for sudden death by mechanisms that remain unclear. Cardiac failure and rhythm disturbances with chest pain, hypotension, cardiac tamponade, and dyspnea are associated with vitamin C deficiency...
November 12, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30407940/copper-beaten-skull-appearance-as-a-response-of-chronically-increased-intracranial-pressure
#17
Milenko Bogdanović, Bojana Radnić, Slobodan Savić, Vesna Popović, Tijana Durmić
We present a case of 19-year-old female patient, who was injured in childhood and subsequently developed hydrocephalus, chronic elevation of intracranial pressure (ICP), and a copper-beaten skull appearance. Chronic hydrocephalus leads to an increase in intraventricular pressure, causing ventricular expansion and dislocation of adjacent cerebral structures. According to literature data, it has been hypothesized that chronically elevated ICP in persons with craniosynostosis, and other developmental structural abnormalities of the skull, may induce bone remodeling...
November 7, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30407939/assessment-of-craniometric-sexual-dimorphism-using-multidetector-computed-tomographic-imaging-in-a-sample-of-egyptian-population
#18
Rana Adel, Hala Mohamed Ahmed, Osama A Hassan, Ehab A Abdelgawad
Sex determination is an initial and essential component of any medicolegal investigations. However, sometimes only cranial remains are available. The objective of this study was to determine sex using 12 craniofacial measurements in multidetector computed tomographic images of 150 Egyptian subjects (80 men and 70 women), with age ranging from 18 to 60 years. The results revealed a significant increase in the mean of all craniofacial measurements in men in comparison with women (P < 0.05). Bizygomatic breadth was the single most discriminant dimorphic parameter with an accuracy of 74%...
November 7, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30359338/sudden-unexpected-death-due-to-pseudo-meigs-syndrome-a-case-report-and-review-of-the-literature
#19
Rosario Barranco, Andrea Molinelli, Raffaella Gentile, Francesco Ventura
Meigs syndrome is the triad of ascites, hydrothorax, and benign ovarian tumor (mostly fibroids). It is a diagnosis of exclusion, and the characteristic symptoms disappear after resection of the tumor. Instead, in Pseudo-Meigs syndrome, the triad includes a nonfibroma ovarian tumor. The latter may consist of benign tumors (ie, of fallopian tube or uterus, struma ovarii, and ovarian leiomyomas) but can also comprise ovarian or metastatic gastrointestinal malignancies.The authors describe a case of sudden death in a 43-year-old woman, with no noteworthy reported history of present illness or medical history and in apparently good health before death...
October 23, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30359337/exsanguination-from-an-ulcerated-atypical-superficial-venous-malformation
#20
Li Ma, Nathan Milne, Geoffrey Strutton, Beng Beng Ong
Venous malformations (VMs) are the most common vascular malformations, and their diagnosis can be challenging. They may develop in any region of the body, with highly variable clinical presentations. Although they typically present early in life, many case reports have documented the sudden appearance of a previously unrecognized venous malformation in adulthood. Pain is the major complaint in most of the cases, and other complications include phlebolith formation and bleeding. To our knowledge, fatal hemorrhage from a VM has not previously been reported in the medical literature...
October 23, 2018: American Journal of Forensic Medicine and Pathology
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