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American Journal of Forensic Medicine and Pathology

Franchi Angélique, Gauchotte Guillaume, Gambier Nicolas, Raul Jean Sébastien, Martrille Laurent
In this daily practice, the forensic pathologist is rarely confronted with postmortem hyperthermia associated with the rapid onset of rigor mortis. We report 2 similar cases where the rectal temperature value taken during the on-scene investigations by the forensic pathologist was greater than 40°C (104°F) in both cases, and rigor mortis was complete within less than 6 hours postmortem. The first case was due to a deadly intoxication by ecstasy and the second one to the deadly association of methadone and a possible neuroleptic malignant syndrome...
September 6, 2018: American Journal of Forensic Medicine and Pathology
Papanu Suttipasit
Sexual assault persists as a global problem. Even when sexual assault does not result in obvious visible wounds, genitoanal injury must be evaluated because it is often pertinent for legal outcomes. Macroscopic ("naked eye") examination is valuable when colposcope is not available or when patients do not consent. This study reviewed the genitoanal injuries of 117 sexually assaulted adult women evaluated macroscopically. Genitoanal injury prevalence was 47%, and nongenitoanal injury prevalence was at 44%...
September 6, 2018: American Journal of Forensic Medicine and Pathology
Rosario Barranco, Andrea Molinelli, Francesco Ventura
Fatalities due to stabbings are usually caused by large blood vessels or organs injuries resulting in hemorrhagic shock. Vagal inhibition from a stab to the neck is an undeniably exceptional event, infrequently described in the literature. In our case report, we describe one such fatality. The body of a deceased 38-year-old man was found near a public garden. According to a bystander, the victim had been assaulted by 2 individuals, sustaining a stab wound to the neck with a broken glass bottle. At the autopsy, there was a large, inverted L-shaped cut wound in the left cervical region, measuring approximately 4...
August 30, 2018: American Journal of Forensic Medicine and Pathology
Nathaniel J Balmert, Joseph A Prahlow
Childhood idiopathic pulmonary arterial hypertension (CIPAH) represents a rare disorder of childhood characterized by dyspnea, exercise limitation, and syncope. Common organ-specific pathology includes right ventricular myocardial hypertrophy. The case presented represents a classic case of CIPAH, where death was partially attributable to an unrecognized esophageal intubation, which was placed during emergency transport to an emergency department. The features of CIPAH are presented, along with a discussion related to esophageal intubation and death...
August 30, 2018: American Journal of Forensic Medicine and Pathology
Leigh Hlavaty, LokMan Sung
Instruments that create stab wounds are required to possess tips of sufficient strength and rigidity to breach the integrity of the skin. Knives, the most common weapons used to create stab wounds, have cutting edges that cleave the skin, leaving unabraded margins. On rare occasions, blunt objects are driven with sufficient force to pierce the skin and become impaled within the body. The morphologic differences between the cutaneous injuries and wound tracks of stab wounds from sharp objects and impalement with blunt ones provide clear delineation of the two...
August 30, 2018: American Journal of Forensic Medicine and Pathology
Bogdanovic Milenko, Savic Slobodan, Curovic Ivana, Radnic Bojana, Durmic Tijana
Iatrogenic penetrating injuries of the thoracic aorta are rare. When surgical treatment is delayed or unavailable, they are associated with high mortality. Herein we present a case of a 36-year-old woman who had a sternal marrow biopsy performed due to laboratory-confirmed pancytopenia. Autopsy revealed 4 needle punctures extending through the full thickness of the upper right quarter of the sternum. Mediastinal soft tissue and the upper part of the pericardium were diffusely effused with blood. On the aortic arch, between the innominate artery and the left common carotid artery, we found a linear penetrating injury (2 mm in length)...
August 30, 2018: American Journal of Forensic Medicine and Pathology
Monia Lusetti, Manuela Licata, Enrico Silingardi, Alessandro Bonsignore, Cristian Palmiere
Image- and performance-enhancing drugs include a wide range of substances used to promote physical changes to enhance appearance. Anabolic androgen steroids are the most widely used image- and performance-enhancing drugs along with a wide variety of additional substances. The aim of this study was to identify the pathological changes pertaining to the cardiovascular system possibly involved in the death and characterize the substances associated with steroid use and their possible role in the death. A series of deaths involving image- and performance-enhancing drug users were selected...
August 27, 2018: American Journal of Forensic Medicine and Pathology
Matthew J Cecchini, Michael J Shkrum
Self-inflicted gunshot wounds are a common cause of firearm-related deaths. The appearance and location of the entry wound, other concomitant findings at autopsy, and correlation with the scene and circumstances are critical in determining the manner of death. A case of a 72-year-old man with a self-inflicted gunshot wound with an unusual injury pattern is described. There was a contact range gunshot entry in the right temple, and an exit wound was seen in the left parietal region. There was a re-entry with an associated exit wound on the left hand...
August 24, 2018: American Journal of Forensic Medicine and Pathology
Maki Fukasawa, Kenji Ninomiya, Yuka Kawakami, Chiaki Fuke, Yoko Ihama, Tetsuji Miyazaki
Dragging injuries caused by automobiles involved in an accident are occasionally reported; however, those without injury to the thoracoabdominal organs are rare. We present an autopsy case of a man in his 20s found dead on the road after being dragged by a passenger automobile for a distance of 3.4 km. The accident caused fatal dragging injuries but no thoracoabdominal injuries. The victim appeared to be drunk and was lying on the road in front of the parked automobile. Dragging injuries are a unique type of traffic accident that sometimes result from limited and poor visibility due to darkness, rain, or fog...
August 7, 2018: American Journal of Forensic Medicine and Pathology
Pamela Tozzo, Patrizia Nespeca, Gloria Spigarolo, Luciana Caenazzo
This report presents a case of an 18-year-old woman found unconscious by police officers outside a club suspected to be victim of a sexual assault. She was not able to give information about the dynamics of the assault, since she was under the effect of a high amount of alcohol. She affirmed to be virgin.The forensic genetic analyses were performed on vaginal and rectal swabs as well as bloody-like traces present on the slip. DNA and RNA analysis were performed using a multiplex for 15 autosomal short tandem repeat markers and of 19 primers specific for different tissues, respectively...
August 3, 2018: American Journal of Forensic Medicine and Pathology
Jack Garland, Winston Philcox, Kilak Kesha, Paul Morrow, Leo Lam, Amy Spark, Cristian Palmiere, Hannah Elstub, Allan D Cala, Simon Stables, Rexson Tse
Cerebrospinal fluid (CSF) is often analyzed at postmortem. The presented preliminary study compared postmortem CSF samples for biochemical analysis from the subarachnoid space around the spinal cord and ventricular space of the brain. This study compared 15 paired CSF samples in which the CSF from the subarachnoid space via lumbar puncture had higher sodium and chloride levels and lower magnesium and potassium levels than CSF from the ventricles. The differences correlated significantly with the deceased's age and had a similar trend with postmortem interval...
July 20, 2018: American Journal of Forensic Medicine and Pathology
Maki Fukasawa, Kenji Ninomiya, Yuka Kawakami, Chiaki Fuke, Tetsuji Miyazaki
We describe an autopsy case of fatal poisoning due to accidental overdose of pilsicainide, which is a Vaughan Williams class IC antiarrhythmic drug (a pure sodium channel blocker). A man in his 50s was found dead in his home at approximately noon. He had ischemic heart disease and insomnia, and had previously demonstrated improper prescription drug adherence. The autopsy revealed old coronary artery bypass grafting and mild fibrosis of myocardium, but no acute myocardial infarction was found in microscopic examination...
July 19, 2018: American Journal of Forensic Medicine and Pathology
Jack Garland, Kilak Kesha, Dianne Vertes, Lucy Modahl, David Milne, Thomas Ruder, Simon Stables, Rexson Tse
Cerebral venous thrombosis is a rare condition which constitutes 0.5% to 2% of all types of stroke and carries a mortality of up to 20% to 50%. It leads to cerebral edema, infarction, hemorrhage and venous hypertension. Clinically the diagnosis is confirmed using enhanced computed tomography (CT) angiography which demonstrates an empty delta sign in cerebral veins, particularly in the superior sagittal sinus. However, postmortem CT (PMCT) findings on cerebral venous thrombosis have not been documented in the literature...
July 17, 2018: American Journal of Forensic Medicine and Pathology
Jared Strote, Matthew J Hickman
BACKGROUND: Emergency physicians encounter patient concerns of police use of excessive force (UOEF). However, unlike other forms of potential assault, there are no guidelines for documentation of these encounters. Our objective was to examine the adequacy of emergency department documentation of injuries from police encounters where formal complaints of UOEF were later filed with the law enforcement agency. METHODS: A retrospective cohort design was used, identifying all citizen complaints of UOEF to a single police department in a 3-year period...
July 17, 2018: American Journal of Forensic Medicine and Pathology
Mustafa Talip Sener, Talip Vural, Ahmet Sahpaz
Specific or nonspecific findings of sexual abuse may be observed upon examination of a child. Examination of the genital area is extremely important for the identification of child sexual abuse (CSA). However, medical conditions detected in the child's genital area may be misinterpreted as signs of CSA. Herein, we present a case of a child with suspected CSA who was treated in the intensive care unit. The following incidental findings were obtained upon anal examination: dilatation, ecchymosis, laceration, and hemorrhage...
June 27, 2018: American Journal of Forensic Medicine and Pathology
K Sathish, Vinod Ashok Chaudhari, Abilash Srinivasa Murthy
Transorbital intracranial injuries are uncommon and mostly accidental in nature. These injuries are usually associated with high mortality. The key to preventing this mortality involves an early diagnosis of intracranial injuries and immediate and appropriate management. Any delay can pose a serious risk to the patient's life. A case of a 55-year-old man who had experienced an accidental self-fall while riding a bicycle is presented. Initially, he was treated at a primary health center. He was referred to the tertiary care institute due to unavailability of ancillary investigation at the primary health center...
September 2018: American Journal of Forensic Medicine and Pathology
Janet M Basinger, Steven E Fiester, James W Fulcher
A case of toxic shock syndrome associated with methicillin-resistant Staphylococcus aureus parotitis in a 13-year-old male is presented. He was initially diagnosed with left-sided parotitis by his primary care physician, was started on sulfamethoxazole/trimethoprim, and became severely ill the following day. He was transported to the hospital after a syncopal episode at home and was found to have altered mental status, hypotension, and hypoxia. He was transferred to a larger care facility and died en route despite aggressive resuscitation...
September 2018: American Journal of Forensic Medicine and Pathology
Vladimir Živković, Danica Cvetković, Slobodan Nikolić
No abstract text is available yet for this article.
September 2018: American Journal of Forensic Medicine and Pathology
María de Los Ángeles Romero Tirado, José Manuel Blanco Pampin, Rosalía Gallego Gómez
Studies about head trauma are experimental or have a clinical or prognosis purpose. In this study, we used samples from human autopsies to answer common medical-legal questions.We studied 21 problem cases and 4 controls. Samples were obtained directly from the injured area, fixed in 10% formalin during 24 hours and then preserved in 70% ethanol. This procedure optimizes the immunohistochemical technique.The neurofilament antibody shows beaded axons since the first moment; over time, they increase their density and diameter as survival time also increases...
September 2018: American Journal of Forensic Medicine and Pathology
Peng-Lin Jia, Yue-Bing Wang, Hua Fu, Wen-Li Huang, Shu-Rong Zhong, Lin Ma, Yu-Hua Li, Yi Dong, Zhong-Chun Sun, Lin Yang, Peng-Fei Qu, Su Zhao, Yong-Qiang Qu, Yan-Mei Xi, Shang-Wen Wang, Xue Tang, Pu-Ping Lei
Long QT syndrome (LQTS) is known to be involved in some sudden unexplained death (SUD) cases. To make clear whether the pathogenic genes of LQTS are involved in SUD in Yunnan province, southwest of China, we examined 4 mutation hotspot segments of KCNQ1, KCNH2, and SCN5A genes in 83 SUD cases using polymerase chain reaction and direct DNA sequencing. Genomic DNA was extracted from paraffin-embedded tissues in 83 cases of sudden cardiac death. One novel homozygous missense variant was identified in exon 3 of KCNQ1, c...
September 2018: American Journal of Forensic Medicine and Pathology
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