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American Journal of Forensic Medicine and Pathology

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https://www.readbyqxmd.com/read/28319470/symptomatic-acute-on-chronic-subdural-hematoma-a-clinicopathological-study
#1
Rudy J Castellani, Gruschenka Mojica-Sanchez, Gary Schwartzbauer, David S Hersh
The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion...
March 18, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28272090/subtentorial-meningioma-misdiagnosed-as-cerebral-hemorrhage-in-postmortem-computed-tomography-imaging-a-case-report
#2
Hui Qian, Yu Shao, Zhengdong Li, Donghua Zou, Jianhua Zhang, Maowen Wang, Lei Wan, Yijiu Chen
This report presents a case of a 52-year-old man who had a traffic accident and died later. External examination could not determine the cause of death. Approximately 3 weeks later, an autopsy was performed. Postmortem computed tomography was performed before the autopsy. Postmortem imaging was interpreted to show hemorrhage beneath the tentorium, and the C5 to C6 (the fifth and sixth cervical vertebra) disc space was widened. During the autopsy, a cervical spinal cord injury was confirmed. However, a meningioma was found under the tentorium instead of a hemorrhage...
March 8, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28272089/mediators-of-inflammation-in-asthma-a-forensic-perspective
#3
Maria Laura Schirripa, Maria Pia Scarpelli, Cristian Palmiere
In the clinical setting, the role of systemic inflammation in patients with asthma has attracted increased attention, and some authors showed that increased IL-6 and high-sensitivity C-reactive protein characterized a group of asthmatic patients. In the realm of forensic pathology, a postmortem diagnosis of asthmatic death can be extremely challenging. The aim of this study was to determine the postmortem serum levels of C-reactive protein, IL-6, and tumor necrosis factor α in a series of severe acute bronchial asthma deaths that underwent medicolegal investigations...
March 8, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28272091/asphyxia-in-motor-vehicle-crashes-analysis-of-crash-related-variables-using-national-automotive-sampling-system-crashworthiness-data-system-and-forensic-case-studies
#4
Steven G Storvik, Julius Q Campbell, Jeffrey B Wheeler
Rates of death because of asphyxia in motor vehicle crashes have been previously estimated using county and statewide data sets, but national estimates have not been reported. The literature regarding asphyxia in motor vehicle crashes primarily involves discussions about clinical findings, and crash-related variables have been sparsely reported. The current study calculated a nationwide fatality rate for asphyxia in motor vehicle crashes of 1.4%. Seventeen case studies of asphyxia were also reported providing crash-, vehicle-, and occupant-related variables...
March 7, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28263236/forensic-image-analyses-of-skin-and-underlying-muscles-as-a-tool-for-postmortem-interval-delimitation-histopathologic-examination
#5
El-Shaymaa El-Nahass, Walaa A Moselhy, Nour El-Houda Y Hassan
One of the biggest challenges for forensic pathologists is to diagnose the postmortem interval (PMI) delimitation; therefore, the aim of this study was to use a routine histopathologic examination and quantitative analysis to obtain an accurate diagnosis of PMI. The current study was done by using 24 adult male albino rats divided into 8 groups based on the scarification schedule (0, 8, 16, 24, 32, 40, 48, and 72 hours PMI). Skin specimens were collected and subjected to a routine histopathologic processing...
March 3, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28263235/unusual-case-of-suicide-with-a-modified-trap-gun
#6
Amal Vadysinghe, Prasanna Dassanayake, Medhani Wickramasinghe
INTRODUCTION: Trap gun is an illegal, locally manufactured gun with a basic trip system used to hunt wild animals. CASE REPORT: The body of a 28-year-old man was found in the jungle in supine position with both legs apart. A trap gun was between the legs pointing toward the cranial side of the body. It had 2 free wires that were not connected together. There was no evidence of foul play.The body had a single-entry wound (2.5-cm diameter) in the anterior chest, with blackening, burning, and tattooing...
March 3, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28263234/evaluation-of-a-novel-and-standardized-technique-for-subcutaneous-upper-limb-dissection
#7
Sam Hoggard, Charles A Wilson
It is often necessary to dissect the subcutaneous tissues to confirm or exclude the presence of cutaneous bruising. We undertook a literature search that demonstrated that there is currently no standardized technique for subcutaneous dissection, and the specific incisions and dissections used probably vary between individual pathologists. It is our experience that dissections wider than the area of cutaneous bruising visible externally often reveal bruises not identified on external inspection. We propose a standardized technique for subcutaneous dissection of the upper limb that allows direct inspection of the subcutaneous tissues of the forearm and dorsum of the hand...
March 3, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28263233/cardiotoxic-arrhythmogenic-effects-of-1-1-difluoroethane-due-to-electrolyte-imbalance-and-cardiomyocyte-damage
#8
Kaushal Joshi, Michael Barletta, John Wurpel
Inhalant abuse is the intentional inhalation of chemical vapors to attain euphoric effects. Many common household products are abused by inhalation and one is 1,1-difluoroethane (DFE), which is a halogenated hydrocarbon used in refrigeration, dust-off spray, and airbrush painting. Although many human DFE abuse cases have been studied, the etiology and mechanism of sudden death is still unknown. In this study, an animal model was used to simulate the human conditions of DFE inhalation abuse that results in sudden death...
March 3, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28230653/suicides-by-jumping-off-istanbul-bridges-linking-asia-and-europe
#9
Ayşe Yurtseven, İbrahim Üzün, Murat Nihat Arslan
AIM: The aim of this study was to determine the injury spectrum and characteristics of people who committed suicide by jumping into water from the July 15th Martyrs Bridge and Fatih Sultan Mehmet Bridges in Istanbul, Turkey. METHODS: This study included all of the jumpers from the July 15th Martyrs Bridge and Fatih Sultan Mehmet Bridge who were autopsied by the Council of Forensic Medicine, Istanbul Morgue Department, between 2000 and 2013. All of the data were collected from archived case files...
February 23, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28230652/a-case-of-postmortem-canine-depredation
#10
Dennis J Chute, Robert J Bready
We report the case of postmortem animal depredation that produced initial confusion for investigators who responded to the scene. A decomposing elderly woman was found in her presumed home with bilateral upper extremity amputations and craniocerebral trauma. This raised suspicion of foul play. Subsequent investigations together with autopsy led the medical examiner to conclude that the cause of death was natural disease and that those injuries found on her body were produced by at least one of the dogs who shared the premises...
February 23, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28114174/case-report-lightning-induced-pneumomediastinum
#11
Ryan Blumenthal, Gert Saayman
We present the case of a 41-year-old woman who was fatally injured during a witnessed lightning strike event and in whom autopsy revealed the unusual keraunopathological finding of overt pneumomediastinum. The possible pathophysiological mechanism(s) of causation of this phenomenon are discussed, with specific reference also to the "Macklin" effect and the role of blast overpressures associated with lightning strike. It is suggested that the latter may lead to sudden alveolar rupture, with subsequent rapid tracking of air along bronchovascular sheaths in a centripetal manner toward the hilum of the lung and thus into the mediastinum...
January 21, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28106684/sudden-death-due-to-unusual-complication-of-takayasu-arteritis-an-autopsy-case
#12
Maher Jedidi, Youssef Chkirbene, Nihed Abdessayed, Tasnim Masmoudi, Mohamed Mahjoub, Souheil Mlayeh, Mohamed Ben Dhiab, Mohamed Kamel Souguir, Mohamed Taher Yacoubi
Takayasu arteritis is an uncommon inflammatory disease with usually a good prognosis. However, sometimes, the evolution can be fatal essentially by a coronary arteries involvement. We present a case of a 19-year-old woman who died suddenly from cardiogenic shock complicating an unknown Takayasu arteritis.At the autopsy, the aorta showed a significant thickening of the wall. The coronary arteries were slightly thickened and did not show any occlusion. Microscopic examination of the aorta showed an abundant granulomatous and a lymphoplasmacytic infiltrate...
January 18, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28085681/basal-ganglion-hemorrhage-as-delayed-complication-of-diethylene-glycol-ingestion
#13
Avneesh Gupta, Francisco J Diaz, Anita Lal, Lokman Sung, Cynthia K Aaron
Diethylene glycol (DEG), an organic compound (HOCH2CH2)2O is a commonly used solvent. Mass poisoning outbreaks have been reported because of frequent contaminations. A PubMed search for diethylene resulted in 795 publications with 151 specifically discussing the toxicity. Of the 151 reported toxicity reviews/case reports, only 6 publications discussed the long-term neurological effects of diethylene toxicity. We report a fatal case of oral ingestion of DEG with complications from delayed toxicity. She died 7 days after the second admission...
March 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28079530/can-intoxication-status-be-used-as-a-prediction-tool-for-manner-of-death-a-comparison-of-the-intoxication-status-in-violent-suicides-and-homicides
#14
D Kimberley Molina, Veronica M Hargrove
Determining the manner of death in medicolegal death investigations can be difficult. The investigator relies on many facets of death investigation, including the circumstances of death and autopsy examination. A study was designed to analyze whether the intoxication status of the decedent could be used as another tool in death investigations. The intoxication status of violent (nonoverdose or poisoning) suicides and homicides was retrospectively reviewed and compared. A total of 625 deaths were identified, including 366 suicides and 259 homicides...
March 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28072596/expression-of-glucose-regulated-protein-78-and-mir-199a-in-rat-brain-after-fatal-ligature-strangulation
#15
Xueying Feng, Dongchuan Zhang, Qingjin Gong, Zhiyong Zhang, Li Quan
The roles of endoplasmic reticulum (ER) stress and microRNA in the brain tissue after fatal mechanical asphyxia have not been clearly elucidated. We examined the expression of glucose-regulated protein 78 (GRP78), the key regulator of unfolded protein response, and miR-199a in the brain tissues of rats subjected to fatal ligature strangulation to understand the roles of ER stress and microRNA in ligature strangulation. The expressions of GRP78 and miR-199a in rat cortex, hippocampi, and midbrain were measured by immunohistochemistry and Western blot analysis in a rat model of ligature strangulation...
March 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28067671/a-fatal-case-of-coin-battery-ingestion-in-an-18-month-old-child-case-report-and-literature-review
#16
Francesco Ventura, Sara Candosin, Rosario Barranco, Alessandro Bonsignore, Luisa Andrello, Luca Tajana, Antonio Osculati
The ingestion of extraneous substances is quite common in clinical practice; it usually befalls in the pediatric age, mostly between 6 months and 6 years. In most cases, complications do not emerge, and the prognosis is considered favorable. However, when a case of battery ingestion occurs, serious adverse events may develop. The ingestion of these components is a potential life-threatening event for children.In this article, we report the case of an 18-month-old child who died from hemorrhagic shock due to an aortoesophageal fistula caused by a 20 mm lithium button battery lodged in the esophagus...
March 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28045743/role-of-survival-time-and-injury-severity-in-fatal-pulmonary-fat-embolism
#17
Juliane Jarmer, Garyfalia Ampanozi, Michael J Thali, Stephan A Bolliger
Pulmonary fat embolism (PFE) is frequent in blunt trauma and may occasionally lead to death. A correlation between fracture grade and severity and PFE grade has been described before, but no correlation between PFE and survival time, fat crushing extent, fat crush grade, or number of body regions with fractures could be noted in this small study. To further examine this, we decided to examine the aforementioned points in a far larger study group.Autopsy protocols of 188 nonresuscitated fatalities with blunt trauma and without right heart injury, which underwent whole body dissection, were retrospectively reviewed concerning the presence and the severity of PFE, injuries, survival time, age, sex, and the body mass index...
March 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28045696/sudden-death-in-a-male-infant-due-to-histiocytoid-cardiomyopathy-an-autopsy-case-and-review-of-the-literature
#18
Hanbing Xie, Xueqin Chen, Ni Chen, Qiao Zhou
Histiocytoid cardiomyopathy (HC) is a very rare cardiac disorder that mainly affects female infants younger than 2 years. It may manifest as ventricular tachycardia or dilated cardiomyopathy and frequently causes sudden death. The most common grossly change is multifocal uneven thickening of the endocardium, presenting a yellowish color, with some area forming nodular appearance, and histologically featured by scattered clusters of histiocytoid myocytes under the endocardium. Here, we present a 19-month-old male infant who died of heart failure, and an autopsy was performed and confirmed the diagnosis of HC...
March 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28045695/manner-of-death-determination-in-fire-fatalities-5-year-autopsy-data-of-istanbul-city
#19
İpek Esen Melez, Murat Nihat Arslan, Deniz Oguzhan Melez, Ahmet Selçuk Gürler, Yalçin Büyük
Death resulting from burns is an important social problem and a frequent accident. However, because approximately 10% of cases are estimated to result from a fire that was deliberately started, all fire-related deaths should be treated as suspicious, and the cause of a fire should be investigated. For the bodies recovered from the scene of a fire, the manner of death could also be suicide or homicide. The objective of this study was to contribute to the clarification of controversial data present in the literature on the manner of death determination of fire-related deaths, through evaluation of autopsy findings of bodies recovered from fires...
March 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28045694/forensic-analysis-of-parachute-deaths
#20
Michael Philip Burke, Johannes Chitty
Deaths associated with parachuting are very uncommon. However, these deaths do tend to be "high profile" in the traditional and social media. When forensic pathologists examine the deceased after a fatal parachuting incident, the anatomical cause of death is usually not in question. For most forensic pathologists, it is usually the case that we will have very limited knowledge of parachuting equipment or the mechanics of a typical successful parachute jump. As such, the investigation of the death should involve a multidisciplinary approach with an appropriate expert providing the formal forensic examination of the parachuting equipment...
March 2017: American Journal of Forensic Medicine and Pathology
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