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American Journal of Forensic Medicine and Pathology

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/29095168/deaths-associated-with-brotizolam-poisoning-from-a-single-drug-overdose-four-reported-cases
#10
Kentaro Sakai, Kazuyuki Saito, Aya Takada, Wakako Hikiji, Yosuke Kikuchi, Tatsushige Fukunaga
Brotizolam is a short-acting hypnotic in the benzodiazepine family, and fatal poisonings by an overdose of brotizolam are rare. This report describes 4 cases of deaths associated with brotizolam poisoning from a single drug overdose. The ages ranged from 51 to 90 years, and the postmortem interval between death and tissue sampling was 1.5 to 2.5 days. These deaths were classified as 1 homicide and 3 suicides. The concentration of the brotizolam ranged from 0.05 to 0.21 mg/L in the blood samples. Ethanol, which could cause mild alcohol intoxication, was detected in the blood samples from 2 cases...
November 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29068812/intra-abdominal-hemorrhage-complicating-electrothermal-arterial-injury-during-pelvic-surgery-a-case-report
#11
Paul Tingey, Adriana Krizova, D'Arcy Little, Joel Ross, Catherine Forse, Michael S Pollanen
Iatrogenic vascular injury is a potentially serious complication of surgical procedures. Here we report a case of delayed fatal intra-abdominal hemorrhage because of electrocautery injury of a right external iliac artery. The decedent, a 31-year-old woman, died suddenly on postoperative day 1 after a laparoscopic staging operation for an ovarian tumor. Her past medical history included a recent diagnosis of a microinvasive carcinoma in the background of a mucinous cystic neoplasm of the right ovary. Postmortem examination revealed a young woman with evidence of emergency intervention, recent laparoscopic pelvic surgery, and pale hypostasis limited to the back surfaces of the body...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29068811/forensic-features-of-clothing-related-deaths-historical-and-cultural-aspects
#12
Roger W Byard
Clothing may both cause death and contribute to ongoing lethal mechanisms by a variety of quite disparate mechanisms. The manner of death may be accidental, suicidal, or homicidal. Accidental deaths include burning from clothing catching on fire, strangulation from clothing tangling in vehicle wheels or exposed machinery, and drowning. Entanglement of clothing in machinery may also result in significant injuries, which are not uncommon in farming communities. Excessive clothing, or its absence, may significantly alter body temperature, and hanging from clothing is a feature in the young or in mentally or physically handicapped adults, or in adults who are intoxicated with alcohol or drugs...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29059065/postmortem-vitreous-humor-magnesium-does-not-elevate-in-salt-water-drowning-when-the-immersion-time-is-less-than-an-hour
#13
Rexson Tse, Ta-Chen Kuo, Kilak Kesha, Jack Garland, Sarah Garland, Sravan Anne, Hannah Elstub, Allan Cala
BACKGROUND: Elevation in postmortem vitreous humor sodium and chloride (PMVSC) in salt water drowning (SWD) when the immersion time is less than 1 hour (SWD1) is hypothesized to result from electrolyte changes in blood from salt water inhalation/ingestion during drowning. After approximately 1 hour after death, electrolytes may diffuse into the vitreous humor via the eye coverings. Another abundant element in salt water is magnesium, which is approximately 50 times higher in concentration than the blood and vitreous humor magnesium levels...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28926347/laryngohyoid-fractures-in-fatal-nonhomicidal-falls-from-a-height
#14
Hüseyin Eş, Muhammed Feyzi Şahin, Erdinç Özdemir
In cases of fall from a height, the presence of laryngohyoid fracture or bleeding at autopsy constitutes a suspicion of strangulation before trauma in these types of cases. This study has aimed to investigate the incidence of laryngohyoid fractures in nonhomicidal fall from height cases, and their relationship with age, sex, height of fall, body mass index, and other injuries.A total of 170 cases proven to be nonhomicidal falls from height with certain witnesses and evidences in 4683 autopsy cases in 2013 were included in this study...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28926346/coprophagic-asphyxiation-in-an-intellectually-disabled-woman
#15
Stephanie LeeAnne Erickson, Aaron David Gambrell, James Fulcher, Michael Ward
The ingestion of one's own feces is referred to as coprophagia. In this report, the author discusses a case of coprophagia-associated death in a 36-year-old woman. The woman had a history of intellectual disability, bipolar disorder, and schizoaffective disorder and was living in a group home. At autopsy, examination of the upper airway revealed 4 distinct spherical boli of impacted fecal matter in the oral cavity and pharynx. Death was attributed to asphyxia due to aspiration of stool bolus during an episode of coprophagia...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28915131/body-mass-index-and-saltwater-drowning
#16
Roger W Byard
Comparison of body mass index (BMI) was undertaken between 30 cases of salt water drowning and 30 age- and sex-matched controls randomly selected from the autopsy files of Forensic Science SA, Adelaide, Australia, during the period 2000 to 2017. The age range of drowning cases and controls was 18 to 80 (average, 49) years, with a male to female ratio of 19:11. The BMIs of the drowning cases ranged from 15.5 to 37.5 (average, 25.4; median, 23). The control cases had higher BMIs ranging from 22.9 to 44.3 (average, 29...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28915130/dolichoectasia-of-vertebrobasilar-arteries-as-a-cause-of-hydrocephalus-and-ischemic-cerebral-stroke
#17
Miodrag Zdravković, Milos Kostov, Sladjana Petrovic, Jovana Zdravkovic
INTRODUCTION: Dolichoectasia of vertebrobasilar artery is a rare vasculopathy, which is characterized by ectasia, elongation, and tortuosity of the basilar artery. CASE DESCRIPTION: A 85-year-old man was referred to the Clinic of Neurology with sudden-onset coma. A brain computed tomography scan showed remarkable fusiform dilatation with elongation of basilar artery, with compressive effect on brain stem. Autopsy confirmed existence of vertebrobasilar dolichoectasia, with organized old thrombus and partially with recent occlusive thrombosis...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28915129/atypical-exit-wound-in-high-voltage-electrocution
#18
Jamshid Parakkattil, Shanmugam Kandasamy, Siddhartha Das, Gerard Pradeep Devnath, Vinod Ashok Chaudhari, Kusa Kumar Shaha
Electrocution fatality cases are difficult to investigate. High-voltage electrocution burns resemble burns caused by other sources, especially if the person survives for few days. In that case, circumstantial evidence if correlated with the autopsy findings helps in determining the cause and manner of death. In addition, the crime scene findings also help to explain the pattern of injuries observed at autopsy. A farmer came in contact with a high-voltage transmission wire and sustained superficial to deep burns over his body...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28901960/sudden-death-in-an-adult-due-to-nontraumatic-diaphragmatic-hernia
#19
Hideaki Kato, Yasuhiro Aoki, Jun Ohtaki, Yoshimi Nakamura, Mohammed Hassan Gaballah, Mamiko Fukuta, Katsumasa Kobayashi
Sudden death due to diaphragmatic hernia in an adult is exceptionally rare. A 43-year-old man was found dead by his cohabiting mother, lying supine on the floor in his house. He had complained of epigastric discomfort for 1 month, and respiratory symptoms occurred 1 day before his death. He had no history of trauma. Postmortem computed tomography scan revealed the enlarged fluid-filled stomach herniated into the left pleural cavity, compressing the left lung with a mediastinal shift to the right. At autopsy, the left pleural cavity was occupied by herniated abdominal contents with mediastinal shift...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28863127/analysis-of-tractor-associated-fatalities
#20
Abdurrahim Türkoğlu, Kerem Sehlikoğlu, Mehmet Tokdemir
INTRODUCTION AND OBJECTIVE: Tractor is regarded as a key equipment in agriculture, and it is also used for transportation and transfer purposes in addition to its agricultural use. Accidents resulting in death in farmlands are frequently encountered. Tractor-related fatalities are the most common ones among the deaths after farm accidents. This study aimed to evaluate the characteristics of tractor-related deaths and to discuss the measures that could be taken to prevent these deaths...
December 2017: American Journal of Forensic Medicine and Pathology
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