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American Journal of Forensic Medicine and Pathology

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https://www.readbyqxmd.com/read/28926346/coprophagic-asphyxiation-in-an-intellectually-disabled-woman
#1
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...
September 19, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28926347/laryngohyoid-fractures-in-fatal-nonhomicidal-falls-from-a-height
#2
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...
September 16, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28915131/body-mass-index-and-saltwater-drowning
#3
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...
September 14, 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
#4
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...
September 14, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28915129/atypical-exit-wound-in-high-voltage-electrocution
#5
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...
September 14, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28901960/sudden-death-in-an-adult-due-to-nontraumatic-diaphragmatic-hernia
#6
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...
September 9, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28863127/analysis-of-tractor-associated-fatalities
#7
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...
August 31, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28863126/a-histological-analysis-of-visceral-organs-to-evaluate-the-effect-of-duration-of-heating-from-refrigeration-to-core-body-temperature-for-ballistics-investigations
#8
Caitlin Humphrey, Jaliya Kumaratilake
Animal organs have been used in ballistics research to investigate the effects on human organs. Such organs are refrigerated until the investigation to minimize autolytic degradation and at times have been reheated to the human core body temperature to simulate the in situ environment. The aim of this investigation was to study the microstructural changes that may occur in fresh chilled visceral organs of the thorax and abdomen (ie, heart, lung, liver, and kidney) during the period of reheating to 37°C. Fifty-millimeter cubes of porcine heart, lung, liver, and kidney were taken rapidly after slaughter, chilled overnight, and the next morning were reheated to core body temperature (37°C)...
August 31, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28863125/ethical-considerations-on-disclosure-when-medical-error-is-discovered-during-medicolegal-death-investigation
#9
Dwayne A Wolf, Stacy A Drake, Francine K Snow
In the course of fulfilling their statutory role, physicians performing medicolegal investigations may recognize clinical colleagues' medical errors. If the error is found to have led directly to the patient's death (missed diagnosis or incorrect diagnosis, for example), then the forensic pathologist has a professional responsibility to include the information in the autopsy report and make sure that the family is appropriately informed. When the error is significant but did not lead directly to the patient's demise, ethical questions may arise regarding the obligations of the medical examiner to disclose the error to the clinicians or to the family...
August 31, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28857762/strangulation-and-its-role-in-multiple-causes-of-death
#10
Leigh Hlavaty, LokMan Sung
Forensic pathologists have a duty to determine the cause and manner of death and are bound by international guidelines in the completion of the death certificate. Sometimes, there are complex circumstances surrounding a death that cannot be captured in the structure of the death certificate and its requirement of listing only 1 cause of death per line. Cases may have multiple causes of death with comorbid medical conditions or inflicted injuries that equally contribute to the ultimate demise. Compared with other forms of homicide, autopsy evidence of strangulation will often be found with other life-threatening traumatic injuries...
August 26, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28825945/postmortem-organ-weights-at-a-south-african-mortuary
#11
Laura Peddle, Gavin Martin Kirk
BACKGROUND: Weighing organs at autopsy provides objective evidence of pathology. Reference ranges must be locally applicable, accurate, and regularly defined. AIMS: The aims of this study were the generation of postmortem organ weight reference ranges for use in South African mortuaries, analysis of factors influencing organ weights, and comparison to international populations. METHODS: This was a retrospective study of autopsy reports from the Salt River medicolegal mortuary in Cape Town, South Africa, between 2013 and 2016...
August 19, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28795995/toxic-myocarditis-caused-by-acetaminophen-in-a-multidrug-overdose
#12
Maxime Gosselin, Yann Dazé, Pascal Mireault, Marie Crahes
We report the case of an 18-year-old woman with personality disorders who was hospitalized a few hours after suicidal ingestion of acetaminophen, quetiapine, acetylsalicylic acid, and ethanol. Twelve hours after admission, severe liver damage was evident, but the patient was stable and awaiting hepatic transplantation. Electrolytes were successfully controlled. The condition of the liver stabilized. Cardiac biomarkers then deteriorated unexpectedly. Localized ST-segment elevations were noted on electrocardiogram, but angiography ruled out myocardial infarction...
August 9, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28796650/using-skin-gene-markers-for-estimating-early-postmortem-interval-at-different-temperatures
#13
Mona Mohamed Ali, Samah Fathy Ibrahim, Amel Ahmed Fayed
Many researches document long-term RNA persistence in a variety of tissues and its applicability in estimating the postmortem interval (PMI). Skin-specific mRNA marker, late cornified envelope 1C (LCE1C), was used to identified skin samples. Before using the LCE1C in criminal casework, its persistence and applicability for estimating PMI in different temperatures were tested. Twelve skin samples were collected from 6 patients, and 6 samples were kept at 24°C and others were kept at 40°C for 5 days. The expression levels of LCE1C mRNA are serially detected and quantified using real-time polymerase chain reaction...
August 8, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28767539/medicolegal-investigations-into-deaths-due-to-crush-asphyxia-after-tractor-side-rollovers
#14
Carlo Moreschi, Ugo Da Broi, Antonia Fanzutto, Sirio Cividino, Rino Gubiani, Gianfranco Pergher
Farm tractors are large, heavy, powerful vehicles with a high center of gravity. When driven carelessly on sloping, irregular, or slippery ground, tractors can overturn sideways and cause the death by crush asphyxia of the driver or passengers, especially if appropriate safety equipment is not fitted or used. The aim of this review is to focus on the diagnostic difficulties with which coroners and forensic pathologists have to cope when a confirmation of crush asphyxia after tractor side rollover is required by judicial authorities...
August 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28767538/two-fatal-intoxications-due-to-tramadol-alone-autopsy-case-reports-and-review-of-the-literature
#15
Sara Gioia, Massimo Lancia, Mauro Bacci, Fabio Suadoni
Since tramadol was marketed, it has been widely prescribed as a pain killer because of its relatively safe profile among opioids.Nevertheless, intoxication can occur: overdose can lead to fatal outcomes mostly in association with other drugs, via the potential interaction with serotonergic antidepressant medications, as well as the potential for increased central nervous system (CNS) depression.Fatal outcomes only attributable to tramadol are a rare entity. In this case report, 2 fatal cases are described due to tramadol stand-alone intoxication with peculiar characteristics...
August 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28737525/death-by-snow-a-fatal-forensic-case-of-cocaine-leakage-in-a-drug-mule-on-postmortem-computed-and-magnetic-resonance-tomography-compared-with-autopsy
#16
Patricia Mildred Flach, Dominic Gascho, René Fader, Rosita Martinez, Michael J Thali, Lars C Ebert
This forensic case presents unique postmortem imaging of a "drug mule" with fatal intoxication due to cocaine leakage on postmortem computed and magnetic resonance (MR) tomography compared with autopsy.Imaging by postmortem computed and MR tomography was performed before autopsy, histology, and toxicology were commissioned. Forensic imaging revealed 91 hyperdense, uniformly shaped body packs with signs of leakage, which was confirmed by autopsy. Postmortem MR imaging displayed the rarely described hypointense appearance of the body packs in T1- and T2-weighted sequences...
July 22, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28719379/critical-evaluation-of-metallization-in-electric-injury
#17
Sigitas Laima, Jana Bytautaite, Sigitas Chmieliauskas, Dmitrij Fomin, Algimantas Jasulaitis, Arturas Jukna, Sandra Mazeikiene, Jurgita Stasiuniene
The article presents 3 forensic medicine cases in the field of electric injury. In addition to traditional findings in electric injury (electric mark and histological findings), the forensic medicine experts in Lithuania also perform an atomic absorption spectrometry analysis. This method confirms the effects of electric current to the body through the electric conductor. Typical macroscopic finding in the skin is electric mark. Histologically, the damaged skin possesses characteristic features of thermal burns...
July 18, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28704207/the-adult-male-rape-victim-forensic-description-of-a-series-of-57-cases
#18
Michelangelo Bruno Casali, Elisa Palazzo, Alberto Blandino, Alessio Battistini, Francesca Motta, Alessandra Kustermann, Cristina Cattaneo
A retrospective analysis on 57 adult male victims of sexual violence has been performed. Age, nationality and anamnesis of the victims, location of the assault, type of violence, number and identity of the assailants, presence of physical injuries, lapse of time between the assault and the request of medical assistance, and toxicological and semen detection tests were analyzed. Victims were mostly in the 31- to 40-year age group. Ten victims referred themselves as either active homosexuals or bisexuals. Forced oral and/or anal penetration was registered in 86...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28692479/association-of-waist-hip-ratio-to-sudden-cardiac-death-and-severe-coronary-atherosclerosis-in-medicolegal-autopsies
#19
Linda Kocovski, Joshua Dogyeong Lee, Sameer Parpia, John Fernandes, Vidhya Nair
Various modifiable and nonmodifiable risk factors, such as abdominal obesity, are known to affect the development of atherosclerotic cardiovascular disease and subsequent sudden cardiac death (SCD). The waist-hip ratio is a surrogate marker of visceral obesity that has been shown in various studies to be a better predictor of cardiovascular risk than the body mass index (BMI), a measurement of generalized obesity. Waist-hip ratio was measured prospectively on medicolegal autopsies performed for 1 year, in addition to standard measurements of BMI and heart weight, and histologic determination of severe coronary atherosclerosis (SCA, coronary artery diameter stenosis >75%)...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28692478/diagnosis-of-vitality-in-skin-wounds-in-the-ligature-marks-resulting-from-suicide-hanging
#20
Isabel Legaz Pérez, Maria Falcón, M Gimenez, F Martínez Diaz, M D Pérez-Cárceles, E Osuna, D Nuno-Vieira, A Luna
Ascertaining the vital origin of skin wounds is one of the most challenging problems in forensic pathology. The forensic literature describes biomarkers and methods for differentiating vital and postmortem wounds, although no clear conclusions have been reached. The aim of this study was to characterize human vital wounds by analyzing the concentrations of metallic ions and the expression of P-selectin and cathepsin D in skin wounds in the ligature marks in a cohort of suicidal hangings for which vitality was previously demonstrated...
September 2017: American Journal of Forensic Medicine and Pathology
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