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American Journal of Forensic Medicine and Pathology

Claire Ferguson, Tiffany Sutherland
The difficulty in classifying manner of death in falls from a height provides offenders an opportunity to avoid detection by having a homicide appear otherwise. Twelve fall homicides were qualitatively examined. Results showed that most homicidal falls occurred at remote outdoor locations, were planned by offenders who were in controlling intimate relationships with the victim, and were motivated by gain. Homicide was established using inconsistencies in offender's statements and the physical evidence, inappropriate postoffense behavior, evidence of planning, and improbable alleged victim behavior...
March 7, 2018: American Journal of Forensic Medicine and Pathology
Aafrinnaz Moulvi, Pooja Minz, Subrata Rath, Richa Ashma
There is a strong evidence in the literature that human odor is unique to an individual; therefore, the focus of this study was to strengthen this evidence through the testing of sweat samples on unrelated individuals with the same ethnicity. Sweat samples were collected from 42 unrelated Indian males and females residing in the same city to determine the chemical constituents in human sweat. The volatile compounds of sweat were subsequently analyzed and identified using gas chromatography-mass spectrometry, and a National Institute of Standards and Technology library was used for individual profiling...
February 23, 2018: American Journal of Forensic Medicine and Pathology
Abilash Srinivasa Murthy, Siddhartha Das, Srinivas Bheemanathi Hanuman
Hydrocarbons are volatile substances that are used in routine life activities for cooking or as automobile fuel. Diesel is one of the commonly used automobile fuels obtained from crude oil. Death due to poisoning by diesel is rarely reported. Most commonly affected is the respiratory system either after aspiration or ingestion. The most common presentation is chemical pneumonitis or aspiration pneumonitis from which patient usually recovers. Gas chromatography techniques help in the detection of volatile substances like diesel...
February 21, 2018: American Journal of Forensic Medicine and Pathology
Rexson Tse, Jack Garland, Kilak Kesha, Paul Morrow, Hannah Elstub, Allan Cala, Amy Spark, Simon Stables, Martin Sage
Elevation of postmortem vitreous sodium and chloride (PMVSC) levels in salt water drowning (SWD) 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. This hypothesis was based on a study where bovine eyeballs were immersed in salt water. There is no human study that could confirm that SWD would result in an initial elevation of PMVSC with no effects from immersion...
February 16, 2018: American Journal of Forensic Medicine and Pathology
Bernard Pawlowicz, John Fernandes, Vidhya Nair
In this case series, we delve into the database of medicolegal cases of the Forensic Pathology Department at Hamilton Health Sciences in Hamilton Ontario from the last 20 years (1996-2017), and review cases of sudden cardiac death due to coronary artery abnormalities. We found 17 cases that fit the criteria, which gave us an incidence of 1.34 per 1000 cases. These cases were further audited for age, sex, type of coronary artery abnormality, symptoms before demise, circumstances of death, presence of significant atherosclerotic disease, and toxicology...
February 15, 2018: American Journal of Forensic Medicine and Pathology
Amal Nishantha Vadysinghe, Prabath Senasinghe, Murugupillai Sivasubramanium, Pemasiri Jayasooriya, Bhatiya G Premarathna, Rathnayake Mudiyanselage Isuri Saumya D Rathnayake, Wickramasinghe Mudiyanselage Medhani Hasanthika P Wickramasinghe
As people age, they may become more vulnerable to injury because of frailty, ill health, or dependency on others. Data from medicolegal death investigation including autopsy and statements from cases reported to 3 medicolegal units in Sri Lanka were analyzed in this study under the strict ethical framework. Of the study population, 265 were male and 75 were female. Mean age was 71.14 years. Commonest manner of death was accidental (62.1%) followed by suicide (32.1%) and homicide (5.6%). Commonest types of incidents were road traffic accidents (26...
February 15, 2018: American Journal of Forensic Medicine and Pathology
Vasiliki Chatzaraki, Michael J Thali, Garyfalia Ampanozi, Wolf Schweitzer
Fatal car-to-pedestrian collisions regularly appear in the forensic pathologist's routine, particularly in places of extended urbanization. Postmortem computed tomography has gained an exceptional role to supplement autopsy worldwide, giving information that is supplementary or complimentary to conventional autopsy. In this retrospective study, a total number of 320 findings in a series of 21 pedestrians fatally hit by cars and trucks of both postmortem computed tomography and autopsy were correlated. According to our results, it is best to combine both methods to give well-founded answers to questions pertaining to both collision reconstruction and cause of death...
February 12, 2018: American Journal of Forensic Medicine and Pathology
Sara Sabatasso, Jessica Vanhaebost, Francesco Doenz, Cristian Palmiere, Katarzyna Michaud, Fabrice Dedouit, Silke Grabherr
Recent studies have indicated that multiphase postmortem computed tomography angiography (MPMCTA) allows detection of a pathological enhancement of the myocardium in regions that correlate with the localization of the infarction at histology. The aim of this study was to verify this hypothesis by examining MPMCTA images in cases of myocardial infarction. Therefore, we investigated 10 autopsy cases where death was attributed to myocardial infarction or which showed cardiovascular pathology. As a control group, we selected 10 cases of non-natural (namely, not cardiac) death...
February 12, 2018: American Journal of Forensic Medicine and Pathology
Rexson Tse, Jack Garland, Kilak Kesha, Yvonne Triggs, Zhi Yap, Simon Stables
Hypothermia and diabetic ketoacidosis are both potentially fatal conditions, which have historically been considered to have associated pathognomonic pathologies. Hypothermia and diabetic ketoacidosis share similar pathological mechanisms, which result in metabolic derangement, with increased post mortem vitreous glucose and β-hydroxybuyrate, and are able to exacerbate and precipitate one another. Although Wischnewsky lesions are associated with hypothermia, and Armanni-Ebstein lesions and basal subnuclear vacuolization are associated with diabetic ketoacidosis, recent studies have demonstrated that there is a significant overlap between the pathological findings of these 2 conditions...
February 2, 2018: American Journal of Forensic Medicine and Pathology
Takeshi Kondo, Motonori Takahashi, Azumi Kuse, Mai Morichika, Kanako Nakagawa, Yoshihiro Tagawa, Tomoya Taniguchi, Yuji Taguchi, Tomohiro Fujiwara, Junpei Tsuchiya, Masahiko Nakamura, Makoto Sakurada, Migiwa Asano, Yasuhiro Ueno
A crossbow is a bow that shoots an arrow when a gun-like trigger is pulled. Deaths caused by accidental crossbow shootings are extremely rare. Here we describe an autopsy case of a penetrating wound to the left cerebral hemisphere caused by an accidental shooting with a crossbow. A man in his early 60s who lived with his wife and had used crossbows for 20 years as his hobby was found one early morning in the shed of his house, collapsed and bleeding from the head and neck. He was taken to a hospital and died after approximately 3 days of conservative treatment...
February 2, 2018: American Journal of Forensic Medicine and Pathology
Christopher A Febres-Aldana, Lydia Hernandez Howard
Sickle cell disease (SCD) manifests itself with vaso-occlusive episodes leading to infarction. Placement of intravascular catheters provides a useful route for management of pain crises as well as other complications. However, catheter misuse is a commonly unrecognized problem, which can have lethal consequences. We present a case of fatal splenic sequestration/hyperhemolysis secondary to foreign body pulmonary and systemic embolization due to intravenous administration of hydromorphone pills in a young woman with SCD...
January 18, 2018: American Journal of Forensic Medicine and Pathology
Thomas Shi, Michael J Shkrum
Sudden death resulting from intracardiac leiomyomatosis is rare. In this case, a 50-year-old woman was found to have intracardiac leiomyomatosis, which originated in veins in the broad ligament. Tumor filled the entire inferior vena cava and extended into the right heart where it had embolized and occluded the right main pulmonary artery. The mechanism of death was sudden right heart failure.
January 18, 2018: American Journal of Forensic Medicine and Pathology
Julius Tikka, Samuli Vaittinen, Lasse Pakanen, Philippe Lunetta
Primary cardiac lymphomas represent approximately 1% to 2% of primary cardiac neoplasms and 5% of malignant cardiac neoplasms. Here we present a case of sudden unexpected death of a middle-aged male resulting from an unusually large cardiac B-cell lymphoma. The neoplasm infiltrated the myocardium of the right atrium and ventricle and, to a lesser extent, the wall of the left atrium and pulmonary trunk. Extensive infiltration of the heart by the primary cardiac lymphoma, combined with the complete lack of symptoms, makes this case unusual...
January 18, 2018: American Journal of Forensic Medicine and Pathology
Pavlos Pavlidis, Maria-Valeria Karakasi, Maria Kouroupi, Efthimia Theodoropoulou, Theodossios A Birbilis
This article presents both a fatal suicide incident by Flobert 9 mm-type smoothbore weapon with a single-shot projectile and a nonfatal case of a suicide attempt by the same weapon type with a dispersion cartridge from the authors' forensic record. A retrospective study was conducted examining 84 cases involving cases of headshots inflicted by all kinds of weapons deriving from the broader region of Eastern Macedonia and Thrace (Northern Greece) between 2000 and 2015, among which only 1 involved lethal wounding by a Flobert 9 mm (1...
January 5, 2018: American Journal of Forensic Medicine and Pathology
Vito Cirielli, Luca Cima, Chiara Chindemi, Olivia Danzi, Claudio Ghimenton, Albino Eccher, Silvestro Mauriello, Federica Bortolotti, Domenico De Leo, Matteo Brunelli, Franco Tagliaro
The polysialylated isoform of the neural cell adhesion molecule (PSA-NCAM) has been shown to be a key player in neuroplastic changes and is expressed in various disorders. We investigated the PSA-NCAM expression on brain cortical tissue in a cohort of drug-related deaths. Brains from 25 drug abusers and 10 control subjects were removed at autopsy, and 2 samples of the right parietal lobe of each case were obtained. The polysialylated isoform of NCAM was evaluated on formalin-fixed and paraffin-embedded tissues...
December 29, 2017: American Journal of Forensic Medicine and Pathology
Isabella Mercurio, Daniele Capano, Riccardo Torre, Aldo Taddei, Gianmarco Troiano, Michele Scialpi, Mario Gabbrielli
Cerebral air embolism is caused by gas bubbles in the vascular system. These bubbles can cause cerebral ischemia by obstructing encephalic blood vessels. It is frequently associated with blunt and penetrating chest trauma as well as iatrogenic interventions. Lung trauma involving laceration of the respiratory tract, lung parenchyma, and blood vessels may result in direct communication of these structures, driving air or gas into the pulmonary venous system. We report a case of a blunt chest trauma that led to massive arterial air embolism that was possible to recognize with the help of postmortem computed tomographic scan examination...
December 22, 2017: American Journal of Forensic Medicine and Pathology
Fiorella Caputo, Rosario Barranco, Alessandro Bonsignore, Giulio Fraternali Orcioni, Francesco Ventura
A bezoar is a mass of undigested, or partially digested, material forming in the lumen of the gastroenteric tract, causing occlusive or subocclusive events. The most frequent types of bezoars are those composed of vegetable fibers, also called phytobezoars, which, by virtue of their high content in cellulose, hemicellulose, and lignin, remain undigested in the stomach and intestines and, from there, can migrate and occlude the narrowest portions of the bowel. The areas that are most frequently affected by occlusive phenomena related to the presence of bezoars are the stomach and the small intestine, although colic localizations are extremely rare...
December 22, 2017: American Journal of Forensic Medicine and Pathology
Ryan Blumenthal, Brigitte Hänert-van der Zee
We present the case of an adult white man found dead in a psychiatric institution with fine white powder (monoammonium phosphate) deposited over the entire face after he insufflated the contents of a dry chemical fire extinguisher. Fine white powder was present within the mouth and sinuses and lined the upper airways. On opening the thoracic cavity, approximately 500 g of fine white powder was present within the right thoracic cavity. The esophagus was ruptured. Traumatic emphysema of the posterior sternum wall was present (pneumomediastinum)...
December 22, 2017: American Journal of Forensic Medicine and Pathology
Margaret LaPorte, Jenna Pollock, Michael Ward, James Fulcher
Pituitary adenomas make up 10% of intracranial tumors, but because of their location, they may go undetected for long periods. In this article, we report the case of a 68-year-old white man found deceased in his residence, who died of acute pituitary tumor apoplexy. He was known to have severe symptoms including acute headache, vision loss, and altered behavior. When found, his home was in extreme disarray, mimicking a possible assault. At autopsy, the decedent had multiple superficial abrasions about the upper and lower extremities, as well as a 2...
March 2018: American Journal of Forensic Medicine and Pathology
Masataka Takamiya, Hisae Niitsu, Kiyoshi Saigusa
An autopsy case of sudden death in a 33-year-old man with neurofibromatosis type 1 (von Recklinghausen disease), pheochromocytoma, and myocarditis is reported. The decedent was found in his bedroom in cardiopulmonary arrest. Polypoid, elastic dermal papules on the neck, chest, abdomen, and back, and flat dark-brown macules on the chest and abdomen were observed. Flat, ovoid, dark-brown freckles were present in both axillae. Examination of the right adrenal gland revealed a tumor measuring 5 cm × 5 cm × 3 cm...
March 2018: American Journal of Forensic Medicine and Pathology
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