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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
Jixiu Zhang, Talafu Tuokan, Yonghua Shi
This article reports a case of Kawasaki disease (KD) and its rapid fatal course in a 5-year-old boy, who 3 days before hospitalization demonstrated fever and diffuse erythema in the face, neck, and torso, as well as swelling and pain below the right earlobe. During the admission, he was diagnosed with mumps and suspected scarlet fever. Abnormal laboratory findings included elevated values of procalcitonin, C-reactive protein, and interleukin 6. Sudden death occurred 8 days after admission. Autopsy confirmed the cause of death to be pericardial tamponade due to a ruptured, inflamed aneurysm of the left anterior descending coronary artery...
June 21, 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...
June 21, 2018: American Journal of Forensic Medicine and Pathology
Vladimir Živković, Danica Cvetković, Slobodan Nikolić
No abstract text is available yet for this article.
June 14, 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...
June 13, 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...
May 31, 2018: American Journal of Forensic Medicine and Pathology
Iana Lesnikova, Marc Niclas Schreckenbach, Maria Pihlmann Kristensen, Liv Lindegaard Papanikolaou, Stephen Hamilton-Dutoit
Immunohistochemistry (IHC) is an important diagnostic tool in anatomic and surgical pathology but is used less frequently in forensic pathology. Degradation of tissue because of postmortem decomposition is believed to be a major limiting factor, although it is unclear what impact such degradation actually has on IHC staining validity. This study included 120 forensic autopsy samples of liver, lung, and brain tissues obtained for diagnostic purposes. The time from death to autopsy ranged between 1 and more than 14 days...
May 24, 2018: American Journal of Forensic Medicine and Pathology
Audrey-Ann M Evetts, Michael J Shkrum, Elena Tugaleva
Reference charts for body and organ measurements of neonates and infants were derived from data on 900 investigations done by the Office of the Chief Coroner for Ontario. The statistical analyses in this new reference source addressed deficiencies in sources currently available to pathologists.The present study also considered whether organ weights differed based on the classification of infant deaths using the original definition of either sudden infant death syndrome (SIDS) or sudden unexplained death (SUDS) which considers cases occurring in an unsafe sleeping environment or under adverse socioeconomic conditions...
May 24, 2018: American Journal of Forensic Medicine and Pathology
Amanda O Fisher-Hubbard, Colin Appleford, Kilak Kesha, Carl J Schmidt, Avneesh Gupta
Carbon monoxide (CO) is the cause of a significant percentage of fatal poisonings in many countries. It is known that fatalities resulting from CO poisoning are underreported and/or misclassified. Carbon monoxide exposure while driving can occur due to faulty exhaust systems, defective ventilation systems, emission from other vehicles, and even cigarette smoking. We report the case of a 23-year-old woman who was involved in a low-speed motor vehicle collision and was found unresponsive in her vehicle due to CO poisoning...
May 16, 2018: American Journal of Forensic Medicine and Pathology
Rexson Tse, Jack Garland, Kilak Kesha, Paul Morrow, Leo Lam, Hannah Elstub, Allan Cala, Amy Spark, Cristian Palmiere, Simon Stables
Diagnosing death due to drowning can be difficult, and several postmortem findings have been postulated to aid the diagnosis. Increased lung weights are often seen in drowning deaths. Lung-body (LB) ratio was described to be the best anatomical lung measurement in diagnosing drowning. Postmortem vitreous humor sodium and chloride (PMVSC) was reported to be a useful biochemical test in diagnosing saltwater drowning when the immersion time is less than 1 hour (SWD1). The presented study compared the diagnostic accuracies between LB ratio, PMVSC, and their combination in diagnosing SWD1 in 20 SWD1 and 50 nonimmersion deaths...
May 16, 2018: American Journal of Forensic Medicine and Pathology
Milenko Bogdanovic, Djordje Alempijevic, Djordje Curcic, Tijana Durmic
We present the case of a 42-year-old man, with a medical history of schizophrenic psychosis, who was found dead on the floor of his bedroom. At the autopsy, a bottle lid with a notched edge was found in the lower pharynx, partially obstructing the larynx and thus keeping the epiglottis in an open position. Airway obstruction was caused by edema and inflammation of the surrounding tissue. After removal of the foreign body, the tissue of the larynx was left with an impression of the bottle lid. The adjacent mucosa was swollen, hyperemic, partly necrotic, and covered with fibrin deposits...
May 16, 2018: American Journal of Forensic Medicine and Pathology
Melad G Paulis, Eman I Hasan
The diagnosis of drowning is still a difficult task in forensic science. Biochemical changes in different body fluids have been examined for the identification of drowning. However, none of them alone gives accurate results in the diagnosis of drowning and differentiation of saltwater and freshwater drowning. This study aimed to examine cerebrospinal fluid changes in drowned rabbits. Six groups of rabbits were used including immersed dead rabbits in freshwater or saltwater (as control groups), alive fully conscious rabbits drowned in freshwater and saltwater, and anesthetized rabbits drowned in freshwater and saltwater...
May 15, 2018: American Journal of Forensic Medicine and Pathology
Malek Zribi, Syrine Azza Manoubi, Narjes Karray, Salma Charfeddine, Wiem Benamar, Zouhir Hammami, Samir Kammoun, Samir Maatoug
"Tako-tsubo" cardiomyopathy, also known as "broken heart syndrome," is one of the rarest types of stress-induced cardiomyopathy. It frequently mimics acute coronary syndrome, characterized by transient left ventricular dysfunction, electrocardiographic changes, and release of myocardial enzymes. After treatment, the patients are cured in most cases without sequelae. Tako-tsubo syndrome is rarely considered as a reason for consultation in the forensic department.Herein, we report a case of a 68-year-old woman who was assaulted by her police officer neighbor...
May 4, 2018: American Journal of Forensic Medicine and Pathology
Cassandra Maria Wygant, Stephen D Cohle
We describe a 24-year-old man with a cystic hygroma of the left side of the lower neck that led to sudden death. Cystic hygroma (cystic lymphangioma) is a congenital malformation of the lymphatic system. The patient, who had a tracheostomy because of airway obstruction from the cystic hygroma, was found dead with his tracheostomy tube on the floor next to him. Complications of cystic hygroma include infiltration of the neck causing airway obstruction, dysphagia, pain, and obstructive sleep apnea.
May 3, 2018: American Journal of Forensic Medicine and Pathology
Lajos Fogel, Gyula Varga, Marta Hubay, Endre Felszeghy, Peter Varga, Roger W Byard
Lethal donkey attacks have very rarely been described. The case of a 65-year-old man who was found deceased on a country road with 2 domestic donkeys nearby is, therefore, reported. Examination of the body revealed contusions and lacerations of the face and scalp, a comminuted fracture of the left maxilla, comminuted fracturing of the right radius and ulna and of the left anterior superior iliac spine, a flail chest, and pulmonary contusions. In addition, there were bite marks on the left thigh, right buttock, right axilla/upper arm, and left cheek which corresponded to the dental arcades of the donkeys...
May 2, 2018: American Journal of Forensic Medicine and Pathology
Winston Philcox, Jack Garland, Faseeh Zaidi, Paul Morrow, Kilak Kesha, Simon Stables, Christopher X Wong, Amy Spark, Rexson Tse
Heart weight is dependent on sex, age, height, and weight. Although previous autopsy studies showed no differences in heart weight between different ethnic groups, none have examined the New Zealand population of Māori and Pacific Islanders (Polynesians). The presented study compared heart weights between 101 European and 85 Polynesian suicide hanging deaths from New Zealand. Univariate linear regression coefficients for age, male sex, height, body weight, body mass index, and Polynesian ethnicity were positive and significant (P < 0...
April 26, 2018: American Journal of Forensic Medicine and Pathology
Rexson Tse, Jack Garland, Kilak Kesha, Paul Morrow, Leo Lam, Hannah Elstub, Allan Cala, Amy Spark, Cristian Palmiere, Simon Stables
Lung weights are often increased in drowning deaths as well as in other types of deaths. Lung weights may also vary with age, sex, and body weight. A variety of methods have been proposed to utilize lung weight data to assist with the diagnosis of drowning. The present study compared lung weight, lung-heart ratio (LH), and lung-body ratio (LB) between 50 consecutive drowning and 50 nonimmersion deaths in order to assess the accuracy in diagnosing drowning. Analysis revealed both LH and LB to be statistically higher in drowning deaths (P < 0...
April 26, 2018: American Journal of Forensic Medicine and Pathology
John Oladapo Obafunwa, Emily Hammerl, David Jaskierny, Livia Taylor, Lynette Russell, Karl Reinhard
In Spring of 2012, the partially undressed and skeletonized remains of a homeless adult Hispanic male was found in a fairly open wooded area in Nebraska. The remains showed evidence of extensive pathologies, which included healed traumas and surgeries. Examination of the decedent's medical records revealed that he had a history of kidney and liver problems, alcohol abuse, several traumas including a major head injury that necessitated a craniotomy, and radiological features of neurocysticercosis. The autologous bone flap, which was replaced after the craniotomy, had resorbed significantly away from the edges of the injury...
June 2018: American Journal of Forensic Medicine and Pathology
Steven P Ellis, Charles Ákos Szabó
Epilepsy is a common neurological disorder associated with increased morbidity and mortality, including premature death from different causes. Sudden unexpected death in epilepsy, or SUDEP, is one of the most common causes of death in people with epilepsy and originally brought to light by medical examiners. It accounts for 5% to 30% of all deaths in individuals with epilepsy and up to 50% in individuals with medically refractory epilepsy. It is commonly associated with a history of generalized tonic-clonic seizures and may be mitigated by other electroclinical risk factors, such as postictal electroencephalographic suppression, prone position, altered heart rate variability, conduction abnormalities, gender, or antiepileptic medications, to name a few...
June 2018: American Journal of Forensic Medicine and Pathology
Cristian Palmiere, Camilla Tettamanti
Increased infection susceptibility in the diabetic population is a controversial issue in the clinical field. The greater frequency of infections in diabetic patients has been speculated as caused by the hyperglycemic environment that favors immune dysfunction. The aim of this study was to investigate the proportion of positive bacterial cultures in a series of diabetic individuals who underwent forensic investigations and assess the frequency of hyperglycemia at the time of death in these cases as well as the percentage of diabetics with cause of death due to bacterial infection...
June 2018: American Journal of Forensic Medicine and Pathology
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