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Autopsy after hospital death

Satoko Mishima-Kimura, Kosei Yonemitsu, Yuki Ohtsu, Ako Sasao, Hiroshi Tsutsumi, Shota Furukawa, Yoko Nishitani
We report a forensic autopsy case of an elderly man who ingested unknown amount of germicidal disinfectant containing 50% benzalkonium chloride (BZK). He survived for 18 days after BZK ingestion and then died because of pneumonia. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used to detect three BZK compounds (C12 -BZK, C14 -BZK and C16 -BZK) in the blood. Extraction of BZK was carried out according to a modified QuEChERS method. Chromatographic separation was achieved on an ODS column and detection was performed in selected reaction monitoring mode...
March 2, 2018: Legal Medicine
Shifan Wu, Luo Zhuo, Xingang Qiu, Zijiao Ding, Mingzhen Yang, Meichen Pan, Qian Liu
RATIONALE: Acute epiglottitis is a potentially life-threaten disease, which makes it more challenging to save the life for doctors. Unexpected deaths in custody are a primary cause of concern for the forensic community and doctor worldwide. PATIENT CONCERNS: We present a case of a 44-year-old male detainee who was clinically suspected of dying of acute epiglottitis. The man experienced failure of resuscitation and died after admitted to a hospital. DIAGNOSES: The autopsy, toxicological testing, the test of immunoglobulin E and bacterial culture suggested the patient died of acute epiglottitis...
February 2018: Medicine (Baltimore)
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
Lewis B Holmes, Hanah Nasri, Rebecca Beroukhim, Anne-Therese Hunt, Drucilla J Roberts, M Hassan Toufaily, Marie-Noel Westgate
BACKGROUND: Stillbirth, defined as death of a fetus in utero after 20 weeks of gestation, occurs in 1 to 2% of pregnancies in the United States. Many of these stillborn infants have associated malformations, including chromosome abnormalities, neural tube defects, and malformation syndromes. Other causes are abnormalities of the placenta and maternal conditions, such as pre-eclampsia and obesity. A consecutive sample of malformed stillborn infants can establish the relative frequency and severity of the associated malformations...
January 2018: Birth Defects Research
Sachil Kumar, Anoop K Verma
Introduction: The aim is to explore the trends in trauma mortality in children aged 0-18 years can help to co-ordinate resources toward research and programs to reduce the burden. Methods: This is a retrospective study carried out on adolescents ≤18 years of age autopsied according to the attorney request at Forensic Medicine & Toxicology department of King George's Medical University, Lucknow, India in the period from January 1st, 2009 to December 31st, 2014...
November 2017: Journal of Clinical Orthopaedics and Trauma
Paul Richard Cassidy
BACKGROUND: The objective of the study was to evaluate practices in Spanish hospitals after intrauterine death in terms of medical/ technical care and bereavement support care. METHODS: A cross-sectional descriptive study using an online self-completion questionnaire. The population was defined as women who had experienced an intrauterine fetal death between sixteen weeks and birth, either through spontaneous late miscarriage/stillbirth or termination of pregnancy for medical reasons...
January 10, 2018: BMC Pregnancy and Childbirth
Morten Vetrhus, Andreas Reite, Jørgen B Vennesland, Kjetil Søreide
BACKGROUND: The available literature on ruptured abdominal aortic aneurysms (rAAA) centers on survival after operation and commonly, reasons why some patients do not undergo surgery are not addressed. The aim of the present study is to examine, in a population-based cohort, the characteristics, stratification and time to death of patients admitted to hospital, but not undergoing operation for rAAA. METHODS: A retrospective, single-center study. All patients admitted to Stavanger University Hospital from the primary catchment area with rAAA on admission or in-hospital from 2000 to 2014 were included...
December 30, 2017: World Journal of Surgery
Eduardo Pelegrineti Targueta, André Carramenha de Góes Hirano, Fernando Peixoto Ferraz de Campos, João Augusto Dos Santos Martines, Silvana Maria Lovisolo, Aloisio Felipe-Silva
Sickle cell disease encompasses a wide range of genotypic presentation with particular clinical features. The entity affects millions of people, particularly those whose ancestors came from sub-Saharan Africa and other countries in the Western Hemisphere, Saudi Arabia, and India. Currently, the high frequency of S and C genes reflects natural selection through the protection of heterozygotes against severe malaria, the high frequency of consanguineous marriages, improvement of some public health policies and the nutritional standards in the poorer countries where newborns are now living long enough to present for diagnosis and management...
October 2017: Autopsy & Case Reports
Joo-Young Na
A case of massive calcification of the myocardium is presented that was diagnosed by postmortem computed tomography (PMCT) and confirmed by conventional autopsy. There are two types of pathologic calcification, dystrophic and metastatic. Massive calcification of the myocardium is associated with variable clinical outcomes, including sudden unexpected death. A 53-year-old man was found after he collapsed beside a walkway. He was transferred to hospital and died approximately two months later. To investigate the cause of death, PMCT and conventional autopsy were performed, which revealed massive calcification of the myocardium, a very rare finding at autopsy...
March 2018: Forensic Science, Medicine, and Pathology
Emily J Cannon, Renee N Bauer
PURPOSE: Since 2012, a medical-surgical nursing course at a midsized state university has provided the opportunity for students to view autopsies with a board-certified forensic pathologist. The autopsies are performed at a midsized hospital relatively close to the campus. The purpose of this study was to discover nursing students' perceptions that emerged during the autopsy experience. METHODS: A convenience sample of 23 baccalaureate nursing students took part in the autopsy experience over a 4-month period...
October 2017: Journal of Forensic Nursing
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
December 2017: Der Anaesthesist
Makhdum Ahmed, Jaynal Abedin, Kazi Faisal Alam, Abdullah Al Mamun, Repon C Paul, Mahmudur Rahman, A Danielle Iuliano, Katharine Sturm-Ramirez, Umesh Parashar, Stephen P Luby, Emily S Gurley
Although acute diarrheal deaths have declined globally among children < 5 years, it may still contribute to childhood mortality as an underlying or contributing cause. The aim of this project was to estimate the incidence of acute diarrhea-associated deaths, regardless of primary cause, among children < 5 years in Bangladesh during 2010-12. We conducted a survey in 20 unions (administrative units) within the catchment areas of 10 tertiary hospitals in Bangladesh. Through social networks, our field team identified households where children < 5 years were reported to have died during 2010-12...
November 6, 2017: American Journal of Tropical Medicine and Hygiene
Takako Sato, Hiroshi Nishioka, Kento Tsuboi, Munehiro Katagi, Akihiro Miki, Takashi Saito, Shuntaro Abe, Masakatsu Nomura, Misa Kitagawa, Hitoshi Tsuchihashi, Koichi Suzuki
In Japan, there are increasing reports of death by poisoning following butane abuse. To determine the specific cause of death in such cases, it is important to confirm the presence of fuel gas components in the body, although careful analysis is required because of their volatile properties. In most reported cases, the subject died suddenly during or immediately after butane aspiration. Thus, the butane concentration in the samples from the deceased should be relatively high. Herein, we present a case of an 18-year-old man found with cardiopulmonary arrest, who then exhibited hypoxic encephalopathy for 16days in a hospital...
November 2017: Legal Medicine
B Ondruschka, C Baier, M Siekmeyer, C Buschmann, J Dreßler, M Bernhard
INTRODUCTION: Cardiopulmonary resuscitation (CPR) may lead to injuries. Forensic experts are sometimes confronted with claims that fatal injuries were caused by chest compressions during CPR rather than by assaults. We want to answer, how often CPR-associated injuries are present in younger children and if they may mimic injuries caused by abuse. MATERIAL AND METHODS: All autopsy records of the Institute of Legal Medicine in Leipzig, Germany in a 6-year study period were used (2011-2016)...
October 2017: Forensic Science International
Lena Lange, Barbara Zedler, Marcel A Verhoff, Markus Parzeller
BACKGROUND: Although sexual activity can cause moderate stress, it can cause natural death in individuals with pre-existing illness. The aim of this study was to identify additional pre-existing health problems, sexual practices, and potential circumstances that may trigger fatal events. METHODS: This medicolegal postmortem, retrospective, and prospective study is based on data of autopsies performed at the Institute of Legal Medicine of the University hospital, Goethe-University, Frankfurt/Main, Germany...
October 2017: Journal of Sexual Medicine
R Rahimi, E Omar, T S Tuan Soh, S F A Mohd Nawi, S Md Noor
BACKGROUND: Hand, foot and mouth disease (HFMD) is caused by enteroviruses such as Coxsackie virus A16 (CVA16) and Enterovirus 71 (EV71). The diagnostic hallmarks are oral ulcers and maculo-papular or vesicular rash on the hands and feet. Severe form of this disease can lead to death due to neurological and cardiopulmonary complications. This case report aims to describe a fatal case of HFMD with minimal oral and skin manifestations. CASE REPORT: A four-year-old girl was brought to a hospital after suddenly becoming unresponsive at home...
August 2017: Malaysian Journal of Pathology
Q Feng, J L Tang
Puerperal fever was a major cause of maternal death in Europe in the 19(th) century. Many efforts were made to investigate the cause of the epidemic but failed. In 1846, Semmelweis, a young obstetrician in Vienna General Hospital, started his historical investigation. His breakthrough was largely due to his doctor friend's accidental injury during autopsy and his consequential death. Semmelweis found the pathological findings in his friend's post mortem examination were very similar to puerperal fever. He postulated his friend's death might be caused by "cadaverous particles" from cadavers and further inferred that puerperal fever might also be caused by the cadaverous particles that doctors brought to the delivering women after autopsy classes...
August 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Yoshiteru Shimoda, Satoru Ohtomo, Hiroaki Arai, Takashi Ohtoh, Teiji Tominaga
BACKGROUND: Cryptococcal meningoencephalitis (CM) causes cerebral infarction, typically, lacunar infarction in the basal ganglia. However, massive cerebral infarction leading to death is rare and its pathophysiology is unclear. We report a case of CM causing massive cerebellar infarction, which led to cerebral herniation and death. CASE PRESENTATION: A 56-year-old man who suffered from dizziness and gait disturbance for one month was admitted to our hospital and subsequently diagnosed with a cerebellar infarction...
August 9, 2017: BMC Neurology
Bente Ediassen Opsjøn, Svein Arne Nordbø, Christina Vogt
Fifteen to 50% of fetal deaths remain unexplained after post-mortem examination depending on inclusion criteria and classification systems. Our aim was to examine a selection of unexplained fetal deaths in order to investigate whether any common chromosome aberrations or viral infections were present. Reports from 351 fetal autopsies performed at the Department of Pathology and Medical Genetics at St. Olavs University Hospital from 2001 through 2010 were reviewed. Of these, 105 fetal deaths were classified as unexplained...
September 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
Roman Pfeifer, Sylvia Schick, Christopher Holzmann, Matthias Graw, Michel Teuben, Hans-Christoph Pape
BACKGROUND: Despite improvements in prevention and rescue, mortality rates after severe blunt trauma continue to be a problem. The present study analyses mortality patterns in a representative blunt trauma population, specifically the influence of demographic, injury pattern, location and timing of death. METHODS: Patients that died between 1 January 2004 and 31 December 2005 were subjected to a standardised autopsy. INCLUSION CRITERIA: death from blunt trauma due to road traffic injuries (Injury Severity Score ≥ 16), patients from a defined geographical area and death on scene or in hospital...
December 2017: World Journal of Surgery
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