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American Journal of Forensic Medicine and Pathology

Ivana Čurović, Slobodan Savić, Milenko Bogdanović, Tijana Durmić
The investigation of deaths that are suspected to be related to medical therapy present several challenges for a forensic pathologist. We present a case of an otherwise healthy 58-year-old woman with multiple nasal polyps who underwent nasal polypectomy. The operation was initially considered successful. However, the patient had never recovered from general anesthesia and was declared deceased 24 hours after the surgery.The autopsy revealed a basilar subarachnoid hemorrhage. The examination of the basilar skull showed a perforation of approximately 15 by 7 mm in the right cribriform plate...
July 26, 2019: American Journal of Forensic Medicine and Pathology
Mehdi Ben Khelil, Meyssa Belghith, Ahmed Chraiti, Meriem Gharbaoui, Nizar Laadhari, Moncef Hamdoun
BACKGROUND: Death in workplaces remains a public health issue. However, data regarding workplace homicides are scarce in most of regions, especially in the Arab world. The aim of our study was to analyze the epidemiological features of workplace homicides in northern Tunisia. MATERIALS AND METHODS: This is a descriptive study with retrospective data collection over a 15-year period (January 2003 to December 2017). RESULTS: We recorded 50 workplace homicide cases...
July 13, 2019: American Journal of Forensic Medicine and Pathology
Ryan Blumenthal, Pieter Evelyn Pienaar Scholtz, Jenna-Lee Shuttleworth
We present the case of a male adult who was admitted to an emergency department after having sustained envenomation from a black mamba (Dendroaspis polylepis). According to the available history, a single fang hooked his right index finger, post venom extraction. After administering antivenom in the accident and emergency department, further vials were transfused in the intensive care unit. An urticarial rash was noted, which was thought to be related to the antivenom. The victim remained in a coma for 3 days, after which he was declared dead...
July 13, 2019: American Journal of Forensic Medicine and Pathology
Rhonda Mittenzwei, Louis Dibernardo, Christine Hulette, William T Harrison
Creutzfeldt-Jakob disease (CJD) is a complex and rapidly fatal prion infection of the central nervous system with characteristic clinical and pathological findings. Herein, we present the case of an 80-year-old man with a 2-month history of rapid cognitive decline and ataxic gait. He was found to have a positive rapid plasma reagin and fluorescent treponemal antibody absorption (FTA-ABS) upon clinical testing and was presumed to have neurosyphilis. His neurological status precipitously declined during his hospitalization and he died...
July 12, 2019: American Journal of Forensic Medicine and Pathology
Ozgur Bulut, Nicolle Freudenstein, Baki Hekimoglu, Safa Gurcan
BACKGROUND AND AIM: The determination of sex from human remains has a crucial role in forensic anthropology. It has been known that the mandible has several useful traits for sex determination. The gonial angle, which is one of them, has been evaluated by forensic practitioners to identify sexual dimorphism with morphologic and metrical analyses. However, there are opposing approaches on the sexual dimorphism of the gonial angle in the literature, which contradict each other. There are also some other studies asserting that it cannot be employed in sex determination...
July 12, 2019: American Journal of Forensic Medicine and Pathology
Siddhartha Das, Srinivas Bheemanathi Hanuman, Pampa Ch Toi, Deepak Barathi Subramania, Siva Pradeep Yanamadala
Barotrauma-associated perforation of the colon is not common and usually occurs due to the passage of compressed air through the anus. Most of the cases are accidental and done for fun often at the victim's workplace. Therefore, it is necessary that the workers should be made aware of the dangers of the equipment they regularly use at their workplace. Here, we describe one such case where a rice mill worker died when compressed air through an air pump pipe entered his rectum. His chief complaint was abdominal pain and breathing difficulty...
July 12, 2019: American Journal of Forensic Medicine and Pathology
Silvia Trotta, Antonella Sorrentino, Giuseppe Bertozzi, Domenico Angiletta, Biagio Solarino
The injection of drugs of abuse causes many millions of deaths each year; deaths are mostly due to fatal overdose and the trauma and infection caused by repeated injections. The scientific literature widely reports cases of infected pseudoaneurysm in injecting drug abusers; however, most of these autopsy cases deal with the rupture of pseudoaneurysm of the femoral artery. We present fatal hemorrhagic shock in a heroin-cocaine abuser subsequent to rupture of pseudoaneurysm of the brachial artery; the man collapsed just before injecting himself with a dose of heroin-cocaine (speedball)...
July 11, 2019: American Journal of Forensic Medicine and Pathology
Suzanna Dana
This is the first article in a new series of interviews with mentors in forensic pathology. These interviews will also be recorded, and the audio files will be available online through the journal's Web site,
July 11, 2019: American Journal of Forensic Medicine and Pathology
Allyson Khau, Judy Melinek
We report 2 unusual cases of tandem bullets. Case 1 is a homicide involving a piggyback screw. Case 2 is a suicide involving multiple tandem bullets as a result of improper ammunition size. Tandem bullet injuries can have a wide variety of presentations. Therefore, it is essential that forensic pathologists understand the mechanisms of tandem bullet wounds and familiarize themselves with the autopsy and radiological findings seen in tandem bullet injuries. This report supports that use of incorrect caliber ammunition and the lodgment of foreign objects in the barrel of a gun are possible causes of tandem bullet injuries...
July 11, 2019: American Journal of Forensic Medicine and Pathology
Venkatesh Janarthanan, Kumaran Moorthi, Kusa Kumar Shaha
Foreign body ingestion is not uncommonly seen in children, with most such ingestions occurring between 6 months to 3 years of age. Button battery ingestion constitutes approximately 2% of all ingested foreign bodies in children. Button batteries are disc-shaped power units used for various electronic appliance, gadgets, and toys and often contain various toxic chemical substances such as heavy metal salts and alkali. Button batteries may become lodged in the upper digestive tract, producing severe damage to the adjacent tissues by various mechanisms...
June 25, 2019: American Journal of Forensic Medicine and Pathology
Crystina R Vachon, Michael V Martinez
Gunshot residue, or GSR, can be a valuable tool in forensic science, but its importance depends greatly on how it is utilized during an investigation and applied in criminal courts. This comprehensive review defines what constitutes GSR resulting from a discharged firearm. Sampling methods and analytical testing instrumentation will be discussed along with data interpretation and limitations of analysis.
June 14, 2019: American Journal of Forensic Medicine and Pathology
Motoki Osawa, Ryoko Nagao, Yu Kakimoto, Yasuhiro Kakiuchi, Fumiko Satoh
Sudden infant deaths might be attributable to adverse reaction to vaccination, but separating them from coincidental occurrences is difficult. This study retrospectively investigated vaccination-related details and postmortem findings for 57 cases of sudden death in children 2 years or younger. Data were extracted from autopsy files at the Department of Forensic Medicine, Tokai University School of Medicine. Vaccination histories were available in 50 cases based on the maternity passbook. Of the 32 cases in which any vaccines were administered, 7 infants (21...
June 13, 2019: American Journal of Forensic Medicine and Pathology
Dora Mirtella, Piergiorgio Fedeli, Mariano Cingolani, Giuseppe Vacchiano
The bone marrow biopsy is usually a safe procedure; however, it can occasionally present important complications. These complications are not always immediately evident or quickly diagnosed and may include pain at the biopsy site, trauma to neighboring structures, vascular injuries, infection, transient pressure neuropathies, pneumoretroperitoneum, and hemorrhage. Several risk factors are recognized, including thrombocytopenia, concurrent use of anticoagulants, and the presence of an underlying myeloproliferative disorder...
June 13, 2019: American Journal of Forensic Medicine and Pathology
Petr Handlos, Marek Joukal, Marek Dokoupil, Matěj Uvíra, Klára Marecová
Reconstruction of a criminal offense is a crucial approach in forensics and criminalistics allowing for the verification of the location, the particular method used, or the use of a specific instrument. This report describes the case of a young man who was killed by an arrow shot from a crossbow. The autopsy revealed a penetration of the head and significant damage to the brain stem. Although the cause of death was evident from the outset, it was necessary to clarify whether or not the arrow was shot as necessary self-defense...
June 12, 2019: American Journal of Forensic Medicine and Pathology
Marin A Pilloud, Victoria M Swenson, Rebecca L George, Laura D Knight
Separation of the head from the body can occur for a variety of reasons and in various locations across the neck. This study presents a review of the literature to identify the patterns of decapitations in forensic cases in relation to manner of death, age, and anatomical location (n = 88). The most common manner of death was suicide, followed by homicide and then accident. Ages ranged from 32 weeks prenatal to 85 years. Decapitation is reported at higher rates for individuals between 19 and 65. The majority of decapitations occurred at the midneck (second to fifth cervical vertebrae), followed by the upper neck and then the lower neck...
June 12, 2019: American Journal of Forensic Medicine and Pathology
Kimberly K Repp, Eva Hawes, Kathleen J Rees, Charles Lovato, Adam Knapp, Michele Stauffenberg
The abundance of actionable information available in a medicolegal suicide investigation is often inaccessible and underutilized in public health to the detriment of prevention efforts. Epidemiologists obtained the Washington County subset of the Oregon Violent Death Reporting System (OR-VDRS). To determine if additional information beyond the OR-VDRS was available through a standard death investigation, an epidemiologist shadowed medicolegal death investigators (MDIs) for nearly 2 years. The MDIs and epidemiologist developed a novel, real-time, MDI-entered surveillance system, the Suicide Risk Factor Surveillance System (SRFSS), to capture suicide risk factor data with greater timeliness and accuracy than available through the OR-VDRS...
May 21, 2019: American Journal of Forensic Medicine and Pathology
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No abstract text is available yet for this article.
September 2019: American Journal of Forensic Medicine and Pathology
Jack Garland, Kelly Olds, Rexson Tse
Infection/inflammation of solid organ can be difficult to appreciate at postmortem computed tomography (CT) scan (PMCT). Perinephric fat stranding is a clinical CT finding to suggest pyelonephritis; however, PMCT scan showing perinephric fat stranding in acute pyelonephritis has not been documented in the forensic literature. We present a death from acute pyelonephritis in a setting of hypertensive heart disease, in which the unenhanced PMCT performed before postmortem examination was able to show florid bilateral perinephric fat stranding...
May 14, 2019: American Journal of Forensic Medicine and Pathology
Jack Garland, Sinead McCarthy, Sarah Hensby-Bennett, Winston Philcox, Toni OʼRegan, Guillaume Rousseau, Cristian Palmiere, Hannah Elstub, Allan Cala, Leah Clifton, Leo Lam, Claire Barker, Benjamin Ondruschka, Lina Woydt, Amy Spark, Kilak Kesha, Paul Morrow, Charley Glenn, Simon Stables, Rexson Tse
Postmortem vitreous humor biochemistry is a useful test in the diagnosis of salt water drowning (SWD). A significant limitation of vitreous humor is the potential effect of prolonged immersion. A recent animal study and case report suggested that cerebrospinal fluid biochemistry may be an alternative to vitreous because it is more resistant to the effects of immersion, given its protected anatomical location. This study compared postmortem cerebrospinal fluid sodium and chloride (PMCSC) levels collected via ventricular aspiration (PMCSC_V) and via lumbar puncture (PMCSC_L) in 13 SWD and 31 nonimmersion deaths...
May 14, 2019: American Journal of Forensic Medicine and Pathology
Bastien Morleo, Gregor Teresinski, Guillaume Rousseau, Rexson Tse, Camilla Tettamanti, Marc Augsburger, Cristian Palmiere
The identification of hypothermia as the cause of death remains challenging in forensic pathology because of unspecific radiological, morphological, and biochemical results. Hyperemia, edema, and petechial hemorrhages within the cerebral parenchyma were described in cases of death by hypothermia. On the other hand, the effect of low temperatures in the brain has been speculated to cause local injuries on a cellular level with potential occurrences of necrosis and inflammation. In the study herein described, endocan, alkaline phosphatase, neuron-specific enolase, S100 protein subunit B, glial fibrillary acidic protein, and C-reactive protein were measured in postmortem serum from femoral blood and cerebrospinal fluid in a series of hypothermia fatalities and control cases...
April 25, 2019: American Journal of Forensic Medicine and Pathology
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