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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
Carlo Moreschi, Ugo Da Broi, Leonardo Ciccone, Tiziano Stocca
Suicides committed by firing 2 gunshots to the head are rare events and pose a significant challenge for coroners and forensic pathologists. The evaluation of the victim's ability to fire 2 shots simultaneously, or to act after a first gunshot, is crucial for the reconstruction of the death scene and to differentiate between homicide and suicide. We report an unusual case of suicide involving 2 gunshot wounds to the head. The medicolegal investigations hypothesized that the victim had either fired 2 shots near simultaneously or he suffered from rapid incapacitation after the first gunshot but was still able to fire a second consecutive and fatal shot to the head...
April 25, 2019: American Journal of Forensic Medicine and Pathology
Krupa Merchant, Christine Schammel, James Fulcher
Methamphetamine is a central nervous system stimulant that induces arousal, a positive mood, cardiac stimulation, and an acute improvement in cognitive domains. Its illicit exploitation is rapidly growing in North America. Typically, extended use of the drug induces organ damage via vasoconstriction and subsequent ischemia. This case specifically discusses hepatic and pancreatic pathology resulting from methamphetamine overdose alongside an unusual discovery of globally necrotic von Meyenburg complexes.
April 24, 2019: American Journal of Forensic Medicine and Pathology
D Kimberley Molina, Norma J Farley
Childhood and adolescent suicides have been increasing worldwide in recent years, and the investigation of such deaths is often complex. Forensic pathologists frequently find themselves having to opine as to the manner of death in these difficult cases. The present study was undertaken to identify distinguishing features in childhood and adolescent suicides to assist in the investigation and prevention of these deaths. A 25-year review of pediatric suicides in a metropolitan area was performed, which showed a steady increase in pediatric suicides over time...
April 15, 2019: American Journal of Forensic Medicine and Pathology
Vasiliki Chatzaraki, Wolf Schweitzer, Michael J Thali, Garyfalia Ampanozi
Nasal septum defects may have forensic relevance because they are associated with various mechanisms, including trauma and cocaine abuse. Like all human body tissues, the nasal septum may be affected by maggots' infestation during postmortem decomposition. Postmortem computed tomography (PMCT) can reveal small findings and related details. Three cases of early postmortem period and 2 cases of advanced decomposition, where external examination of the nasal cavities and PMCT revealed nasal septum defect, are presented...
April 10, 2019: American Journal of Forensic Medicine and Pathology
James R Gill, Holly G Olko, Maura E DeJoseph
This study on cremation clearance examines whether physical inspections detect more unnatural unreported deaths than medicolegal investigations without inspections. We reviewed all deaths reported to the medical examiner for cremation clearance during 2 distinct years and compared subsequent amendments of death certificates after 2 different investigative methodologies (1 with and 1 without physical inspection). Of 10,367 deaths in 2012, there were 86 deaths (0.83%) in which the investigation with physical inspection resulted in amendments to the death certificate...
April 8, 2019: American Journal of Forensic Medicine and Pathology
D Kimberley Molina, Kathy Pinneri, John A Stash, Ling Li, Kathryn Vance, Caroline Cross
Abnormal organ weights often serve as an indicator of underlying disease or other pathological process making assessment of organ weight a critical part of the autopsy examination and interpretation. Unfortunately, normal organ weights for children are often based on studies done in the 1930s and 1960s. Thus, the present study was designed to accurately assess organ weights in children to establish reference ranges for use in autopsy examinations. A total of 1759 traumatic deaths in children aged 0 to 12 years were reviewed...
April 8, 2019: American Journal of Forensic Medicine and Pathology
William T Harrison, Thomas Bouldin, Anne Buckley, Januario Estrada, Roger McLendon, Kimberly Janssen
Primary central nervous system tumors are an extremely rare cause of sudden, unexpected death in children as most patients develop symptoms because of increased intracranial pressure and seek medical attention. Rarely, a forensic pathologist may encounter a primary intracranial neoplasm in a pediatric decedent that was not suspected before death. Herein, we present a case of a supratentorial neuroepithelial tumor found at autopsy in a 3-year-old African American boy without any reported significant medical history...
April 2, 2019: American Journal of Forensic Medicine and Pathology
Marwa Boussaid, Mohamed Amin Mesrati, Yosra Mahjoub, Hiba Limem, Nouha Ben Abdeljalil, Abdelfatteh Zakhama, Abir Aissaoui
Chronic calcific constrictive pericarditis is a rare condition. It can cause severe morbidity and even mortality. The diagnosis may be difficult to establish due to its variable clinical signs. We report an autopsy case of a 54-year-old male with a past medical history of well treated hypertension, diabetes and dyspnea present of 2 weeks, who was discovered dead in his bed. The postmortem examination showed a large band of calcification of the pericardium with obliteration of the pericardial space. Both pericardium and epicardium were thickened with bread-and-butter appearance...
March 30, 2019: American Journal of Forensic Medicine and Pathology
Hsuan-Yun Hu, Shyh-Yuh Wei, Tai-Yun Wu, Wei-Hsiang Huang, Chih-Hsin Pan
Tuberculosis (TB) is one of the most important public health issues worldwide, and global efforts have altered the TB epidemic. This study analyzed 71 cases of TB at autopsy notified via Taiwan Medical Examiner Surveillance for Lethal Infectious Disease (Taiwan Med-X) between 2012 and 2017 and applied immunohistochemistry to formalin-fixed lung tissue. Tuberculosis was present in 0.57% (71/12,369) forensic autopsy cases in the institute. Among the study cases, 30 (42.3%) cases were newly diagnosed with TB at autopsy, whereas 41 (57...
March 23, 2019: American Journal of Forensic Medicine and Pathology
Lisa Franceschetto, Luigi Carlini, Massimo Lancia, Mauro Bacci
Impalement injuries occur when a large foreign body traverses or penetrates a body cavity or extremity. Nowadays, impalement injuries are uncommon and are usually a consequence of a fall onto a blunt object or a road accident. The authors report a case of a woman found dead in her apartment, seemingly killed by a firearm injury to the abdomen. However, after the autopsy was carried out, it became clear that the injuries had the features of an impalement. After the inquiry, the murder weapon was identified as a battering ram, used by the robbers to break into the house of the woman...
March 23, 2019: American Journal of Forensic Medicine and Pathology
Martin Janík, Jozef Krajčovič, František Novomeský, Ľubomír Straka, Petr Hejna
Multiple sclerosis, currently incurable and potentially profoundly disabling demyelinating central nervous system disease, is associated with higher occurrence of suicide as affected individuals are prone to major depression and psychosis. Despite progressively incapacitating neurologic impairment, well-staffed institutions, and limited repertoire of methods of suicide, which prevents patients from purposefully ending their lives, suicide-determined patients typically commit suicide resulting from a medication overdose, sharp force traumata, self-neglect, or deliberate starvation...
March 23, 2019: American Journal of Forensic Medicine and Pathology
Fabio De-Giorgio, Simone Grassi, Arnaldo Carbone
No abstract text is available yet for this article.
March 14, 2019: American Journal of Forensic Medicine and Pathology
Stephan Andreas Bolliger, Silvan Gort, Beat Kaelin, Vera Barrera, Michael Josef Thali, Rosa Maria Martinez
Occasional case reports have described isolated cases of conducted electrical weapon (CEW) probes piercing the human skull. In an experimental setting, we examined whether these cases were just unfortunate incidents, how deeply such probes can pierce the skull, and whether firing distance and CEW probe type play a role in the skull-piercing capability.We fired 5 different CEW cartridges (XP 10.6 m, XP 7.6 m, smart 10.6 m, smart 7.6 m, and smart probe 7.6 m) from 4 different distances (0.5, 1, 2, and 4 m) at head phantoms made of either 5- or 7-mm-thick polyurethane spheres covered with a thin layer of gelatine and buckskin...
March 9, 2019: American Journal of Forensic Medicine and Pathology
Sara Gioia, Mariano Cingolani
No abstract text is available yet for this article.
March 9, 2019: American Journal of Forensic Medicine and Pathology
Chittaranjan Behera, Mohit Chauhan, Asit Kumar Sikary
Application of color on the external body surface before, during, and after death, such as during a festivity, cultural occasion, or after death ritual, can present as an artifact at forensic autopsy. The present study is a retrospective review of body color artifacts collected from postmortem reports, inquest papers and photographs of each individual case autopsied at our institutes during a 12 year period from 2004 to 2015. The reason for body colorations were various festivities, after death rituals and beautification products, among others...
March 9, 2019: American Journal of Forensic Medicine and Pathology
Valeria Santoro, Chiara Marini, Grazia Fuzio, Francesco Introna, Antonio De Donno
Age estimation is a crucial matter in several forensic and legal instances. The literature recommends carrying out hand and wrist radiograph to assess skeletal age. Much research has been conducted to examine the application of various methods in different categories. Our study aims to evaluate the reliability of Greulich and Pyle, Tanner-Whitehouse 2, and FELS methods in Beninese and Italian samples, with a total of 204 subjects, 102 (51 were male and 51 were female) from Benin and 102 (51 were male and 51 were female) from Italy, aged between 4 and 19 years...
March 9, 2019: American Journal of Forensic Medicine and Pathology
Fabio De-Giorgio, Simone Grassi, Massimo Miscusi, Luca Ricciardi, Filippo Maria Polli
Although strangulation is generally homicidal, the scientific literature reports several cases in which it is suicidal or even accidental. The former eventuality is particularly interesting because extremely atypical ligatures (such as locks of hair), complex dynamics, and uncommon findings can be involved. Only a meticulous evaluation of the body and of both direct and circumstantial evidence can help in the complex differential diagnosis that includes murder, suicide, and accident. In accidental strangulation, the number and severity of injuries depend on the magnitude of applied force...
March 9, 2019: American Journal of Forensic Medicine and Pathology
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