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American Journal of Forensic Medicine and Pathology | Page 2

Silvia Farkašová Iannaccone, Peter Vasovčák, Dorota Sopková, Peter Švajdler, Reinhard Dettmeyer, Alessandra Rampazzo, Daniel Farkaš
In this article, we report the autopsy findings of a 23-year-old woman, who was found unconscious at home by her relatives. During the transportation to the hospital, the woman was handed over to the ambulance personnel, who were the first to provide cardiopulmonary resuscitation. In the hospital, after an hour-lasting asystole, the heart activity was restored. Prolonged cardiac arrest led to hypoxic brain injury, which resulted in a persistent coma. Examinations carried out during hospitalization detected hypokinetic interventricular septum, frequent ventricular extrasystoles and ventricular fibrillation...
March 5, 2019: American Journal of Forensic Medicine and Pathology
Milenko Bogdanović, Vesna Popović, Slobodan Savić, Tijana Durmić, Bojana Radnić
This case represents a planned complex suicide in which the victim combined gunshot to the head and hanging. The most interesting finding in the presented case was pale face, but without any visible injury to it at the time the body was found (more than 24 hours after death), whereas at autopsy (20 hours later), black eyes were prominent. The removal of the ligature led to the decompression of the neck and its blood vessels with consequential blood redistribution, which, alongside the liquid state of blood, resulted in the aforementioned finding...
March 5, 2019: American Journal of Forensic Medicine and Pathology
Mark W Kroll, Michael A Brave, Scott R Kleist, Mollie B Ritter, Darrell L Ross, Steven B Karch
INTRODUCTION: It has been suggested that law enforcement officer (LEO) weight on the backs of prone subjects may cause asphyxia. METHODS: Law enforcement officers used their agency-trained "local" single- and double-knee techniques, the "Wisconsin" 3-Point Ground Stabilization, and the Human Factor Research Group Inc single-knee tactical handcuffing techniques, and the weight force was measured. RESULTS: Forty-one LEOs (36 men, 5 women) participated, aged 38...
March 2019: American Journal of Forensic Medicine and Pathology
Zhuoqun Wang, Lei Wan, Yu Shao, Donghua Zou, Ningguo Liu, Yijiu Chen
Postmortem computed tomography (PMCT) and PMCT angiography are increasingly used in forensic practice. However, their application in court is still limited because they need professional equipment or software to be displayed. In this article, the authors introduce 3-dimensional (3D) printing technology as a new approach to provide evidence in court. A 67-year-old woman suffered from severe sick sinus syndrome, and she was fitted with a ventricular demand inhibited pacemaker. The operation failed as the doctor accidentally perforated her heart with an electrode wire...
March 2019: American Journal of Forensic Medicine and Pathology
Milenko Bogdanović, Bojana Radnić, Slobodan Savić, Vesna Popović, Tijana Durmić
We present a case of 19-year-old female patient, who was injured in childhood and subsequently developed hydrocephalus, chronic elevation of intracranial pressure (ICP), and a copper-beaten skull appearance. Chronic hydrocephalus leads to an increase in intraventricular pressure, causing ventricular expansion and dislocation of adjacent cerebral structures. According to literature data, it has been hypothesized that chronically elevated ICP in persons with craniosynostosis, and other developmental structural abnormalities of the skull, may induce bone remodeling...
March 2019: American Journal of Forensic Medicine and Pathology
Rosario Barranco, Andrea Molinelli, Raffaella Gentile, Francesco Ventura
Meigs syndrome is the triad of ascites, hydrothorax, and benign ovarian tumor (mostly fibroids). It is a diagnosis of exclusion, and the characteristic symptoms disappear after resection of the tumor. Instead, in Pseudo-Meigs syndrome, the triad includes a nonfibroma ovarian tumor. The latter may consist of benign tumors (ie, of fallopian tube or uterus, struma ovarii, and ovarian leiomyomas) but can also comprise ovarian or metastatic gastrointestinal malignancies.The authors describe a case of sudden death in a 43-year-old woman, with no noteworthy reported history of present illness or medical history and in apparently good health before death...
March 2019: American Journal of Forensic Medicine and Pathology
Leigh Hlavaty, William Kasper, LokMan Sung
Celebratory use of fireworks has been an integral part of human civilization for over millennia. While the majority of firework use is festive, their explosive nature can result in traumatic injuries and death. The authors present the death of a 21-year-old man found unresponsive on the floor of his parent's garage with extensive damage to his head after an explosion was heard. Firearms could not be found, but there were unexploded homemade and commercially produced firecrackers and components for the manufacture of additional firecrackers...
March 2019: American Journal of Forensic Medicine and Pathology
Simone Cappelletti, Daria Piacentino, Costantino Ciallella
A systematic review of the literature regarding drug packaging methods in body packing and materials used is presented, with the aim (a) to summarize data regarding the packaging methods adopted by drug trafficking organizations, (b) to support forensic pathologists and police forces to classify and describe drug packages, (c) to propose a new classification for drug packaging techniques, and (d) to better clarify the impact of packaging methods on radiological detectability.Packaging methods have been described in 2981 cases, permitting us to summarize the different materials used and to propose a new classification for packaging method based on the materials used...
March 2019: American Journal of Forensic Medicine and Pathology
Aytul Bugra, Taner Das
Volatile substance addiction and toxic gas inhalation are now an important health problem. The pleasure-based inhalation of butane gas, also known as lighter refill gas, is especially prevalent among children and young people. The most important reasons for this situation are that they are cheap and easy to obtain and lack of legal supervision. The exhaled gas is absorbed through the alveolar surface and rapidly enters the bloodstream and leads to clinical signs. It can cause dizziness, nausea, vomiting, confusion, hallucinations, and euphoria in the acute phase...
March 2019: American Journal of Forensic Medicine and Pathology
Matthew J Cecchini, Michael J Shkrum
Self-inflicted gunshot wounds are a common cause of firearm-related deaths. The appearance and location of the entry wound, other concomitant findings at autopsy, and correlation with the scene and circumstances are critical in determining the manner of death. A case of a 72-year-old man with a self-inflicted gunshot wound with an unusual injury pattern is described. There was a contact range gunshot entry in the right temple, and an exit wound was seen in the left parietal region. There was a re-entry with an associated exit wound on the left hand...
March 2019: American Journal of Forensic Medicine and Pathology
Alessandra Spagnolia, Walter L Kemp
When a hunter intentionally fires a weapon and the projectile strikes another human, the manner of death is most often certified as a homicide. The intent of the individual firing the weapon is unknown and the possibility that a hunting "accident" represents a concealed intentional homicide must always be considered. However, in some circumstances such as a documented ricochet, the manner of death may be certified as accident.The death of a hunter who was being mauled by a grizzly bear and subsequently died will be presented...
February 21, 2019: American Journal of Forensic Medicine and Pathology
Daniel W Dye, Gerald McGwin, Daniel S Atherton, Brandi McCleskey, Gregory G Davis
In 2005, the National Association of Medical Examiners approved the Forensic Autopsy Performance Standards. Standard B3.7 indicates that a forensic pathologist shall perform a forensic autopsy when the death is by apparent intoxication by alcohol, drugs, or poison.The Jefferson County Coroner/Medical Examiner Office has observed an increase in our caseload by 10% per year since 2012. We designed a study to determine if a pathologist could correctly classify the cause of death (COD) and manner of death (MOD) of suspected drug-related deaths without information from the internal examination...
February 15, 2019: American Journal of Forensic Medicine and Pathology
Rosagemma Ciliberti, Giuseppe Armocida, Marta Licata
On May 16, 2017, the judgment of the Italian court ended the legal battle concerning the repatriation request of the famous skull, belonging to the "brigand" Giuseppe Villella. During the autopsy examination on the corpse of Villella, Lombroso observed a median occipital dimple on the skull, a feature visible in other mammals, including primates, but absent in humans. This feature could demonstrate an anomalous dimension of the median lobe of Villella's cerebellum. From this anatomical finding, Lombroso consolidated the atavism theory, which established a close connection between morphological features and behavior...
January 24, 2019: American Journal of Forensic Medicine and Pathology
Merryl Terry, Donna Marlowe Stewart
Sudden unexplained death in infancy is a leading cause of death among infants between 1 month and 1 year of age in the United States. The medical examiner is frequently given the difficult task of attempting to rule out other causes of death such as infantile trauma or child abuse. A thorough postmortem examination of the skin is a crucial component of the autopsy, as is sufficient knowledge of both benign and traumatic skin pathologies. In addition to lifesaving interventions performed by medical personnel, traditional remedies may also be performed that could be confused with trauma...
January 23, 2019: American Journal of Forensic Medicine and Pathology
Sinead McCarthy, Jack Garland, Sarah Hensby-Bennett, Winston Philcox, Kilak Kesha, Simon Stables, Rexson Tse
Acute esophageal necrosis (AEN), also known as black esophagus, is a rare clinical entity. It is recently described to be associated with diabetic ketoacidosis (DKA) in a few case reports. Wischnewsky lesions (WLs) are a classic postmortem finding seen in fatal hypothermia but are recently described to be associated with DKA. Interestingly, the pathogenesis and morphology of AEN and WLs appear to share similar characteristics. Both AEN and WLs are reported to be seen simultaneously in hypothermic deaths and deaths related to alcohol abuse, but not in DKA...
January 23, 2019: American Journal of Forensic Medicine and Pathology
Sarah Hensby-Bennett, Jack Garland, Winston Philcox, Sinead McCarthy, Veronica Playle, Kilak Kesha, Simon Stables, Rexson Tse
Streptococcus pneumoniae is the leading cause of adult bacterial meningitis. Differing from Neisseria meningitidis (the second most common cause of acute bacterial meningitis), contact tracing and chemoprophylaxis are not required. At postmortem, the differentiation between S. pneumoniae and N. meningitidis is traditionally done by culture and polymerase chain reaction performed on blood or cerebrospinal fluid, but may take hours, if not days, to analyze. We present a death from bacterial meningitis in a 73-year-old woman in which a rapid urinary pneumococcal antigen testing was able to identify S...
January 17, 2019: American Journal of Forensic Medicine and Pathology
Jack Garland, Winston Philcox, Kilak Kesha, Sinead McCarthy, Leo Chi Sing Lam, Cristian Palmiere, Sarah Hensby-Bennett, Simon Stables, Rexson Tse
To ascribe a cause of death from drowning in a body immersed in water can be difficult because of the absence of specific postmortem findings and unreliable ancillary tests. Postmortem vitreous biochemical analysis is documented to be a useful adjunct ancillary test to aid the diagnosis of saltwater drowning. A major confounding factor in using postmortem vitreous is the effect of electrolyte diffusion and water osmosis during immersion. A recent animal study suggested that cerebrospinal fluid (CSF) biochemical analysis, which is unaffected by immersion, may be an alternative...
January 17, 2019: American Journal of Forensic Medicine and Pathology
Sara Gioia, Lisa Franceschetto, Massimo Lancia, Mauro Bacci, Fabio Suadoni
The authors report a case of a man who developed stroke symptoms a few days after a road accident on his motorcycle. Radiographic examinations revealed the presence of bilateral dissection of the extracranial internal carotid arteries with signs of involvement of the brain parenchyma.The location, timing, and presentation lead to the conclusion that the carotid lesions were secondary to the motorcycle collision; in particular, we suppose that it is due to the pressure exerted by the helmet strap worn. Although helmets have undoubtedly prevented serious injuries, this report highlights that the helmets themselves may cause injuries, especially to cervical soft tissues and vessels...
January 7, 2019: American Journal of Forensic Medicine and Pathology
Cassandra Maria Wygant, Stephen D Cohle
We describe an 8-year-old white boy with a history of fetal alcohol syndrome and pica, who was found dead on the floor by his mother. The child died from massive intestinal dilatation causing asphyxia. We discuss the potential pathogenetic mechanisms of intestinal dilation in patients with fetal alcohol syndrome.
January 7, 2019: American Journal of Forensic Medicine and Pathology
Stacy A Drake, Dwayne A Wolf, Yijiong Yang, Sherhonda Harper, Jennifer Ross, Thomas Reynolds, Eileen Girandio
This study examined medicolegal death investigation records and autopsy reports of a medical examiner's office to identify the circumstances surrounding sudden unexpected infant deaths (SUID) and geospatial analyses to pinpoint areas of infant death concentration. Analysis of 732 records of SUID deaths occurring in a 10-year span resulted in the conclusion that environmental factors associated with the sudden death were to some extent modifiable. Co-sleeping (sharing a sleeping surface, or bed-sharing) on various surfaces (mattress, pallet, couch) occurred in 53...
December 18, 2018: American Journal of Forensic Medicine and Pathology
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