Erratum: Postmortem Hyperthermia: Two Case Reports and a Review of the Literature
No abstract available (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Erratum Source Type: research

Fatality Due to Button Battery Lodgment in the Upper Digestive Tract of a Neonate: An Unusual Presentation
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. A death of a neonate due to a button battery lodging in the upper digesti...
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Necessary Defense or Homicide?: The Importance of Crime Scene Reconstruction in Crossbow Injuries
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. Ballistic investigation of the seized weapon and reconstruction of the crime was absolutely essential to bring forth conclusive evidence to convict the perpetrators of the murder. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Retroperitoneal Hemorrhage Caused by Trephine Biopsy
We present 2 cases of fatal hemorrhage after bone marrow biopsy. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Acute Methamphetamine-Induced Hepatic and Pancreatic Ischemia
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. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Nasal Septum Defects Detected on Postmortem Computed Tomography
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. In the early postmortem period cases, the lesions' edges appeared smoother on PMCT, whereas in the advanced...
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Sudden Unexpected Death in a Child From an Anaplastic Ependymoma
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. The tumor had significant mass effect and caused cerebral edema, which ultimately resulted in transtentorial ...
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Severe Calcific Chronic Constrictive Pericarditis as an Unexpected Cause of Death: An Autopsy Case
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. Microscopic examination showed thickened pericadium which is formed by a fibrous paucicellular tissue containing extensive basophilic calcifications. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Rapid Streptococcus Pneumonia Antigen Detection on Postmortem Urine in a Death Due to Pneumococcal Meningitis
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. pneumoniae as the causative organism within 1 hour. This was confirmed by subsequent brain swab culture. The rapid urinary pneumococcal antigen test in the case prevented the need for contact tracing and chemoprophylaxis. This case highlights the potential use of this test to rapidly identify the culprit organism at postmortem examination when acute bacterial meningitis is detected. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Medicolegal Investigations in Cases of Double Suicidal Gunshots to the Head Using 2 Different Handguns: A Report of an Unusual Case
This article focuses on the diagnostic difficulties involved, together with analysis of the death scene and autopsy findings, in cases where the courts demand confirmation that a double gunshot to the head is in fact a case of suicide. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Two Cases of Tandem Bullets—One Homicide and One Suicide
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. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Elevated Cerebrospinal Fluid Sodium and Chloride Levels in a Saltwater Drowning Death
We report a saltwater drowning death from presumed suicide in which the postmortem CSF sodium and chloride level was elevated compared with nonimmersion deaths. This case gives evidence to support the potential use of postmortem CSF sodium and chloride level as an adjunct to the diagnosis of saltwater drowning. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Elevation of Postmortem Cerebrospinal Fluid Sodium and Chloride Levels Is a Potential Adjunct Test in the Diagnosis of Salt Water Drowning
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. It showed a significant elevation in PMCSC levels in SWD deaths for both PMCSC_V and PMCSC_L (P (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Patterns in Forensic Decapitations: A Review of the Literature and Case Report
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. This pattern holds true for all manners of death; however, in homicides, the percentage occurring a...
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Biomarkers of Cerebral Damage in Fatal Hypothermia: Preliminary Results
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 ...
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Medicolegal Investigation for Cremation Clearance: How and Why?
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. Of 11,906 deaths in 2016 without physical inspection, ther...
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Sudden Infant Death After Vaccination: Survey of Forensic Autopsy Files
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 (21.9%) had received immunization within 7 days of death. The most frequent vaccine cited as the last immunization before death was Haemophilus influenzae B. Although a temporal association of vaccines with sudde...
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Evaluation of a Novel Medicolegal Death Investigator–Based Suicide Surveillance System to the National Violent Death Reporting System
This study demonstrates the truly exceptional data quality and timeliness of MDI information over traditional sources. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

A 25-Year Review of Pediatric Suicides: Distinguishing Features and Risk Factors
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. Male pediatric suicides were more common than female, with both ha...
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Understanding Gunshot Residue Evidence and Its Role in Forensic Science
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. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Invited Review Source Type: research

“The Scalpel is Passed,” a Conversation With Dr Vincent J.M. DiMaio
Editor's Note 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, http://links.lww.com/FMP/A31. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - August 15, 2019 Category: Forensic Medicine Tags: Highlights Source Type: research

Commentary on: Sudden Death in an Adult Due to Nontraumatic Diaphragmatic Hernia
No abstract available (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Letters to the Editor Source Type: research

I Am Seen, Therefore I Am: Considerations on the Selfie Generation
No abstract available (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Letters to the Editor Source Type: research

Black Esophagus (Acute Necrotizing Esophagitis) and Wischnewsky Lesions in a Death From Diabetic Ketoacidosis: A Possible Underlying Mechanism
We report a death in a 67-year-old woman who died of DKA. At postmortem examination, the esophagus and stomach showed AEN and WLs, respectively. Although not previously reported together, both AEN and WLs have separately been described in cases of DKA. This case raises a possible unifying etiology of AEN and WLs in DKA (and probably also in hypothermic deaths and deaths related to alcohol abuse), manifested in different parts of the gastrointestinal tract. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Biochemical Differences Between Vitreous Humor and Cerebral Spinal Fluid in a Death From Diabetic Ketoacidosis
We present a case report of a 21-year-old man who died of diabetic ketoacidosis confirmed at autopsy. Ventricular system, LP, and VH were biochemically analyzed and showed that glucose was highest in VH (41 mmol/L) and was 6 and 8 mmol/L higher than CSF in the LP and VA, respectively. β-Hydroxybutyrate was also highest in VH (20 mmol/L) and was 5 and 6 mmol/L higher than LP and VA, respectively. Our findings suggest that postmortem CSF glucose and β-hydroxybutyrate may not truly reflect that of VH and vary between CSF sampling sites. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Arrhythmogenic Ventricular Cardiomyopathy Associated With Fibromuscular Dysplasia of Ostial Right Main Coronary Artery
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. The patient died...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Neonatal Death Caused by Interrupted Aortic Arch Associated With 22q11.2 Deletion Syndrome: An Autopsy Case Report
A case of clinically unsuspected fatal interrupted aortic arch (IAA) is described. A 17-day-old Japanese girl unexpectedly entered respiratory arrest at home. On autopsy, the heart was hypertrophic, with no apparent connection between the ascending and descending aortas. The ascending aorta branched into common carotid and right subclavian arteries, whereas the left subclavian artery arose from the descending aorta, which was supplied by the ductus arteriosus, indicating type B IAA. In addition, ventricular septal defect, bicuspid aortic valve, patent foramen ovale, and thymic aplasia were identified. The immediate cause o...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Neisseria meningitidis Isolated in Vitreous Humor in a 5-Month-Old Infant Death From Meningococcal Sepsis
We describe a fatal case of meningococcal sepsis in a 5-month-old infant where N. meningitidis was detected in vitreous humor, cerebrospinal fluid, and blood through PCR. The presented case report gives further evidence in the potential use of vitreous PCR analysis in suspected meningococcal sepsis, particularly in the pediatric population. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Transient Pigmentary Lines of the Newborn in a Postmortem Examination: A Case Report
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. Eastern medicinal therapies such as c...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Fatal Intestinal Obstruction in a Patient With Fetal Alcohol Syndrome
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. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Late Occurrence of Raccoon Eyes: The Role of the Ligature
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. Considering the described postponed appearance of periorbital ecchymosis, thi...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Wheelchair-Assisted Ligature Strangulation: An Unusual Suicide by a Quadriparetic
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. Here we describe a successful suicide comm...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Cervical Spine Involvement in a Challenging Case of Accidental Strangulation
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. This implies that high-energy stra...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

A Case of Bilateral Extracranial Internal Carotid Artery Dissection Due to the Helmet Strap After Motorcycle Crash
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 caus...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

An Unusual Case of Homicide by Impalement With a Battering Ram
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. This is the first case ever described in ...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Gunshot Suicide: Cherry-Red Discoloration of the Temporal Muscle Beneath the Exit Wound
The article describes a case of gunshot suicide to the head in a 51-year-old man. The entrance wound was located in the left temple and exit wound in the right temple. The entrance wound had the characteristics of a hard-contact gunshot wound. The most interesting finding in this case was cherry-red discoloration of the right temporal muscle surrounding the exit wound. This finding could make the determination of the entrance versus exit gunshot wound challenging, especially if the wounds are of atypical appearance. In addition, the finding described in the presented case could be the proof that carbon monoxide may follow ...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Fatality While Bear Hunting: A Homicide or an Accident?
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. While the man had injuries from the mauling, these injuries were, with treatment, su...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Suicide Decapitation by a Detonating Cord: A Case Report
We report the case of a man who committed suicide by detonation cord resulting in decapitation. This case report highlights the fact that the injury patterns observed in explosion-related deaths can be highly variable and that in cases with isolated injuries postmortem imaging and histology are an important adjunct to the standard death investigation. The ultimate goal of explosion-related investigations should be geared toward a well-documented and complete postmortem examination with the appropriate use of ancillary studies that provide a clear interpretation of the mechanism, cause, and manner of death. (Source: The Ame...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Rebury the “Atavistic Skull” Studied by Lombroso?
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 beha...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Historical Review Source Type: research

Body Coloration Artifacts Encountered at Medicolegal Autopsy in India
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. The body coloration mimicked antemortem changes, such as cyanosis, injury, jaun...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Historical Review Source Type: research

A Comparison of 3 Established Skeletal Age Estimation Methods in an African Group From Benin and an Italian Group From Southern Italy
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. Hand-wrist radiographs were carried out at Saint Luc Hospital i...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Depressions of Dermestes maculatus (Coleoptera: Dermestidae) on Bones Could be Pupation Chambers
Dermestes maculatus DeGeer beetles feed and can leave marks on bones. This species is of medical, veterinary, and forensic importance. The aim of this work was to determine if the depressions produced on bones by these beetles could be product of pupation. We studied under controlled conditions the behavior of D. maculatus larvae maintained at 24°C ± 3°C, 52.7% average relative humidity, and a 12:12-hour light/dark cycle and fed on pig carcasses. Observations were made, and photographs were taken. The results indicated that depressions produced by D. maculatus were consequence of feeding or pupation. This is...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Tuberculosis Surveillance in Taiwan Forensic Autopsy Cases: A Retrospective Analysis of 71 Cases From 2012 to 2017
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 (57.7%) cases were notified before death and have still seen the TB pathological changes. Regarding the death investigation, cause of death was TB accounted for 46.5%, and non-TB, 53.5% (including trauma, 26.8%; other diseas...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

A Descriptive and Geospatial Analysis of Environmental Factors Attributing to Sudden Unexpected Infant Death
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 53.4% of the infant deaths. Geographic areas where the largest n...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Penetration Depths of Conducted Electrical Weapon Probes Into Human Skull Phantoms
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 bucksk...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Correctly Identifying Deaths Due to Drug Toxicity Without a Forensic Autopsy
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. The determination of the COD an...
Source: The American Journal of Forensic Medicine and Pathology - May 14, 2019 Category: Forensic Medicine Tags: Original Articles Source Type: research

Childhood Idiopathic Pulmonary Arterial Hypertension Complicated by Esophageal Intubation: A Case Report
Childhood idiopathic pulmonary arterial hypertension (CIPAH) represents a rare disorder of childhood characterized by dyspnea, exercise limitation, and syncope. Common organ-specific pathology includes right ventricular myocardial hypertrophy. The case presented represents a classic case of CIPAH, where death was partially attributable to an unrecognized esophageal intubation, which was placed during emergency transport to an emergency department. The features of CIPAH are presented, along with a discussion related to esophageal intubation and death. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 6, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Sudden, Unexpected Death Due to Pseudo-Meigs Syndrome: A Case Report and Review of the Literature
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 apparentl...
Source: The American Journal of Forensic Medicine and Pathology - February 6, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Symmetrical Apophyses on the Posterior Margins of the Thyroid Cartilage: A Previously Undescribed Anatomical Variation With Potential Forensic Implications
In this report, we describe a laryngeal anatomical variation never described before, consisting of 2 apophyses symmetrically arising from the posterior margins of the thyroid laminae. Postmortem computed tomography performed on the laryngeal visceral block excluded previous traumatic injuries or natural pathologies of the laryngeal cartilages, confirming the congenital origin of the finding. An “omega epiglottis” and 3 laryngeal cysts in the piriform sinuses also coexisted, suggesting the possibility of underlying common developmental mechanisms. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 6, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research

Postmortem Diagnosis of Myocardial Infarction Due to Butane Gas Intoxication in a Child: A Case Report
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. In severe cases, bronchospasm, hypoxia, ventricular arrhythm...
Source: The American Journal of Forensic Medicine and Pathology - February 6, 2019 Category: Forensic Medicine Tags: Case Reports Source Type: research