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Isolated Right Atrial Rupture From Blunt Chest Trauma in Motor Vehicle Collisions: Mechanisms of Injury and Outcomes
Isolated right atrial rupture after nonpenetrating blunt chest trauma is rare, and very few cases have been reported in the literature. Isolated right atrial rupture is a diagnostic challenge in these patients, who are mostly victims of motor vehicle collisions. The clinical presentation is heterogeneous and can vary depending on rupture location and size. The anatomical sites mostly involved are the appendage and the free wall followed by the superior and inferior vena cava junctions. The present case study shows a fatal isolated rupture of the right atrial appendage in a victim of a motor vehicle collision. At the emerge...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Case Reports Source Type: research

Arrhythmogenic Right Ventricular Cardiomyopathy in a Young Athlete
We present a case of arrhythmogenic right ventricular cardiomyopathy (ARVC) resulting in sudden death in a high school athlete. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Case Reports Source Type: research

Death by Copper Ammonium Complex–Containing Fungicide
We report a case of suicide by ingestion of copper ammonium complex–containing fungicide with an elevated postmortem copper level. A 77-year-old woman was found dead at home by her relative after ingesting a fungicide containing 8% copper ammonium complex solution. Turquoise emesis was found at the scene, and on autopsy, turquoise material was found throughout the gastrointestinal tract. Postmortem central blood copper level was 500 μg/dL. Cause of death was determined to be acute copper toxicity. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Case Reports Source Type: research

Fatal 4-MEC Intoxication: Case Report and Review of Literature
We report a case of a 35-year-old man found dead and naked at home by his friend. Although no anatomic cause of death was observed at autopsy, toxicological analysis identified 4-MEC and hydroxyzine at therapeutic level (160 ng/mL). 4-Methylethcathinone was quantified in autopsy samples by a validated method consisting in liquid-liquid extraction and gas chromatography coupled to tandem mass spectrometry: peripheral blood, 14.6 μg/mL; cardiac blood, 43.4 μg/mL; urine, 619 μg/mL; vitreous humor, right 2.9 μg/mL and left 4.4 μg/mL; bile, 43.5 μg/mL; and gastric content, 28.2 μg/mL. The cause of death was 4-MEC intoxic...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Case Reports Source Type: research

Fatal Fluorosilicic Acid Exposure After a Motor Vehicle Crash: A Case Report
Fluorosilicic acid (FSA) is a corrosive liquid used in manufacturing and other processes. High-level exposures to FSA cause fluoride toxicity resulting in profound hypocalcemia, potentially leading to sudden death. Prompt recognition of exposure risk allows appropriate environmental management precautions, reducing the risk of further casualties. Herein, we present a case report of death due to FSA exposure sustained during a motor vehicle crash involving a truck transporting the material and the management thereof. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Case Reports Source Type: research

Critical Analysis of Laboratory Testing Methodologies When Interpreting Conflicting Results at Autopsy
Toxicological analysis is an important diagnostic component of a postmortem examination and may involve both antemortem and postmortem specimens. Here, we present a case in which an antemortem specimen, when reanalyzed in the forensic toxicology laboratory, resulted in values that contradicted the reported values from the medical record and required further investigation. This case involves a 51-year-old man decedent with a medical history of chronic alcohol abuse. His antemortem urine drug screen, performed upon admission to an emergency department, was negative. His serum blood alcohol level at presentation was reported ...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Case Reports Source Type: research

Camel-Related Deaths—A Forensic Overview
Camels are ungulates of the genus Camelus and have been used for centuries in parts of Asia and Africa for transport and sustenance. Handling of camels is not without its dangers, and 4 cases from South Australia are reported with a review of lethal camel-related issues. Case 1 is a 56-year-old man who died of multiple blunt force injuries after he had attempted to move a 7-year-old female dromedary (Camelus dromedarius). Case 2 is a 65-year-old woman who was crushed by 1 or more camels that she had been training. Case 3 is a 1-year-old girl who died of blunt craniocerebral trauma after the car in which she was traveling r...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Review Article Source Type: research

Comparison of Frontal Sinuses for Personal Identification in 3 Populations Using Cameriere’s Code Number
The identification of unknown individuals is of crucial importance to society, especially in the context of mass disasters involving individuals of different nationalities. The comparison of frontal sinus patterns is an important tool for personal identification. In Cameriere’s method, a new personal code number (codC) containing 8 digits was elaborated, based on the measurements of frontal sinus patterns. The present study is an update of this previous work. Digital radiographic images of the skulls of 299 individuals of different nationalities (100 Italians, 99 Kosovars, and 100 Turks) were analyzed, adopting the same ...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Original Articles Source Type: research

Evaluation of the Ossification Stage of Proximal Humeral Epiphysis by 1.5-T Magnetic Resonance Imaging for Determination of Skeletal Age
Purpose The aim of the study was to investigate whether the skeletal age can be evaluated assessed by means of analysis of ossification stage at proximal humeral epiphysis using magnetic resonance imaging (MRI). Methods This retrospective study was carried out in the radiology department of a tertiary healthcare center and 1.5-T MRI views of the shoulder obtained from 203 patients aged 8 to 29 years were evaluated. The ossification stage of proximal humeral epiphysis was evaluated on T1-weighted MRI sequences, and its correlation with age was sought. Results Our series consisted of 77 women (37.9%) and 12...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Original Articles Source Type: research

Skull Fracture Patterns and Morphologies Among Fatal Motorcycle Traffic Accident Victims in Vietnam
We aim to describe morphological structures of skull fractures and relevant factors in motorcycle accident victims in Vietnam. This work represents a retrospective cross-sectional study based on forensic reports of fatal motorcycle accident victims. Between January 2013 and August 2019, a total of 226 fatal motorcycle accident patients with skull fracture diagnoses were enrolled. Linear and depressed fractures were the common patterns (46.0% and 37.2% of cases, respectively), whereas stellate (11.5%) fractures were rare. Fractures of the temporal bone (68.6% of cases) and basilar skull (60.6%) were the most common, whereas...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Original Articles Source Type: research

Pattern of Suicide Methods and Postmortem Toxicological Findings in Suicide-Related Deaths: A Retrospective 7-Year Forensic-Based Study in Iran
In this study, we evaluated postmortem toxicological finding among forensic autopsies on suicidal deaths from 2010 to 2016 at the Legal Medicine Center of Zanjan Province (northwest of Iran). All suicide fatal cases were investigated to define the cause and manner of death. Toxicological analyses were performed using thin-layer chromatography, high-performance liquid chromatography, gas chromatography/mass spectrometry, headspace gas chromatography, and gas chromatography equipped with nitrogen phosphorus detector. Demographic data (age, sex, educational level, residential location, and marital status), cause of death, and...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Original Articles Source Type: research

Histopathological Differentiation of Antemortem and Postmortem Electrical Burn Mark Produced by Low Voltage
The study was undertaken to differentiate antemortem electrical (AME) and postmortem electrical (PME) burn marks with the help of histopathology. The electrical burn mark was produced on 25 dead bodies. Alongside 25 cases of electrocution deaths were included for comparison. Slides were prepared and stained with hematoxylin-eosin stains. Intraepidermal and subepidermal separation; coagulative necrosis of the epidermis; nuclear elongation and hyperchromasia of epidermal cells; homogenization of the dermis; nuclear elongation and hyperchromasia of hair follicles, sweat glands, sebaceous glands, and blood vessel endothelium w...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Original Articles Source Type: research

Fetal Autopsy—Categories and Causes of Death at a Tertiary Care Center
Conclusions Fetal autopsy is a valuable and cost-effective modality for the confirmation of cause of fetal death. Fetal autopsy can also prove beneficial to the parents in planning for future pregnancies. Fetal autopsy can serve as the ultimate tool in diagnosing cause of fetal death in cases where no other diagnostic clue is available. Therefore, it should be encouraged and couples to be counseled regarding its importance and clinical utility. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Original Articles Source Type: research

Xylazine, a Veterinary Tranquilizer, Detected in 42 Accidental Fentanyl Intoxication Deaths
We report the detection of xylazine in 42 deaths in Connecticut from March to August 2019. Xylazine combined with an opioid or stimulant may affect the toxicity of these drugs. Detection of xylazine may help the forensic pathologist distinguish illicit from prescribed fentanyl, and law enforcement agents track the illicit drugs to a specific drug supplier. Because of its lack of response to naloxone, emergency medicine physicians need to be aware of its potential presence as it may affect therapy. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Original Articles Source Type: research

New Mexico’s COVID-19 Experience
The 2019 novel coronavirus disease (COVID-19) has spread worldwide, infiltrating, infecting, and devastating communities in all locations of varying demographics. An overwhelming majority of published literature on the pathologic findings associated with COVID-19 is either from living clinical cohorts or from autopsy findings of those who died in a medical care setting, which can confound pure disease pathology. A relatively low initial infection rate paired with a high biosafety level enabled the New Mexico Office of the Medical Investigator to conduct full autopsy examinations on suspected COVID-19–related deaths. Full...
Source: The American Journal of Forensic Medicine and Pathology - February 10, 2021 Category: Forensic Medicine Tags: Original Articles Source Type: research