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Forensic Pathologists and Clinical Trauma Reviews: Performance Improvement, Public Health, and a Concise Autopsy Documentation Guide. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-09-16 Deland Weyrauch,Jacqueline Nunez,Christopher C Borck,Jonathan Gates,Monika Nelson,Tyler J Jones,Lisa Henneberry,James R Gill
As a powerful tool for discovering and documenting injury, the forensic autopsy has been incorporated into trauma care quality improvement. Autopsy findings are used to determine the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) to assess a patient's trauma severity. Clinical trauma services use autopsy reports to educate, improve patient care, and strengthen the information used in
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Conduction System Hamartoma: Autopsy Case Series. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-09-03 Beyza Keskin Ozturk,Eylul Gun
Conduction system hamartoma is a benign hamartomatous lesion arising from Purkinje and Purkinje-like cells of the heart. We aimed to investigate the cases that we detected during postmortem histopathological examination. The histopathology reports of the cases autopsied between 2012 and 2022 were reviewed retrospectively. The cases were evaluated in terms of histopathological features, demographic
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TASER 7 and TASER 10 Probe Penetration Into Human Skull Simulants. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-09-03 Natalia Khmara,Silvan Gort,Beat Kaelin,Michael J Thali,Stephan A Bolliger
The older generation TASER probes X26 and X2 have been shown to be capable of piercing the skull with their tips. With the introduction of the new TASER 7 and the far more powerful TASER 10, concerns have arisen as to whether these weapons might penetrate the skull more deeply and thus prove to be potentially lethal. For this reason, we tested the penetration capacity of these weapons on polyureth
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Fatal Moans and Bones in Crohn's: A Case of Heterotopic Mesenteric Ossification. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-08-26 Joyce Opara,Heather Jarrell,Nicole R Jackson
Heterotopic mesenteric ossification (HMO) represents a rare reactive condition characterized by abnormal bone formation within the mesentery. HMO's etiology remains enigmatic, with proposed triggers including trauma-induced metaplasia or bone fragment dislodgment from other sites during abdominal surgery. With fewer than 100 documented cases in the literature, much about this condition remains unknown
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Circumstances and Pathological Findings in Civilian Helicopter-Related Fatalities. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-08-20 Marianne Tiemensma,Salona Prahladh,Roger W Byard
Helicopters are used worldwide in a range of commercial and private industries and are particularly useful in northern Australia due to the sparse population scattered over large distances with remote regions difficult to access by any other means of transport. Nine civilian helicopter-related fatalities were reported to the Northern Territory coroner between January 2004 and December 2023. The victims
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Firearm Fatalities in the Pediatric Population: A Retrospective Study From the Cook County Medical Examiner's Office. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-08-12 Alexandra Cina, Ilaria Tarozzi, Ponni Arunkumar, Lorenzo Gitto
Gunshot injuries are one of the leading causes of death from trauma in the United States. In recent years, the US has experienced an increasing number of fatal pediatric cases related to firearms.A search of the database of the Cook County Medical Examiner's Office over the period January 2016-December 2021 revealed 418 deaths by gunshot wounds (GSWs) among people aged between 0 and 18 years old. Subjects
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Ruptured Aortic Valve Aneurysm Caused by Infective Endocarditis in a SARS-CoV-2-Positive Autopsy Case. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-08-12 Shojiro Takasu, Sari Matsumoto, Yuko Kanto, Kimiharu Iwadate
Aortic valve aneurysm, an extremely rare complication secondary to infective endocarditis (IE), may cause heart failure due to rupture of the aneurysm. Coronavirus disease 2019 (COVID-19) has been reported to cause cardiovascular complications and alter susceptibility to secondary infections such as IE. Herein, we report a case of IE with a fatal outcome caused by rupture of an aortic valve aneurysm
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The Mechanism of Death in Electrocution: A Historical Review of the Literature. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-08-02 Mark W Kroll, Richard M Luceri, Igor R Efimov, Hugh Calkins
Our present understanding of electrocution followed a long path of detours and speculation. It is now hard to appreciate how mysterious was an unexpected sudden death-without visible trauma-and we should be sympathetic to the surprising theories that came from well-intentioned attempts to find something in the autopsy of an electrocution victim.The early hypotheses (1880s) tended to favor effects on
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Suicide by Ethyl Methacrylate Ingestion. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-08-02 Samuel P Prahlow, Taylor Wilson, Amy C Gruszecki
This case report characterizes a unique way in which suicide was accomplished through ingestion of chemicals typically used to create acrylic fingernails that resulted in death. Ethyl methacrylate and acrylic powder are commonly combined to form acrylic nails in nail salons. The process of applying acrylic nails utilizes each substance by mixing both before it typically solidifies within seconds of
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Drug Trends in the Teenage Postmortem Population From 2017 to 2021. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-07-22 Jennifer L Swatek, Brianna L Peterson
The teenage population is highly vulnerable to drug exposure, use, and misuse due to the physical and emotional development that occurs at those ages. Social influences, like the isolation experienced during the COVID-19 pandemic and social media, can exacerbate this vulnerability. To better understand the potential impact of these influences on teenage drug use, postmortem results reported by a large
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Sudden Death Due to Necrotizing Fasciitis After Routine Cervical Radiofrequency Ablation Treatment. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-07-18 Ravi Trivedi, Joyce L deJong, Patrick A Hansma
Cervical facet joint neurotomy, also known as cervical radiofrequency ablation (RFA) or cervical facet rhizotomy, is a medical procedure aimed at alleviating chronic neck pain caused by issues related to the cervical facet joints through ablation of neurons (J Pain Res 2021;14:2807-2831). Although generally safe, adverse events can occur. Infection is a rare consequence of this procedure. Most injection-site
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Caseous Calcification of the Mitral Annulus: Calcified Toothpaste of the Heart. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-07-18 Kyla M Jorgenson, Phillip D McMullen, Bruce I Goldman, Marisa Jacob-Leonce
Caseous calcification of the mitral annulus (CCMA) is a rare variant of mitral annular calcification (MAC) usually described as an antemortem finding. We report a case of sudden cardiac arrest in a 39-year-old male with end-stage renal disease undergoing hemodialysis with a history of Fabry disease by kidney biopsy. Autopsy revealed significant circumferential annular calcification in both mitral and
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Radiological Imaging in Forensic Pathology: Exploring Nonlinear Bullet Trajectories. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-07-16 Joshua Wilberg,Suzanna Del Rio,Alyssa Tamburo,John C Walsh,H Theodore Harcke
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Catastrophic CPR-Related Injuries in Vascular Ehlers-Danlos Syndrome: A Case Report and Review. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-07-16 Jesse L Fitzgerald, Breanne N Vergonet, Wendy S Warren, Andrew J Rohrer
This article presents a case of severe CPR-related injuries leading to diagnosis of vascular Ehlers-Danlos syndrome. The subject is a 36-year-old female with a past medical history of a 10-mm aneurysm of the right internal carotid artery discovered on imaging 3 years prior to death. Major autopsy findings included subarachnoid hemorrhage in the base of the brain, bilateral hemothoraces, hemopericardium
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Virchow's Second Protocol; a 21st-Century Review. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-07-16 Patrick Hansma
Rudolf Virchow published several autopsy protocols in his 1876 book on postmortem examinations. The protocols demonstrate the application of the 1875 Regulations to medicolegal practice. The book went through several editions and translations throughout the remainder of the 19th century, but the second autopsy protocol was subject to scathing criticism in 1915. This article summarizes the protocol
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Association Between Cardiovascular Disease and Death by Anaphylaxis: A 20-Year Retrospective Study in Queensland, Australia. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-07-16 Jack Garland, Peter Smith, Rexson Tse, Beng Ong, Nathan Milne
Despite its severity, anaphylaxis carries a low mortality rate of less than 1%, making the cohort seen in the forensic pathology setting a small and unique subset of the majority of cases of anaphylaxis in the community. Clinically, cardiovascular disease has been recognized as a risk factor for fatal anaphylaxis; however, there is scant forensic pathology research investigating this risk factor, whereas
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Experimental Tests on External and Terminal Ballistics of Different Types of Projectiles Fired From .38 SPL Caliber Cartridges and Study of Permanent Cavitation in Anatomical Modeling With 10% Ballistic Gelatin. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-07-16 Lucas Meciano Pereira Dos Santos, João Paulo Mardegan Issa
The present study investigated the main morphological differences between the permanent cavities formed by 4 different types of projectiles fired from .38 SPL caliber cartridges in blocks of 10% ballistic gelatin with standardized formulation (Federal Bureau of Investigation Protocol), all fired from the same distance and from the same firearm, associated with its performances in external and terminal
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Suicide by an Electric Power Drill and Spade Drill Bit: An Unusual Mechanism of Death. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-07-16 Trevor Watkins, Nathan Milne, Beng Beng Ong
Self-inflicted penetrating brain injuries with drills have been reported but are uncommon and typically involve the use of conventional drill bits. We report an unusual case of a 56-year-old man with a history of psychiatric illness who completed suicide using an electric drill and spade-type drill bit. Multiple superficial scalp and deeper bony injuries were sustained, although without breach of the
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MDMB-4en-PINACA-Related Deaths in Cook County Jail: Awareness and Preventive Measures. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-06-28 Lorenzo Gitto, Tracy Wadsworth, Daniel Isenschmid, Alex J Krotulski, Barry K Logan, Ilaria Tarozzi, Ponni Arunkumar
Since January 2023, a series of fatalities has occurred in the Cook County Jail. Upon reviewing surveillance videos, in some cases, the inmates shared paper strips, and it was followed by the onset of labored breathing and loss of consciousness. Scene investigation revealed burnt paper strips near the body in 3 cases. No trauma was observed during autopsy. The expanded toxicology panels did not detect
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A Pediatric Case of Dilated Cardiomyopathy Due to NKX2-5 Mutation: Autopsy and Postmortem Molecular Diagnosis. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-06-25 María Eugenia Zuluaga,Brittany DePasquale,Ana Isabel Sanchez-Barbero,Natalie Adolphi,Daniel F Gallego
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Amniotic Fluid Embolism: An Illustrated Report and Review of Literature. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-06-12 Nicolas Kostelecky,Margarita Loxas,Rachel Multz,Margaret E Flanagan,Jared T Ahrendsen,Jeffery Goldstein
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How (Cautious) Social Media Use May Improve Education and Pipeline Efforts of a Growing Postpandemic Forensic Pathologist Workforce Shortage. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-06-12 Casey P Schukow, Carley Holmes, Meagan Chambers, Omar Rayes, Nicole R Jackson, Amy H Deeken, Leigh A Hlavaty
Many subspecialties of pathology have initiated novel methods and strategies to connect with medical students and residents, stimulate interest, and offer mentorship. Emerging concern about the future of forensic pathology has been highlighted in contemporary literature as recruitment of new fellows has stagnated and workforce shortage concerns have blossomed. Amidst these challenges, the potential
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A 3-Year Retrospective Review of Complex Suicides With a Review of the Literature. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-06-12 Alexandra Paredes Rivera, Awa Sarr Dramé, Laura D Knight
Complex suicide is defined as death by the intentional use of more than 1 method to end one's life. Complex suicides can fit into the planned or premeditated category, where 2 or more methods are used simultaneously or in close succession, or unplanned, the use of 2 or more methods, in which the first method attempted fails (often because it is too unpleasant or painful), and another method is employed
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Is That Innocent to Touch the Adipose Tissue?: An Autopsy Case Series of Fat Embolism Syndrome. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-06-12 Aytül Buğra, Taner Daş, Eylül Gün, Ferah Karayel
Although fat embolism in the pulmonary or systemic circulation is usually associated with long bone fractures, it can also occur less frequently during surgical operations, such as liposuction, fat grafting, and joint repair. This study aims to present cases of macro fat embolism resulting in sudden death during the perioperative period. Three cases with a history of sudden death during the perioperative
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Three Deaths Associated With Facial and Upper Airway Burns Related to Oxygen Use. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-06-12 Cassidy A Hinton, Joseph A Prahlow, Brandy Shattuck, Anna Tart
Despite the implementation of numerous strategies to prevent unintentional burns, fire-related thermal injuries remain a significant source of morbidity and mortality. Unfortunately, fires that occur in the setting of medical oxygen do so despite many safeguards and warnings that accompany oxygen therapy. Oxygen-related accidental fires can occur both within the home and medical settings, and burns
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Tolerant or Intolerant? Learning From Studying Drug Concentrations in the Living and the Dead. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-06-12 Laura M Labay, Sherri L Kacinko, Brittany K Casey, Justin O Brower
Tolerance is the diminished response to a drug that occurs when that drug is repeatedly used, and the body adapts to its continued presence. This means that greater blood concentrations are required to achieve desired effects, produce impairment, or cause death. Without case-specific information, the pharmacodynamic impacts of a drug on an individual are difficult to ascertain based on its concentration
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Lehigh Defense Xtreme Defense Penetrator Ammunition. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-06-01 Garrett Phillips
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Letter to the Editor: Self-Manipulation Inaccurately Associated With the Chiropractic Profession. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Kevin W Meyer,Robert J Trager,Clinton J Daniels,Zachary A Cupler
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Cardiac Myxoma With Postmortem Computed Tomography and Postmortem Examination Correlation. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Yan Bo Dora Chan,Rexson Tse,Melissa Thompson
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Federal Ammunition: Syntech Total Synthetic Jacket. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Garrett Phillips
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The Forensic Perspective of Infectious Endocarditis: A Retrospective Study With Recommendations for the Future. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Alison Krywanczyk, Thomas Gilson
Increasing rates of infectious endocarditis (IE) are well-described in the United States and worldwide, yet forensic literature regarding IE is sparse. Autopsy databases may help identify subsets of patients at increased risk of mortality. We reviewed all deaths due to IE in our office between 2010 and 2022 (with full autopsy performed) and found 29. The average age was 44 years. Manners of death included
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The Effect of the COVID-19 Pandemic on Suicide Trends in Pretoria, South Africa. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Kay-Leigh Robinson, Candice Pretorius, Ryan Blumenthal, Pieter Meyer
Suicide is one of the worldwide leading causes of unnatural death. Pretoria is a capital city of South Africa and is the fourth most populated city in South Africa. Between 16 and 22 suicide cases are recorded daily in South Africa.Case files from the Pretoria Medico-Legal Laboratory were reviewed between 1 January 2015 to 31 December 2021, which spanned the COVID-19 pandemic. All cases of possible
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Perforation of the Heart During Elective Removal of an Inferior Vena Cava Filter. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Sapna P Desai, Christine Z Yu, Frank Evangelista, James R Gill
A common treatment for venous thromboembolic disease in patients with contraindications to anticoagulation includes placement of an inferior vena cava (IVC) filter. Temporary filters are available to avoid the risk of long-term permanent placement. A woman in her 60s with a history of uterine serous carcinoma presented to the emergency department with cardiac arrest following elective attempted IVC
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Gender Identity in Forensic Death Investigation: A Narrative Review and Suggested Guidelines for Documenting and Reporting. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Juniper Fedor, Alison Krywanczyk, Anthony Redgrave
In the current body of forensic literature, there is little guidance available regarding death investigations of transgender, intersex, and gender diverse individuals. An increase in the prevalence of gender diverse identifying people and the frequency in which these individuals experience a premature death makes it more likely these deaths will fall under the jurisdiction of the medical examiner's
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A Possible Mechanism of Laryngohyoid Fractures in Hanging: A Preliminary Observation. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Matt Meredith, Peter Harris, Christopher Day, Nathan Milne, Trevor Watkins, Beng Beng Ong
Fractures of the hyoid bone, particularly the greater horns, and thyroid cartilage (superior horns) are known to be associated with hanging deaths. Depending on the literature, the frequency of these fractures varies from 0% to 83%. The mechanism underlying these fractures is believed to be direct compression or indirect traction from the ligature. The relationship of these structures with the cervical
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When Vaping Isn't Actually Safer: A Death From Toxic Alcohol Contaminated Vape Juice. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Timothy Ogburn, Irfan Chaudhry, Laura D Knight
Vape juice is a diluent for e-cigarette active ingredients, nicotine or tetrahydrocannabinol (THC). Lack of strict regulation in vape juice production is a concern as ingredients and their concentrations may vary widely from the labeling.A 43-year-old woman was transported via ambulance to the hospital after ingesting homemade vape juice, presenting unresponsive with decerebrate posturing. She reportedly
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Fentanyl Deaths in Infants and Children: A Case Series and Literature Review. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-23 Katrina Monday, Brandy Shattuck, Kristie Barba, Carolyn H Revercomb
Death due to fentanyl and its various analogs has resulted in an exponential rise in deaths throughout the United States, overwhelming many medical examiner offices for over a decade. Its potency and prevalence have caused fentanyl to become the most reported substance in overdose fatalities, with an accompanying increase in exposure of the most vulnerable, infants and children. This report provides
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A Narrative Review on the Clinical Relevance of Imaging the Circumventricular Brain Organs and Performing Their Anatomical and Histopathological Examination in Acute and Postacute COVID-19. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-5-13 Agustin Castañeyra-Perdomo, Jose Luis Gonzalez-Mora, Emilia Maria Carmona-Calero, Nikos Makris, Jose Luis Carrasco-Juan
Autopsy followed by histopathological examination is foundational in clinical and forensic medicine for discovering and understanding pathological changes in disease, their underlying processes, and cause of death. Imaging technology has become increasingly important for advancing clinical research and practice, given its noninvasive, in vivo and ex vivo applicability. Medical and forensic autopsy
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Case Series: Hepatic and Splenic Titanium Dioxide Deposition in Association With Intravenous Drug Use. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-02 Griffin C Phenegar,Jamie E Kallan,Robert F Corliss
Titanium dioxide is a versatile compound that is found in a variety of consumer products, medical hardware, and pharmaceuticals. Although oral and topical ingestion of this compound is common, intravenous introduction is much less common. We present three cases where significant titanium dioxide deposits were identified in liver and splenic tissue of three decedents, all of whom died of illicit drug
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Method Validation Study of Dipstick Urinalysis as a Screening Tool for Sodium Nitrite Toxicity. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-05-02 Jessicia S Schmitt,Laura D Knight
The incidence of suicide by intentional nitrite ingestion has increased since 2017. Limited options exist for commercial laboratory analysis for nitrite/nitrate. This study investigates the use of urine dipsticks for screening at autopsy for potential toxicity with sodium nitrite and, less commonly, alkyl nitrite. Archived samples of blood, urine, vitreous fluid, and gastric contents from 4 sodium
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Pulmonary Thromboemboli Due to Leiomyoma. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-03-27 Julita Gongolli, Anna Vanderschaegen, Shannon Renfrow, Kimberly D Collins, Joseph A Prahlow
Uterine leiomyomas are the most common pelvic tumor in women and the most frequent indication for hysterectomy. Although benign lesions, leiomyomas can cause dysfunctional uterine bleeding, pelvic pain or discomfort, infertility, and spontaneous abortion. Despite the fact that uterine leiomyomas can result in a significant amount of morbidity, it is relatively rare for these common tumors to lead to
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Fatal Vertebral Artery Dissection Following Self-Manipulation of the Cervical Spine. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-03-18 Jane E Persons, Stephanie Stauffer
Cervical spine manipulation is a known risk factor for vertebral artery dissection. In this report, we present a case of fatal vertebral artery dissection that occurred as the result of self-manipulation of the cervical spine. The decedent was a 40-year-old man with no significant past medical history. He was observed to "crack his neck" while at work. Soon after, he began experiencing neck pain, then
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False-Positive Rate for Suspected Drug-Related Deaths Following Full Autopsy. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-03-18 Addie Hancock, Jerri McLemore, Greg Russell
The sharp increase in drug-related deaths has tempted medical examiner/coroner offices to perform external examinations with comprehensive toxicology testing instead of performing a standard autopsy. Compounding the problem of an increasing workload has been the decrease in available forensic pathologists. Opting for external examinations on suspected drug-related fatalities, however, is antithetical
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Brain Autopsy Findings in a Patient Who Received Lipid Emulsion Therapy for Suspected Drug Intoxication. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-03-18 Hannah Cutshall, Murat Gokden
Lipid emulsion therapy (LET) is the intravenous administration of lipid solution for parenteral alimentation, especially in preterm infants and adults with debilitating illnesses. It has also been used in attempts of detoxification in suspected cases of drug overdose. Whether this interferes with circulation and/or perfusion is debatable, and it is suggested that it may interfere with coagulation process
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Fatal Iron Tablet Aspiration: Importance of Early Diagnosis and Forensic Pathologist Awareness. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-03-13 Yvonne Hojberg, Mahmuod Abdeljaber, Yvonne Milewski, Joyce deJong, Joseph A Prahlow
Pill aspiration is a significant source of foreign body aspiration in the United States and can occur without swallowing dysfunction or illness. Consequences depend on various factors, such as the pill's chemical composition, size, and diagnostic delay. Aspiration of iron tablets poses a higher risk because of hydroxyl radical formation and subsequent caustic burns, inflammation, obstruction, and/or
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Suicide by Gunshot Wound to the Posterior Head and Neck: A Retrospective Case Series and Review of the Literature. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-03-07 Nicholas R Bovio, Jared K Brooks, Joseph A Prahlow
Suicide by firearm is a significant public health concern in specific regions of the world. Depending on firearm availability, any type of firearm may be used, including handguns, shotguns, and long rifles. Common entrance wound sites in suicidal gunshot wounds include the head, with classic gunshot wound locations including the temple, the forehead, the submental aspect of the chin, and inside the
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Metallization and High Voltage Burn in Lightning. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-03-05 Abhishek Das,Shouvanik Adhya
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Extremity Injuries in Pillion Riders of Fatal 2-Wheeler Road Traffic Accidents: An Autopsy-Based Study. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-03-05 Sathish Ayyappan, Sanjay Sukumar, Vinod Ashok Chaudhari
The extremities are the important anatomical regions that are disproportionately injured during road traffic accidents in poor and medium-income countries. The data regarding extremity injuries, particularly in pillion passengers, are minimal globally. We analyzed the pattern of extremity injuries and their association with various parameters such as collision type, seating position, road type, and
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The Role of Fingernails in Death Investigation. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-03-05 Ashesh Gunwantrao Wankhede
In forensic pathology, forensic onychology studies fingernails and toenails for medicolegal purposes. It mainly deals with DNA profiling from nails, toxicological analysis for detecting poisons, and the collection of trace evidence present under the nails. Injuries to fingernails and their interpretation for medicolegal purposes are the neglected areas of this study. We have discussed the most common
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Femicide in the United States: A Study of Connecticut Autopsy and Death Investigation Data. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-02-27 Abigail L Alexander, James R Gill
We examined the records of the Connecticut Office of the Chief Medical Examiner for all female homicides from 2012 to 2021 to ascertain the rate of femicide. The investigative data were subcategorized as femicides and nonfemicides. The records included autopsy, toxicology, and investigators' reports. All underwent autopsy examination. The relationship of the perpetrator, cause of death, and special
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An Autopsy Case of Saphenous Vein Graft Rupture. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-02-27 Thomas Auen, Erin Linde
Saphenous vein graft aneurysms are rare complications after coronary artery bypass grafting that carry serious complications. Less than 10 case reports of autopsy findings consistent with ruptured saphenous vein grafts exist in the literature. We report a case of a female presenting at autopsy who, after coronary artery bypass grafting 20 years prior, demonstrated findings of a saphenous vein graft
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Accidental Gunshot Wound Fatalities Related to Dropped Firearms. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-02-27 Margaret M Smith, Joyce L deJong, Joseph A Prahlow
A death resulting from the accidental discharge of a firearm represents a rare but oftentimes preventable tragedy. Such deaths may occur in a variety of settings. One such setting involves the discharge of a loaded firearm, which occurs when it is accidentally dropped, thrown, or falls to the ground. We report on 3 cases in which a loaded firearm discharged when it was dropped, resulting in the deaths
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Homicide Manner-of-Death Classification in Arrest-Related Death. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-02-27 Mark W Kroll, Dwayne A Wolf, J Celia Cobb, Tasha Z Greenberg, Sebastian N Kunz, James E Brewer, Howard E Williams
Multiple studies have documented various factors that influence or determine forensic pathologist classification of manner of death. There do not appear to be any published studies on manner of death classification specifically regarding arrest-related deaths (ARDs). The goal of this study was to consider a large body of cases of nonfirearm ARDs to analyze the homicide classification with regards to
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Pilot Application of SEM/EDX Analysis on Suspected Cigarette Burns in a Forensic Autopsy Case of Child Abuse. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-02-27 Stefano Tambuzzi, Guendalina Gentile, Riccardo Primavera, Enrico Muccino, Riccardo Zoja
Cigarette burn lesions present forensic scenarios that are often difficult to investigate, both from a morphological diagnostic point of view and with regard to the mode of infliction, especially if the victim is unable to speak or has died. Although there may be the suspicion for a lesion to be produced by a lit cigarette, to date one can only rely on the morphological aspects that characterize it
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Sudden Death Due to Rupture of Aneurysm of Sinus Valsalva: An Autopsy Case. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-02-07 Merve Temel Dağ, Aytül Buğra, Abdul Kerim Buğra
Aneurysm of sinus Valsalva is a defined as dilatation of the sinuses located between the aortic valve annulus and the sinotubular junction and mostly found in the right coronary sinus. It can be either congenital or acquired. This condition is usually asymptomatic unless it can cause intracardiac rupture or aortic valve insufficiency. Extracardiac rupture and associated fatal cases of cardiac tamponade
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Two Bullet Wounds, One Bullet: The Atypical Fragmentation of a .223 Caliber Ammunition. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-2-2 Addie Hancock, Mark Giffen
As the fifth leading cause of death in individuals aged 1 to 64 years in the United States, forensic pathologists frequently encounter firearm-related deaths and are trained to approach these cases by utilizing information from the investigation, radiographs, and autopsy findings to discern the logical sequence of events that lead to death. We also emphasize the importance and utility of various factors
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Self-Chiropractic Cervical Spinal Manipulation Resulting in Fatal Vertebral Artery Dissection: A Case Report and Review of the Literature. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-02-01 Cameron Fink, Clare H Bryce, Laura D Knight
Chiropractic cervical spinal manipulations have several complications and can result in vascular injury, including traumatic dissection of the vertebral arteries. A 43-year-old woman was admitted to the emergency department after performing a self-chiropractic spinal manipulation. She experienced headache and vomiting and was unresponsive with severe hypertension at the time of hospital admission.
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A Comparative Investigation of Equine-Related and Bovine-Related Human Fatalities in Oklahoma. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-02-01 Kaylan Peterson, Wayne Lord, Ross Miller, Mark McCoy, Timothy Dwyer, Amber Fortney, Sean Laverty
This study examined 71 cases, where 45 cases were equine-related and 26 were bovine-related. Data for this study were collected by examining cases between 2000 and 2022 from the Oklahoma Office of the Chief Medical Examiner database.A majority of the equine-related fatality cases involved males aged 0 to 18 and 60 to 69 years, with sustained injuries of the head, neck, and thoracic regions while being
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Forensic Analysis of the Abraham Lincoln Assassination: An On-Site Study of the Presidential Box at Ford's Theatre. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-01-25 Theodore N Pappas, Sven Swanson, Michael M Baden
On April 14, 1865, Abraham Lincoln was assassinated while watching a play from the Presidential Box at Ford's Theatre in Washington, DC. There is still controversy concerning the findings of Lincoln's autopsy. The physicians that attended the autopsy documented that the bullet entered the left occipital region of the brain, but opinions differ as to the path the bullet took through the brain. The official
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A Series of 8 Illicit Fentanyl Intoxication Deaths in Infants and Toddlers. Am. J. Forensic Med. Pathol. (IF 1.0) Pub Date : 2024-01-25 Gregory A Vincent, Jacqueline Nunez, James R Gill
We report 8 children younger than 2 years who died from acute illicit fentanyl intoxications in Connecticut between 2020 and 2022.The Connecticut Office of the Chief Medical Examiner (CT OCME) investigates all unexpected, violent, and suspicious deaths in Connecticut. The CT OCME's electronic database was searched for fentanyl deaths by age. All underwent autopsies and toxicology testing.The ages ranged