Academic Forensic Pathology最新文献

{"title":"Reducing Errors in Hospital Death Certification: A Two-Step Proposal for Medicolegal Triage and Cause-of-Death Accuracy.","authors":"Emarson L Sison, Jomar L Aban","doi":"10.1177/19253621261448613","DOIUrl":"https://doi.org/10.1177/19253621261448613","url":null,"abstract":"","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621261448613"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Death Related to Fistulas Involving the Gastrointestinal and Cardiovascular Systems.","authors":"Allan J Medwick, Joseph A Prahlow","doi":"10.1177/19253621261448610","DOIUrl":"https://doi.org/10.1177/19253621261448610","url":null,"abstract":"<p><p>Gastrointestinal tract fistulas are relatively uncommon and can be congenital or acquired. Acquired fistulas which communicate with the cardiovascular system are of particular concern, as they may be associated with significant morbidity and mortality. When found at autopsy, gastrointestinal fistulas should be thoroughly documented. Sudden and unexpected deaths with a history of gastrointestinal or cardiovascular surgery and a recent history of gastrointestinal bleeding or fever of an undetermined etiology should be approached with a high index of suspicion by medical examiners and signal a need for more careful dissection and documentation. This study reports on three deaths related to acquired, postsurgical fistula formation involving the gastrointestinal and cardiovascular systems.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621261448610"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of the COVID-19 Pandemic on Sexual Violence Against Girl Children: A Study on Victims Presented for Medico-Legal Examination at two major Hospitals in the Western Province of Sri Lanka.","authors":"Lasantha De Silva, Indira Kitulwatte, Jishal Avishka Gnanarathna","doi":"10.1177/19253621261441351","DOIUrl":"https://doi.org/10.1177/19253621261441351","url":null,"abstract":"<p><strong>Introduction: </strong>The lockdown resulting from the COVID-19 pandemic caused many negative impacts on the lives of people, especially children. Among such negative consequences, sexual violence (SV) is commonly reported globally.</p><p><strong>Materials and methods: </strong>A comparative retrospective, descriptive study on girl child victims of SV, who presented to two major hospitals in Sri Lanka during the period of lockdown and immediately before, was conducted.</p><p><strong>Results: </strong>Among the total of 260 victims, there were 120 pre-lockdown and 140 during the lockdown. Even though the perpetrator was the romantic partner in the majority of cases during both periods, a significant number of relatives were involved as perpetrators during the lockdown (p = 0.001). There was a significant difference in crime location, with a higher incidence at the victim's residence during lockdown. In contrast, places other than the residence were commonly used before the lockdown (P = 0.0423). Delay in complaining to the Police was observed in both groups, with 41% during the lockdown and 33% in the pre-lockdown period. There was a significantly higher chance of delayed presentations when the perpetrator was someone other than the romantic partner (P = 0.0201). The medical evidence of vaginal penetration was present in a significantly higher proportion of victims during lockdown compared to pre-lockdown(P = 0.0216).</p><p><strong>Conclusions: </strong>The prolonged lockdown resulted in significant risks to innocent, dependent girl children, behind the closed doors of their own homes and through their very own caregivers. The need to have community services to ensure the safety of girl children, especially in such situations, is highlighted.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621261441351"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropathological Patterns of Homicidal Head Injuries: A One-Year Prospective Autopsy-Based Study in Nairobi, Kenya.","authors":"Wangai Kiama, Moses Obimbo, Edward Muge, Julius Ogengo","doi":"10.1177/19253621261441352","DOIUrl":"https://doi.org/10.1177/19253621261441352","url":null,"abstract":"<p><p><b>Background:</b> Traumatic brain injury (TBI) is a leading global cause of death and disability. Sub-Saharan Africa bears a disproportionately high TBI-related mortality, with homicide contributing significantly, yet data on the region's neuropathological patterns of homicidal head trauma remain limited. <b>Objective:</b> To describe the mechanisms of injury, demographic characteristics, and neuropathological patterns of homicidal head injuries in Nairobi, Kenya. <b>Materials and Methods:</b> This prospective descriptive study was conducted over one year at Nairobi City Mortuary (July 1, 2009-June 30, 2010). Data on age, biological sex, and circumstances of death were obtained from police reports and identification documents. All violent deaths undergoing medicolegal autopsy were reviewed, and cases with confirmed homicidal head injuries were analyzed. Autopsy findings, including skull fractures and intracranial injuries, were documented, entered into Statistical Package for the Social Sciences, and summarized using frequencies, percentages, means, and standard deviations. <b>Results:</b> During the one-year study, 2278 cases of violent death were examined, of which 1060 (46.5%) involved head injuries. Among these, 630 cases (59.4%) were confirmed as homicidal. The mean age of victims was 26.9 ± 9.4 years, with the 20 to 29 year age group representing the largest proportion (46.1%). Males predominated, accounting for 96.1% of cases. The leading mechanism of injury was gunshot (50.3%), followed by blunt force trauma (46.7%) and sharp force injuries (3.0%). Skull fractures occurred in all victims, most commonly involving the frontal bone (23.2%). Brain contusions (19.7%), lacerations (18.6%), and epidural hematomas (15.2%) were the most frequent intracranial injuries. <b>Conclusion:</b> Homicidal head injuries represent a substantial proportion of violent deaths in Nairobi and predominantly affect young adult males. Characteristic neuropathological patterns observed during autopsy include multiple skull fractures and intracranial hemorrhages associated primarily with firearm and blunt force trauma.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621261441352"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the Diagnostic Lens: Mast Cell Activation Syndromes and the Hidden Spectrum of Angioedema Associated Mortality in COVID-19.","authors":"Emarson Laureano Sison, Jomar Lozano Aban","doi":"10.1177/19253621251409437","DOIUrl":"10.1177/19253621251409437","url":null,"abstract":"<p><p>COVID-19 related \"quorum deaths\" may conceal fatal angioedema/anaphylaxis that is misclassified as primary respiratory failure or cardiac arrest, particularly when urticaria or an identifiable allergen is absent. We propose an expanded diagnostic and forensic framework in which SARS-CoV-2-associated endothelial injury converges with mast cell activation disorders and complement system maladaptation, producing a self-amplifying mast cell-endothelium-complement axis capable of terminal vascular collapse without prominent systemic inflammation. To reduce diagnostic indeterminacy and improve cause-of-death attribution, we outline pragmatic postmortem approaches: early serum tryptase sampling, complement studies (C4 and C1-inhibitor levels), targeted histology for perivascular mast cell degranulation in the larynx and terminal pulmonary bronchioles, and selected genetic testing for hereditary angioedema and mast-cell-related variants (e.g., SERPING1, KIT D816V). Integrating these investigations into forensic workflows may reduce misclassification, strengthen pharmacovigilance, and support pandemic-era risk stratification and equity.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621251409437"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Tea-Steeping Metaphor: Origin, Application, Advantages, Disadvantages, and Impact on Forensic Medicine Teaching.","authors":"Pragnesh Parmar, Gunvanti Rathod","doi":"10.1177/19253621251409452","DOIUrl":"10.1177/19253621251409452","url":null,"abstract":"<p><p>Modern medical education increasingly emphasizes deep learning, professional identity formation (PIF), and longitudinal competency development. The tea-steeping metaphor, drawn from the gradual infusion process of tea leaves into water, offers a novel lens to conceptualize immersive and time-dependent learning. This metaphor holds particular relevance in forensic medicine, where learners must develop a nuanced understanding of medico-legal principles, ethical reasoning, and procedural competence over time. Objective of this article is to explore the origin, educational applications, benefits, limitations, and practical impact of the tea-steeping metaphor in the context of forensic medicine teaching. A narrative review methodology was employed, integrating theoretical frameworks from constructivist learning, competency-based education, and experiential learning. Real-world applications in forensic education were examined, including longitudinal case-based learning, simulation-based training, reflective practice, and PIF. The tea-steeping metaphor supports gradual cognitive and affective skill development by allowing learners to process complex information over time and within context. In forensic medicine, this approach enhances critical thinking, ethical decision-making, and integration of theory with practice. Benefits include promotion of deep learning, reflective practice, and adaptability. However, challenges such as time constraints, potential information overload, and the need for optimal learning conditions limit its universal applicability. The tea-steeping metaphor provides a valuable pedagogical framework for forensic medicine education. When implemented strategically, it can foster immersive, reflective, and ethically grounded learning experiences. Further research is warranted to assess its longitudinal outcomes and adaptability across diverse educational contexts.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621251409452"},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12799476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the Diagnostic Lens: Mast Cell Activation Syndromes and the Hidden Spectrum of Angioedema-Associated Mortality in COVID-19.","authors":"Emarson L Sison, Jomar L Aban","doi":"10.1177/19253621251409454","DOIUrl":"10.1177/19253621251409454","url":null,"abstract":"","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621251409454"},"PeriodicalIF":0.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12759015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-evaluation of Sudden Death in Wiskott-Aldrich Syndrome: Forensically Problems in Distinguishing Natural Hemorrhage Versus Trauma, Surge of Intracranial Pressure After Vomiting and Putting Forward a Hypothesis of Hemorrhage Threshold to Perfect Elucidation of Murders in Pediatric Hemology.","authors":"Emarson L Sison, Jomar L Aban","doi":"10.1177/19253621251395339","DOIUrl":"10.1177/19253621251395339","url":null,"abstract":"","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621251395339"},"PeriodicalIF":0.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12618207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thanatological Epigenetics as a Postmortem Forensic Tool: A Contextual Call for Epigenetic Clock Research in Asia.","authors":"Ace John P Bugaoan, Don Eliseo Lucero-Prisno, Jomar L Aban","doi":"10.1177/19253621251374280","DOIUrl":"10.1177/19253621251374280","url":null,"abstract":"","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621251374280"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal Industrial Accident Involving a Chemical Blender Machine: A Rare Case Report.","authors":"Deepu Mathew, Vinod Ashok Chaudhari, Abisha Tino Ln, Richard Robert S","doi":"10.1177/19253621251374279","DOIUrl":"10.1177/19253621251374279","url":null,"abstract":"<p><p>Machinery, whether it is operating or idle, may cause various types of contact injuries, including caught-in or caught-between incidents with moving parts, avulsions, amputations, burns, crush injuries, falls, and impacts with the machine or surrounding surfaces. Despite the prevalence of industrial accidents, fatalities caused by chemical blender machines have never been reported. This case reports a rare fatal case involving a 48-year-old male who sustained musculoskeletal injuries after falling into a chemical blender mixer while manually stirring powder in an industrial setting. The victim became trapped in the machine for ∼30 s, leading to extensive lacerations and fractures, and died due to hemorrhagic shock. The autopsy revealed multiple lacerations and fractures on the lower limbs due to the machine's helical blades, alongside a deep laceration on the right shoulder. Internal injuries included rib fractures, liver lacerations, and significant blood loss, ultimately causing death. The unique design of the blender machine blades, with helical-shaped blades, played a critical role in the injury pattern. A crime scene investigation emphasized the absence of proper safety measures, such as guarding mechanisms, which allowed the victim's entrapment.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":" ","pages":"19253621251374279"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}