Academic Forensic Pathology最新文献

{"title":"Fatal Motor Vehicle-Pedestrian Collision Injury Patterns-A Systematic Literature Review.","authors":"Moheem Masumali Halari, Michael James Shkrum","doi":"10.1177/1925362120986059","DOIUrl":"10.1177/1925362120986059","url":null,"abstract":"<p><strong>Introduction: </strong>Injury patterns in pedestrians struck by motor vehicles were described in medical literature first published almost a half century ago. \"Classical\" triads of injury distribution were described for adults (skull-pelvis-extremity) and subsequently applied to children (head-hip or pelvis-distal femur/knee joint). Notably, these classical triads were derived from two publications reporting clinical observations of only 11 patients, all of whom were adults.</p><p><strong>Methods: </strong>A systematic literature review was conducted using Medline, CINAHL, EMBASE, and Cochrane to determine the evidence-base for motor vehicle collision (MVC)-pedestrian injury \"triads\" and other trauma patterns described for pedestrians in the adult and pediatric age groups.</p><p><strong>Results: </strong>Of the 1540 full-text articles identified in the review, 56 articles published in English met the inclusion criteria, that is, motor vehicle-pedestrian collision resulting in specific, fatal injuries determined by postmortem examinations. There were variations in injury patterns that differed from the \"classical\" triads. These differences likely stem from advances in vehicle design and safety features which have affected the nature and distribution of injuries.</p><p><strong>Discussion: </strong>Further research on the correlation of specific injuries sustained by pedestrians of different ages with various types of vehicles and impacts are needed to assess the validity of previously observed injury patterns in relation to the current motor vehicle fleet. Delineation of injury patterns can assist health care teams in trauma management. Vehicle manufacturers and government regulators can better assess whether the introduction of advanced driver assistance features designed to protect pedestrians when struck will be effective in reducing severe injuries. In forensic pathology practice, knowledge of pedestrian injury patterns based on data representative of impacts involving modern vehicles can provide MVC death investigators the means to determine MVC dynamics and pedestrian kinematics.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 3-4","pages":"144-157"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120986059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25559980","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":"Medico-Legal Opinion Based on Autopsy Findings of a Victim of an Explosion Involving Mass Fatality.","authors":"Yalini Thivaharan,&nbsp;Indira Deepthi Gamage Kitulwatte","doi":"10.1177/1925362120983669","DOIUrl":"https://doi.org/10.1177/1925362120983669","url":null,"abstract":"<p><strong>Introduction: </strong>Investigation into explosions is one of the major areas in forensic medicine and pathology. Medico legal issues associated with these deaths are diverse and forensic experts are often expected to make clarifications. Assistance of a methodical scientific investigation of such a death in evaluation of unanswered medico legal issues, of an autopsy of one of the victims of Easter Sunday explosions is discussed.</p><p><strong>Case history: </strong>The deceased was a 15-year-old girl who was participating in the Easter mass at St. Sebastian's Church - Kattuwapaitya, Negombo, Sri Lanka when a suicide bomber blew himself up. The mother of the deceased noticed the deceased being rushed to the hospital. However, she was pronounced dead on admission. Pre-autopsy radiology revealed spherical shrapnel in the temporal region. At autopsy, the fatal injury was found on the head and a detailed study revealed skull fractures associated with penetration by 3 shrapnels. There was a keyhole lesion among the penetrations. Internal examination revealed an extensive dural tear underlying the compound fracture. The brain was grossly edematous with lacerations on the frontal and parietal lobes associated with localized subarachnoid hemorrhage. There were multiple underlying contusions on bilateral frontal white matter. Small subarachnoid haemorrhage was noted on the basal aspect of the brain.</p><p><strong>Discussion: </strong>Careful evaluation of the autopsy findings assisted in formulating the opinion scientifically on event reconstruction including the proximity of the victim to the epicenter of explosion and nature of explosive device, period of survival, mechanism of causation of skull fractures and the mechanism of death in addition to the cause of death.</p><p><strong>Conclusion: </strong>A forensic pathologist following a meticulous autopsy examination, along with a team of ballistic experts and specially trained police personnel play a pivotal task in analyzing a scene of explosion and an autopsy of a victim, in concluding the case and in bringing justice to all the victims and survivors of the catastrophe.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 3-4","pages":"158-165"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120983669","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25559981","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 Investigation and Forensic Medicine in South Africa: Historical Perspectives, Status Quo, and Quo Vadis?","authors":"Gert Saayman","doi":"10.1177/1925362120986678","DOIUrl":"https://doi.org/10.1177/1925362120986678","url":null,"abstract":"CORRESPONDENCE Gert Saayman, Pretoria, South Africa, gsaayman@up.ac.za ETHICAL APPROVAL STATEMENT OF HUMAN AND ANIMAL RIGHTS STATEMENT OF INFORMED CONSENT","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 3-4","pages":"115-130"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120986678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25559531","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 Postmortem Interpretation of Cardiac Genetic Variants of Unknown Significance in Sudden Death in the Young: A Case Report and Review of the Literature.","authors":"Saleh Fadel,&nbsp;Alfredo E Walker","doi":"10.1177/1925362120984868","DOIUrl":"https://doi.org/10.1177/1925362120984868","url":null,"abstract":"<p><p>Sudden cardiac death (SCD) in adolescents and young adults is a major traumatic event for families and communities. In these cases, it is not uncommon to have a negative autopsy with structurally and histologically normal heart. Such SCD cases are generally attributed to channelopathies, which include long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. Our understanding of the causes for SCDs has changed significantly with the advancements in molecular and genetic studies, where many mutations are now known to be associated with certain channelopathies. Postmortem analysis provides great value in informing decision-making with regard to screening tests and prophylactic measures that should be taken to prevent sudden death in first degree relatives of the decedent. As this is a rapidly advancing field, our ability to identify genetic mutations has surpassed our ability to interpret them. This led to a unique challenge in genetic testing called variants of unknown significance (VUS). VUSs present a diagnostic dilemma and uncertainty for clinicians and patients with regard to next steps. Caution should be exercised when interpreting VUSs since misinterpretation can result in mismanagement of patients and their families. A case of a young adult man with drowning as his proximate cause of death is presented in circumstances where cardiac genetic testing was indicated and undertaken. Eight VUSs in genes implicated in inheritable cardiac dysfunction were identified and the interpretation of VUSs in this scenario is discussed.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 3-4","pages":"166-175"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120984868","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25559982","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":"Historical Shifts in China's Forensic Medicine Education and Service Mode Since 1949.","authors":"Zhiyuan Xia","doi":"10.1177/1925362120981245","DOIUrl":"https://doi.org/10.1177/1925362120981245","url":null,"abstract":"<p><p>China (only China mainland included in this article) differs significantly from any other country of the world, in terms of its current system of forensic medicine, which could be generally characterized by \"the three world's firsts\": the world's first to establish undergraduate degree in forensic medicine nationally, the world's first to add forensic medicine division to police criminal investigation system nationally, and the world's first to permit market-oriented forensic medicine services nationally. To understand how such an interesting system was developed, the important historical shifts in China's forensic medicine education and service mode that have ever occurred since 1949 are analyzed in this article. Then the advantages and deficiencies of the current system are briefly discussed. Finally, principles for China's future forensic medicine system are proposed.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 3-4","pages":"131-143"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120981245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25559532","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":"Validation of OraQuick HCV Rapid Antibody Test in Postmortem Specimens.","authors":"Claire E Rose,&nbsp;Lisa Duncan,&nbsp;Amy M Hawes","doi":"10.1177/1925362120957521","DOIUrl":"https://doi.org/10.1177/1925362120957521","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study is to evaluate the performance of OraQuick HCV Rapid Antibody Test against a \"gold-standard\", FDA-approved, laboratory-based serum immunoassay (SI) in postmortem blood. To date, OraQuick HCV Rapid Antibody Test has not been evaluated for use in postmortem testing. This OraQuick test is a manually performed, visually interpreted, single use immunoassay for the qualitative detection of antibodies to the hepatitis C virus (HCV).</p><p><strong>Methods: </strong>Blood was collected from 51 decedents whose deaths were investigated in the jurisdiction of the Knox and Anderson County Medical Examiner's Office (MEO) January 2017 through April 2017. For each consented case, blood was tested using both the OraQuick HCV Rapid Antibody Test and a laboratory-based hepatitis C serum immunoassay (\"gold standard\" reference assay). Results from the OraQuick HCV Rapid Antibody Test were compared against a laboratory-based hepatitis C serum immunoassay.</p><p><strong>Results: </strong>Using the laboratory-based serum immunoassay (SI) as the \"gold standard\" for assessing true HCV antibody positivity, and comparing SI against OraQuick rapid test, sensitivity for the OraQuick rapid test was 95.65% and specificity was 96.15% in postmortem blood.</p><p><strong>Discussion: </strong>Our results demonstrate that OraQuick HCV rapid antibody test is reliable for diagnosis of hepatitis C infection in postmortem blood with a relatively short (less than approximately 21.5 hours) postmortem sample acquisition time. The OraQuick in some cases may be superior to traditional, laboratory-based HCV SI due to potential increased viscosity of postmortem blood.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 2","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120957521","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38679055","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":"Alleged Homicidal Choking in a Woman Recovering From Guillain-Barré Syndrome.","authors":"I D G Kitulwatte,&nbsp;P A S Edirisinghe","doi":"10.1177/1925362120953732","DOIUrl":"https://doi.org/10.1177/1925362120953732","url":null,"abstract":"<p><p>Few reported cases of homicidal choking in medical literature involve aged, infants, and debilitated. Whenever an allegation is made, the forensic expert is expected to provide a balanced opinion based on scientific evidence. We report a sudden death of a woman recovering from Guillain-Barré syndrome (GBS), with an allegation of homicidal choking. A 53-year-old female was diagnosed of having Guillain-Barré syndrome and was managed in the hospital. She was slowly recovering and liquid meals were replaced by solids and she was mobilized. A relation was feeding her when she developed a sudden cardiac arrest. Her sisters alleged intentional choking. At autopsy, there were a few seeds of rice in her trachea at the bifurcation and in the right bronchus. Stomach contained few seeds of rice mixed with mucous. The contents of the trachea were tested for pH and were acidic. Microscopy revealed widespread viral myocarditis. Myocarditis is reported to coexist with GBS rarely and can lead to a sudden cardiac arrest. Few seeds of rice in the trachea cannot cause death from choking. Further, the acidic pH of the contents indicated gastric origin and therefore possible agonal aspiration or postmortem regurgitation.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 2","pages":"94-96"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120953732","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38679057","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":"Medical Examiner Review of the Characteristics of Fire-Related Homicides.","authors":"Kyle S Conway,&nbsp;Carl J Schmidt,&nbsp;Theodore T Brown","doi":"10.1177/1925362120964377","DOIUrl":"https://doi.org/10.1177/1925362120964377","url":null,"abstract":"<p><p>While fire-related deaths are regularly encountered by medical examiners, fire-related homicides are relatively uncommon. Although some large retrospective studies of fire-related deaths have been performed, few large studies have specifically reviewed fire-related homicides. Autopsy, scene investigation, and ancillary studies were reviewed for 38 fire-related homicides evaluated at the Wayne County Medical Examiner's Office in Detroit, Michigan. The largest proportion of cases were inhalation-related deaths in dwelling fires (n = 21, 55%), followed by deaths from thermal injury after immolation (n = 8, 21%) and traumatic death with contemporaneous or subsequent immolation (n = 8, 21%). There was one case of postmortem immolation. Although carboxyhemoglobin (COHb) levels played a significant role in evaluation of these cases, no single factor was diagnostic of a particular cause or manner of death. Fire-related homicides present unique diagnostic challenges because multiple insults frequently contribute to the cause death. Death at the scene and COHb level above 10% are the most useful factors in establishing smoke and soot inhalation as the cause of death. Some autopsy findings are helpful in establishing or ruling out smoke and soot inhalation as contributing to or sole cause of death, but an evaluation of the entire circumstances and autopsy findings is necessary.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 2","pages":"87-93"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120964377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38679056","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":"Editorial for Academic Forensic Pathology.","authors":"Dr Christopher Milroy","doi":"10.1177/1925362120973053","DOIUrl":"https://doi.org/10.1177/1925362120973053","url":null,"abstract":"We are living in changed times with the global pandemic of COVID-19. Forensic medicine specialists are affected by the viral pandemic as much as other medical disciplines and many of our colleagues have been conducting autopsies and other investigations to develop our understanding of this novel virus. Academic meetings in person are now replaced by virtual meetings, which provide both challenges and opportunities. We are getting used to giving evidence remotely. This journal has been online since its formation, which has the ability to reach a larger audience with your publication for others reading, learning, and education. Forensic Pathology has always found case reports a key part of our literature. Indeed, that is how the science developed in the 18th and 19th century. While a single case report does not falsify established science, it does show that an unexpected event can happen—a potentially important finding in a court case. We thus encourage all of you to consider submitting such cases, as well as more detailed studies for consideration by this journal. Once more I thank the authors and reviewers for their work and the SAGE staff for all their help.","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 2","pages":"71"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120973053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38679053","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 Due to Obstruction of Airways by a Hyperplastic Polyp: An Unusual Complication of Treated Desmoid Fibromatosis.","authors":"Natasha Richards,&nbsp;Jayantha Herath","doi":"10.1177/1925362120964084","DOIUrl":"https://doi.org/10.1177/1925362120964084","url":null,"abstract":"<p><p>Desmoid fibromatosis (DF) is a rare, locally aggressive but benign clonal fibroblastic lesion of deep soft tissue. It can occur at any age. Extra-abdominal lesions are more common in the pediatric population, with equal sex predilection. Desmoid fibromatosis of the head and neck, particularly the anterior neck, is more difficult to manage because of the proximity to vital structures and may eventually require definitive airway management with insertion of a tracheostomy tube. Indwelling tracheostomy tubes carry their own set of complications. This is the case of a 21-month-old boy who died suddenly due to tracheal obstruction by a hyperplastic polyp. He was diagnosed with DF of the neck before he was 1 month old and required an indwelling tracheostomy tube as a result. Chronic tracheostomy intubation can be complicated by granulation tissue polyp or, less commonly, fibroepithelial polyp formation that can become large enough to cause airway obstruction. To the authors' knowledge, this is the first case of hyperplastic polyp causing fatal airway obstruction.</p>","PeriodicalId":36813,"journal":{"name":"Academic Forensic Pathology","volume":"10 2","pages":"97-103"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1925362120964084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38679058","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}