American Journal of Forensic Medicine and Pathology最新文献

Skeletonization of Human Remains by Amazonian Ichthyofauna in Less Than 24 Hours.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-26 DOI: 10.1097/PAF.0000000000001042

Gisleine Medrado, Daniela Nóbrega, Priscila Kitagawa, Sanmya Leite, Ademir Franco

引用次数: 0

Sudden Unexpected Death Due to Undiagnosed Pilocytic Astrocytoma.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-18 DOI: 10.1097/PAF.0000000000001041

Lauren K Santoro, Devan C Glensor, J Jun Guan

{"title":"Sudden Unexpected Death Due to Undiagnosed Pilocytic Astrocytoma.","authors":"Lauren K Santoro, Devan C Glensor, J Jun Guan","doi":"10.1097/PAF.0000000000001041","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001041","url":null,"abstract":"Abstract: Pilocytic astrocytomas are slow-growing neuroepithelial tumors most commonly found in children, with favorable prognoses. Prognosis is less favorable in the rare adult case in which survival rates decrease with age. Because of the rarity of these tumors in adults, undiagnosed pilocytic astrocytomas causing sudden death are hardly ever encountered in the forensic autopsy setting. The San Francisco Office of the Chief Medical Examiner was presented with a 27-year-old female patient with unknown medical history and recent complaints of nausea and vomiting. Postmortem computed tomography revealed a well-demarcated heterogeneous right cerebellar cystic mass. The autopsy showed an edematous brain with hydrocephalus and fourth ventricular compression, due to a heterogeneous mass found in the right cerebellum. Histopathological examination of the mass revealed findings consistent with the microscopic diagnosis of pilocytic astrocytoma. This case highlights one example of an adult patient with untreated pilocytic astrocytoma in which obstructive hydrocephalus ultimately resulted in death, and discusses the advantages of utilizing post-mortem computed tomography in addition to autopsy.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Getting Crunchy With COVID-19: A Unique Case of Catastrophic Multiorgan Calciphylaxis.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-10 DOI: 10.1097/PAF.0000000000001035

Andrew Johnson, Kathryn Manocchia, Marisa Jacob-Leonce

{"title":"Getting Crunchy With COVID-19: A Unique Case of Catastrophic Multiorgan Calciphylaxis.","authors":"Andrew Johnson, Kathryn Manocchia, Marisa Jacob-Leonce","doi":"10.1097/PAF.0000000000001035","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001035","url":null,"abstract":"Abstract: Calciphylaxis, or calcific uremic arteriolopathy, is a rare condition with a poorly understood pathophysiology. It is often associated with diseases that cause abnormalities in calcium metabolism, such as end-stage renal disease (ESRD) and hyperparathyroidism. While it most often affects the skin, involvement of extracutaneous organs, called systemic calciphylaxis, has been reported.Interestingly, other risk factors have now been identified with the development of calciphylaxis including recent infections, corticosteroid or warfarin use as well as diabetes mellitus, autoimmune diseases, and protein C or S deficiency.We present a 48-year-old female patient with a history of human immunodeficiency virus infection, and recent hospitalizations for acute pancreatitis and COVID-19 who presents with nonspecific abdominal pain, weakness, and mild erythematous skin lesions. Subsequently, the patient developed acute vision loss, severe hypertension, and acute kidney injury with significantly worsening skin lesions. Ultimately, the patient deteriorated rapidly and succumbed. At autopsy, cutaneous calciphylaxis was confirmed, affecting over 50% of body surface area as well as widespread organ involvement by visceral calciphylaxis, most strikingly in the heart and lungs. This case highlights the importance of considering COVID-19 and other nonuremic risk factors as being a trigger for developing catastrophic systemic calciphylaxis.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metastatic Cardiac Tumor Mimicking Coronary Artery Aneurysm on Postmortem Computed Tomography.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-10 DOI: 10.1097/PAF.0000000000001038

Norihiro Shinkawa, Rina Yamada, Minako Azuma, Ninako Shinkawa, Nobuhiro Yukawa

引用次数: 0

Postmortem Computed Tomography Features of Necrotizing Epiglottis.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-04 DOI: 10.1097/PAF.0000000000001031

Vinod Khanijow, Kate O'Connor, Rexson Tse, Sinead McCarthy

引用次数: 0

Is Obesity a Factor in Lethal Opioid Toxicity?

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-04 DOI: 10.1097/PAF.0000000000001029

Jeremy W S Hunter, Corinna Van Den Heuvel, Lilli Stephenson, Ian F Musgrave, Roger W Byard

{"title":"Is Obesity a Factor in Lethal Opioid Toxicity?","authors":"Jeremy W S Hunter, Corinna Van Den Heuvel, Lilli Stephenson, Ian F Musgrave, Roger W Byard","doi":"10.1097/PAF.0000000000001029","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001029","url":null,"abstract":"Abstract: Both obesity and opioid abuse are increasing in numbers globally. As these entities may be associated with significant respiratory compromise, it was hypothesized that synergism may occur and that as a result of this obese individuals may be more sensitive to the effects of opiates, that is, that deaths may occur at lower blood levels. To investigate this possibility, case files at Forensic Science SA, Adelaide Australia, were reviewed for all cases that occurred between 2000 and 2019 where deaths had been attributed to heroin or morphine toxicity. There were 259 cases (66 females, 193 males; age range: 18-91; average: 41.5). The average body mass index (BMI) was 26.8 (females, 26.1; males, 27.0). The total number of obese (BMI ≥ 30 < 40) decedents was 50, and the total number of morbidly obese (BMI ≥ 40) decedents was 17. No significant association was found in the obese or morbidly obese between BMI and postmortem drug levels of <0.01, ≥0.1 < 0.3, ≥0.3, <0.4, or ≥0.4 mg/L (P = 0.30, Fisher exact test). The lack of association between fatal postmortem opiate levels and BMI suggests that the negative respiratory effects of opioids and a high BMI may in some way be compensated for by as yet unidentified metabolic/pharmacokinetic factors in obesity.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sudden Death Due to Necrotizing Fasciitis After Routine Cervical Radiofrequency Ablation Treatment. 常规宫颈射频消融治疗后因坏死性筋膜炎猝死。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-07-18 DOI: 10.1097/PAF.0000000000000976

Ravi Trivedi, Joyce L deJong, Patrick A Hansma

引用次数: 0

Suicide by Ethyl Methacrylate Ingestion. 摄入甲基丙烯酸乙酯自杀。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-08-02 DOI: 10.1097/PAF.0000000000000979

Samuel P Prahlow, Taylor Wilson, Amy C Gruszecki

{"title":"Suicide by Ethyl Methacrylate Ingestion.","authors":"Samuel P Prahlow, Taylor Wilson, Amy C Gruszecki","doi":"10.1097/PAF.0000000000000979","DOIUrl":"10.1097/PAF.0000000000000979","url":null,"abstract":"Abstract: 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 combining the two compounds. Ingestion of these compounds has not been previously described within the medical literature. The decedent was a nail technician at a local salon. He was found unresponsive in his yard which led to a 911 call. At the scene, a mostly empty 16-oz bottle of ethyl methacrylate, a chemical used at the salon where he worked, was found. At autopsy, the decedent's body had a strong chemical odor consistent with odors present at nail salons. Significant gastrointestinal tract damage was seen including discoloration within the esophagus, and the stomach contained a molded, hardened nail compound. The cause of death was ruled as complications of nail acrylic powder and liquid ethyl methacrylate ingestion. This case shows the unusual findings seen at autopsy from a decedent who committed suicide by ingestion of ethyl methacrylate with acrylic powder.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"82-86"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The National Association of Medical Examiners Eckert Memorial Award.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2025-01-22 DOI: 10.1097/PAF.0000000000001001

引用次数: 0

Caseous Calcification of the Mitral Annulus: Calcified Toothpaste of the Heart. 二尖瓣环钙化：心脏钙化牙膏。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-07-18 DOI: 10.1097/PAF.0000000000000971

Kyla M Jorgenson, Phillip D McMullen, Bruce I Goldman, Marisa Jacob-Leonce

{"title":"Caseous Calcification of the Mitral Annulus: Calcified Toothpaste of the Heart.","authors":"Kyla M Jorgenson, Phillip D McMullen, Bruce I Goldman, Marisa Jacob-Leonce","doi":"10.1097/PAF.0000000000000971","DOIUrl":"10.1097/PAF.0000000000000971","url":null,"abstract":"Abstract: 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 aortic valves with a caseous gross appearance. Histologically, these areas consisted of amorphous basophilic material accompanied by a surrounding granulomatous-appearing infiltrate. Von Kossa staining on non-decalcified tissue revealed strong positive staining, confirming CCMA diagnosis. While identifiable, the atrioventricular node was displaced and distorted by caseous deposits. Toluidine blue staining of myocardium showed osmophilic accumulations, and electron microscopy (EM) showed myeloid/zebra bodies, consistent with Fabry disease. We posit that Fabry disease leads to end-stage kidney disease, altering calcium phosphate metabolism, a proposed mechanism for CCMA. This case highlights the multifactorial nature of sudden cardiac death in decedents with various structural cardiac changes and potential renal-disease-induced electrolyte imbalances. We aim to bring awareness to this rare entity, its potential role in a sudden cardiac death, and to highlight the need to use non-decalcified tissue when staining for calcium to establish the diagnosis.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"59-63"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0