American Journal of Forensic Medicine and Pathology最新文献_第7页

Drug Trends in the Teenage Postmortem Population From 2017 to 2021. 2017 至 2021 年青少年死后人群的毒品趋势。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-07-22 DOI: 10.1097/PAF.0000000000000977

Jennifer L Swatek, Brianna L Peterson

{"title":"Drug Trends in the Teenage Postmortem Population From 2017 to 2021.","authors":"Jennifer L Swatek, Brianna L Peterson","doi":"10.1097/PAF.0000000000000977","DOIUrl":"10.1097/PAF.0000000000000977","url":null,"abstract":"Abstract: 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 reference laboratory from 2017 to 2021 corresponding to the teenage population were evaluated for various drugs of misuse. These data revealed a marked increase (385%) in reported fentanyl cases and a 13% increase in positivity rate. Methamphetamine- and cocaine-positive cases also increased 126% and 54%, with a net percent positivity of +0.6% and -0.5%, respectively. Conversely, heroin showed a consistent decline in reported cases (67%) and a net decrease of 1.0% in positivity rate. In addition to commonly misused drugs, trends for other substances that are prevalent in social media and therefore may disproportionally impact teens, MDMA/MDA, mitragynine, and diphenhydramine, were also assessed. A discussion of drug-related social media trends is presented to provide additional context for the data and trends reported herein, ultimately creating a framework through which social influences on teenage drug use can be better understood.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"28-33"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749764","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

Conduction System Hamartoma: Autopsy Case Series. 传导系统 Hamartoma：尸检病例系列。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-09-03 DOI: 10.1097/PAF.0000000000000981

Beyza Keskin Ozturk, Eylul Gun

{"title":"Conduction System Hamartoma: Autopsy Case Series.","authors":"Beyza Keskin Ozturk, Eylul Gun","doi":"10.1097/PAF.0000000000000981","DOIUrl":"10.1097/PAF.0000000000000981","url":null,"abstract":"Abstract: 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 data, autopsy findings, causes of death, microbiological results, and accompanying cardiac anomalies. There was a total of 4 cases. The female-to-male ratio was 3/1. The mean age of the cases was 5.8 months. The heart weight was found within the normal range when evaluated according to age and gender. Microscopy revealed sharply demarcated cell groups or layers with histiocyte-like cells with foamy cytoplasm. Congenital heart disease and lung infection were given as causes of death in all cases. The lesion, which was previously called histiocytoid cardiomyopathy and many different names, is known as \"conduction system hamartoma\" in the latest World Health Organization classification (5th edition). Being aware of this entity that causes fatal arrhythmias and sudden cardiac deaths is important for pathologists. Autopsy findings should be evaluated by taking extra samples from the heart if necessary, especially in suspected cases below 2 years of age.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"64-68"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121240","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

Bladder Wash as an Alternative Postmortem Toxicology Specimen: Forensic Pathologists' Perspectives. 膀胱冲洗作为另一种死后毒理学标本：法医病理学家的观点。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-02-27 DOI: 10.1097/PAF.0000000000001034

Luke N Rodda, Kylie E Candela, Amy P Hart, Ellen G Moffatt, Sue Pearring, Karen S Scott

{"title":"Bladder Wash as an Alternative Postmortem Toxicology Specimen: Forensic Pathologists' Perspectives.","authors":"Luke N Rodda, Kylie E Candela, Amy P Hart, Ellen G Moffatt, Sue Pearring, Karen S Scott","doi":"10.1097/PAF.0000000000001034","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001034","url":null,"abstract":"Abstract: In postmortem forensic investigations, where the bladder is voided or dehydrated prior to autopsy, it is possible to wash the bladder with saline to collect the resulting \"bladder wash\" and any residual urine for toxicological analysis. Although this method is not yet commonplace or standard, a recent study has demonstrated that bladder wash is an effective alternative specimen in postmortem forensic toxicology. The current study aimed to assess forensic pathologists' opinions on the use of bladder wash samples both before and after reviewing bladder wash toxicological data. An online survey was distributed to forensic pathologists from NAME, and responses were analyzed to identify any shifts in perceptions after data presentation. The findings revealed that most forensic pathologists recognized the benefits of bladder wash collection and analysis as well as its usefulness in determining the cause and manner of death, with noticeable changes in perspective following exposure to supporting data. This study highlights the potential value of standardizing the easy and accessible collection of bladder wash for postmortem toxicological analysis, thereby providing forensic pathologists with invaluable information when other biological specimens are unavailable.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517556","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

Flecainide Intoxication: An Unusual Case of Suicide. 弗莱卡因中毒：一个不寻常的自杀案例。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-02-21 DOI: 10.1097/PAF.0000000000001026

Shumin Fan, Keith Norman Norton

引用次数: 0

Disseminated Mycobacterium tuberculosis from Infected Bone Graft Source: Case Study in Iatrogenic Infection and Our Approach. 骨移植源感染的播散性结核分枝杆菌：医源性感染病例研究和我们的方法。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-02-19 DOI: 10.1097/PAF.0000000000001027

Thomas Herb, Jeffrey Jentzen, Carl Schmidt

{"title":"Disseminated Mycobacterium tuberculosis from Infected Bone Graft Source: Case Study in Iatrogenic Infection and Our Approach.","authors":"Thomas Herb, Jeffrey Jentzen, Carl Schmidt","doi":"10.1097/PAF.0000000000001027","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001027","url":null,"abstract":"Abstract: Iatrogenic infections of cadaveric bone grafts have led to 2 outbreaks of Mycobacterium tuberculosis (Mtb) infection in the United States that have resulted in multiple fatalities. We report a case of one of the bone graft recipients from the 2023 outbreak. A 57-year-old immunocompromised female with a history of renal failure status post 3 kidney transplants underwent a laminectomy with a cadaveric bone graft due to spinal stenosis. She was later hospitalized with diffuse lymphadenopathy and surgical site purulent ulceration. The workup included positive cultures for Mtb. Despite appropriate therapy, the patient died in the hospital. Autopsy findings included purulent discharge from the surgical site, medullary abscesses of one of the transplanted kidneys, diffuse pinpoint areas of softening in the liver, and lung congestion. Histology of the liver and right lung demonstrated loose granulomas with abundant acid-fast organisms. The kidney abscesses were due to Candida species infection. Overall, findings were consistent with disseminated Mtb infection. Additional investigation found similar infections in recipients of the same bone graft source. We compare the Mtb outbreaks to similar outbreaks, including cases of fungal meningitis due to steroid injections, and discuss our approach and strategy in cases of iatrogenic infection.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442818","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

Preventing Fentanyl-Related Overdose Deaths with Naloxone-A Medical Examiner Study. 用纳洛酮预防芬太尼相关的过量死亡——法医研究

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-02-13 DOI: 10.1097/PAF.0000000000001028

Gabriel D Alexander, Pamela A Ferreira, Stephanie A Dean, Russell T Alexander

{"title":"Preventing Fentanyl-Related Overdose Deaths with Naloxone-A Medical Examiner Study.","authors":"Gabriel D Alexander, Pamela A Ferreira, Stephanie A Dean, Russell T Alexander","doi":"10.1097/PAF.0000000000001028","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001028","url":null,"abstract":"Abstract: An epidemic of fentanyl overdose deaths has led to community naloxone use to save lives, and it has been suggested that businesses face legal liability for failing to provide naloxone. This study reviewed Maryland fentanyl-related overdose deaths in 2022. A death was considered preventable by widespread availability and use of naloxone in the following circumstances: a witnessed arrest, a person suffering an overdose found within 30 minutes of last being known alive, a person found unresponsive who showed potential to be resuscitated by emergency medical services, or the person being \"found dead\" in a public area such that a reasonable opportunity existed for someone else to find the decedent earlier and administer naloxone before death occurred. Of the 2047 overdose deaths in the study, 13.5% were deemed possibly preventable, and 2.7% were found such that a business could have possibly provided naloxone. The preventable overdoses were most commonly found by a \"close contact\" (family, friend, boy/girlfriend, and room/housemate) in a residence. A targeted effort to educate and supply naloxone to people who use drugs and their close contacts offers the best chance of reducing fentanyl overdose deaths. Mandating all businesses to carry naloxone is not supported by this study.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411704","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

Chainsaw Kickback Injury in a Child. 儿童电锯反打伤。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-02-13 DOI: 10.1097/PAF.0000000000001030

Jochen Pfeifer, Anke Rondorf, Ramona Filip, Katrin Altmeyer, Hashim Abdul-Khaliq

引用次数: 0

Unearthing the Unexpected: First Report of Ossa Cordis in a Human Heart. 发掘意想不到的：人类心脏中Ossa Cordis的第一份报告。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-31 DOI: 10.1097/PAF.0000000000001018

Mehrnoosh Ghandili, Mark A Giffen

{"title":"Unearthing the Unexpected: First Report of Ossa Cordis in a Human Heart.","authors":"Mehrnoosh Ghandili, Mark A Giffen","doi":"10.1097/PAF.0000000000001018","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001018","url":null,"abstract":"Abstract: The ossa cordis (OC), or cardiac bone, is a bony structure within the cardiac skeleton of mammals, believed to maintain heart shape during systole and enhance contraction efficiency. Found in large mammals, especially ruminants, and has recently been described in chimpanzees; however, OC has not previously been described in humans. Herein, we present an incidental finding of OC in the heart of a 39-year-old man who suffered a stab wound to chest. A thorough postmortem examination revealed a 0.8 × 0.6 × 0.4-cm, well-defined, boomerang-shaped, bony structure embedded in atrioventricular node location in the right atrium within the triangle of Koch. The heart showed cardiomegaly and moderate atherosclerosis in the left anterior descending and right coronary arteries but was otherwise normal, without fibrosis, valvular abnormalities, or degenerative changes. Histological analysis revealed mature bone with trilineage hematopoietic elements. This finding highlights anatomical similarities between human hearts and other species, raising questions about whether OC in humans and primates is linked solely to degenerative cardiac disorders or represents a normal aspect of mammalian heart development and aging. To our knowledge, this is the first reported case of an OC in a human.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069900","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

Hidden Trauma: An Analysis of the Identification of Contusions on Different Skin Tones. 隐性创伤：不同肤色挫伤的识别分析。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-24 DOI: 10.1097/PAF.0000000000001014

Lydia R Du, David M Waters, Meredith A Reynolds, Lorenzo Gitto

{"title":"Hidden Trauma: An Analysis of the Identification of Contusions on Different Skin Tones.","authors":"Lydia R Du, David M Waters, Meredith A Reynolds, Lorenzo Gitto","doi":"10.1097/PAF.0000000000001014","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001014","url":null,"abstract":"Abstract: While abrasions and lacerations are typically easily identified, darker pigmentation of the skin may obscure contusions. Forensic pathology literature shows a disproportionate number of illustrations of contusions on lighter skin tones compared to darker ones. Skin and soft tissue dissection is the most reliable method to confirm contusions.The authors seek to establish a correlation between skin tone and the visual identification of contusions, confirmed by soft tissue dissection. Additionally, they aim to determine the utility of specialized dissections for identifying contusions on different skin tones to identify cases that may benefit from such procedures.A review of cases from the Cook County Medical Examiner's Office from 2014 to 2024 was conducted. The office database was searched for deaths in custody, causes including \"assault,\" and \"child abuse.\" Autopsy photos were compiled into predissection and postdissection sets, reviewed for skin tone, visual identification of contusions, and final confirmation of soft tissue hemorrhage.Results found a negative association between skin color and accurate visual identification of contusions and determined that decedents with a skin tone of 7 or higher on the Massey-Martin scale may benefit from specialized dissections.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025604","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

Technical Note: Application of Luminol and Leucomalachite Green Tests to Wischnewsky Spots After Formalin Fixation. 技术说明：鲁米诺和绿孔雀石绿试验在福尔马林固定后威氏斑的应用。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-24 DOI: 10.1097/PAF.0000000000001019

Norihiro Shinkawa, Ai Sonoda, Eiji Kakizaki, Nobuhiro Yukawa

引用次数: 0