American Journal of Forensic Medicine and Pathology最新文献_第9页

Incidental Finding of an Early-Stage Intrauterine Pregnancy at Autopsy. 尸检意外发现早期宫内妊娠

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-20 DOI: 10.1097/PAF.0000000000001007

Garrett Phillips

引用次数: 0

Illustrated Forensic Pathology: Necklacing. 插图法医病理学：项链。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-11 DOI: 10.1097/PAF.0000000000001004

Ryan Blumenthal, Robert Maximilian

引用次数: 0

Tolerant or Intolerant? Learning From Studying Drug Concentrations in the Living and the Dead. 宽容还是不宽容？从研究活人和死人体内的药物浓度中学习。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-01 Epub Date: 2024-06-12 DOI: 10.1097/PAF.0000000000000962

Laura M Labay, Sherri L Kacinko, Brittany K Casey, Justin O Brower

{"title":"Tolerant or Intolerant? Learning From Studying Drug Concentrations in the Living and the Dead.","authors":"Laura M Labay, Sherri L Kacinko, Brittany K Casey, Justin O Brower","doi":"10.1097/PAF.0000000000000962","DOIUrl":"10.1097/PAF.0000000000000962","url":null,"abstract":"A bstract: 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 alone. One starting point, however, is to compare reported findings with reference ranges associated with therapeutic, toxic, and lethal outcomes. Toxicologists have observed concentrations dramatically increase over time in the living population for some drugs to concentrations that can easily be associated with impairment and lethal outcomes. It is, therefore, important to continually monitor and be familiar with drug concentrations found in the living to interpret postmortem concentrations. To emphasize this approach, we compared fentanyl concentrations from JAN 2010 to OCT 2023 in individuals investigated for driving under the influence of drugs to postmortem cases. This comparison highlights the changing nature of tolerance, stresses the importance of not relying solely on reference ranges for result interpretations, and discusses the importance of the autopsy in identifying or ruling out other potential causes of death.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"292-296"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635999","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

Circumstances and Pathological Findings in Civilian Helicopter-Related Fatalities. 与民用直升机相关的死亡事故的情况和病理结果。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-01 Epub Date: 2024-08-20 DOI: 10.1097/PAF.0000000000000964

Marianne Tiemensma, Salona Prahladh, Roger W Byard

{"title":"Circumstances and Pathological Findings in Civilian Helicopter-Related Fatalities.","authors":"Marianne Tiemensma, Salona Prahladh, Roger W Byard","doi":"10.1097/PAF.0000000000000964","DOIUrl":"10.1097/PAF.0000000000000964","url":null,"abstract":"Abstract: 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 were all male (age range, 34-74 years; mean, 52 years). All fatal crashes occurred in remote areas, the majority on cattle stations. Pilots were the sole occupants in 5/9 incidents; in 4 incidents, there were injured survivors. All fatal incidents involved Robinson piston engine helicopters (Robinson R44 models in 2 incidents and Robinson R22 models in the remaining 7). Scene investigations, postmortem examinations, and ancillary investigations were frequently hampered by decomposition of the remains, resulting from difficult search operations and delayed location, retrieval, and storage. Head injuries were present in all cases with chest and spinal injuries in more than half. Integrated assessment of injuries with toxicological and aviation investigations facilitated understanding of the crash dynamics.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"299-307"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005997","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 Forensic Perspective of Infectious Endocarditis: A Retrospective Study With Recommendations for the Future. 从法医角度看感染性心内膜炎：一项回顾性研究及对未来的建议。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-01 Epub Date: 2024-05-23 DOI: 10.1097/PAF.0000000000000942

Alison Krywanczyk, Thomas Gilson

{"title":"The Forensic Perspective of Infectious Endocarditis: A Retrospective Study With Recommendations for the Future.","authors":"Alison Krywanczyk, Thomas Gilson","doi":"10.1097/PAF.0000000000000942","DOIUrl":"10.1097/PAF.0000000000000942","url":null,"abstract":"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 natural (69%), accident (28%), and homicide (3%). For all accidental deaths, acute intoxication was included in either part I or II. The aortic valve was most affected (62%), followed by tricuspid (28%) and mitral (24%). Seventy-six percent of affected valves were native, and 24% were prosthetic. Common risk factors included intravenous drug use (48%) and chronic ethanolism (21%). No sustained increase in deaths due to IE was identified. These data show marked differences from clinical literature, including a lower average age and higher incidence of substance use disorders, and it is unlikely selection bias is the sole reason. There was inconsistency in death certification, most notably by not including pertinent IE risk factors. Improving consistency and quality of IE death certification will aid in detecting regional trends and assist multi-institutional collaboration efforts.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"287-291"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249232","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

When Vaping Isn't Actually Safer: A Death From Toxic Alcohol Contaminated Vape Juice. 当吸食电子烟实际上并不更安全时：死于受有毒酒精污染的 Vape Juice。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-01 Epub Date: 2024-05-23 DOI: 10.1097/PAF.0000000000000951

Timothy Ogburn, Irfan Chaudhry, Laura D Knight

{"title":"When Vaping Isn't Actually Safer: A Death From Toxic Alcohol Contaminated Vape Juice.","authors":"Timothy Ogburn, Irfan Chaudhry, Laura D Knight","doi":"10.1097/PAF.0000000000000951","DOIUrl":"10.1097/PAF.0000000000000951","url":null,"abstract":"Abstract: 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 made a tincture combining a vape juice purchased online (containing \"ethylene glycol\") and THC for \"endometriosis-related pain relief.\" Laboratory evaluation revealed anion gap metabolic acidosis, elevated serum lactate, and high serum osmolality. Urine fluoresced under Wood's lamp, and fomepizole was administered as an ethylene glycol antidote, but she expired the following afternoon. Clinical serum toxicology results returned after death revealed 235 mg/dL of methanol, and no ethylene glycol.Autopsy findings included ischemic changes of the gastrointestinal tract and cerebral edema with herniation. Postmortem toxicology performed on hospital admission blood revealed methanol (220 mg/dL), propylene glycol (59 mg/dL), Δ-9 THC and metabolites, and medications administered during hospitalization. The medical examiner determined the cause of death to be methanol and propylene glycol toxicity.To our knowledge, this is the first report of accidental death from ingestion of vape juice contaminated with toxic alcohol.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"335-339"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249234","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

Letter to the Editor: Self-Manipulation Inaccurately Associated With the Chiropractic Profession. 致编辑的信：自我操纵与脊骨神经科学专业的联系不准确。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-01 Epub Date: 2024-05-23 DOI: 10.1097/PAF.0000000000000950

Kevin W Meyer, Robert J Trager, Clinton J Daniels, Zachary A Cupler

引用次数: 0

Amniotic Fluid Embolism: An Illustrated Report and Review of Literature. 羊水栓塞：图解报告和文献综述。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-01 Epub Date: 2024-06-12 DOI: 10.1097/PAF.0000000000000956

Nicolas Kostelecky, Margarita Loxas, Rachel Multz, Margaret E Flanagan, Jared T Ahrendsen, Jeffery Goldstein

引用次数: 0

Fatal Vertebral Artery Dissection Following Self-Manipulation of the Cervical Spine. 自我操纵颈椎导致致命的椎动脉交叉。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-01 Epub Date: 2024-03-18 DOI: 10.1097/PAF.0000000000000932

Jane E Persons, Stephanie Stauffer

{"title":"Fatal Vertebral Artery Dissection Following Self-Manipulation of the Cervical Spine.","authors":"Jane E Persons, Stephanie Stauffer","doi":"10.1097/PAF.0000000000000932","DOIUrl":"10.1097/PAF.0000000000000932","url":null,"abstract":"Abstract: 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 developed strokelike symptoms and became unresponsive. He was transported to a local medical center, where imaging showed bilateral vertebral artery dissection. His neurological status continued to decline, and brain death was pronounced several days later. An autopsy examination showed evidence of cerebellar and brainstem infarcts, herniation, and diffuse hypoxic-ischemic injury. A posterior neck dissection was performed to expose the vertebral arteries, which showed grossly visible hemorrhage and dilation. There was no evidence of traumatic injury to the bone or soft tissue of the head or neck. Bilateral dissection tracts were readily appreciated on microscopic examination. Death was attributed to self-manipulation of the neck, which in turn led to bilateral vertebral artery dissection, cerebellar and brainstem infarcts, herniation, hypoxic-ischemic injury, and ultimately brain death.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"352-354"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144705","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

A 3-Year Retrospective Review of Complex Suicides With a Review of the Literature. 对复杂自杀事件的三年回顾及文献综述。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2024-12-01 Epub Date: 2024-06-12 DOI: 10.1097/PAF.0000000000000961

Alexandra Paredes Rivera, Awa Sarr Dramé, Laura D Knight

{"title":"A 3-Year Retrospective Review of Complex Suicides With a Review of the Literature.","authors":"Alexandra Paredes Rivera, Awa Sarr Dramé, Laura D Knight","doi":"10.1097/PAF.0000000000000961","DOIUrl":"10.1097/PAF.0000000000000961","url":null,"abstract":"Abstract: 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 subsequently that is successful.A retrospective review of 3 years of suicide fatalities examined by the Washoe County Regional Medical Examiner's Office in Reno, Nevada, was conducted. A total of 725 suicide cases dated from April 1, 2020, to April 1, 2023, were reviewed, including autopsy, toxicology, and scene investigation reports. Among the 725 suicide cases reviewed, 19 cases (2.62%) of complex suicide were identified. Of those cases, 17 employed 2 methods, and 2 cases employed 3 methods. No cases were identified with >3 methods.In the 19 complex suicides that were identified, gender, age, marital status, military service, sexual orientation, religion, race, occupation, incident location, suicide note, suicidal ideation history, past suicide attempt, psychiatric disorders, and motive for suicide were examined in addition to methods used.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":"308-313"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635957","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