首页期刊导航|The American Journal of Forensic Medicine and Pathology
期刊信息/Journal information
The American Journal of Forensic Medicine and Pathology
Masson Publishing USA
The American Journal of Forensic Medicine and Pathology

Masson Publishing USA

0195-7910

The American Journal of Forensic Medicine and Pathology/Journal The American Journal of Forensic Medicine and Pathology
正式出版
收录年代

    The Public Health Role of Medical Examiner Offices During COVID-19 and Other Mass Fatality Events

    Bhullar, Manreet K.Gilson, Thomas P.Lee, Junghyae
    4页
    查看更多>>摘要：The public health role of a medical examiner office (MEO) in a pandemic is largely undefined; however, death data may be useful in strategic planning. Deaths reportable to MEO are defined in statute, with discretion as to the assumption of jurisdiction. We analyzed the daily reported death numbers (DRDNs) in our jurisdiction from March 1, 2020, to March 31, 2021, and compared them with hospital admission and COVID-19 fatality data over the same period. The DRDN from an MEO is easily obtained and may be useful as a supplemental and surrogate metric in certain pandemic mass casualty decisions. Hospital admission data were analyzed in real time and with a 2-week time-shift, as deaths lag hospital admissions as a disease surveillance metric. Moderate correlation was observed between DRDN and hospital admissions (r = 0.570), and this improved to strong correlation (0.645) when the 2-week time-shift was incorporated into the analysis. Both evaluations were statistically significant (P < 0.0001). The DRDN also moderately correlated (r = 0.412) with the number of COVID-19 deaths. Because death certification and hospital diagnosis may be delayed, real-time trend recognition in a pandemic may benefit from use of DRDN from MEO.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Comprehensive Severe Acute Respiratory Syndrome Coronavirus 2 Detection Using Polymerase Chain Reaction and Rapid Antigen Testing in Postmortem Specimens

    Kanuka, HirotakaIwadate, KimiharuMatsumoto, SariTakasu, Shojiro...
    5页
    查看更多>>摘要：Polymerase chain reaction (PCR) is indispensable for diagnosing coronavirus disease 2019 (COVID-19) in autopsy cases. In this study, we performed comprehensive reverse transcription quantitative PCR (RT-qPCR) and rapid antigen tests for COVID-19 on forensic postmortem specimens, regardless of the antemortem symptoms and causes of death. Immediately before forensic external examination and autopsy, a wiping solution was collected from the nasopharynx with a dry swab, and rapid antigen testing and RT-qPCR were performed. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected by RT-qPCR in 12 of the 487 cases; the infection rate was 2.46%. Of the RT-qPCR-positive cases, 7 were associated with COVID-19-related deaths. Cycle threshold values were not correlated with the cause of death or postmortem time. The sensitivity and specificity of the rapid antigen test were 91.67% and 100.00%, respectively. The RT-qPCR positivity rate of forensic cases was higher than the cumulative infection rate for the entire population. SARS-CoV-2 could be detected with the rapid antigen test and RT-qPCR within 216 hours of death. Because the rapid antigen test showed the same sensitivity and specificity as those observed in clinical practice, the test combined with RT-qPCR may be useful for diagnosing COVID-19 even in postmortem specimens.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Non-Firearm-related Homicides at the Medical University of South Carolina, 2013-2018

    Sullivan, ChristopherPresnell, Susan Erin
    7页
    查看更多>>摘要：After high-profile events involving firearms, gun violence often becomes the center stage of public discourse with national media attention, overshadowing less common causes of homicidal deaths, such as sharp force injury, blunt trauma, and asphyxia. A retrospective analysis of all cases referred for medicolegal autopsy to the Medical and Forensic Autopsy Division of the Department of Pathology and Laboratory Medicine at the Medical University of South Carolina from 2013 to 2018 documented 793 deaths where the manner was classified as homicide. Of these, 18% (144) of the deaths were caused by non-firearm-inflicted injuries. Nonfirearm homicides were further categorized by method; demographic data including decedent age, race, and sex; and other variables such as incident site, decedent relationship status to the alleged perpetrator, number of other homicide fatalities associated with a homicide event, and the presence of drugs and alcohol in the decedents. Data accrued in this review were compared with national statistics published by the Centers for Disease Control and Prevention and to the overall Medical University of South Carolina firearm-related homicide decedent demographic statistics for this same period. Findings augment existing information available regarding non-gun-related homicides and may be valuable in contributing to the ongoing public and political debate regarding firearm and nonfirearm fatalities.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Investigating the Source of Fatal Pulmonary Thromboembolism in a Coronial Postmortem Population

    Rivers-Kennedy, April DimityByard, Roger W.Van den Heuvel, CorinnaQuill, Rachael...
    4页
    查看更多>>摘要：The incidence of how often a deep vein thrombosis is found in the calves of the legs at coronial postmortem examination is unclear. This study retrospectively examined postmortem examination reports from Australian Coronial investigations of sudden death resulting from pulmonary thromboembolism to determine the likelihood of dissection of the deep veins of calves of the legs revealing the source of a pulmonary thromboembolism. From 450 cases taken from the National Coronial Information System (NCIS) for 2016, the postmortem reports of 327 cases were reviewed to provide demographic details of victims of sudden death from pulmonary thromboembolism. In 235 cases, it was possible to determine in 76.6% a thrombus had been found in the deep veins of the calves of the legs after dissection. In 141 cases, it was documented that both sides had been examined. From these. it was determined there was no statistically significant difference in the prevalence of thrombus in either side. However, it was shown that the presence of an abnormality of a lower limb (such as leg or hip infection, burns, surgery and nonoperated fractures, or a larger circumference) increased the likelihood that a deep vein thrombus would be found on that side.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Hydatid Disease, an Uncommon Etiology of Death in Forensic Practice

    Mahjoub, YosraBoussaid, MarwaMesrati, Mohamed AmineHadj, Meriem Bel...
    5页
    查看更多>>摘要：In Tunisia, hydatid cyst is an endemic parasitic disease. The cyst may remain asymptomatic, discovered accidentally, or in case of a complication, the most serious of which is sudden death. We propose, in this article, to analyze the degree of involvement of the cyst in the mechanism of death, through the review of 25 cases. A total of 7932 autopsy cases were performed during the study period. Twenty-five cases of hydatid cyst discovered at autopsy were collected and death was attributed to hydatid cyst in 13 cases. The seat of the cyst was variable and death was due to anaphylaxis in 10 cases, to hydatious embolism in 2 cases and to cardiac arrhythmia, resulting from a cardiac localization of a large hydatid cyst, in 1 case. Although rare, echinococcosis can be a life-threatening disease. Its involvement in the death mechanism remains difficult in many cases.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Comparative Study of Acute Anogenital Injury Between Consensual and Nonconsensual Postmenarche Adolescents

    Suttipasit, PapanuSinlapamongkolkul, PhakatipWongwittayapanich, Surachet
    16页
    查看更多>>摘要：In Thailand, sexual activity involving those under the legal age of consent may be legally and medically problematic, even if it is consensual. Thus, differentiating anogenital injury characteristics that occur during consensual versus nonconsensual acts with adolescent female subjects could aid legal advocates and improve health care and social support for these patients. Our study included postmenarche female patients having acute anogenital injuries after consensual and nonconsensual penetration. We found that nonconsenting patients had more cases of anogenital injury than consenting (69.8% vs 55.5%), with at least 1 abrasion, contusion, laceration, labia major or minor injury, and external or internal site injury. Both consensual and nonconsensual cases had the same common sites for injury type, reflecting the same injury mechanism; prior sexual intercourse was a significant protective factor against some anogenital injury prevalence, types, and sites for both groups. Adolescents forced into nonconsensual acts had more nonanogenital injuries. Looking at factors such as age, prior sexual activity history, and use of condom and/or contraceptive pills, it is very clear that early sexual education, particularly around consent, is critically needed in Thailand for the best interests of adolescents and children so that they and/or their guardians can access the health and legal resources required.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Loss of Nuclear Basophilic Staining as a Postmortem Interval Marker

    Alabbasi, Samah F.Viramontes, Ariel C.Diaz, Francisco J.Weedn, Victor W....
    5页
    查看更多>>摘要：Introduction The loss of basophilia (LOB), as an objective marker of postmortem interval (PMI), was evaluated. Such a correlation has been previously reported in stillborn fetuses. Method Loss of basophilia in different tissues was scored using hematoxylin and eosin-stained slides obtained from 65 random autopsy cases. Scatter plots were used to visually assess the correlation of PMI with our LOB scores. Decomposition was assessed using a modified total body score. Results Loss of basophilia was found to be correlated with PMI (total and unrefrigerated intervals). Specifically in this study, we found full or partial basophilic staining up to 26 hours after death, and complete LOB was seen in cases as early as 36 hours in liver and 60 hours in heart. Loss of basophilia also well correlated with the modified total body score. The LOB varied by tissue and was uncorrelated to histologically observable bacteria and fungi. Refrigeration appeared to stop the autolytic process that causes the LOB. Conclusion Complete LOB can be expected between 1 and 2 days after death in unrefrigerated liver and heart tissues because of autolysis.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Postmortem Interval Estimation With Corneal Endothelial Cell Density

    Ozsoy, SaitKaya, BurakBalandiz, HuseyinAkyol, Mesut...
    6页
    查看更多>>摘要：Objectives In the neonatal period, healthy people have the highest corneal endothelial cell density (CECD) (5000-7000 cells/mm(2)). Corneal endothelial cell density declines with age in adults (2500-3000 cells/mm(2)) and continues to decline in the postmortem period. We measured CECD in cases with different postmortem interval (PMI) and investigated its association with PMI. Methods A total of 555 corneas harvested from 285 cases with a known time of death were examined using a specular microscope. Results Postmortem corneal removal time ranged between 10 and 1395 minutes. The CECD averages were 2653 for right cornea and 2678 cells/mm(2) for left cornea. An inverse but nonlinear relationship was found between age and CECD. In both men and women, there was an inverse and weak correlation between age and CECD (rho = -0.282; P < 0.001; rho = -0.264; P < 0.001, respectively). There was no significant relationship between postmortem corneal removal time and CECD (rho = 0.049; P = 0.421; rho = 0.011; P = 0.855 for right and left corneas, respectively). The highest decline in time dependent CECD was detected between the 480th and 540th minutes at -7.2%. Conclusions We found no significant decrease in CECD numbers according to PMI or cause of death. Experimental studies on cases with known and standardized antemortem CECD values will provide essential results in estimating PMI.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    A Survey of Fetal Deaths as Reported to a Medical Examiner's Office

    Sandoval, AliciaWinston, David
    4页
    查看更多>>摘要：This article is a review of the fetal deaths reported to the Pima County Office of the Medical Examiner in Tucson, Arizona, from January 2000 to May 2020. The 115 cases included in this study were analyzed for the decedent's estimated gestational age, sex, maternal drug use, toxicology results, and cause of death. The male/female ratio was 0.95:1.0. The average gestational age of nonterm infants older than 20 weeks was 27.2 weeks. Nearly half of the cases had suspected or known maternal drug use. In these cases, cocaine and methamphetamine were most often detected in postmortem testing of the fetus. The most common causes of death in descending frequency were intrauterine fetal demise of unknown etiology, drugs, infection, and prematurity. Other notable causes of death included trauma and placental abruption. Congenital malformations were detected in only 3.5% of cases.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Medicolegal Implications of Fatalities Because of Entanglement in the Augers of Feed Mixer Wagons

    Moreschi, CarloDa Broi, UgoTse, RexsonGarland, Jack...
    9页
    查看更多>>摘要：Feed mixer or total mixed ration mixer wagons are powerful agricultural machines used to shred and mix silage with other ingredients and deliver it direct to the feeding troughs on livestock farms. Fatalities involving these feed mixers may occur when operators become trapped in the augers or, less frequently, are crushed by moving wagons. Death can occur very rapidly because of dismemberment, multiple lesions, or crushing. The aim of this review is to focus on the diagnostic evaluations that need to be performed to confirm that the death was accidental and to exclude a hypothesis of murder or suicide. Forensic investigations in such cases must involve the detailed analysis of the death scene and the mechanical characteristics of the machinery with an accurate postmortem and toxicological examination.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins