|
1. |
Biosafety Considerations for Autopsy |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 107-122
Kurt Nolte,
David Taylor,
Jonathan Richmond,
Preview
|
PDF (585KB)
|
|
摘要:
An autopsy may subject prosectors and others to a wide variety of infectious agents, including bloodborne and aerosolized pathogens such as human immunodeficiency virus, hepatitis B and C viruses, andMycobacterium tuberculosis. Other hazards include toxic chemicals (e.g., formalin, cyanide, and organophosphates) and radiation from radionuclides used for patient therapy and diagnosis. These risks can be substantially mitigated through proper assessment, personal protective equipment, appropriate autopsy procedures, and facility design.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
2. |
Asphyxial Deaths Caused by Automobile Exhaust Inhalation not Attributable to Carbon Monoxide Toxicity: Study of 2 Cases |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 123-126
Gregory Schmunk,
James Kaplan,
Preview
|
PDF (29KB)
|
|
摘要:
The authors report two suicides that resulted from the intentional inhalation of automobile exhaust gases in which death occurred without the formation of physiologically significant amounts of carboxyhemoglobin. These circumstances are correlated with measurements of the involved vehicles’ exhaust gases, which showed reduced concentrations of carbon monoxide present, reflecting improvements in automobile engine technology. In the absence of carbon monoxide toxicity, the authors attribute death in these cases to asphyxia caused by carbon dioxide intoxication and diminished atmospheric oxygen concentrations.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
3. |
Infanticide: Is Its Incidence Among Postneonatal Infant Deaths Increasing?An 18-year Population-Based Analysis in California |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 127-131
Henry Krous,
Julie Nadeau,
Patricia Silva,
Roger Byard,
Preview
|
PDF (49KB)
|
|
摘要:
The decline in the incidence of sudden infant death syndrome (SIDS) and recent recommendations regarding the differentiation of SIDS and child abuse has generated speculation that some cases of infanticide were misdiagnosed as SIDS. The aims of this study were to determine the change in incidences and proportions of postneonatal deaths from all causes, SIDS, and infanticide in California over an 18-year interval encompassing years before and after the Back to Sleep campaign. Selected postneonatal mortality data from 1981 through 1998 obtained from the California Department of Health Services were analyzed and graphically displayed. The total postneonatal mortality and incidence of SIDS deaths per 100,000 live births decreased 45% and 66%, respectively, during the study interval; the incidence of infanticide remained low. The ratio of infanticide to SIDS increased from 4.3 per 100 in 1981 to 10.2 per 100 in 1998. Infanticide deaths, as a percentage of the total number of postneonatal deaths, increased slightly from the first to the second half of the study interval but never rose above 3.2%. It is concluded that this increased percentage is due to a decrease in SIDS deaths and not to an actual increase in infanticide deaths.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
4. |
Analysis of the Incidence of Pelvic Trauma in Fatal Automobile Accidents |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 132-136
Julie Adams,
Gregory Davis,
Robert Heidepriem,
Jorge Alonso,
C. Bruce Alexander,
Preview
|
PDF (87KB)
|
|
摘要:
Pelvic fractures are frequent complications of motor vehicle accidents, and motor vehicle accidents are the most common cause of pelvic fracture. Although pelvic fractures are associated with considerable morbidity and mortality, there has traditionally been no attempt to grade or classify pelvic fractures during postmortem examination. The authors performed a retrospective study of cases examined at the Jefferson County Coroner/Medical Examiner Office from 1994 to 1996, reviewing investigative reports and autopsy findings. Radiographs were examined for the presence and Tile type of pelvic fracture. Pelvic fractures were identified in 88 of 392 cases (23%). In most (89%), the pelvic fracture was readily classified according to Tile type on the basis of radiographs and the inferred mechanism of injury. This study indicates that current estimates of the mortality of pelvic fractures are low because of the exclusion of individuals who do not survive to hospitalization. Furthermore, pelvic fractures in rapidly fatal motor vehicle accidents tend to be more severe than fractures in individuals who have a significant interval of survival. The presence and classification of pelvic fractures may be readily determined by radiographs in most cases. The Tile classification scheme is easy to apply and has important implications in the comparison of study groups.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
5. |
Modified CardiectomyDocumenting Sudden Cardiac Death in Hearts Selected for Valve Allograft Procurement |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 137-141
Charles Wetli,
Richard Kolovich,
Lisa Dinhofer,
Preview
|
PDF (718KB)
|
|
摘要:
Medical examiners frequently deny requests by tissue procurement organizations for heart valves intended for allograft transplantation. Most of these denials are in cases of sudden apparent natural death, often where a cardiac cause is suspected. The basis of denial in these cases is that the heart must be removed and the valves procured off site under sterile conditions. This prevents the medical examiner from determining and documenting the cause of death. A dissection technique was therefore devised to increase the number of heart valves available for allograft transplantation and to simultaneously allow the pathologist to document a cardiac cause of sudden death. Interagency procedures, the dissection technique, and case summaries are provided.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
6. |
A Newspaper Surveillance Study of Homicide-Suicide in the United States |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 142-148
Julie Malphurs,
Donna Cohen,
Preview
|
PDF (52KB)
|
|
摘要:
The objective of this study was to identify the number and subtypes of homicide-suicides in the United States by age group and state over a 3-year period from 1997 through 1999. A total of 673 homicide-suicides, including 674 perpetrators and 779 victims, were identified from Internet searches of 191 national newspapers, and they were classified according to a modified Hanzlick-Koponen typology. One quarter of the homicide-suicides were perpetrated by persons 55 years or older, and 77% were spousal/consortial, higher than the 57% observed in the younger age group; 11% of the older homicide-suicides were familial, compared with 16% in the younger age group. Whereas only 3% of older homicide-suicides were infanticide/pedicide, 16% of the younger homicide-suicides involved parents killing their children. Forty-five states, including the District of Columbia, reported a homicide-suicide during the 3-year period, and they occurred most frequently in Florida (163), California (98), Texas (36), and New York (35). Newspaper surveillance is useful to identify where homicide-suicides are occurring most frequently, but they are underestimates of the true prevalence. However, the number of incidents detected is large enough that the cases detected may be a fairly representative sample.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
7. |
Therapy-Related Café Coronary DeathsTwo Case Reports of Rare Asphyxial Deaths in Patients under Supervised Care |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 149-154
Donna Hunsaker,
John Hunsaker,
Preview
|
PDF (600KB)
|
|
摘要:
Café coronary deaths, as initially characterized, denote fatal occlusion of the upper airway by food substances. Such fatalities typically occur in individuals who either are clinically inebriated or have clinically significant neuromuscular dysfunction. Both conditions impair mastication and deglutition. The authors review the accidental deaths of two neurologically compromised patients under supervised care. Both subjects underwent complete medicolegal autopsy. In one case, ingestion of a prescribed emollient laxative precipitated death; in the other, death was attributable to aspiration of a contrast medium during a diagnostic radiographic procedure. These therapy-related deaths, which are regarded as a variation of the traditionally described café coronary fatalities summarized in the discussion, represent adverse events occurring during medical care. The adverse outcomes reviewed here are potentially avoidable and require special attentiveness by the clinicians directed to the particular condition of each patient. Such true aspiration-related deaths are confirmed on autopsy examination and are to be differentiated from the findings of agonal aspiration of gastric contents commonly encountered by the autopsy pathologist investigating deaths due to a great variety of natural and traumatic causes.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
8. |
Analysis of Ionic Ratios in Myocardial Tissue and Their Relation to Cardiac Damage |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 155-158
M. Torres,
Eduardo Osuna,
María Pérez-Cárceles,
Maximiliano Gómez-Zapata,
Aurelio Luna,
Preview
|
PDF (37KB)
|
|
摘要:
The authors evaluated the usefulness of the postmortem biochemical analysis of ionic ratios in different parts of the heart and their relation to cardiac damage caused by chest trauma, as observed by anatomopathologic study. Fifty-nine 59 cases were studied, selected from routine necropsies, and samples were taken from different sites of cardiac tissue. The cause of death was trauma in 40 cases and nontraumatic causes in 19 cases. The object of this study was to analyze the levels of Na+, K+, Ca+2, Mg+2, and Zn+2in different zones of the heart, and the relationship between intracellular and extracellular ion ratios and the different causes of death and any anatomopathologic alterations observed. The biochemical tests revealed a possible relation between the ionic values and cause of death. Alterations in cell membrane permeability and corresponding modification of the ionic ratios were produced earlier than histologic alterations, which need longer to establish themselves whether or not they follow a traumatic process.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
9. |
Determination of Ethylene Glycol Tissue Content After Fatal Oral Poisoning and Pathologic Findings |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 159-161
Philippe Hantson,
Roger Vanbinst,
Paul Mahieu,
Preview
|
PDF (70KB)
|
|
摘要:
A 23-year-old comatose man who had drunk an unknown amount of ethylene glycol was admitted to the hospital 5 hours after ingestion. The initial plasma ethylene glycol concentration was 116.2 mg/100 ml. A severe metabolic acidosis was present. Despite aggressive therapy with ethanol, hemodialysis, and intensive care support, the patient died 27 hours after poisoning. The plasma ethylene glycol concentration immediately before death was 35.9 mg/100 ml. Brain edema and acute renal tubular necrosis were evident at postmortem examination. Oxalate crystals were identified in both organs. Ethylene glycol content or concentration was determined in tissues and biologic fluids.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
10. |
Toxicologic Analysis in Cases of Possible Sudden Infant Death SyndromeA Worthwhile Exercise? |
|
The American Journal of Forensic Medicine and Pathology,
Volume 23,
Issue 2,
2002,
Page 162-166
Neil Langlois,
Peter Ellis,
Dianne Little,
Bogdan Hulewicz,
Preview
|
PDF (37KB)
|
|
摘要:
The diagnosis of sudden infant death syndrome (SIDS) is one of exclusion. At the Department of Forensic Medicine, Westmead Hospital, toxicologic analysis is performed as part of the postmortem examination of all apparent SIDS deaths. The results for the 5-year period January 1, 1994, to December 31, 1999, were audited to determine whether such routine testing was worthwhile. During this time there were 117 cases with a history consistent with SIDS. Drugs were detected in 19 (16%) of these cases. In 1 case, death was attributed to the finding of methadone. The presence of methadone was regarded as a possible contributing factor to death in a further 2 cases. The presence of possible methadone toxicity had not been expected from the history given before the examination in these 3 cases. In 114 cases there was a suitable sample for alcohol testing; in no case was alcohol detected. In 13 cases the postmortem examination revealed an anatomic cause of death (including 3 cases consistent with whiplash/shaken baby/impact head injury), which excluded a diagnosis of SIDS. In conclusion, routine toxicologic testing in all possible cases of SIDS death supplements the postmortem examination in excluding cases of non-SIDS.
ISSN:0195-7910
出版商:OVID
年代:2002
数据来源: OVID
|
|