摘要:

Physicians disagree on several issues regarding head injury in infants and children, including the potential lethality of a short-distance fall, a lucid interval in an ultimately fatal head injury, and the specificity of retinal hemorrhage for inflicted trauma. There is scant objective evidence to resolve these questions, and more information is needed. The objective of this study was to determine whether there are witnessed or investigated fatal short-distance falls that were concluded to be accidental. The author reviewed the January 1, 1988 through June 30, 1999 United States Consumer Product Safety Commission database for head injury associated with the use of playground equipment. The author obtained and reviewed the primary source data (hospital and emergency medical services’ records, law enforcement reports, and coroner or medical examiner records) for all fatalities involving a fall.The results revealed 18 fall-related head injury fatalities in the database. The youngest child was 12 months old, the oldest 13 years. The falls were from 0.6 to 3 meters (2–10 feet). A noncaretaker witnessed 12 of the 18, and 12 had a lucid interval. Four of the six children in whom funduscopic examination was documented in the medical record had bilateral retinal hemorrhage. The author concludes that an infant or child may suffer a fatal head injury from a fall of less than 3 meters (10 feet). The injury may be associated with a lucid interval and bilateral retinal hemorrhage.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

A 13-year-old girl experienced a fall during gym class that caused immediate unresponsiveness and death. The lone witness reported that the decedent lost her balance as she approached a hurdle and fell, striking her head on a crossbar of the hurdle near the ground. Autopsy revealed no external injury. Internal injury that could be demonstrated anatomically was confined to a contusion within the right semicapitis muscle at the base of the skull. In the absence of an anatomic cause of death, possible explanations of the death include a cardiac dysrhythmia, a vasovagal stimulus, and diffuse axonal injury caused by a concussive force to the junction of the medulla and spinal cord. Animal studies have shown that severe concussion can cause death via profound autonomic dysfunction without leaving anatomic evidence of injury, and that the essential component of concussion is an element of rotational injury to the brain. The authors believe that the blow to the neck caused this death by the transmission of a concussive force through the reticular activating system. The prompt work of police in distinguishing the lone witness from several people in the area who thought they knew what had happened was essential for diagnosis. On reaching our conclusions, the authors notified first the family, then the superintendent of the school system, and finally the news media. The authors told each party in turn that they would be contacting the others.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Right ventricular cardiomyopathy dysplasia, now a well-established clinical and morphologic entity, was first reported in the medical literature in 1982. The cases of sudden death of two young men are here reported, with macroscopic and histologic findings. The anatomical explanation of such death was a fibrotic, lipomatous, or fibrolipomatous replacement and infiltration of the myocardium of the right ventricle. It is suggested that death due to right ventricular cardiomyopathy seems to be the result of electrical instability of right ventricular myocardium. There were no congenital malformations such as septal defect or valvular deformity. The subjects’ heart weights were normal. Signs of myocardial degeneration and necrosis with or without inflammatory infiltrates were not identified.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Epidemiologic studies of sudden infant death syndrome (SIDS), the leading cause of death of infants during the postperinatal period (7–365 days), have mainly focused on the deaths of single infants. Simultaneous sudden infant death syndrome (SSIDS), the death of a pair of twins occurring at the same time, has received limited attention within the medical community. To the authors’ knowledge, this article is the first to describe the 41 SSIDS cases cited in the world literature from 1900 to 1998 by the location of death, a summary of the circumstances surrounding the deaths, and evaluation of these cases in terms of a proposed definition of SSIDS. This evaluation critiques whether the 41 pairs of SSIDS cases adhere to a newly proposed definition of SSIDS. Twin infant deaths must meet all three criteria to be considered SSIDS. The study found that only 12 pairs of twins met all three criteria (29.2%), nine pairs met two criteria (21.9%), alternative cause of death was offered in five pairs of twins (12.1%) and in the remaining 15 pairs (36.6%), only limited information was available; therefore, no conclusions could be reached.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The first reported case of simultaneous sudden infant death syndrome (SSIDS) in Allegheny County, Pennsylvania, occurred on February 27, 1998. Two-month-old black fraternal twin girls were both found dead in their crib at the same time. After an in-depth death scene investigation, police investigation, toxicologic analysis, and complete autopsies, a specific cause of death could not be identified. The deaths of the two girls were therefore ruled simultaneous sudden infant death syndrome.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The National Center for Health Statistics (NCHS) is responsible for publishing Standard Certificates of Birth and Death for the United States of America. The standard certificates are revised roughly every 10 years. The revision process is designed to ensure that the standard certificates meet, as nearly as possible, the use for which they are intended at all levels: individual, local, state, and federal. The authors report on the most recent revision of the U.S. Standard Certificate of Death, recording the process and the role of the National Association of Medical Examiners in the process. Changes recommended during revision include requesting known aliases of a decedent and rearrangement of the certificate to provide more room for those items requesting dates and for describing how the injury occurred. New items have been added asking for information regarding traffic fatalities, the role of tobacco use in causing death, and whether female decedents were pregnant. Once approved by the Department of Health and Human Services, the new standard certificate will be made available to the states. Each state will have 2 years to adapt the U.S. Standard Certificate of Death to its use and to implement new state death certificates on January 1, 2003.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Artillery weapons are designed to inflict death and destruction by way of fragmentary and blast injuries. As pieces of modern machinery, they are also capable of causing serious injury by their very complex nature. The authors present a case analysis of an artillery piece that caused a projectile death without a shell.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Reported cases in Europe of large felines attacking humans are rare. Recently, in France, a man was attacked in an animal park by a tigress he had raised. He received fatal cervical wounds. This case of death by bites and lacerations, together with others in the recent international literature, underline the hereditary ferocity of such felines and the way in which they prefer to inflict lesions to the neck.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

A Hispanic woman, 7¼ to 7½ lunar months pregnant, was strangled to death by her common-law husband. After receiving information from an informant, a reporter uncovered the remains of the woman and fetus in a grave in a river bank near Eloy, Arizona. The remains were submitted by local law enforcement officials to the forensic pathologist for medicolegal examination. After this analysis, they were turned over to the consulting forensic anthropologist for positive identification of the mother and for fetal age determination to assess possible viability. During the 1970s and 1980s, viability for a fetus of this age was thought possible, although not probable. Prosecution of the common-law husband on the charge of first-degree murder of his wife was successful, whereas a comparable charge for the fetus was not sought. Many issues are raised, including gestational age estimation in relation to fetal viability. Fetal age is reassessed by means of measurements from diaphyseal lengths. These measurements allowed for comparability of fetal age estimations between published studies, with discussion of changing dates of fetal viability made possible through technologic advances. Because fetal viability changes with these advances, it is necessary to establish and update the guidelines for medicolegal practice.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The HUMARA CAG repeats polymorphism was studied in an Italian population sample. Polymerase chain reaction amplification and automated fluorescent analysis were used. A total of 19 and 15 repeats was observed in female and male subjects, respectively, and one new allele was found. The authors conclude that this X-linked short tandem repeat, typed without ambiguity and with a heterozygosity of 0.902, is useful in parentage testing of female subjects.

ISSN:0195-7910    

出版商:OVID    

年代:2001

数据来源: OVID