摘要:

Homicides due to asphyxia are relatively uncommon. To better understand the presentation of such cases, the files of the Bexar County Medical Examiner's Office were reviewed from January 1, 1985, through December 31, 1998, for all such homicides. A total of 133 cases were found. The largest category was ligature strangulation with 48 deaths (21 male, 27 female). Petechiae were present in the conjunctivae and/or sclerae in 86% of the cases; fractures of the hyoid and/or thyroid cartilage were present in 12.5%. There were a total of 41 deaths from manual strangulation (27 female, 14 male). Petechiae were present in 89% of the cases. In cases of manual strangulation, fractures of the hyoid, thyroid, or cricoid cartilage were found in all the male victims and slightly more than one half of the female victims. Twenty-six cases of suffocation were found; 20 of the victims were ≤2 years of age. Only 1 of these children had petechiae and/or scleral hemorrhage. Five deaths were due to choking. Three of the deaths involved adults who were gagged; 2 deaths involved infants with foreign material pushed into the mouth. Other categories of asphyxia were as follows: 9 deaths due to more than one form of asphyxia; 1 death due to hanging, and 3 deaths due to drowning. Rape was the motive in 66% of the female victims of ligature strangulation and 52% of those due to manual strangulation.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Lethal and sublethal injuries to infants caused by anteroposterior manual compression can be accompanied by lateral rib fractures, hemorrhage into the viscera, and when severe, rupture of large vessels and solid organs. Abusers may claim that these injuries were sustained in an attempt to perform cardiopulmonary resuscitation (CPR). The difference between injuries caused by CPR and injuries caused by inflicted anteroposterior compression is examined in one sublethal and two lethal cases.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

To evaluate the level of agreement between medical examiner investigators' opinion of the manner of death and what the manner of death was as certified by forensic pathologist medical examiners (MEs), we reviewed the case records stored in a database of all deaths reported to the office of the medical examiner in Fulton County, Georgia. Of 15,771 deaths reported to the office during a 10-year period, a difference exists in 1908 cases. In 900 natural deaths, the investigators recorded 135 accident, 10 homicide, 10 suicide, and 745 undetermined manners of death. In 755 accidental deaths, the investigators recorded 16 natural, 8 homicide, 13 suicide, and 718 undetermined manners of death. In 107 homicides, the investigators recorded 12 natural, 8 accident, 0 suicide, and 87 undetermined manners of death. In 70 suicides, the investigators recorded 9 natural, 9 accident, 3 homicide, and 49 undetermined manners of death. In 61 deaths classified as undetermined, the investigators recorded 25 natural, 13 accident, 17 homicide, and 6 suicide manners of death. In 15 deaths, the discrepancy exists due to an apparent error in the database information. This study confirms a high concordance between investigator and ME opinion regarding manner of death but also documents the need for case review and autopsies by forensic pathologists to confirm the investigators' opinion of the manner of death, determine the manner of death when the investigator selects undetermined, and on occasion, refute the investigators' opinion regarding the manner of death.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The diagnosis of the vital origin of wounds in many cases remains an unsolved problem for the forensic pathologist. Practical experience enables the expert to diagnose the vital or postmortem origin of wounds on the basis of macroscopic examination. In some cases, optic microscopy is used to confirm the diagnosis. In many other cases, additional more sensitive and specific markers of vitality are required. In the past 50 years, comprehensive research on this topic has resulted in a better understanding of the acute inflammatory reaction. The development and application of sensitive and specific markers through research in the areas of histochemistry, enzymology, and biochemistry has provided a partial solution to the problems involved in wound vitality diagnosis. A review of this challenging area of forensic pathology, including an explanation of these methods and markers, is presented in this paper.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Multiple self-inflicted gunshot wounds to the head are rare and usually present a challenge to the pathologist and to the police in determining the manner of death. We report a case of two suicidal gunshot wounds to the head. The literature is reviewed, and the pertinent findings, including location of the wounds, location of the brain injuries, types of weapons used, and criteria important to determine the manner of death, are discussed.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Pulmonary hemosiderosis has been attributed to airborne fungi in water-damaged homes in studies of a cluster of cases in infants and children in Cleveland, Ohio, in 1997. We have searched for such emerging infectious agents in the Coastal Plain of North Carolina, which is subject to intermittent flooding. Pulmonary tissue from 206 infants and young children whose deaths had been investigated from October 1978 to September 1996 was retained at East Carolina University School of Medicine. Ages ranged from premature newborns to 49-months. One hundred and ten deaths were attributed to sudden infant death syndrome (SIDS). New sections were cut and analyzed using hematoxylin and eosin, Prussian blue for iron, and Gomori methenamine silver for fungal organisms. Twenty-three infants and children had iron-containing macrophages. Sixteen of these had underlying illnesses, but 4 were originally diagnosed as SIDS. Only one of these had sufficient hemosiderosis to be considered as having pulmonary hemosiderosis and no fungi were present. One case without iron had fungi and was not originally diagnosed as SIDS. The single case of pulmonary hemosiderosis found in this rural area is not similar to the cluster in Cleveland. The study identifies no fungal organisms as emerging infectious diseases in this area.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Determining the cause of death when a restrained person suddenly dies is a problem for death investigators. Twenty-one cases of death during prone restraint are reported as examples of the common elements and range of variation in these apparently asphyxial events. A reasonable diagnosis of restraint asphyxia can usually be made after ruling out other causes and collecting supportive participant and witness statements in a timely fashion. Common elements in this syndrome include prone restraint with pressure on the upper torso; handcuffing, leg restraint, or hogtying; acute psychosis and agitation, often stimulant drug induced; physical exertion and struggle; and obesity. Establishing a temporal association between the restraint and the sudden loss of consciousness/death is critical to making a correct determination of cause of death.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

A case of a deceased 77-year-old woman presenting to the coroner for postmortem examination scribed. A plastic tie used to seal loaves of sliced bread and other plastic-wrapped food stuffs was found clamped by its "teeth" to a length of small bowel proximal to the cecum, resulting in localized mucosal ulceration, thickening, and edema of the bowel wall. There was also infarcted small bowel due to aortic atherosclerosis, which was submitted as the cause of death. The presence of the bread tie probably did not significantly contribute to death but was as an unusual finding at postmortem examination and has not been previously described.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

A case of acute intoxication with propranolol is reported. A 60-year-old man was found dead in his car with no evidence of trauma or signs of asphyxia. Near the car, a pharmaceutical box of Inderal, a pharmaceutical formulation containing propranolol, was found. The man was not under therapy with this medication, but circumstantial data suggested the use of this medicine by his sister. High blood levels of propranolol confirmed the suspected drug use and induced us to discuss the probable lethal mechanism of this substance. The analysis of this compound was performed by liquid-liquid extraction followed by gas chromatography/mass spectrometry determination.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Toxicologic analysis of decomposed specimens provides greater analytical challenges than those encountered with fresh postmortem specimens. Despite the difficulties involved, in cases in which the cause of death is not determined at autopsy or when there is a strong indication of drug intoxication, all reasonable steps must be undertaken to perform as comprehensive a drug screen as possible. An unidentified white male was found in a field near a river. The body was decomposed and skeletonized, and 3- to 4-mm maggots were present on the body. Near the body was an empty bottle of secobarbital that had been prescribed to a female. There was no evidence of injury. Calf muscle and maggots were sent for toxicologic analysis. No volatile substances or drugs were detected in the calf muscle. Because intoxication due to secobarbital was strongly suggested from the scene investigation, the only other specimen available, the maggots, were tested for acid-neutral drugs. Secobarbital was identified by retention time and was confirmed by full-scan electron ionization gas chromatography/mass spectrometry. Based on the available information, the medical examiner ruled that the cause of death was secobarbital intoxication and the manner of death was suicide.

ISSN:0195-7910    

出版商:OVID    

年代:2000

数据来源: OVID