Abstract Pseudomesotheliomatous carcinomas (PMC) are rare tumors that clinically, macroscopically, and sometimes histologically resemble malignant pleural mesotheliomas. We report a case of a 91 year woman who was found to have diffuse nodular pleural thickening and a lung mass during a workup for persistent cough. She declined rapidly and died before a histologic diagnosis could be made. Postmortem examination revealed a tumor that diffusely involved the pleural surface with local...
Sat Mar 30, 2019 02:00
Abstract Some authors have suggested that in the fetus, neonate and infant, intradural hemorrhage (IDH) is relatively common and often presents alongside subdural hemorrhage (SDH). These authors have theorized that pediatric SDH may result from an IDH due to blood leakage from a dural vascular plexus. In this study, we report the inter-observer variation for detection of IDH from a retrospectively collected series of pediatric autopsy photographs, with and without SDH. Autopsy...
Wed Mar 27, 2019 02:00
Abstract To describe the technical characteristics of fatal diving mishaps and to elucidate the causes of death using a sequence analysis and a multidisciplinary investigation of diving-related fatalities. All cases of diving deaths recorded on the coast of Girona (Spain) between January 2009 and May 2018 were analyzed. Most data were obtained from the police technical reports and the forensic pathology service. Each accident was analyzed in order to identify the trigger, disabling...
Wed Mar 27, 2019 02:00
Abstract We report a case of a contraindicated attachment of a speaking valve to a tracheal tube with an inflated cuff, which rapidly resulted in the patient's death. The attached one-way valve allowed unrestrained inspiration through the tracheal tube but prevented physiological expiration. The increased pulmonary pressure resulted in alveolar rupture and replaced expiration with a steady release of air into the peribronchial sheaths and the mediastinum, resulting in what is commonly...
Sat Mar 23, 2019 02:00
Fri Mar 22, 2019 02:00
Abstract We report on the visualization of cellular material within lip-prints using Diamond™ dye (DD). The transfer of cellular material via the lips can occur in cases of contact with food or drinking items as well as cases of alleged sexual assault involving oral contact. DD can effectively detect cellular material transferred by touch. Here we investigate if lip-prints can be detected and whether there is consistency within, or variability between, a person's propensity to...
Fri Mar 22, 2019 02:00
Abstract Transorbital penetrating intracranial injuries are uncommon amongst the civilian population, but they can be found in fatal work-related accidents. An unusual case of accidental fatal penetrating intracranial injury in a 44-year-old man at work is reported. He was working in a building site driving a tractor with a rear- mounted flail mower. While he was mowing grass close to a crane, he became unconscious and then comatose. A cranium X-Ray and a brain CAT scan taken before...
Tue Mar 19, 2019 02:00
Abstract Due to their anatomical location, occipital condylar fractures (OCFs) are usually not observed during traditional autopsies and are therefore considered a rare injury. The aim of this study was to determine the true frequency of OCFs using post-mortem computed tomography (PMCT) in traumatic casualties. We retrospectively analyzed 438 PMCT studies of victims of traffic accidents, falls from height, violence, and low-energy head injuries (324 males and 114 females). OCFs...
Tue Mar 12, 2019 02:00
Abstract Two-dimensional photographic documentation is a substantial part of post-mortem examinations for legal investigations. Additional three-dimensional surface documentation has been shown to assist in the visualization of findings and contribute to the reconstruction of the sequence of events. However, 2D photo documentation and, especially, 3D surface documentation, are time-consuming procedures that require specially trained personnel. In this study a 3D imaging system,...
Sat Mar 09, 2019 02:00
Abstract A decrease in the volume of the hippocampus is associated with severe mental illness, especially schizophrenia, and has been studied extensively in the living using magnetic resonance imaging. Autopsy cohorts also represent a valuable data source for imaging studies. However, post-mortem magnetic resonance imaging (PMMRI) is subject to unique challenges, such as the lower core temperature of scanned subjects and the influence of decomposition processes. This study aimed...
Mon Mar 04, 2019 02:00
Abstract Inflicted blunt force trauma and/or repetitive acceleration-deceleration trauma in infants can cause brain injury. Yet, the exact pathophysiologic mechanism with its associated thresholds remains unclear. In this systematic review an overview of animal models for shaking trauma and their findings on tissue damage will be provided. A systematic review was performed in MEDLINE and Scopus for articles on the simulation of inflicted head injury in animals. After collection,...
Mon Mar 04, 2019 02:00
Abstract A 63-year-old mechanic, diagnosed with schizophrenia, was found next to a hydraulic press used for removing car wheel bearings. He was in a sitting position, bent towards the machine, with his head placed between the piston and the pressing plate. His flexed left arm was resting on the lever beneath the machine pedestal, and on the right side there was a power switch that was still in the "on" position. His right arm was beside his body, but away from the machine. On...
Wed Feb 06, 2019 11:33
Abstract Melioidosis is an infectious disease caused by Burkholderia pseudomallei, a gram-negative intracellular bacillus. Tuberculosis, also an infectious disease, is caused by Mycobacterium tuberculosis, an acid fast bacillus. In both diseases, patients commonly present with fever and respiratory symptoms due to sepsis which might lead to respiratory failure or sudden death if left untreated. Not only are these two entities similar in clinical presentation, but the autopsy...
Wed Feb 06, 2019 11:33
Abstract The present study aimed to determine whether postmortem period, physical constitution, cause of death, and cardiopulmonary resuscitation are associated with positional changes in the postmortem appearance of conjunctival petechiae. We retrospectively investigated serial forensic autopsies from 6 h to 6 days postmortem (n = 442; male, 303; female, 139; median age, 62 years; range, 0–100 years). The causes of death were sharp instrument injury, blunt force trauma, fire,...
Wed Feb 06, 2019 11:33
Abstract A three-year-old boy with mild symptoms of an upper respiratory tract infection and recent onset vomiting collapsed at home. Resuscitative attempts in hospital were eventually unsuccessful. At autopsy an obstruction of the small intestine, with ischemia, was identified. It had been caused by strangulation of the small intestine through a congenital mesenteric defect. Moderate mesenteric lymphadenopathy, with enlarged lymph nodes in the region of the herniated small intestine,...
Wed Feb 06, 2019 11:33
Abstract A 47-year-old previously-well woman was found dead on the floor of a shower cubicle on a property in rural South Australia. The impression of the attending doctor and police was of collapse due to natural disease. Although there was significant stenosing coronary artery atherosclerosis found at autopsy, cherry pink discoloration of tissues prompted measurement of the blood carboxyhemoglobin level which was found to be 55%. The source of the gas was a poorly-maintained...
Wed Feb 06, 2019 11:33
Abstract Hoarding is defined as the acquisition of, and failure to discard, possessions of little use or value to others, usually associated with a significant degree of clutter in the individual's home. We describe a case of a woman who died from a combined traumatic and confined space asphyxia, after being trapped under some of the objects amassed in her apartment. The event was considered to be accidental; by taking into account the information gathered during assessment of...
Wed Feb 06, 2019 11:33
Wed Feb 06, 2019 11:33
Abstract This case represents a planned complex suicide in which the victim shot himself in the head after dousing his living quarters with gasoline. The spark induced ignition of gasoline vapors and led to an explosion. Liquid gasoline is not flammable, but the vapor/mixture of gases above the surface of the liquid is. In this case the victim might have counted on the resulting fire and/or explosion, but we are not able to tell that with certainty. We have assumed that the plan...
Wed Feb 06, 2019 11:33
Abstract A 67-year-old obese woman (BMI 38.3) was found at autopsy to have deep venous thrombosis of the left calf with bilateral peripheral and saddle pulmonary thromboemboli and a 165 mm long segment of paradoxical thromboembolus wedged between the right and left atria through a patent foramen ovale. Death was due to acute right-sided decompensation caused by obstruction of the pulmonary outflow tract from bilateral pulmonary thromboemboli. Paradoxical thromboemboli pass from...
Wed Feb 06, 2019 11:33
Abstract Fatal subarachnoid hemorrhage (SAH) caused by anterior communicating artery (ACoA) rupture is a rare event in medicolegal practice. Anatomical variations of the ACoA tend to make its anatomical structure, and as a result, blood flow through it, more complicated, which may increase hemodynamic stress and cause weak spots in the affected blood vessels. Variant ACoAs are prone to rupture in the event of a blunt-force trauma. Here, we report a fatal case of SAH caused by...
Wed Feb 06, 2019 11:33
Abstract The management of mass fatalities following disasters is a complex process which requires the involvement of multiple stakeholders and resources. A garbage dump at Meethotamulla in Sri Lanka suddenly collapsed, resulting in the death of 32 individuals. Efforts to implement best practice guidelines in Disaster Victim Identification (DVI) during this disaster revealed several important aspects that need to be considered by the forensic community. Delays in initiating the...
Wed Feb 06, 2019 11:33
Abstract Fournier gangrene is a rare fulminant necrotizing infection of the skin and soft tissue of the perineum that may result in rapid death. We describe the autopsy case of a 70-year-old female with uncontrolled diabetes mellitus who was found unexpectedly dead in her house where she lived with her dog. Examination of the body revelaed a deep necrotic ulceration of the perineum with exposure of the underlying deep muscles that was initially misinterpreted by police officers...
Wed Feb 06, 2019 11:33
Abstract A major task of forensic investigations is the documentation and interpretation of evidence to reconstruct a forensically relevant incident. To accomplish this task, a scene is documented not only with photographs but also with 3D documentation technologies. The resulting 3D data are used for 3D visualization and to perform 3D reconstructions. In this article, we present an approach for using forensic 3D data in conjunction with virtual reality to perform scene walkthroughs...
Wed Feb 06, 2019 11:33
Abstract Although forensic parasitology remains in its infancy compared with more developed fields like forensic entomology, parasites can be useful forensic indicators. We present the case of an individual who disobeyed animal health legislation and crossed animal quarantine boundaries and two state lines with a cattle tick (Rhipicephalus australis) infested horse. Following recognition of the infestation by animal health officers, the individual asserted that the infestation...
Wed Feb 06, 2019 11:33
Abstract Sodium nitrite is used as a coloring agent or preservative in food, as well as an antimicrobial agent in meat and fish and some cheeses. In high amounts it can be toxic for humans, causing methemoglobinemia. This is an unusual and potentially fatal condition in which hemoglobin is oxidized to methemoglobin (MHb), reducing the amount of oxygen that is released from hemoglobin, similar to carbon monoxide poisoning. MHb levels of 70% are generally lethal, but the existence...
Wed Feb 06, 2019 11:33
Abstract Two cases of intestinal obstruction in the mentally disabled are reported. The first case concerns 61-year-old oligophrenic woman who resided in a nursing home, where she was found hypotensive and unresponsive. Upon opening the peritoneal cavity at autopsy, extremely dilated (measuring on average 12 cm in diameter) loops of the colon emerged– they compressed the small intestine and other intraperitoneal organs, lifting both hemidiaphragms deep into the pleural cavity....
Wed Feb 06, 2019 11:33
Abstract Kratom is a plant with dose-dependent mixed stimulant and opioid properties whose pharmacologic characteristics and social impact continue to be described. The main active isolate of kratom is mitragynine, an indole-containing alkaloid with opioid-like effects. Kratom toxicity and kratom-associated fatalities have been described, including those in association with additional drugs. In this paper we describe the case of a 27-year-old man who was found deceased with a...
Wed Feb 06, 2019 11:33
In the original version of this manuscript Table 3, SIDS I column currently reads 1/8 (13) for the following: Bed share/co-sleeping (%), Found prone and co-sleep/bed-share (%), Co-sleep/bedshare and smoke exposure (%). However, the correct value should be '0/8 (0)'. Consequently, the correct p value.
Sat Jan 26, 2019 02:00
Abstract Single nucleotide polymorphism (SNP) profiling is an effective means of individual identification and ancestry inferences in forensic genetics. This study established a SNP panel for the simultaneous individual identification and ancestry assignment of Caucasian and four East and Southeast Asian populations. We analyzed 220 SNPs (125 autosomal, 17 X-chromosomal, 30 Y-chromosomal, and 48 mitochondrial SNPs) of the DNA samples from 563 unrelated individuals of five populations...
Wed Feb 06, 2019 11:33
Abstract Electrical injuries contribute a small but significant fraction to all burn trauma cases, and an even smaller proportion to those that are lethal. Accidental death rates among teenagers are the highest of all age-groups, and taking a "selfie" has been a practice that has, on rare occasions, led to such a death, often from electrocution. The case of a young man and his friend, who were electrocuted after climbing onto the roof of a parked railway wagon to take selfies is...
Wed Jan 16, 2019 02:00
Abstract Cardiac injury following blunt chest trauma is common in motor vehicle accidents due to a crush or blast injury. Severe cardiac trauma is associated with a very high mortality. If a cardiac injury develops several weeks after non-penetrating chest trauma, establishing a causal link between the traumatic event and the cardiac injury becomes complicated. This article reports a case of fatal delayed hemopericardium and hemothorax following a motor vehicle accident including...
Wed Jan 16, 2019 02:00
Abstract The concept of spontaneous combustion has huge appeal as an historical fiction but it has no scientific background. However, in some deaths involving fire, a body can burn away virtually completely with minimal thermal destruction to the neighboring environment. We report an extraordinary case of the self-immolation of an elderly woman who set herself on fire with suicidal intentions. The unusual appearance and location of the body closely resembled the phenomenon of so-called...
Wed Jan 16, 2019 02:00
Abstract Cerebral capillary telangiectasia (CCT) is a type of vascular malformation that is incidentally encountered in clinical practice. Diseased vessels are small and usually clinically benign over the course of a patient's life. Although most CCT patients are asymptomatic, the situation becomes complicated when trauma is encountered. A case of sudden death due to an epileptic episode after very mild head trauma is reported, including a retrospective study of 12 cases, to remind...
Wed Jan 16, 2019 02:00
Wed Jan 16, 2019 02:00
Abstract Intravascular devices aid in drug administration and fluid replacement for hospitalized patients and are thus an integral part of modern medical care; however, poor aseptic technique and improper manipulation of infusion devices increase the risk of infections secondary to catheterization that can progress to sepsis and septic shock. We report the case of a woman who presented with altered mental status after receiving normal saline through an intravenous catheter placed...
Sat Jan 12, 2019 02:00
Abstract A 16-month-old girl who was hospitalized with pneumonia and treated with antibiotics died after the nurse erroneously connected her intravenous left forearm catheter to the oxygen supply. Autopsy revealed an impressive gas embolism in the left subclavian and brachiocephalic veins, reduced crepitus and enlarged lung volume, and congestion of the meningeal vessels with some areas showing small air bubbles. Dilation of the right atrium and the right ventricle with efflux...
Fri Jan 11, 2019 02:00
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