Academic Forensic Pathology最新文献

Paraquat is a highly toxic agent used as an herbicide worldwide. Despite its easy and widespread availability, data regarding cases of paraquat poisoning in India is limited. Diagnosis often becomes difficult without a clear history, owing to its rather nonspecific and varying presentation. In the present case, a 22-year-old man was brought with a history of high-grade fever, sore throat, and oral ulcers for around a week. He was symptomatically treated at multiple hospitals and was worked up for suspected diagnoses like diphtheria and influenza (H1N1). Later during treatment, it was revealed that "Paraxzone" was procured online by the patient himself two weeks before the onset of his symptoms. Thence, the treatment regimen was modified following suspicion of paraquat poisoning. However, the delay in diagnosis led to the worsening his condition, and the patient succumbed to death due to pulmonary and renal complications after 16 days of survival. The postmortem examination, supplemented with histopathological evaluation, supported the diagnosis of paraquat poisoning. Paraquat poisoning can mimic a myriad of clinical conditions. Thorough history taking, a high degree of suspicion, and collaborative work with the investigating agency are of paramount importance while dealing with cases of suspected paraquat poisoning in hospital settings.

Introduction: The oral cavity is home to numerous microorganisms including bacteria, fungi, and viruses which together form the oral microflora. It is the second most diverse microbial site in the human body after the gastrointestinal tract. Microbial degradation is a common phenomenon that occurs after death, with the early and advanced stages of decomposition being closely associated with oral microbial activity.

Methods: This article reviews the current state of knowledge on the role of the oral microflora in postmortem events, and highlights the growing importance of terms such as forensic microbiology and thanatomicrobiome. This article also discusses next-generation sequencing, metagenomic sequencing studies, and RNA sequencing to study the oral thanatomicrobiome and epinecrotic communities in forensic oral genetics.

Results: The indigenous microorganisms in the oral cavity are among the first to respond to the process of decomposition. DNA/RNA sequencing is a relatively simple, precise, and cost-effective method to estimate biological diversity during various stages of postmortem decomposition. The field of thanatomicrobiology is rapidly evolving into a key area in forensic research.

Conclusion: This article briefly narrates oral microflora and its implications in forensic odontology. The role of microbial activity in postmortem events is gaining importance in forensic research, and further studies are needed to fully understand the potential applications of advanced technology in the study of the oral thanatomicrobiome.

Coronavirus disease 19 (COVID-19) vaccination is considered an important part in improving health outcomes globally. While various adverse events following vaccination against COVID-19 have been reported, eosinophilic diseases have rarely been documented in the literature and are poorly understood. Although vaccination is lauded as being "safe," it has become apparent that adverse reactions related to the vaccines can have detrimental health effects for certain individuals. We present a case of a death related to multiple severe preexisting comorbidities, complicated by new-onset gastrointestinal complaints which were temporally associated with recent COVID-19 vaccination and did not subside, but worsened prior to death. Autopsy revealed evidence of eosinophilic enteritis, associated with ascites, as well as eosinophilic inflammation elsewhere, including the lungs and heart. Histological examination revealed abundant eosinophils in tissues, including the small intestines, epicardium, and lungs. Whether or not the eosinophilic inflammatory process was caused by the recent vaccination cannot be stated with certainty; however, the temporal association between vaccination, symptom onset/progression, and death, and the literature which suggests a possible association between coronavirus vaccination and eosinophilic reactions leads to the conclusion that this death might have been related to an adverse reaction to COVID-19 vaccination.

A 32-year-old Caucasian male was found unconscious at his sober-living home and pronounced dead after transportation to the emergency room. The decedent had a documented history of substance-use disorder and past suicide attempts, but according to his family, he was sober for the past year. Significant autopsy findings were cardiomegaly, hepatomegaly, congested lungs, cerebral edema, and obesity. The toxicology examination of blood and tissues using liquid chromatography tandem mass spectrometry detected only mitragynine in the central blood (7.5 mg/L), peripheral blood (3.3 mg/L), liver (42.2 mg/kg), and gastric contents (33.1 mg). The qualitative identification of 7-hydroxymitragynine was performed only on the central blood. The pathologist ruled the cause of death acute mitragynine intoxication combined with cardiomegaly with left ventricular hypertrophy, with severe hepatomegaly and obesity listed as other significant conditions. The mode, or manner, of death was determined to be an accidental overdose. To the authors' knowledge, this is the first reported case where mitragynine was the only drug detected. This case study will contribute to the understanding of mitragynine-only death investigation and provide valuable toxicology information for medical examiners and pathologists.

Introduction: Regarding male breast cancer, a rare disease comprising ∼1% of breast cancers, data are generally scant. The present study aimed to quantify the imaging detected breast cancer in male gender corpses, determining in this way the prevalence of silent breast cancer in male gender.

Methodology: The population target has been male corpses without clinical expression of breast cancer. Seventy-four male corpses have been submitted to bilateral subcutaneous radical mastectomy. Samples have been submitted to echography and mammography imaging and every lesion superior to BI-RADS 4a has been excised.

Results: One excisional biopsy has been performed and no case of breast cancer has been identified.

Discussion: Our findings suggest that screening of the general population for male breast cancer is not necessary.

Introduction: In order to reduce transmission of COVID-19, in March 2020 the UK national and devolved governments imposed restrictions including spatial distancing, stay-at-home orders, and travel restrictions. The aim of this study is to compare the characteristics of cases referred to the Coronial system for autopsy in the months before and during the lockdown period.

Methods: In all, 580 autopsy cases, performed in the London area between January and June 2020 were included in the study.

Results: In the postlockdown period, there was an increase in the proportion of black individuals referred for autopsy, which just attained statistical significance (p = 0.047). The proportion of decomposed bodies submitted for examination was significantly increased (p = 0.011). The study did not show a significant increase in the proportion of out-of-hospital (community) deaths, traumatic deaths, or deaths due to alcohol or drug abuse or overdose.

Conclusion: The study shows no evidence that COVID-19 preventative measures led to a change in the causes of death referred to the Coroner, except, of course, for COVID-related deaths. The proportion of black people among subjects for autopsy increased, probably because of a relatively higher incidence of COVID deaths among this group. Decomposed subjects were more common, probably due to social isolation.

Nasogastric feeding tubes are commonly used in medical practice to provide nutritional support to patients who cannot take in an adequate amount of food orally. Although rare, nasogastric tubes errantly placed into the respiratory tract may cause serious complications, including death. We present an unusual autopsy case of a fatal hydrothorax that consisted of the enteric feeding solution following placement of a small-bore feeding tube into the left lung, despite no perforation of the tracheobronchial tree or esophagus. Alternative mechanisms for the formation of an enteral nutritional hydrothorax in the absence of a perforation from a feeding tube can be explained by the properties of the fluid, increased alveolar permeability, and underlying lung damage.

Among the various types of asphyxial deaths, strangulation is one of the commonly encountered cases as structures in the neck make it vulnerable to fatality. In most such cases, ligature material, usually cloth, is used for the commission of the offense. Clothing may be associated with a wide range of both accidental and deliberately induced deaths. Accidental strangulation due to entrapment of the neck in clothing, especially in relation to vehicular accidents, has also been described in the literature, but these cases are mostly associated with long scarf-like clothing. Loose clothing and intoxication act as critical factors in entrapping the person in such an event. This case report highlights the rare occurrence of accidental strangulation due to the entanglement of clothing other than a long scarf consequent upon road traffic incident.