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Illustrated Forensic Pathology: Necklacing. 插图法医病理学:项链。
IF 0.8 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-09-01 Epub Date: 2024-12-30 DOI: 10.1097/PAF.0000000000001004
Ryan Blumenthal, Robert Maximilian
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引用次数: 0
Is Obesity a Factor in Lethal Opioid Toxicity? 肥胖是致死性阿片类药物毒性的一个因素吗?
IF 0.8 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-09-01 Epub Date: 2025-03-04 DOI: 10.1097/PAF.0000000000001029
Jeremy W S Hunter, Corinna Van Den Heuvel, Lilli Stephenson, Ian F Musgrave, Roger W Byard

Abstract: Both obesity and opioid abuse are increasing in numbers globally. As these entities may be associated with significant respiratory compromise, it was hypothesized that synergism may occur and that as a result of this obese individuals may be more sensitive to the effects of opiates, that is, that deaths may occur at lower blood levels. To investigate this possibility, case files at Forensic Science SA, Adelaide Australia, were reviewed for all cases that occurred between 2000 and 2019 where deaths had been attributed to heroin or morphine toxicity. There were 259 cases (66 females, 193 males; age range: 18-91; average: 41.5). The average body mass index (BMI) was 26.8 (females, 26.1; males, 27.0). The total number of obese (BMI ≥ 30 < 40) decedents was 50, and the total number of morbidly obese (BMI ≥ 40) decedents was 17. No significant association was found in the obese or morbidly obese between BMI and postmortem drug levels of <0.01, ≥0.1 < 0.3, ≥0.3, <0.4, or ≥0.4 mg/L ( P  = 0.30, Fisher exact test). The lack of association between fatal postmortem opiate levels and BMI suggests that the negative respiratory effects of opioids and a high BMI may in some way be compensated for by as yet unidentified metabolic/pharmacokinetic factors in obesity.

摘要:肥胖和滥用阿片类药物的人数在全球范围内都在增加。由于这些实体可能与严重的呼吸系统损害有关,因此假设可能会发生协同作用,因此肥胖者可能对阿片类药物的影响更加敏感,也就是说,可能会在较低的血药浓度下死亡。为了研究这种可能性,我们查阅了澳大利亚阿德莱德南澳大利亚州法医科学中心(Forensic Science SA)在 2000 年至 2019 年期间发生的所有归因于海洛因或吗啡中毒致死的病例档案。共有 259 个案例(66 名女性,193 名男性;年龄范围:18-91 岁;平均:41.5 岁)。平均体重指数(BMI)为 26.8(女性 26.1;男性 27.0)。肥胖(体重指数≥ 30 < 40)的死者总数为 50 人,病态肥胖(体重指数≥ 40)的死者总数为 17 人。在肥胖者和病态肥胖者中,体重指数与死后药物水平之间没有发现明显的关联。
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引用次数: 0
A Self-immolation Dilemma. 自焚困境。
IF 0.8 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-09-01 Epub Date: 2025-04-28 DOI: 10.1097/PAF.0000000000001049
Lindsey M Martens, Allison B Anderson, Selly Strauch, Susan Roe

Abstract: Setting oneself on fire, termed self-immolation, has high mortality and morbidity.A 60-year-old female patient with a history of depression and anxiety was found by drone search deceased with thermal injuries in a cornfield. Her abandoned vehicle was found with a dead battery and out of fuel 1/4 mile away. A lighter was lying 8 feet from the decedent, and a string of rosary beads, clothing, cigarettes, pliers, and a glass bottle with a cross on it were found nearby.Autopsy findings were notable for charring of the face, torso, and portions of the extremities, soot deposition in the peripheral airways, erythema of the epiglottis, bilateral lateral tongue hemorrhages, and pulmonary congestion and edema.The toxicology report revealed a blood carbon monoxide level of 23.8%. A blood volatile screen was negative. Blood drug screen was positive for a metabolite of marijuana and loperamide.The patient was determined to be alone at the time of the fire and death. No fuel or ignitable fluid was identified. The origin of the fire and the manner of death were listed as undetermined. The cause of death was determined to be thermal injuries and smoke inhalation. Whether this case represents a deliberate act or a possible accident remains in question.

摘要自焚是一种死亡率和发病率都很高的自焚行为。60岁女性患者,有抑郁和焦虑病史,经无人机搜索发现死于玉米地热伤。她的弃车在四分之一英里外被发现电池没电了,也没油了。在离死者8英尺的地方发现了一个打火机,附近还发现了一串念珠、衣服、香烟、钳子和一个上面有十字架的玻璃瓶。尸检结果为面部、躯干和四肢部分炭化,周围气道中有烟灰沉积,会厌红斑,双侧舌出血,肺充血和水肿。毒理学报告显示血液中一氧化碳含量为23.8%。血液挥发性检查呈阴性。血液药物检测大麻和洛哌丁胺的代谢物呈阳性。病人被确定在火灾和死亡时是独自一人。没有发现燃料或可燃液体。火灾的起因和死亡方式被列为未确定。死因被确定为热伤和吸入烟雾。这起案件究竟是蓄意行为还是可能的意外事故仍有待商榷。
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引用次数: 0
Sudden Neonatal Death Due to Primary Endocardial Fibroelastosis: Forensic Autopsy Findings. 原发性心内膜纤维弹性增生引起的新生儿猝死:法医尸检结果。
IF 0.8 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-08-20 DOI: 10.1097/PAF.0000000000001066
Tijana Petrović, Tijana Gojković, Milenko Bogdanović, Tatjana Atanasijević, Jelena Kuzmanović, Slobodan Savić
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引用次数: 0
Mast Cell Degranulation as a Histopathologic Marker in Fatal Anaphylaxis: An Illustrated Case of Vespidae Envenomation. 肥大细胞脱颗粒作为致死性过敏反应的组织病理学标记:一个蜘蛛中毒的例子。
IF 0.8 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-07-31 DOI: 10.1097/PAF.0000000000001064
Nuha Mahmood, Rachel Martindale, Jared Brooks
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引用次数: 0
An Autopsy Case of ANCA-Negative Small Vessel Vasculitis With Glomerular Crescents. anca阴性小血管炎伴月牙状肾小球尸检1例。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-06-23 DOI: 10.1097/PAF.0000000000001058
Thomas Auen, Erin Linde
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引用次数: 0
Type B Right Ventricular Thrombus With Postmortem Computed Tomography and Postmortem Examination Correlation. B型右心室血栓与死后ct和死后检查的相关性。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-06-16 DOI: 10.1097/PAF.0000000000001056
Gurnoor Bhatia, Samantha Waugh, Rexson Tse
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引用次数: 0
Meckel Diverticulum as a Lead Point for Fatal Volvulus in an 84-Year-Old Man. 梅克尔憩室作为84岁男性致死性肠扭转的先导点。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-06-06 DOI: 10.1097/PAF.0000000000001051
Hiro Ross, Jonathan Zuckerman
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引用次数: 0
Retained Cutaneous Bee Stinger in an Anaphylactic Death. 过敏性死亡中残留的皮肤蜂刺。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-06-06 DOI: 10.1097/PAF.0000000000001054
Nathan Milne, Rachel Allavena, Jack Garland, Beng Beng Ong
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引用次数: 0
A Rare Case of Neonatal Death Due to a Cranial Vault Fracture Following the Use of Obstetric Vacuum Extractor and Review of Literature. 使用产科真空吸引器造成颅顶骨折导致新生儿死亡的罕见病例及文献综述。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2025-06-01 Epub Date: 2024-11-05 DOI: 10.1097/PAF.0000000000000996
Fiorella Caputo, Isabella Caristo, Rosario Barranco, Luca Vallega Bernucci, Flaminia Torielli, Francesco Ventura

Abstract: In the course of childbirth, if complications arise during the expulsion of the fetus, instruments can be employed to facilitate delivery. The vacuum extractor, or ventouse, is considered a relatively safe tool associated with a low rate of complications and mortality. However, it is crucial that the instrument be applied in the correct position and that the pulling force is not excessive to minimize damage to the fetal cranial structures. Fractures of the cranial vault following the application of obstetric vacuum extraction are very rare events.This paper presents a case of perinatal death due to cranial vault fracture and subgaleal hematoma following vacuum extractor application. Only through postmortem examination was it possible to identify incorrect positioning of the ventouse, which was lateralized compared to the recommended position. The misplacement of the device led to an imbalance of forces, causing the cranial vault fracture that led to the infant's demise.A thorough postmortem examination is essential in cases of perinatal death resulting from operative delivery to ascertain the cause of death and reconstruct the dynamics of events during childbirth. In particular, the examination of injuries on the decedent neonate may reveal improper positioning of the instrument.

摘要:在分娩过程中,如果在胎儿排出过程中出现并发症,可以使用器械促进分娩。真空吸引器或排气罩被认为是一种相对安全的工具,并发症和死亡率较低。然而,至关重要的是,必须在正确的位置使用器械,而且拉力不能过大,以尽量减少对胎儿颅骨结构的损伤。本文介绍了一例围产期死亡病例,原因是使用真空吸引器后出现颅顶骨折和气管下血肿。只有通过尸检才有可能发现排气阀的位置不正确,与推荐位置相比,排气阀偏向一侧。在手术分娩导致围产期死亡的病例中,彻底的尸检对于确定死亡原因和重建分娩过程中的动态变化至关重要。特别是,对新生儿伤痕的检查可能会发现器械位置不当。
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引用次数: 0
期刊
American Journal of Forensic Medicine and Pathology
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