American Journal of Forensic Medicine and Pathology最新文献

Domestic accidents account for a significant proportion of accidental deaths. We describe, for the first time, fatal mechanical asphyxiation caused by an electric desk in a 26-year-old man. Forensic autopsy, including toxicological analysis, was performed. Blood and urine samples were analyzed for drugs, narcotics, and alcohol. From an autopsy perspective, we primarily observed pale, shape-defined skin imprints accentuated by cervicofacial congestion and livor mortis. No significant pathologic conditions were found, particularly cardiac conditions. Toxicologically, the absence of identifiable narcotics or medications confirmed that the victim was not influenced by substances that could impair alertness or consciousness. The direct cause of death was acute mechanical asphyxia due to atypical external neck compression, which was consistent with the mechanical action of a height-adjustable electric desk at this anatomic site. Because the electric desk was equipped with an upward and downward anticollision system, it can be assumed that this feature was disabled by the victim, and suicide, therefore, cannot be ruled out. We present the first case of lethal mechanical asphyxia caused by an electric desk that occurred without the concomitant use of narcotics and/or medications impairing alertness in a young man with no significant pathologic conditions.

Acute necrotizing eosinophilic myocarditis is an uncommon type of myocarditis commonly presenting as fulminant congestive heart failure and histologically characterized by dense eosinophilic infiltrates in a background of necrotic cardiomyocytes. We present the case of a 27-year-old woman who died suddenly due to severe shock and multiorgan failure and was found to have acute necrotizing eosinophilic myocarditis at autopsy. We discuss the possible precipitating factors underlying our case and the considerations this case and others in the literature provide to pathologists investigating the unexpected death of young adults.

Forensic entomology is a crucial discipline in forensic investigations, primarily used for postmortem interval (PMI) estimation, species identification, and crime scene reconstruction. Recent advancements in molecular techniques, computational models, and climate-adaptive forensic entomology have enhanced the field's forensic applications. However, challenges related to methodological standardization, environmental variability, and legal admissibility persist. This comprehensive review examines recent developments in forensic entomology, focusing on molecular methodologies, AI-assisted species identification, and environmental influences on forensic insect succession. Literature was sourced from Scopus, Web of Science, and PubMed, emphasizing peer-reviewed studies published in the last 2 decades. Key themes include PMI estimation advancements, forensic insect ecology, and legal challenges in forensic entomology. Findings highlight improved accuracy in PMI estimation through genetic and computational approaches, the expansion of forensic molecular entomology applications, and the impact of climate change on forensic insect activity. While AI and molecular forensics have revolutionized species identification, standardization and legal frameworks remain insufficient. The study underscores the need for globally harmonized forensic entomology protocols, forensic training programs, and ethical guidelines. Future research should integrate metagenomics, forensic AI, and climate-adaptive forensic models to enhance forensic accuracy and reliability.

Abstract: Pilocytic astrocytomas are slow-growing neuroepithelial tumors most commonly found in children, with favorable prognoses. Prognosis is less favorable in the rare adult case in which survival rates decrease with age. Because of the rarity of these tumors in adults, undiagnosed pilocytic astrocytomas causing sudden death are hardly ever encountered in the forensic autopsy setting. The San Francisco Office of the Chief Medical Examiner was presented with a 27-year-old female patient with unknown medical history and recent complaints of nausea and vomiting. Postmortem computed tomography revealed a well-demarcated heterogeneous right cerebellar cystic mass. The autopsy showed an edematous brain with hydrocephalus and fourth ventricular compression, due to a heterogeneous mass found in the right cerebellum. Histopathological examination of the mass revealed findings consistent with the microscopic diagnosis of pilocytic astrocytoma. This case highlights one example of an adult patient with untreated pilocytic astrocytoma in which obstructive hydrocephalus ultimately resulted in death, and discusses the advantages of utilizing post-mortem computed tomography in addition to autopsy.

Positional asphyxia is a rare but potentially fatal condition where an individual's body assumes a position interfering with normal respiratory movements and leading to asphyxiation. We report a case of an 83-year-old farmer trapped in the tank of a vineyard spray atomizer while attempting maintenance and stuck in the opening of the tank with his upper body inside and legs outside. He was unable to extricate himself, and rescuers, who arrived 2 hours later, found the victim dead. The forensic autopsy showed patterned external injuries corresponding to the edge of the opening of the tank, internal signs of asphyxia such as pulmonary congestion and pleural petechiae, in the absence of major traumatic injuries. The cause of death was confirmed as positional asphyxia due to the head-down position and abdominal compression, which impaired breathing. The victim disregarded safety protocols, which prohibit entry into the loading tank of the sprayer, which is classified as a confined space by manufacturers. This incident highlights the importance of adhering to safety guidelines in all working routines, using appropriate personal protective equipment (PPE) and following proper maintenance procedures and adequate safety practices. Enhanced safety measures and safer equipment design are crucial to prevent similar occurrences.

Railway-related fatalities present significant challenges to forensic pathologists due to extensive injuries and complex biomechanical factors involved. This retrospective observational study was conducted on autopsy cases involving 28 railway transection injuries, focusing on injury morphology and correlation with the body's position on the tracks. Among 28 railway injury cases, 8 had death scene photographs and circumstantial findings suggesting a suicidal manner of death and allowing evaluation of body position suitable for analysis and correlation. An abrasion collar was consistently observed in a suicidal transected wound at the wound margin. Five cases involved decapitation, 1 showed thoracic transection, 1 case involved both neck and bilateral thigh transections, and 1 case had a transaction at the back. The abrasion collar was always present on the portion in contact with the wheel flange (on the inner aspect of the rail), with varying width depending on anatomic site, pressure, and contact duration. In some cases, thermal effects and pressure, such as compression, scorching, or blackening and dehydration of tissues, were also observed. The mechanism and factors affecting the formation of the abrasion collar are discussed. The abrasion collar is a significant and valuable forensic marker that provides insight into body orientation and the dynamics of railway fatalities.