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American Journal of Forensic Medicine and Pathology最新文献

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Perforation of the Heart During Elective Removal of an Inferior Vena Cava Filter. 在择期取出下腔静脉过滤器时发生心脏穿孔。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-05-23 DOI: 10.1097/PAF.0000000000000947
Sapna P Desai, Christine Z Yu, Frank Evangelista, James R Gill

Abstract: A common treatment for venous thromboembolic disease in patients with contraindications to anticoagulation includes placement of an inferior vena cava (IVC) filter. Temporary filters are available to avoid the risk of long-term permanent placement. A woman in her 60s with a history of uterine serous carcinoma presented to the emergency department with cardiac arrest following elective attempted IVC filter removal. Three months prior, a temporary filter was placed because anticoagulation medication was stopped in preparation for a hysterectomy. During the IVC retrieval procedure, which was performed using an intravascular approach from the right jugular vein, the filter was tilted, requiring the use of a different retrieval sheath. During catheter reentry, the patient complained of discomfort in the chest and neck, after which she became hypotensive, lost consciousness, and died. Autopsy revealed 2 cardiac perforations, one in each ventricle. Approximately 600 mL of liquid and clotted blood was within the tense pericardial sac. An IVC filter was found in place, with no adjacent hemorrhage.To our knowledge, this is the first reported fatality due to cardiac perforation by an access sheath during intravascular removal of an IVC filter. This instance also documents the time course of the cardiac perforations to the resultant loss of consciousness.

摘要:对于有抗凝禁忌症的患者,静脉血栓栓塞性疾病的常见治疗方法包括放置下腔静脉(IVC)滤器。为了避免长期永久置入的风险,可以使用临时过滤器。一名 60 多岁的女性患者曾患子宫浆液性癌,在急诊科就诊时,因试图取出 IVC 过滤器而心跳骤停。三个月前,由于准备进行子宫切除术而停用了抗凝药物,因此放置了一个临时过滤器。在使用右颈静脉血管内入路进行的 IVC 取出手术中,过滤器发生倾斜,需要使用不同的取出鞘。在导管再入过程中,患者主诉胸部和颈部不适,随后出现低血压、失去知觉并死亡。尸检发现两处心脏穿孔,每个心室一处。紧张的心包囊内有大约 600 毫升液体和凝固的血液。据我们所知,这是首例在血管内移除 IVC 过滤器时因入路鞘造成心脏穿孔而导致死亡的报道。据我们所知,这是第一例在血管内移除 IVC 过滤器时因入路鞘造成心脏穿孔而死亡的病例,该病例还记录了从心脏穿孔到意识丧失的时间过程。
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引用次数: 0
A Pediatric Case of Dilated Cardiomyopathy Due to NKX2-5 Mutation : Autopsy and Postmortem Molecular Diagnosis. 一例 NKX2-5 基因突变导致的小儿扩张型心肌病:尸检和死后分子诊断。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-06-25 DOI: 10.1097/PAF.0000000000000967
María Eugenia Zuluaga, Brittany DePasquale, Ana Isabel Sanchez-Barbero, Natalie Adolphi, Daniel F Gallego
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引用次数: 0
Pulmonary Thromboemboli Due to Leiomyoma. 子宫肌瘤导致的肺血栓栓塞。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-03-27 DOI: 10.1097/PAF.0000000000000938
Julita Gongolli, Anna Vanderschaegen, Shannon Renfrow, Kimberly D Collins, Joseph A Prahlow

Abstract: Uterine leiomyomas are the most common pelvic tumor in women and the most frequent indication for hysterectomy. Although benign lesions, leiomyomas can cause dysfunctional uterine bleeding, pelvic pain or discomfort, infertility, and spontaneous abortion. Despite the fact that uterine leiomyomas can result in a significant amount of morbidity, it is relatively rare for these common tumors to lead to death. Here we present a case of fatal pulmonary thromboembolism that occurred due to pelvic vein thrombosis in the setting of leiomyomas.

摘要:子宫纵膈肌瘤是女性最常见的盆腔肿瘤,也是子宫切除术最常见的适应症。虽然是良性病变,但子宫肌瘤可导致功能失调性子宫出血、盆腔疼痛或不适、不孕和自然流产。尽管子宫纵膈肌瘤会导致大量的发病,但这种常见肿瘤导致死亡的情况却相对罕见。在此,我们介绍了一例因子宫肌瘤导致盆腔静脉血栓形成而引起的致命性肺血栓栓塞症病例。
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引用次数: 0
How (Cautious) Social Media Use May Improve Education and Pipeline Efforts of a Growing Postpandemic Forensic Pathologist Workforce Shortage. 社交媒体的(谨慎)使用如何改善教育和后流行病法医病理学家队伍日益短缺的输送工作。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-06-12 DOI: 10.1097/PAF.0000000000000960
Casey P Schukow, Carley Holmes, Meagan Chambers, Omar Rayes, Nicole R Jackson, Amy H Deeken, Leigh A Hlavaty

Abstract: Many subspecialties of pathology have initiated novel methods and strategies to connect with medical students and residents, stimulate interest, and offer mentorship. Emerging concern about the future of forensic pathology has been highlighted in contemporary literature as recruitment of new fellows has stagnated and workforce shortage concerns have blossomed. Amidst these challenges, the potential role of social networking platforms like social media (SoMe) in enhancing autopsy pathology/forensics education has garnered attention, yet literature focusing specifically on its application in autopsy and forensic pathology remains limited. This review aims to provide a comprehensive narrative overview of the current literature on the established uses of SoMe in forensic pathology. It seeks to build upon existing recommendations, introducing a contemporary compilation of online resources designed to facilitate virtual engagement among pathologists, learners, patients, and families. The review supports the idea that strategic, ethical, and conscientious use of SoMe has a place in addressing the growing workforce shortages and closing educational gaps in forensic pathology by enhancing exposure to the field and dispelling antiquated stereotypes.

摘要:许多病理学亚专科已开始采用新颖的方法和策略与医学生和住院医师建立联系、激发兴趣并提供指导。随着新研究员招聘工作的停滞和劳动力短缺问题的凸显,当代文献中对法医病理学未来的担忧日益突出。在这些挑战中,社交媒体(SoMe)等社交网络平台在加强尸检病理学/法医病理学教育方面的潜在作用引起了人们的关注,但专门关注其在尸检和法医病理学中应用的文献仍然有限。本综述旨在对当前有关 SoMe 在法医病理学中的既定用途的文献进行全面的叙述性概述。它试图在现有建议的基础上,介绍旨在促进病理学家、学习者、患者和家属之间虚拟接触的当代在线资源汇编。该综述支持这样一种观点,即战略性、合乎道德且认真地使用 SoMe,可以通过增加对该领域的接触和消除陈旧的刻板印象,解决法医病理学领域日益增长的劳动力短缺问题并缩小教育差距。
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引用次数: 0
Acute Fluoride Toxicity Due to Intentional Ingestion of Hydrofluoric Acid Commercial Product. 故意摄入氢氟酸导致的急性氟中毒 商业产品。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-10-29 DOI: 10.1097/PAF.0000000000000948
Tatianna Macias, Kaileigh Bingham Abujasen, Phillip C Usera, Laura D Knight

Abstract: Hydrofluoric (HF) acid, an irritating and corrosive acid, is commonly found in cleaning supplies. Fatal HF acid ingestion has been documented, although relatively rare. We report a case of acute fluoride toxicity suicide due to the ingestion of a commercial product containing HF acid and ammonium bifluoride. To our knowledge, this is the first to describe the associated gastrointestinal histopathology in detail.A 56-year-old woman was found deceased near a rust remover product and a notebook containing suicide methods via chemical ingestion. Gross autopsy findings included laryngeal mucosal petechial hemorrhages; patchy esophageal mucosal denudation; and autolyzed, red-black discolored gastric mucosa. Histology of the esophagus demonstrated superficial mucosal ulceration with necrosis of the squamous mucosa, vascular congestion, and lymphoid aggregates in the lamina propria; muscularis mucosae and muscularis propria were unperturbed. The stomach showed superficial coagulative necrosis of the oxyntic crypts, with fresh microhemorrhage dissecting the glandular mucosa away from the muscularis mucosae; muscularis mucosae, submucosa, muscularis propria, and serosa were all spared.Toxicology revealed an elevated fluoride ion concentration (20 mg/L). Death was attributed to acute fluoride toxicity due to intentional ingestion of a commercial product containing HF acid and ammonium bifluoride, and the manner was suicide.

摘要:氢氟酸(HF)是一种具有刺激性和腐蚀性的酸,常见于清洁用品中。尽管相对罕见,但摄入氢氟酸导致死亡的案例也有记录。我们报告了一例因摄入含有氢氟酸和氟化氢铵的商用产品而导致急性氟中毒自杀的病例。据我们所知,这是第一例详细描述相关胃肠道组织病理学的病例。一名 56 岁的女性被发现死于一种除锈剂产品和一本载有通过摄入化学品自杀的方法的笔记本附近。尸体解剖大体结果包括喉部粘膜瘀斑出血、食道粘膜斑点状变性和自溶的红黑色变色胃粘膜。食管组织学检查显示,食管黏膜表层溃疡,鳞状黏膜坏死,血管充血,固有层有淋巴细胞聚集;黏膜肌层和固有肌层未受影响。胃部显示氧隐窝表层凝固性坏死,腺体粘膜与粘膜肌层之间有新鲜的微出血;粘膜肌层、粘膜下层、固有肌层和浆膜均未受损。死亡原因是故意摄入含有氟化氢酸和氟化氢铵的商业产品导致急性氟中毒,死亡方式为自杀。
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引用次数: 0
Federal Premium® BallistiClean® Ammunition. Federal Premium® BallistiClean® 子弹。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-11-05 DOI: 10.1097/PAF.0000000000000958
Lucien C Haag
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引用次数: 0
Unsafe Cribs Remain an Issue. 不安全的婴儿床仍是一个问题。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-03-05 DOI: 10.1097/PAF.0000000000000926
Roger W Byard
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引用次数: 0
Brain Autopsy Findings in a Patient Who Received Lipid Emulsion Therapy for Suspected Drug Intoxication. 一名因疑似药物中毒而接受脂质乳剂治疗的患者的脑部尸检结果。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-03-18 DOI: 10.1097/PAF.0000000000000933
Hannah Cutshall, Murat Gokden

Abstract: Lipid emulsion therapy (LET) is the intravenous administration of lipid solution for parenteral alimentation, especially in preterm infants and adults with debilitating illnesses. It has also been used in attempts of detoxification in suspected cases of drug overdose. Whether this interferes with circulation and/or perfusion is debatable, and it is suggested that it may interfere with coagulation process. The emulsifying agent has been identified microscopically mainly in the lungs of these patients, with rare reports in adults and even more rare ones in the brain; however, although it is rarely reported in other organs, to our knowledge, no reports of gross autopsy findings in the brain are available in the English literature, nor are there reports of pathologic findings after lipid emulsion therapy administration for drug toxicity. Although it is also debated in the literature whether this material forms as an artifact or represents the actual agent, here we report the gross and microscopic autopsy findings in the brain of a patient who received LET for suspected beta-blocker intoxication. It will be beneficial for pathologists who perform autopsies in the forensic or medical settings to be aware of these findings, along with the uses and potential complications of LET.

摘要:脂质乳剂疗法(LET)是一种静脉注射脂质溶液的肠外营养疗法,尤其适用于早产儿和患有衰弱疾病的成人。脂质乳剂疗法还被用于疑似药物过量病例的解毒尝试。这是否会干扰血液循环和/或灌注还有待商榷,有人认为它可能会干扰凝血过程。从显微镜下看,乳化剂主要存在于这些患者的肺部,成人很少见,脑部更少见;不过,虽然其他器官也很少见,但据我们所知,英文文献中没有关于脑部大体解剖结果的报道,也没有关于药物中毒使用脂质乳剂治疗后病理结果的报道。虽然文献中对这种物质是作为人工制品还是代表真正的药剂还存在争议,但我们在此报告了一名因疑似β-受体阻滞剂中毒而接受 LET 治疗的患者脑部的大体和显微尸检结果。对于在法医或医疗机构进行尸检的病理学家来说,了解这些发现以及 LET 的用途和潜在并发症将大有裨益。
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引用次数: 0
Winchester Service Grade Ammunition. 温彻斯特军用弹药。
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-05-23 DOI: 10.1097/PAF.0000000000000952
Lucien C Haag
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引用次数: 0
Desalkylgidazepam. 去烷基西地西泮
IF 1 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2024-12-01 Epub Date: 2024-11-05 DOI: 10.1097/PAF.0000000000000992
Veronica Hargrove, D Kimberley Molina
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引用次数: 0
期刊
American Journal of Forensic Medicine and Pathology
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