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Biomedical subjects

R Hanzlick

Publications and source records attributed to R Hanzlick.

At least 91 records · Page 5Linked to original sources
PubMed1993

Sharpening of autopsy tools.

This article describes basic tool-sharpening techniques in which grinding wheels, files, abrasive papers, stones, strops, and steels are used to repair and sharpen the edges of autopsy tools including chisels, knives, scissors, and shears. In general, files or grinding wheels are used to repair edges with gross defects such as burrs, nicks, or chips, or to restore the bevel of an edge, and then a stone is used to sharpen the edge; whereas abrasive paper, strops, or steels are used to remove rust or oxidation products and to touch up an already sharp edge immediately prior to use. Although pathologists may prefer to delegate the sharpening of tools to others or to buy new tools when old ones become dull, there may be occasions when knowledge of sharpening techniques is beneficial either to sharpen a tool or to ensure that proper sharpening techniques are used by others.

Autopsy↗
PubMed1993

National Association of Medical Examiners Pediatric Toxicology Registry. Report 2: Phenylpropanolamine update.

The National Association of Medical Examiners (N.A.M.E.) has an ongoing project referred to as the Pediatric Toxicology (PedTox) Registry, which contains data for drugs and poisons detected in children. A recent PedTox Registry report on phenylpropanolamine (PPA) reported blood PPA concentrations in 12 dead children whose deaths were not attributed to PPA. Since that report, another article has been published describing plasma PPA concentrations in living children who were given PPA to evaluate its effect on incontinence. The 10 children in the incontinence study were older than most of the 12 deceased children whose PPA concentrations were reported in the PedTox Registry (10 of whom < or = 5 years of age). The plasma PPA levels observed in the incontinent children fell within the range of blood PPA concentrations reported in the PedTox Registry. Plasma PPA levels of up to 642 ng/ml (0.642 mg/L) were well tolerated in children > or = 6 years of age. Insufficient data exist to determine how similar blood PPA concentrations are tolerated by children < 6 years of age, although some data indicate that such levels may be well tolerated in the younger age group as well.

Adolescent↗
PubMed1993

Death certificates. The need for further guidance.

Although instructions for proper completion of the cause-of-death section of the death certificate are available, a number of published examples are controversial, confusing, or inconsistent with other recommendations and guidelines. Several such examples are described to illustrate the need for improved instructions for death certification, with the goal of improving the consistency, accuracy, and reliability of death statistics. Also discussed is the general relationship between state vital records registrars, the National Center for Health Statistics, and the World Health Organization, in terms of death certification paperwork, procedure, policy, and death certificate revision. Since medical examiners certify substantial numbers of deaths, the need for medical examiners to be involved in revisions of death certificate forms and policies is emphasized.

Coroners and Medical Examiners↗
PubMed1992

Gunshot wounds of the female breast: a risk for intra-abdominal injury.

We report the results of a clinical study of female patients sustaining gunshot wounds to a breast. Thirteen homicides were reviewed by the Fulton County Medical Examiner. A prospective series of patients treated by the Grady Memorial Hospital Trauma Service included eight additional cases. Ten (48%) of the combined series of 21 patients had significant intra-abdominal injury; of these, five (24%) had injuries confined to the abdomen as a result of a missile striking a breast. A wound pattern consisting of a superior breast entrance wound, an inferior breast exit wound, and an inframammary thoracoabdominal reentry wound was noted in five patients, four of whom had intra-abdominal injuries and three only intra-abdominal injuries. Careful examination for this wound pattern should alert the clinician to the possibility of intra-abdominal injury. One should anticipate a 50% incidence of intra-abdominal injury in female patients sustaining gunshot wounds to a breast.

Abdominal Injuries↗
PubMed1991

Cocaine metabolite detection in homicide victims.

We analyzed the blood of homicide victims for the presence of cocaine's major metabolite, benzoylecgonine. During 1989 in Fulton County, Georgia, 81% of 275 homicide victims were tested for benzoylecgonine; 40% tested positive. The proportions of blacks and victims of firearm injuries who tested positive for benzoylecgonine were significantly larger than the respective proportions for whites and victims of injuries not involving firearms. The data show overall proportions of benzoylecgonine positivity much larger than those previously reported in the literature. The relationships between homicide, race, firearms, and cocaine use deserve further study.

Black or African American↗
PubMed1991

A simple dictation device.

A simple device for autopsy and scene dictation uses a small cassette recorder with a built-in microphone attached to a remote push-button switch worn on the belt or waistband. The recorder is carried in a shirt or scrub suit pocket and is functional under a protective apron or gown. The components, construction, advantages, and disadvantages of the device are presented.

Autopsy↗
PubMed1990

Heart weights of white men 20 to 39 years of age. An analysis of 218 autopsy cases.

Review of autopsy data for 218 white men between 20 and 39 years of age who died of injuries or suddenly and unexpectedly indicated a mean heart weight of 371 g. The mean for those dying of external causes was 364 g whereas the mean for those dying of natural causes was 446 g. A coefficient for heart weight expressed as a percentage of body weight was lower in heavy individuals than lightweight individuals; it ranged between 0.38% and 0.55%, with a mean of 0.48%. Heart weight, including epicardial fat, increased with age and body weight. These data may be useful to those who are called upon to investigate sudden and unexpected deaths.

Adult↗
PubMed1990

Suicide by jumping from high-rise hotels. Fulton County, Georgia, 1967-1986.

During a 20-year period from 1967 through 1986, 19 suicidal jumps from high-rise hotels (HRHs) accounted for 24% of all fatal jumping episodes and 1% of all suicides in Fulton County, Georgia, U.S.A. The rate of suicidal jumps from HRHs did not increase during the study period. The number of fatal jumps per hotel-year correlated with the height of the interior hotel atrium. The mean age for all victims was 34 years, and 63% of victims were white males. The majority of victims were local residents who were alone when they jumped and were not registered hotel guests. Registered guests tended to jump from the floor on which their room was located whereas nonregistered individuals tended to jump from the upper-most floors in the hotel. Of 19 HRH jumps, 13 occurred from the inside. Suicide notes were found in 37% of cases. HRH jumps were least common between 6 p.m. and midnight, all decedents were dressed in street clothing, only one was heard to have screamed, and all but one were dead on the scene. Alcohol and drug involvement was minimal. We hope that this information will be useful to those who investigate such deaths and to those who study the behavioral manifestations of suicide.

Adolescent↗
PubMed1989

Postmortem tricyclic antidepressant concentrations. Lethal versus nonlethal levels.

Evidence has accumulated that postmortem release of tissue-bound tricyclic antidepressants (TCAs) may cause falsely elevated postmortem blood levels, thus rendering it more difficult to determine if the cause of death was an overdose. This study, a review of 24 TCA-related deaths, is aimed at defining the practical significance of such a problem and providing a workable approach to interpreting postmortem TCA levels. Deaths clearly due to TCA drugs were compared with deaths that were not caused by TCA drugs, but in which the decedent's postmortem blood tested positive for TCA medications. There is little evidence that postmortem elevations in blood TCA levels cause frequent problems in differentiating lethal from nonlethal levels (overdose from nonoverdose cases). The data suggest that using a heart blood level of 0.100 mg/dl as an indicator of lethality is practical at the present time and poses little likelihood of error. Isolated cases suggest that postmortem TCA increases can occur; further work is needed in this area to clarify more fully the significance and frequency of such cases. At present, it seems prudent to utilize peripheral blood samples for TCA testing on autopsy material, if a conservative estimate of TCA concentration is desired, possibly augmented by liver TCA levels and parent-metabolite ratios if money, facilities, and time permit.

Antidepressive Agents, Tricyclic↗
PubMed1989

Health care history and utilization for Atlantans who died homeless.

A limited study of 18 deaths among homeless persons in Atlanta, Georgia, has shown that about two-thirds had utilized public health care facilities prior to their death, often over a period of many years. Utilization of two available, specific clinics for the homeless could not be demonstrated. The county hospital and alcoholism treatment center accounted for all documented episodes of health care. Formal, medical documentation of significant alcohol-related morbidity was shown in 50% of those who died homeless. Other common medical problems included seizure disorders, hypertension, pneumonia, chronic pulmonary disease, and non-lethal trauma. These data may be used practically during medico-legal death investigation and by public health agencies when planning policy and procedure relevant to the homeless population. Paucity of data concerning mortality in the homeless should prompt additional, region-specific studies to determine risk factors in areas where homelessness is manifest.

Adult↗
PubMed1988

Death certificates, natural death, and alcohol. The problem of underreporting.

Previous studies have identified an apparent underreporting of alcohol-related natural deaths on death certificates. This survey consists of a review of death certificates in one urban county, and provides further evidence that alcohol-caused natural deaths are underreported by physicians who sign death certificates.

Alcoholism↗
PubMed1988

Pleural pearl. An immature pleural ball?

An incidental, pearl-like body was attached to the visceral pleura of a young man who committed suicide. The lesion consisted of concentric laminations of collagen and mesothelial type cells, and was associated with a resolved pleurisy. The possible relationship of this lesion to previously reported "pleural balls" is discussed.

Adult↗