Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Forensic Pathology”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed2004

HELLP syndrome as a cause of unexpected rapid maternal death--a case report and review of the literature.

Unexpected rapid death after delivery due to HELLP syndrome (HS) may become the subject of a forensic expertise. Since this syndrome is rarely encountered in forensic pathology, our objective was to point to some specific findings which might present forensic aspects of HS. These include unexpectedness, suddenness and fulminant course of this syndrome, which may confuse physicians, and on the other hand these characteristics cast doubt on violent injury, diagnostic oversights or iatrogenic injuries. Absence of classical signs of preeclampsia and non-specific clinical symptoms cause considerable differential diagnostic problems leading to a diagnostic delay or initial wrong non-obstetric diagnosis. A definitive postmortem diagnosis of HS in questionable cases of maternal death and consecutive forensic expertise of suspected medical malpractice should be based on accepted laboratory criteria and characteristic histopathological alterations.

Adult↗
PubMed2001

Forensic investigations in Kosovo: experiences of the European Union Forensic Expert Team.

The international community has intervened ethnic hostilities in Kosovo, the Federal Republic of Yugoslavia. A team of Finnish forensic experts worked in December 1998 and January 1999 in Kosovo under the mandate of the European Union. The team investigated human remains from three locations of alleged ethnic violence. Concerning the events in Klecka, Volujak and Racak, the International Criminal Tribunal for the former Yugoslavia received documents of great gravity. The standard methods of forensic pathology were complemented with radiological, forensic odontological, physical anthropological and molecular genetic investigations.

Journal Article↗
PubMedDate not supplied

[Role of experts in forensic medicine in opinioning for courts and insurance agencies].

Forensic medicine belongs to a group of medical specialties which are listed as basic specialties according to the Ministry of Health. As indicated already by the specialist program, the aim of such studies involves mastering of abilities which permit the medical doctor to provide competent opinions for courts and other organs in the administration of justice, consistent with the current medical knowledge, forensic experience and requirements of the law. Therefore, obtaining specialist qualifications in forensic medicine the doctor is expected to be prepared for forensic certification in penal, civil and insurance matters on the basis of a medical examination and/or court files. It should be explained that forensic medicine practiced in Poland and in some European countries represents a much broader specialty than forensic pathology practiced in the USA and some English-speaking countries. In the latter countries the specialty represents a part of broadly understood pathology. The situation of a forensic physician in organization of the execution of justice in the USA, his/ her competencies and range of activities are completely distinct to those characterizing a forensic physician in Poland. In its range accepted in Poland, forensic medicine has a broader scope. It deals not only with the narrow range of penal proceedings but also pertains the entire problems of certification for the courts and other organs which deal with implementation of justice, as well as for other institutions such as various insurance companies. One of the reasons for separation of forensic medicine from other specialties was the fact that appropriate forensic opinioning requires more than encompassing respective medical knowledge. Also needed is the ability to understand intentions and aims of justice execution and the capacity to formulate opinions in such a range and in such a way that it will be perceived by the addressee in an unbiased form.

Europe↗
PubMed2006

[The expression of GFAP after brain concussion in rats].

OBJECTIVE: To study the expression of GFAP and pathologic changes after rats brain concussion, so that to provide evidence on brain concussion for forensic identification. METHODS: Forty-five SD rats were divided into 3, 6, 12, 24 h and 2, 4, 7, 10 d and normal control groups in terms of different wounding time after brain concussion model established, and the expression of GFAP after rats brain concussion were then observed by using SP immunohistochemical method. RESULTS: In normal control brain, low-level GFAP expressions could be observed. After six hours' brain concussion, GFAP positive cells increased obviously. The trend reached to the peak at 7d, partly declined at 10d, then decreased gradually. CONCLUSION: Brain concussion induced the expression of GFAP. The detection of GFAP could be useful for diagnosis of brain concussion on forensic pathology, and could be a reference index for timing of injury after brain concussion.

Animals↗
PubMed2004

Is 'virtual histology' the next step after the 'virtual autopsy'? Magnetic resonance microscopy in forensic medicine.

AIM: The study aimed to validate magnetic resonance microscopy (MRM) studies of forensic tissue specimens (skin samples with electric injury patterns) against the results from routine histology. METHODS AND RESULTS: Computed tomography and magnetic resonance imaging are fast becoming important tools in clinical and forensic pathology. This study is the first forensic application of MRM to the analysis of electric injury patterns in human skin. Three-dimensional high-resolution MRM images of fixed skin specimens provided a complete 3D view of the damaged tissues at the site of an electric injury as well as in neighboring tissues, consistent with histologic findings. The image intensity of the dermal layer in T2-weighted MRM images was reduced in the central zone due to carbonization or coagulation necrosis and increased in the intermediate zone because of dermal edema. A subjacent blood vessel with an intravascular occlusion supports the hypothesis that current traveled through the vascular system before arcing to ground. CONCLUSION: High-resolution imaging offers a noninvasive alternative to conventional histology in forensic wound analysis and can be used to perform 3D virtual histology.

Adult↗
PubMedDate not supplied

[Incidence of scalp involvement by Demodex folliculorum Simon ectoparasites in a pathologic-anatomic and forensic medicine autopsy sample].

29% of unselected pathological and forensic autopsy cases revealed mites of the species Demodex folliculorum longus and brevis in hair follicles and sebaceous glands of the scalp. The attack by these parasites was equal in male and female subjects and correlated to the number of sebaceous glands but not to the density of hair follicles. However there was a tendency to an increased number of parasites inhabiting the scalp of people of advanced age, dark hair colour or with a bald head. A chronic lymphocytic infiltration of the skin was conspicuous in more than 70% of cases with Demodicosis folliculorum.

Adolescent↗
PubMed1996

Immunohistochemical investigation of pulmonary surfactant in perinatal fatalities.

In order to verify forensic pathological significance of immunohistochemical investigation of pulmonary surfactant, 11 forensic and 16 clinico-pathological cases of perinatal death were comparatively examined. Surfactant appeared in some infants of 31-32 weeks gestation and was usually positive thereafter, indicating maturity of fetal lungs, although it may not have fully developed until about the 36th week of gestation. It was negative in all cases of the hyaline membrane disease except for a full-term infant (secondary respiratory distress syndrome). In usual cases, surfactant coating the expanded alveolar epithelia with its diffuse deposit in the intra-alveolar spaces was considered to indicate duration of hypoxia under persistent respiration (agonal state). Such finding was most intensely observed in asphyxia and in severe respiratory failure from intrinsic causes in the infants over ca. 36 weeks of gestation. With reference to pulmonary micromorphology, the amount of intra-alveolar surfactant seemed to be most closely related to the alveolar septal (interstitial) edema.

Cause of Death↗
PubMed1964

THE INVESTIGATION OF OBSCURE DEATHS.

Unexpected death from obscure causes places a responsibility on the coroner which is delegated to the police, the pathologist and the laboratory. Important insurance and civil litigation issues may be at stake and crime must not be overlooked. This article stresses the importance of (a) powers of observation, (b) awareness of possibilities, (c) a flexible mind and (d) competence in forensic pathology. Cases quoted and illustrated show mistakes which have caused error-and injustice.The importance of discussion with clinical colleagues is emphasized; painstaking autopsy and meticulous laboratory examinations are vital. Poisoning is particularly easily overlooked.

Autopsy↗
PubMedDate not supplied

Use of the histopathology in the differential diagnosis of drowning in fresh and salty water: an experimental model establishment in rats.

PURPOSE: To develop a method of differential diagnosis to drowning, due to analysis of the alveolar macrophages quantitative, in rats submitted to induced drowning in fresh water and salty water. METHODS: Were used 15 male adult rats Wistar EPM-1, weight 360g (SD=21,3), randomized in three groups: G1--Control; G2--Fresh water; G3--Salty water, each one with n=5. The animals have been anesthetized and tracheostomized to insert a cannula inside the trachea, for drowning induction. The lungs have been removed, weighed, prepared for histology and colored by immunohistochemistry. The macrophages have been counted in both lungs (right and left) of each animal. The statistical test used was ANOVA (SPSS.10) with p<0,05. RESULTS: The amount of macrophages was G3>G2>G1 with p=0,0001 in each comparison. The weight of lungs of G3 and G2 was higher than G1, with p>0,0001, however G3 and G2 do not possess difference statistics in the weight of lungs. CONCLUSION: The developed diagnostic method was efficient in rats. The results, if expanded, will be able to assist the Forensic Pathology for technique of low cost and high trustworthiness.

Analysis of Variance↗
PubMed2005

Dumping of victims in walls.

A case is described in which a 58-year-old woman was shot and then dumped in a wall. She was immured under the staircase in the basement of a residential house by the offender, who was acting alone. The body was not found until 8 months later. The victim had been reported missing by members of her family. The cool environment delayed the onset of putrefactive changes so that it was not difficult to conduct forensic pathologic investigations into the bullet wound, with traces of gunpowder residue found on the victim's head. The way in which the offense was committed did not provide any indication of diminished responsibility on the part of the 27-year-old offender, which was reflected in the judicial consequences.

Autopsy↗
PubMed2005

Postmortem cardiac troponin T levels in the blood and pericardial fluid. Part 1. Analysis with special regard to traumatic causes of death.

In forensic pathology, previous studies have suggested the possible application of cardiac troponins in the diagnosis of myocardial infarction. However, there appears to be insufficient practical data on other causes of death. The present study was a comprehensive analysis of the cardiac, peripheral blood and pericardial levels of cardiac troponin T (cTnT) in serial medicolegal autopsy cases (n = 405) with a survival time <24 h and within 48 h postmortem to assess the validity of investigating myocardial damage with special regard to traumatic causes of death. These included blunt and sharp instrument injury (n = 122 and 21, respectively), asphyxiation (n = 35), drowning (n = 27), fire fatalities (n = 94), hyperthermia (n = 13), hypothermia (n = 6), fatal methamphetamine (MA) abuse (n = 12) and carbon monoxide (CO) poisoning (n = 5) in comparison with myocardial infarction (MI, n = 57) and cerebrovascular diseases (n = 13). Cases within 12h postmortem usually showed lower cardiac and pericardial cTnT levels than did those of longer postmortem time of 12-48 h. In the early postmortem period of <12 h, significantly elevated serum cTnT levels were observed for hyperthermia. Thereafter, fatal MA abuse, CO poisoning and MI cases also showed higher levels. However, cTnT remained at lower levels for hypothermia and drowning. The elevation of cTnT was associated with the pathology of advanced myocardial damage involving swelling and liquefactive necrosis. The above-mentioned differences were the smallest for peripheral blood. These findings suggest that elevations in postmortem serum and pericardial cTnT levels depend on the severity of myocardial damage at the time of death and are related to the pathological findings, although postmortem interference should be taken into consideration.

Adolescent↗
PubMed2005

Black thyroid: report of an autopsy case.

A distinctive but very rare side effect of exposure to minocycline is black pigmentation of the thyroid gland. Until 2002, not more than 30 cases of black thyroid had been reported in the English literature. We report on a 24-year-old woman with known antemortem ingestion of minocycline. The woman suffered from a depressive disorder with repeated suicide attempts and committed suicide by a gunshot to the head. At autopsy, the thyroid gland showed coal-black coloration. Upon histology, clumps of black-brown pigment were seen in the colloid, and a granular precipitate of this pigment was noted in the apical portions of the follicular epithelial cells. The diagnosis of minocycline-associated black thyroid was established. Forensic pathological significance of black thyroid may arise from the fact that hypothyroidism has been occasionally associated with minocycline-related black thyroid and that hypothyroidism may contribute to the development of depressive disorders (and thus, in given cases, may be responsible for suicide attempts). Under this assumption, the presence of black thyroid would represent more than just a morphological curiosity in specific cases.

Adult↗
PubMed2006

Medical examiners, coroners, and public health: a review and update.

CONTEXT: Traditionally, the emphasis of work done by medical examiners, coroners, and the death investigation community has been viewed as serving the criminal justice system. During the last several decades, however, an important role for these 3 groups has emerged within public health. OBJECTIVE: To provide important background information on death investigation systems, the evolution and framework of public health entities that rely on information gathered by medical examiners and coroners, and the role of medical examiners and coroners in epidemiologic research, surveillance, and existing public health programs and activities. DATA SOURCES: Previous articles on epidemiologic aspects of forensic pathology and the role of medical examiners and coroners in epidemiologic research and surveillance; a review of the Web sites of public health and safety agencies, organizations, and programs that rely on medical examiner and coroner data collected during medicolegal investigations; and a review of recent public health reports and other publications of relevance to medical examiner and coroner activities. CONCLUSIONS: The role of medical examiners and coroners has evolved from a criminal justice service focus to a broader involvement that now significantly benefits the public safety, medical, and public health communities. It is foreseeable that the public health role of medical examiners and coroners may continue to grow and that, perhaps in the not-too-distant future, public health impact will surpass criminal justice as the major focus of medicolegal death investigation in the United States.

Coroners and Medical Examiners↗
PubMed2005

Postmortem serum endotoxin level in relation to the causes of death.

Serum endotoxin is a clinical marker of sepsis. However, it is vulnerable to bacterial contamination, and the postmortem stability has not been established. In the present study, to evaluate the forensic pathological significance of postmortem endotoxemia in relation to the causes of death, we investigated a series of 111 autopsy cases (postmortem interval<48 h), in part, using bacteriological investigations. Systemic endotoxemia involving both the cardiac and peripheral blood was observed in some specific causes of death, including pneumonia (n=1/3), peritonitis (n=2/5), delayed traumatic death with severe secondary infection (n=7/33), drownings (freshwater, n=3/9; saltwater, n=3/16), fire deaths (n=3/16), and also in protracted deaths under critical medical care (n=2). Most cases of fatal blunt injury (n=4/5) showed sporadic endotoxemia in cardiac or peripheral blood, whereas there was no elevation of serum endotoxin in acute hemorrhagic death from sharp instrument injury (n=6). The bacteriological investigation showed some characteristic profiles in infections and drownings. These observations suggested that, although endotoxin is a vulnerable serum marker to ante and postmortem interference, systemic postmortem endotoxemia involving peripheral blood may be a possible indicator of antemortem bacteremia related to some specific causes of death accompanied by advanced infection or pulmonary alveolar damage in the dying process especially due to drownings and fires.

Adolescent↗
PubMed2005

Study of the diagnostic value of iron in fresh water drowning.

The aim of our study was to test the diagnostic value of iron (Fe) in fresh water drowning by investigating the postmortem levels of hemodilution in drowning cases compared to control cases. Twenty-six typical fresh water drowning cases were selected from 128 immersion cases autopsied in our Department of Forensic Pathology between 1998 and 2004. The exclusion criteria were a long postmortem interval and other causes of death than drowning. For all selected cases, the diagnosis of drowning was based on the presence of autopsy findings and positive diatom test. A control population of 12 cases was also selected. For each drowning and control case, iron blood levels were measured in the left ventricle (LV) and right ventricle (RV) of the heart. The mean difference of iron concentration (RVFe-LVFe) between the drowning group and the control group was statistically compared. Furthermore, iron measurements were performed in 19 drowning cases showing advanced putrefaction. The mean difference of iron concentration was significantly higher in the drowning cases compared with controls (P<0.001). All drowning cases showed hemodilution. No overlap was found in the RVFe-LVFe levels between the two groups. Resuscitation attempts seemed to have no effect on the results. In cases of drowning showing advanced putrefaction, the iron test was not reliable because biochemical iron measurement was often prevented by no sufficient blood in the heart or postmortem clots. In conclusion, according to our results, iron seems to be a good biochemical marker in fresh water drowning with a short postmortem interval.

Adolescent↗
PubMed2004

Forensic ethnic identification of crania: the role of the maxillary sinus--a new approach.

Forensic pathologists may be asked to identify the ethnic group and gender of a cranium of unknown origin. An analysis of the maxillary sinus--its volume, shape, and dimensions in dried crania of different ethnic and gender groups (European and Zulu male and female)--was conducted to establish a new approach. A variation in maxillary sinus volume may mean a variation in anatomic landmarks between the groups. Ethnic and gender variations in the shape of the maxillary sinus of the crania were investigated. This research was further extended to predict the gender and ethnic group from an unknown cranium to make this research valuable to the fields of forensic pathology and anthropology. Helical, multislice computed tomography was performed using 1-mm coronal slices. The area for each slice was obtained by tracing the outline of each slice. The computed tomographic machine calculated a volume by totalling the slices for each sinus. Advanced computer methodology including a neural network was designed and applied to search for classification patterns in data. A discriminant analysis was performed to improve classification results. Ethnic and gender variations were found in the different groups, and the predictive role of the maxillary sinus in ethnic classification was established. It was found that European crania had significantly larger antral volumes than Zulu crania, and males had larger volumes than females. Dimensions of European sinuses were larger than those of Zulu sinuses. The medial antral wall of the sinus allowed for ethnic classification. The discriminant analysis allowed for a very successful 90% ethnic prediction, while gender prediction was ultimately 79%. The measurements taken and the formulae created in this research will be valuable to those in the field who are seeking to ethnically classify a cranium into one or another ethic group. This research aims to be an aid in identification, as well as a starting point for other scientific studies based on other ethnic groups. Perhaps its true value will lie in confirming ethnicity by adding to existing criteria. It must be noted that this classification is based on actual measurements and therefore eliminates the some of the subjectivity present in current methods of ethnic classification.

Adult↗
PubMed2005

A 25-year retrospective review of deaths due to pediatric neglect.

Neglect, defined as the failure of a caregiver to adequately provide safety, food, clothing, shelter, education, protection, medical/dental care, and supervision for a child in his/her care, is a relatively uncommon but important cause of child mortality. A retrospective review of pediatric deaths (age 18 years or less) referred to the Medical University of South Carolina Forensic Pathology Office for autopsy over the past 25 years revealed 16 deaths due to some type of pediatric neglect. Cases were analyzed as to age, sex, race, cause and manner of death, autopsy findings, ancillary studies, past medical history, social/family history, and caregiver. Six cases of malnutrition/starvation and/or dehydration were identified, composing the most common cause of death in the neglect cases identified and the majority of the homicides due to neglect. Other deaths in which neglect contributed significantly included toxic ingestions (2 cases), hyper-/hypothermia (2 cases), unusual drowning/aspiration (4 cases), electrocution (1 case), and delayed/absent medical therapy (2 cases, including one of the previously mentioned ingestions). Of these additional cases, 7 were certified as accidental manner, 2 as natural, and 1 as a homicide. Cases which fell into a "gray zone" in which the appropriateness of invoking neglect was a matter of opinion or societal convention were excluded from the review; examples included conventional accidental drowning, choking on food or aspiration of foreign body, overlying/wedging during sleep, accidental hanging, and motor-vehicle traffic accidents (pedestrians, unrestrained passengers). The findings of this review reinforce the fact that malnutrition/starvation and dehydration compose the most common form of lethal pediatric neglect while highlighting less common forms of neglect and the difficulty of determining manner of death in cases in which neglect plays a more questionable role than in seemingly clear-cut malnutrition/starvation and dehydration cases. We demonstrate the typical victim and scenario that investigators will encounter in cases of fatal pediatric neglect, often a child under the age of 1 year who has been deprived of food and/or drink for some time, or an older, more independently mobile child who has not been adequately supervised. These children may or may not have a demonstrable prior history of maltreatment or (nonfatal) neglect, and review of medical records is an important part of the investigation. We additionally discuss key gross autopsy findings, appropriate specimen collection, helpful ancillary studies, microscopic findings of significance, potential mimickers of neglect, and other special considerations in cases of pediatric neglect.

Cause of Death↗
PubMed1990

[Ultrastructural pathology of mechanical skeletal muscle damage].

In continuation of previous light microscope investigations the question has been raised whether the criteria determined for vital muscle damage using light microscopy, could be verified and perhaps extended for the ultrastructural region. In addition to existing human pathological material taken early post mortem, muscle tissue obtained from animal experiments was also examined. The evaluation concentrated on the muscle cells, the cell organelles and the contractile apparatus. An evaluation of semi-thin-sections was carried out in parallel. The following reaction patterns could be defined as vital reactions: hypercontraction bands, zones of rupture in narrow topological relationship to organelle changes, microstructure changes with disintegration of the fibre structure, subsarcolemmic and interfibrillary oedema, decomposition of the sarcolemma. The earliest vital reactions were detectable after only a few minutes survival time. The comparison between the results of animal experiments and human pathology and the application of the results to forensic pathology will be discussed.

Animals↗