The American journal of forensic medicine and pathology
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Am J Forensic Med Pathol · Sep 2012
Case ReportsThe atypical entrance wound: differential diagnosis and discussion of an unusual cause.
The appearance of gunshot entrance wounds on the body depends upon many factors including, the type of firearm, the type of ammunition, the location of the wound on the body, and the circumstances of how a wound was sustained. Atypical gunshot entrance wounds are usually created when the bullet is destabilized prior to entering the body and consequently does not enter the body nose first but sideways or at an angle. ⋯ The cause of the atypical nature of the wound was determined to be increased yaw due to bullet instability caused by the condition of the firearm used, not a ricochet or intermediate target. The case emphasizes the importance of collaborative investigation between the different forensic agencies in gunshot cases.
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Am J Forensic Med Pathol · Sep 2012
Sudden infant death syndrome: diagnostic practices and investigative policies, 2004.
Using a 2004 population-based survey of all US medical examiner and coroner offices, we examined the characteristics of offices accepting an infant death case and calculated the percentage of offices that had death scene investigation or autopsy policies for the investigation of sudden unexpected infant death (SUID). We also calculated the percentage of offices that used and did not use sudden infant death syndrome (SIDS) as a cause of death, and we compared differences in characteristics among those offices. Of medical examiner and coroner offices, 52% did not report an infant death in 2004. ⋯ At least 5% of offices that reported an infant death did not use SIDS as a cause of death classification. These findings have important implications for understanding recent trends in SIDS and SUID. Supporting the implementation of national standards for investigating and certifying infant deaths could provide guidelines for consistent practices in medical examiner and coroner offices.
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Am J Forensic Med Pathol · Mar 2012
Comparative StudyFracture of the cricoid as a potential pointer to homicide. A 6-year retrospective study of neck structures fractures in hanging victims.
The distinction of a suicidal hanging from a simulated hanging following a homicidal strangulation is highly challenging. The present study evaluates the fracture of the cricoid cartilage as a potential pointer toward homicide. Despite the numerous studies on neck structures fractures in hanging, this is the first study to concentrate on the cricoid cartilage. ⋯ The general incidence of fractures in homicidal no-hanging strangulation was 65.4% (34 cases),with an incidence of fracture of the cricoid cartilage of 20.6%. By compiling studies from the literature, only one cricoid cartilage over 2700 suidical hanging cases was found, whereas an incidence of 5 to 20% is found for homicidal strangulation. It is therefore proposed that the presence of a fracture of the cricoid in an apparent suicidal hanging should be considered highly suspicious.
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A 48-year-old-woman was struck dead by lightning on October 24, 2010, in Pretoria, South Africa. The cause of death was due to direct lightning strike. ⋯ Small pieces of concrete were located embedded within the shrapnel wounds. This case report represents the first documented case of secondary missile formation (shrapnel injury) due to lightning strike in the literature.
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After surgery, the most common foreign bodies retained in the abdominal cavity are the surgical sponges. The aim of the present study was to emphasize the importance of gossypiboma, which is a serious and medicolegal problem. The records of 12 patients with a confirmed diagnosis of gossypiboma after abdominal surgery at Dicle University Hospital were retrospectively reviewed between January 1994 and December 2009. ⋯ To eliminate the risk of gossypibomas, all sponges should be counted at least twice (once preoperatively and once postoperatively); use of small sponges should be avoided during laparotomy, and only sponges with radiopaque markers should be used. The surgeon should explore the abdomen before closure. In cases in which the sponge count is uncertain, an abdominal x-ray should be performed before closure.