Journal of forensic sciences
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Bullet embolism is a relatively unusual complication of gunshot wounds. Embolism to the right atrium comprises <5% of all reported intravascular bullet emboli. ⋯ The missile remained within the heart without clinical significance for several years and was recovered from the right atrium only at the time of autopsy. To the best of our knowledge, this is the first documented case of a 0.38-caliber bullet which embolized to the right atrium and remained inconsequential for an extended period of time.
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Case Reports
Retrograde venous cerebral air embolism from disconnected central venous catheter: an experimental model.
There are few reported cases of death attributed to retrograde cerebral air embolism from central venous catheter. The pathophysiological mechanism and the necessary conditions are not fully understood, also because of missing experimental data. We performed experimental simulation while working on a possible case of retrograde cerebral air embolism. ⋯ At angles between 0 and 45°, the air bubbles followed the fluid flow. At angles >45°, the air bubbles showed the tendency to flow upstream; this phenomenon was more evident the more vertically the hose was located. We were able to demonstrate that a retrograde air embolism can be caused by a disconnected catheter and is even more likely if the neck is in a vertical position.
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Case Reports
Acute arsenic poisoning: clinical, toxicological, histopathological, and forensic features.
This report describes a suicide case by acute arsenic intoxication via intravenous injection. A 30-year-old woman injected arsenic As (V) (sodium arseniate disodique: Disodium Hydrogena Arsenik RP) in a successful suicide attempt. Three hours following administration, the woman developed severe digestive symptoms. ⋯ These findings were in agreement with acute arsenic poisoning. The symptoms developed by this young woman (intoxication by intravenous administration) were comparable to oral intoxication. The clinical signs, survival time, and administration type are discussed in light of the literature on acute and chronic arsenic poisoning.
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A number of questions must be asked before asthma can be accepted as a valid diagnosis: were the episodes of shortness of breath investigated? Are there changes at autopsy in keeping with asthma? Did asthma either contribute to the terminal episode, cause death, or was it coincidental? Finally, is it possible that other conditions may have accounted for the clinical manifestations? A review of files at FSSA over a 10-year period from 1999 to 2008 identified six cases where shortness of breath and/or wheezing had been incorrectly attributed to asthma. Five were due to pulmonary thromboembolism and one to multiple injuries. ⋯ There was no morphological evidence of asthma in any case. Autopsy examination may, therefore, be crucial in revealing other conditions that may have caused or contributed to episodic breathlessness that may have been incorrectly attributed to asthma.
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Suicide by burning is an extreme act that is uncommon in the United States and throughout the Western world. The characteristics of people who complete such acts are not well understood. To address this issue, we examined the death records of the King County Medical Examiner's Office in Washington State over the 13 years from 1996 to 2009. ⋯ Self-burning predominantly occurred at the decedent's residence with the intent of suicide given. There was no unifying theme in motivating factors. Together, these data represent the characteristics of people whose death is because of suicide by burning in King County, Washington.