Reducing the risks of wound consultation: adding digital images to verbal reports.

Purpose: The purpose of this study was to examine the impact of digital images on the assessment and recommendations of a WOC nurse who was providing remote nurse-to-nurse consultations on home care patients with wounds.

Methods: In a descriptive comparative study, data were collected by home care nurses from a sample of 43 adult patients with a total of 89 wounds with various etiologies. To determine whether or not the addition of a digital photograph influenced the WOC nurse's assessment and recommendations, the WOC nurse first completed a wound assessment and recommendation form based on a verbal report from the home care nurse.

The use of digital images in evaluating homecare nurses' knowledge of wound assessment.

Purpose: The purpose of this study was to evaluate homecare nurses' knowledge of wound assessment using digital images and case studies.

Design: A descriptive design was used.

Subjects And Setting: Subjects were a convenience sample of 33 registered nurses from a Washington, DC, metropolitan-based home health agency.

Morphological changes in the skin during experimental allergic encephalomyelitis and multiple sclerosis: bases for new diagnostic test.

Skin specimen from the medial malleolar area of patients with multiple sclerosis and guinea pigs with experimental allergic encephalomyelitis were examined by light and electron microscopy. Demyelination, inflammation, and dystrophic changes in peripheral nerves and skin correlating with clinical manifestations were revealed in both sclerosis and encephalomyelitis. Maximum changes were revealed in nerve-associated cells (Merkel cells), Langerhans cells reflecting inflammation intensity, and fibroblasts responsible for nerve integrity and resistance against external stimuli.

The moving, projected, annual total. A kinetic prognostic entity.

A simple, inexpensive method of prognostically calculating and graphically recording annual case loads of the various deaths investigated by today's medicolegal offices is presented. Graphic depiction of the numerical data provides a convenient way to compare current prognostications with the records of preceding years.

Pedicide revisited. The slaughter continues.

Pedicide, a reliable indicator of interpersonal violence and severe child abuse, has risen in Cuyahoga County (Metropolitan Cleveland), Ohio, U.S.A.

[Neuromorphologic aspects of experimental herpetic infection].

At intracerebral, intracutaneous, intracorneal and intraneural ways of infection with herpes simplex to mice and rabbits it has been stated immunomorphologically and electron microscopically that reproduction of the virus has been observed in various cells of the nervous system and accompanied with appearance of certain dystrophic changes in them. Reproductivity of the disease, duration of the incubation period, spread of the pathological process, successiveness of the lesion in the nervous system structures are determined by neurotropism of the strain and by the infection variant. The subclinical course of the infection does not exclude a productive reproduction of the virus in sensitive cells and corresponding morphologic equivalent.

Forensic pathology then and now. Retrospect and reflections.

The past half-century has witnessed significant progress and multiple, meaningful changes in the day-to-day practice of forensic pathology as it has in all other branches of laboratory and clinical medicine. Associated with the welcome advancing "scientific" aspects of our work have been gratifying changes in the professional status of our much misunderstood area of medical activity, the latter most vividly and convincingly represented by American Board of Pathology certification in Forensic Pathology and the appearance of such growing, vital, national professional organizations as the American Academy of Forensic Sciences and our National Association of Medical Examiners and the creation of such highly respected periodicals as the Journal of Forensic Sciences and our American Journal of Forensic Medicine and Pathology. Objective assessment of the foregoing accomplishments leads to the inescapable conclusion that forensic pathology has emerged from its previous role as the "invisible profession" and become a respected and productive branch of laboratory medicine.

A comparison of post-mortem ethanol levels obtained from blood and subdural specimens.

Post-mortem subdural ethanol levels have been proposed as a useful test in certain forensic cases involving head trauma, particularly when the time interval from injury to death may have caused a lowering of the blood ethanol concentration to insignificant or undetectable levels. This study of 75 autopsied persons from whom both blood and subdural ethanol levels were obtained, shows the usefulness of the subdural ethanol level, especially where there is a prolonged or unknown post-traumatic time interval. Use of such a test is recommended in these situations.

Homicidal poisoning. A dying modality of lethal violence?

Review of the experience of the Cuyahoga County (Cleveland, Ohio and its suburbs) Coroner's Office with homicidal poisonings over the past 3 1/2 decades reveals that this modality of felony homicides constitutes but a tiny fraction of the total case load and small percentages of overall homicides and drug- and chemical-caused deaths of all types. These findings are representative of selected medicolegal establishments across the country, as well as in the United States as a whole. Precise definition of the several types of felonious homicidal poisonings is suggested in the interest of clarity and accuracy of statistical data.

Trauma as a life-lengthening agency--a biologic paradox.

Traumatic antero-posterior chest compression in two persons promptly (immediately?) following spontaneous rupture of acute, free wall myocardial infarcts created pericardio-pleural fistulae with resultant relief of pericardial tamponade, thus permitting cardiac contractions to occur after they naturally and ordinarily would have ceased.

Bullet or bite--a contribution to the morphogenesis of gunshot dermal injury.

Histopathologic studies of dermal dog bites revealed changes identical with those observed in distant gunshot skin entrance wounds and in a presternal skin stab wound made by a screwdriver. The similarity of the epithelial and collagen changes produced by these three totally different traumatizing, perforating agencies indicate that it is the bullet's penetrating and crushing power, and not its caloric content, that is responsible for the characteristic dermal collagen changes noted in these common injuries.

Multivascular atheromatous coronary microembolism.

We report an unusual case of coronary-multivascular, small coronary artery embolism by atheromatous elements originating in a plaque in the main right coronary artery of a 52-year-old man who died of acute thrombotic occlusion of the severely stenotic left anterior descending vessel. The embolized arteries showed the characteristic multiphasic inflammatory changes of different ages previously described in arteries occluded by this material. The myocardium supplied by the involved channels showed ischemic damage of varying ages.

"Swinging in the park". An investigation of an autoerotic death.

Death during autoerotic episodes is of special concern to law enforcement officials, the coroner or medical examiner, the family of the decedent, and to society as a whole. As in the probing of any violent demise, accurate preservation of all evidentiary material, complete photographic documentation, reconstruction of the scene, and interviews with family and acquaintances ("psychological autopsy") are mandatory for proper completion of the case. A recent, atypical instance of sexual asphyxia arising from a bizarre incident exemplifies the foregoing dicta and provides a vivid example of "psychopathia sexualis.

Bullet embolism with radiologic documentation. A case report.

A case of bullet embolism is reported wherein a handgun missile, fired during a "shoot-out," perforated (among other structures) the anterior and posterior walls of the thoracic aorta, rebounded into the aortic lumen, and was transported to the left femoral artery where it came to rest. Roentgenographic study was instrumental in promptly locating the errant bullet whose recovery established the identity of the responsible firearm. The implications of bullet embolism of the arterial, venous, and paradoxical types for the forensic pathologist and the clinician are discussed briefly.

Factitial aplastic anemia.

A 29-year-old married nurse with pancytopenia was discovered to be surreptitiously ingesting alkylating agents. Despite her life-threatening behavior, there was no evidence that she was psychotic, depressed, or cognitively impaired. Psychological testing was indicative of a sociopathic personality.

Wounding characteristics of "shotshell" ammunition: a report of three cases.

Wounds caused by "shotshells" in three homicides are presented. Characteristics of shotshell ammunition based on test firings of .38 Special shotshells are detailed.

In vitro cytotoxicity of periodontally diseased root surfaces.

The purpose of this experiment was to develop a model system for controlled in vitro testing of root surface toxicity. Human gingival fibroblasts were placed into a depression created in the root surfaces of ten heat sterilized periodontally involved teeth, one half of which were root planed to remove all irritants. The teeth and fibroblasts were incubated in culture medium for 5 days, after which the cells were fixed and stained.