Abusive Pediatric Thoracolumbar Fracture Due to Forced Hyperextension: Case Report, Biomechanical Considerations, and Review of the Literature.

Pediatric thoracolumbar fractures are rare due to the physiological differences which afford greater resilience to the immature spine. Most pediatric thoracolumbar fractures occur as the result of high energy trauma, such as motor vehicle accidents, and modes of reasonable accidental injuries are limited by age and developmental capabilities of the child. These fractures can occur as the result of inflicted blunt force trauma and child abuse, and in most cases, the mechanism of injury to the spine is not known.

The Difficulties in Assessing Wounds Created by .410 Bore Ammunition and Weapons.

When interpreting firearm injuries, the distinction between gunshot wounds and shotgun wounds is important, and separation of these categories is typically straightforward. However, .410 bore firearms can make the classification difficult.

Discordance of Gross and Histologic Findings in Estimating the Range of Fire of Gunshot Wounds.

Forensic pathologist use soot and/or stippling surrounding entrance gunshot wounds in categorizing range of fire. If absent, some pathologists suggest utilizing histology when the range is diagnostically critical. This study investigates the concordance of macroscopic and microscopic findings in estimating range of fire by evaluating gunshot entrance and exit wounds made through human tissue analogs at defined distances using two handgun calibers.

Carfentanil-Associated Mortality in Wayne County, Michigan, 2015-2017.

Objectives: To identify opioids associated with a spike in opioid-related mortality in Wayne County, Michigan, from July 2016 through February 2017.

Methods: We reviewed records from the Wayne County Medical Examiner's Office of 645 people who died because of accidental nonmedically prescribed opioid overdoses from July 2015 through July 2017. We analyzed basic demographics, locations of death, and all opioid toxicology results.

Horticultural Homicide: Stab Wound to the Chest Masquerading as Impalement by Rose Bush.

Instruments that create stab wounds are required to possess tips of sufficient strength and rigidity to breach the integrity of the skin. Knives, the most common weapons used to create stab wounds, have cutting edges that cleave the skin, leaving unabraded margins. On rare occasions, blunt objects are driven with sufficient force to pierce the skin and become impaled within the body.

Strangulation and Its Role in Multiple Causes of Death.

Forensic pathologists have a duty to determine the cause and manner of death and are bound by international guidelines in the completion of the death certificate. Sometimes, there are complex circumstances surrounding a death that cannot be captured in the structure of the death certificate and its requirement of listing only 1 cause of death per line. Cases may have multiple causes of death with comorbid medical conditions or inflicted injuries that equally contribute to the ultimate demise.

Idiopathic Megacolon: Report of 2 Deaths With Review of the Literature.

Abnormal dilation of the colon and rectum can develop from a range of disease processes. When encountered at autopsy, its contribution to death requires assessment and a thorough investigation of its origins. Elimination of known causes elicits a diagnosis of idiopathic megacolon.

The Modern Compound Bow.

Bows and arrows are ancient weapons that have risen and fallen as the preeminent armaments used by man. Because of the ubiquity of firearms, fatalities from archery injuries in the United States have radically declined. However, when deaths involving this weapon do present themselves, the paucity of reference materials can be a hurdle for forensic pathologists and other forensic scientists.

Basal Ganglion Hemorrhage as Delayed Complication of Diethylene Glycol Ingestion.

Diethylene glycol (DEG), an organic compound (HOCH2CH2)2O is a commonly used solvent. Mass poisoning outbreaks have been reported because of frequent contaminations. A PubMed search for diethylene resulted in 795 publications with 151 specifically discussing the toxicity.

Hyperthermia, Thermal Injuries, and Death from a Forced Convection Heat Source: A Case Report and Experimental Model.

Heat-related deaths of children are most often encountered in the context of enclosed vehicles in summer months. Deviating from this, a 16-month-old boy was found unresponsive in a stroller that was placed adjacent to a space heater during mid-winter. The cause of death was hyperthermia and thermal injuries.

Examination of Ricochet Gunshot Wounds From Commonly Encountered Surfaces.

Proper interpretation of gunshot wounds is vital for the forensic pathologist and requires experience and expertise, as well as consultation with a firearms and ballistics expert and careful scene investigation in cases of atypical gunshot wounds. This study is the first large-series examining ricochet gunshot wounds involving different firearm calibers. Typical gunshot wounds created from 4 handgun calibers (22 Long Rifle, 9 × 19 mm Parabellum, .

Applying the Principles of Homicide by Heart Attack.

Homicide by heart attack is a well-established model in forensic pathology that describes death elicited during or immediately after a criminal act where a threat or fear of physical injury is present. After its introduction nearly 4 decades ago, the principle has undergone a handful of modifications but still maintains its core concepts. All cases of this nature during a 20-year period at the Wayne County Medical Examiner's Office were compared and contrasted for demographics, circumstances and scene investigation, and autopsy and toxicology findings.

Companion Cases in a Large Urban Medical Examiner's Office.

Companion death cases, as defined in this study, include 2 or more deaths that occur at the same location or 1 death at a specific location combined with 1 or more individuals transported from that same location to a hospital where death was pronounced within 1 hour of arrival. These types of cases can have multiple causes and manners of death. The Wayne County Medical Examiner's Office conducted a retrospective study of companion death cases that came into the office from mid 2007 to the end of 2014.

Resuscitation and Prevalence of External Facial, Neck, and Chest Injuries in Infants.

Cardiopulmonary resuscitation can transmit external injuries to the face, neck, and chest regions of infants. The aim of this study was to compare and contrast observations made during infant autopsies to delineate differences in the external appearance of those who did and those who did not receive resuscitation. We investigated 344 infant deaths between mid 2007 and 2013 in Wayne County, Detroit, Michigan, and identified 38 infants (11%) who displayed abrasions and/or contusions, independent of the cause of death.

Takayasu Arteritis of the Coronary Arteries Presenting as Sudden Death in a White Teenager.

Takayasu arteritis is a rare disease that expresses chronic, large vessel inflammation. The etiology remains unclear and its presentation depends on the affected arteries. With coronary artery involvement, manifestations range from chest pain and shortness of breath to sudden death.

Contribution of opiates in sudden asthma deaths.

Asthma is a common disease in the United States and is frequently encountered during medicolegal autopsies. Patients are often young and have a witnessed collapse or are found dead. Opiate abuse is also pervasive and is repeatedly seen in death investigations.

Spectrofluorimetric analysis of 7-hydroxycoumarin binding to bovine phenol sulfotransferase.

Phenol sulfotransferases (SULT1s, EC 2.8.2.