The American journal of forensic medicine and pathology
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Am J Forensic Med Pathol · Dec 2010
Case ReportsTwo-handed cardiopulmonary resuscitation can cause rib fractures in infants.
The discovery of acute rib fractures in deceased infants and young children can be unsettling. Although significant injuries may occur subsequent to resuscitative efforts in adults, it is well documented that such injuries are rare in much younger individuals. ⋯ However, little is known about what, if any, injuries might occur subsequent to the delivery of "2-handed" CPR. Five unrelated, nonsequential cases of infant death are reported where multiple acute anterolateral rib arc fractures followed 2-handed CPR delivered by trained medical personnel.
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Am J Forensic Med Pathol · Dec 2010
Living victims of strangulation: a 10-year review of cases in a metropolitan community.
The prevalence of reported domestic violence or intimate partner violence has greatly increased, with approximately 1.5 million women violently assaulted annually in the United States by an intimate partner. Strangulation is often seen in violence against women, including domestic violence cases. Strangulation is defined as "a form of asphyxia characterized by closure of the blood vessels or air passages of the neck as a result of external pressure on the neck." This is a 10-year case review of 102 living victims of strangulation who underwent medicolegal evaluation at the Clinical Forensic Medicine Program at a State Medical Examiner's Office serving Southern Indiana and all of Kentucky. ⋯ A paucity of cases involved only strangulation, as most of the victims were subjected to myriad forms of blunt force trauma which included not only the head and neck but also other bodily regions. This is a unique presentation of strangulation of living persons as most evidence of strangulation in the forensic literature has been derived from postmortem examinations of the victims. This comprehensive study discussing the examination of a living strangulation victim offers valuable insight into the mechanism and the physical findings involved in the strangulation process.
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Am J Forensic Med Pathol · Dec 2010
A 10-year epidemiologic review of homicide cases in children younger than 5 years in Fulton County, GA: 1996-2005.
The primary purpose of this study was to present the epidemiologic review of homicide deaths certified by the Fulton County Medical Examiner's Office from January 1, 1996 through December 31, 2005 in children younger than 5 years. The secondary purpose of this study was to determine if the observed cases of homicide deaths among children younger than 5 years in Fulton County are significantly greater than expected when compared with those in the State of Georgia. For purposes of this study, only homicide deaths of Fulton County residents were included. ⋯ Although this study was unable to collect information on the victim's suspect/offender characteristics, it was noted that only 37% of the cases (n=18) went to trial. Most homicide investigations were under the Atlanta police jurisdiction (n=28, 57.1%). Results from this study may assist local and state government officials in recognizing the epidemiologic characteristics of children at risk to help them allocate limited resources efficiently and implement preventive measures to at-risk populations effectively.
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Am J Forensic Med Pathol · Sep 2010
Case ReportsUnprovoked fatal shark attack in Lifou Island (Loyalty Islands, New Caledonia, South Pacific) by a great white shark, Carcharodon carcharias.
The case of a fatal, unprovoked shark attack is reported and analyzed. The incident took place on the 30th of September 2007, in the lagoon of Luengoni Bay, Lifou Island (Loyalty Islands, New Caledonia). A young French woman who was snorkeling was severely bitten on the right thigh and died of hemorrhage. An analysis based in particular on the size and color of the shark, the characteristics of the wounds, and the behavior of the shark before and after the bite suggests that the aggressor was a great white shark, Carcharodon carcharias.
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Occasionally, individuals accused of inflicting fatal injuries on infants and young children will claim some variant of the "CPR defense," that is, they attribute the cause of injuries found at autopsy to their "untrained" resuscitative efforts. A 10-year (1994-2003) historical fixed cohort study of all pediatric forensic autopsies at the Miami-Dade County Medical Examiner Department was undertaken. To be eligible for inclusion in the study, children had to have died of atraumatic causes, with or without resuscitative efforts (N(atraumatic) = 546). ⋯ This study indicates that in the pediatric population, injuries secondary to resuscitative efforts are infrequent or rare, pathophysiologically inconsequential, and predominantly orofacial in location. In our population, CPR did not result in any rib fractures or significant visceral injuries. Participation of nonmedical or untrained individuals in resuscitation did not increase the likelihood of injury.