RESUMEN
Although the arcus corneae (AC) has long been used as an age indicator for forensic purposes, its diagnostic value has not been evaluated. To evaluate the AC as a predictor of chronological age, the author has studied the correlation of AC with respect to age of the deceased. A cross-sectional study was conducted of 342 Thai corpses at the Maharat Nakhon Ratchasima Hospital, Thailand. AC was graded into three levels: no AC, incomplete ring, and complete ring. One-way analysis of variance, chi-square test, binomial logistic regression, sensitivity, specificity, predictive values, and likelihood ratios were used for analysis. The Cohen's kappa was used to determine the intraobserver and interobserver reliability. The prevalence of AC and the probability of complete AC were significant higher in corpses aged 60 years and above than in those under 60 years. Consequently, this study confirmed that the prevalence of AC was significantly correlated with the age of Thai individuals. If the complete AC is used as an indicator of age of 60 years and above, complete AC has high sensitivity (92.56%) but low specificity (72.85%), low positive predictive value (65.12%), but high negative predictive value (94.71%). For diagnostic value, the presence of AC can be used for age screening but not for absolute confirmation. The absence of AC indicates young age, incomplete AC indicates middle age, and complete AC indicates old age. The high intraobserver and interobserver reliability provides assurance of the value of AC as a means to estimate personal age.
RESUMEN
Streptococcus suis causes meningitis, septicemia, arthritis, endocarditis and death in both pigs and humans. Sudden death is rarely documented in the forensic field and almost all cases were diagnosed pre-mortem. Here we report a 49-year-old man who died from S. suis type 2 infection. S. suis was identified as the causative pathogen using bacterial culture, standard biochemical and coagglutination tests, specific DNA amplification by polymerase chain reaction, and histopathologic examination. We discuss the postmortem investigation of a suspected S. suis infection.
Asunto(s)
Muerte Súbita/etiología , Infecciones Estreptocócicas/diagnóstico , Streptococcus suis/aislamiento & purificación , Animales , Patologia Forense , Humanos , Riñón/patología , Masculino , Productos de la Carne/efectos adversos , Productos de la Carne/microbiología , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Púrpura/patología , ARN Ribosómico 16S/genética , Streptococcus suis/genética , PorcinosRESUMEN
Pulmonary embolism (PE) is one of the most undiagnosed causes of death, and more than half of fatal PE is discovered only during autopsy. The author reports a case of sudden death from massive pulmonary thromboembolism due to an inferior vena cava (IVC) thrombosis caused by chronic pancreatitis. An extensive search for the location of the thrombus identified the source of emboli. The probable mechanism of IVC thrombosis caused by chronic pancreatitis is discussed. Awareness of this serious complication of chronic pancreatitis may have prevented the sudden death.
RESUMEN
A 20-year-old well nourished woman was found dead suddenly and unexpectedly in her bedroom. According to her medical history, Graves' disease was diagnosed in August 2000 and the symptoms of thyrotoxicosis were poorly controlled. Autopsy and histology revealed diffuse enlargement of the thyroid gland (125 g, diffuse hyperplastic goiter), pulmonary edema, cardiomegaly (440 g) without coronary artery occlusion or stenosis. The cardiac muscles showed interstitial fibrosis with hypertrophy of the myocardial fibers. The circumstances and scene of death as well as the detailed postmortem analysis indicated that thyroid crisis from Graves' disease was the cause of death.
Asunto(s)
Muerte Súbita/etiología , Enfermedad de Graves/complicaciones , Cardiomegalia/patología , Femenino , Patologia Forense , Humanos , Miocardio/patología , Edema Pulmonar/patología , Bazo/patología , Crisis Tiroidea/etiología , Glándula Tiroides/patología , Adulto JovenRESUMEN
This paper presents and discusses 30 cases of cadavers that had been transferred for forensic entomology investigations to the Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, northern Thailand, from 2000 to 2006. Variable death scenes were determined, including forested area and suburban and urban outdoor and indoor environments. The fly specimens found in the corpses obtained were the most commonly of the blow fly of family Calliphoridae, and consisted of Chrysomya megacephala (F.), Chrysomya rufifacies (Macquart) Chrysomya villeneuvi Patton, Chrysomya nigripes Aubertin, Chrysomya bezziana Villeneuve, Chrysomya chani Kurahashi, Lucilia cuprina (Wiedemann), Hemipyrellia ligurriens (Wiedemann), and two unknown species. Flies of the family Muscidae [Hydrotaea spinigera Stein, Synthesiomyia nudiseta (Wulp)], Piophilidae [Piophila casei (L.)], Phoridae [Megaselia scalaris (Loew)], Sarcophagidae [Parasarcophaga ruficornis (F.) and three unknown species], and Stratiomyiidae (Sargus sp.) were also collected from these human remains. Larvae and adults of the beetle, Dermestes maculatus DeGeer (Coleoptera: Dermestidae), were also found in some cases. Chrysomya megacephala and C. rufifacies were the most common species found in the ecologically varied death scene habitats associated with both urban and forested areas, while C. nigripes was commonly discovered in forested places. S. nudiseta was collected only from corpses found in an indoor death scene.