Cases Of Accidental Death Research Articles

2023 Annual Report of the Japanese Brain Bank Network for Neuroscience Research (JBBNNR)

AbstractBackgroundThe Japanese Brain Bank Network for Neuroscience Research (JBBNNR) received the renewal of Grant‐in‐Aid for Transformative Research Areas, MEXT, Japan from 2022 to 2027, whose center is the Brain Bank for Aging Research (BBAR), the first and only Japanese Brain Bank dedicated for aging and dementia research.MethodJBBNNR, in close collaboration with the Brain Bank Committee, the Japanese Society of Neuropathology (JSNP), is recruiting brain donors, propagating the BBAR protocols for neuropathological examination, and keeping the policy of open resource. JBBNR member consists of BBAR, the Brain Bank for Neurodevelopmental, Neurological and Psychiatric Disorders, Mihara Memorial Hospital and Fukushimura Hospital.ResultIn 2022, the effect of the pandemic of COVID‐19 still influenced the recovery of postmortem brains, owing to the recommendation of the National Institute of Infectious Disease (NIID), Japan, not to use electrical scissors in autopsy. This year, JBBNNR conducted a small number of COVID‐19 autopsies with prion format, following the informal permit of NIID. The total number of hospital autopsy cases slowly recovered. The effort to include legal autopsy of suicide victims and accidental death cases of developmental disorders experienced difficulty in Japanese culture and law. This year JSNP acknowledged ten board certified neuropathologists, whose main aim is to keep the Japanese brain bank system. JBBNNR is based on full autopsy and provided pathological basis to support brain‐ first, body‐ first hypothesis of Parkinson disease (PD). The high quality resource of JBBNNR contributed to first‐ line research, published in Nature and Cell this year.ConclusionJBBNNR continued to contribute neuroscience research, focused on AD and PD/ DLB in Japan.

Novel GluN2B-Selective NMDA Receptor Negative Allosteric Modulator Possesses Intrinsic Analgesic Properties and Enhances Analgesia of Morphine in a Rodent Tail Flick Pain Model.

Many cases of accidental death associated with drug overdose are due to chronic opioid use, tolerance, and addiction. Analgesic tolerance is characterized by a decreased response to the analgesic effects of opioids, requiring increasingly higher doses to maintain the desired level of pain relief. Overactivation of GluN2B-containing N-methyl-d-Aspartate receptors is thought to play a key role in mechanisms underlying cellular adaptation that takes place in the development of analgesic tolerance. Herein, we describe a novel GluN2B-selective negative allosteric modulator, EU93-108, that shows high potency and brain penetrance. We describe the structural basis for binding at atomic resolution. This compound possesses intrinsic analgesic properties in the rodent tail immersion test. EU93-108 has an acute and significant anodyne effect, whereby morphine when combined with EU93-108 produces a higher tail flick latency compared to that of morphine alone. These data suggest that engagement of GluN2B as a target has utility in the treatment of pain, and EU93-108 could serve as an appropriate tool compound to interrogate this hypothesis. Future structure-activity relationship work around this scaffold could give rise to compounds that can be co-administered with opioids to diminish the onset of tolerance due to chronic opioid use, thereby modifying their utility.

Using machine learning to find genes associated with sudden death.

To search for significant biomarkers associated with sudden death (SD). Differential genes were screened by comparing the whole blood samples from 15 cases of accidental death (AD) and 88 cases of SD. The protein-protein interaction (PPI) network selects core genes that interact most frequently. Machine learning is applied to find characteristic genes related to SD. The CIBERSORT method was used to explore the immune-microenvironment changes. A total of 10 core genes (MYL1, TNNC2, TNNT3, TCAP, TNNC1, TPM2, MYL2, TNNI1, ACTA1, CKM) were obtained and they were mainly related to myocarditis, hypertrophic myocarditis and dilated cardiomyopathy (DCM). Characteristic genes of MYL2 and TNNT3 associated with SD were established by machine learning. There was no significant change in the immune-microenvironment before and after SD. Detecting characteristic genes is helpful to identify patients at high risk of SD and speculate the cause of death.

Accidental death during pregnancy and puerperium from 2009 to 2019 in Hunan, China: a cross-sectional study

ObjectiveFew studies have analysed accidental maternal deaths. This study analysed the basic situation and classification of maternal accidental deaths and compared the differences between urban and rural areas.DesignA cross-sectional study...

Reflections on the aconitine poisoning

Aconitine is a natural toxic substance belonging to the family of aconitum alkaloids, which is used in small doses by Traditional Chinese practitioners. We present a case of accidental death due to acute aconitine poisoning. A 65-year-old Chinese man presented to a medical clinic with fever and shoulder pain. Soon after administration of intravenous ceftriaxone, a bottle of Chinese medicinal wine was administered. The man rapidly experienced headache, hearing loss and tinnitus, nausea, diarrhea, numbness of the lips, tongue, face, and the upper and lower extremities, cold sweat,fall of blood pressure, and discomfort of the entire body, and he died on the same day. Postmortem examination showed cyanosis of the nail beds, severe congestion in lungs and other organs, bilateral pleural effusions, and infiltration of basophils in the intestinal submucosa. No significant increase of IgE was found in the blood. Toxicological analysis detected aconitine in the medicinal wine, blood, and stomach contents by liquid chromatography-tandem mass spectrometry (LC-MS⁄MS). Aconitine was quantified in cardiac blood as 16.4ng/ml, and in stomach contents (63.8ng/ml) and wine sample (10.1 ug/ml). The cause of death was aconitine poisoning. This case report highlights the danger of aconitine. LC-MS⁄MS has the advantages of high analytic speed, sensitivity, and accuracy. It would be desirable for the government to control the use of aconitine-containing herbal extracts.

Road accidents analytics with data visualization: a case study in Shah Alam Malaysia

Road accident has become a serious problem of concern due to the increasing trend of the occurrences in line with the increase in the number of registered vehicles in Malaysia year by year. Causes of road accidents may come from various factors. Information on the causes is important to increase knowledge in assisting various responsible bodies with the theory and framework for establishing appropriate regulation, policy as well as for intervention planning and purposes in controlling and managing road accidents problem. Thus, this study aims to produce a road accidents profile of Shah Alam based on secondary data from MIROS and PDRM using descriptive and inferential data analytics. The application of data visualization methodology and techniques have shown that among all states in Malaysia, Selangor having the highest frequency of road accidents. For the cases of Shah Alam, there exist a temporal time scale pattern of road accidents occurrence. More number of accidence happened during the day compared to night. The most critical time the accidence took place is during busy hours; between 8.00 to 10.00 am in the morning, during evening hours between 4.00 to 6.00 pm and night hours after 6.00 pm until 8.00 pm. The accidental death cases were found mostly come from motorbike with (90-250cc), followed by car and lorry and were found mostly occurred at straight-ahead road as well as municipal road. The most type of collision is straying, digressing, or skidding followed by back collision and side collision. The severity of accidents impact is found associated with drivers demographic factors in which accidental death cases involving male is higher than female with age group between 21 to 25 years old.

A Three-Year Study on Acute Poisoning Cases Brought for Medico-Legal Autopsy in a North-Eastern City of India.

PurposeDeath due to acute poisoning is one of the significant health challenges to cope-up. It is imperative to know the death victims’ pattern due to acute poisoning to prepare the relevant preventive and remedial measures. Therefore, the present study aimed to assess the pattern of the dead victims of acute poisoning in a tertiary care centre.Materials and MethodsIt is a hospital record-based study and conducted in a tertiary care centre. Descriptive statistics to study the distribution of the cases among different age groups, sex, type of poison compounds was computed and analysed using SPSS software version 20.ResultsThe present study detected poisonous substances in 244 (41.8%) cases out of 584 death cases of suspected acute poisoning with the male preponderance of 62.29%. A higher incidence of acute poisoning was noticed among the young age group 21–30 years (33.6%) with 48 (31.6%) cases among males and 34 (36.9%) cases of the female. The Organophosphates (OP) was the main compound found in 151 (61.9%) fatal cases, followed by Carbamate in 45 (18.4%) cases. We also observed a maximum, 76 (36.2%) cases of suicidal victims in the age group of 21–30 years. Children and lower age group were more vulnerable to accidental poisoning as 26.5% cases of accidental death were reported in both the age group of 0–10 and 11–20 years respectively, gradually declining and practically found nil in above 60 years group. These differences of frequencies were found statistically significant (p < 0.0001), χ2 = 55.1.ConclusionThe results suggest due consideration to the young adolescents’ groups without any sexual discrimination to define guidelines for appropriate handling, storage and transportation of the poisonous compounds. Organophosphate’s involvement as the most preferred agent in acute poisoning is to be remembered to help manage poisoning cases.

Pattern of Head Injuries in Deaths Due to Two-Wheeler Road Traffic Accidents

Background: In India, from the past two decades, along with urbanization, industrialization, populationexplosion and migration of people, there has also been rapid growth in the field of road transportation. Consof this can be seen in the form of increased deaths due to RTA.Method: We conducted a cross sectional studyin department of forensic medicine, Gandhi Medical College,Hyderabad including all cases of accidental deaths due to two-wheeler, aged above 6 years between October2014 to May 2016.Results: Majority cases were in the age group of 21-30 years, 27 (25.7%) and males 89(84.8%). Majorityvictims encountered accident due to skid 40(38.1%) and head on collision being common 50(47.6%). Linearfracture of vault was found in almost half cases, 53(50.5%). Subdural and subarachnoid haemorrhage werethe most common one we encountered.Conclusions: Males in productive age group encountered fatal RTA and also linear fracture, SDH and SAHwere common pattern of injury seen in them. Stringent laws and awareness have to be created to reduce thefatalities.

Impact of COVID lockdown on autopsy cases: A comparative study

The present comparative study was conducted at Civil Hospital Jalandhar for all postmortem examination cases in a period from 23/3/2020 to 3/5/2020 in curfew/ lockdown due to COVID-19 with 23/3/2019 to 3/5/2019. A total of 59 and 96 postmortems was conducted in the respective period. The study shows the percentage change in the cause of death during the period of curfew/lockdown when people stayed at home. In this study, it has been found that there is a 38.54% decrease in death cases whose postmortem was conducted in the lockdown /curfew period. There was about a 4% increase in death cases in males. Death-cases decreased in all age groups except between 31 to 50 years. Accidental death cases, including road traffic and railway, fell by about 22%, and poisoning/drug overdoses death cases decreased by about 7%;however, hanging cases increased by about 11%. © 2020, Punjab Academy of Forensic Medicine and Toxicology. All rights reserved.

Epidemiology of alcohol-related accidental death in Tokyo Metropolitan area (2015).

Background Alcohol consumption may be a risk factor for accidental deaths; however, characteristics of alcohol-related deaths are unclear. We investigated characteristics of alcohol-related accidental deaths to facilitate target strategies. Methods In this article, 1060 cases of accidental deaths examined by the Tokyo Medical Examiner’s Office (2015) were divided into two groups: deceased individuals who drank alcohol (alcohol; n = 212) and those who did not (control; n = 848). Age, sex, alcohol consumption patterns, and manners/causes of deaths were compared. Places where individuals in the alcohol group met with an accident, and their blood alcohol concentration was assessed. Results Lower mean age (60.5 vs. 73.7 years) and a higher male ratio (75.9% vs. 58.5%) were observed in the alcohol group. Daily alcohol consumption was more common in the alcohol group (70.8% vs. 13.4%). Falling was the leading cause of death in the alcohol group, but without a significant difference (alcohol: 31.6%, control: 30.4%). Incidence rates of drowning (22.2% vs. 7.9%) and poisoning (11.3% vs. 2.0%) were significantly higher in the alcohol group. The mean blood alcohol concentration was 1.6 mg/mL. Of the total alcohol-related accidents, 60.8% occurred at home. Falling down the stairs was the primary type of falling, and majority of drownings occurred in a bathtub. Conclusion Male habitual drinkers (middle-aged to older adults) should be targeted to prevent alcohol-related accidental deaths. More than 50% of deaths occurred at home and care should be taken when performing daily activities, including using stairs and while bathing.

Suicide contagion in response to widely publicized celebrity deaths: The roles of depressed affect, death-thought accessibility, and attitudes.

Suicide contagion often occurs when a suicide death that is widely publicized (typically by the media) results in increases in suicide rates. However, the underlying cognitive and emotional mechanisms behind how and when suicide contagion occurs have been, up to this point, hazily understood. The present study: (a) tested whether individuals with depressed affect respond differently to celebrity suicides widely publicized by the media compared with those who do not have depressed affect, (b) measured 2 potential cognitive mechanisms that may be involved in suicide contagion, death-thought accessibility and attitudes about the acceptability and normality of suicide, and (c) compared responses to widely publicized suicide versus accidental death and natural death. The findings highlight a key moderator--depressive affect--that predicts the likelihood of being susceptible to suicide contagion effects following media coverage of a suicide death, clarify that its boundary conditions include cases of accidental death, and elucidate 2 cognitive mechanisms, death-thought accessibility and attitudes toward suicide acceptability and normality. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Language: en

Incipient progressive supranuclear palsy is more common than expected and may comprise clinicopathological subtypes: a forensic autopsy series.

We investigated 998 serial Japanese forensic autopsy cases (0-101years old, mean age 61.7±21.9), with no case selection, using immunohistochemistry to detect cases with progressive supranuclear palsy (PSP). Twenty-nine cases (mean age 82.3±7.2years, 11 males, 18 females) fulfilled the National Institute of Neuronal Disorders and Stroke (NINDS)-PSP pathological criteria (2.9% of all cases, 4.6% of cases over 60). All had neuronal and glial inclusions in the basal ganglia and brainstem. However, 13 cases had low tau pathology and were categorized as atypical PSP. In addition to PSP pathology, multiple types of astrocytic inclusions and comorbid proteinopathies, particularly a high prevalence of argyrophilic grain disease, were found. All cases had not been diagnosed with PSP and had preserved daily functioning prior to death. However, 14 (48.3%), 11 (37.9%), and 16 (55.2%) cases showed signs of dementia, depressive state, and gait disturbance, respectively. Sixteen accidental death cases (55.2%), including from falls and getting lost, and 11 suicide cases (37.9%) appear to have a relationship with incipient PSP pathology. Cluster analysis using the distribution and amount of 4-repeat-tau pathology classified the cases into three subgroups: Group 1 (10 cases) had typical PSP pathology and seven cases (70.0%) had dementia as the most frequent symptom; Group 2 (7 cases) had significantly higher frequency of gait disorder (6 cases, 85.7%), and less neocortical tau pathology than Group 1; Group 3 (12 cases) had relatively mild PSP pathology and high argyrophilic grain burdens. Granular-shaped astrocytes were the dominant astrocytic inclusion in all cases. We conclude that in forensic cases incipient PSP occurs with a higher prevalence than expected. If these findings can be extrapolated to other population-based cohorts, PSP may be more common than previously thought.

English

Electro-fishing (passing electricity through water to catch fish) requires sophisticated equipment. While this method is commonly employed by scientists for survey and fisheries management, a crude and illegal form electro-fishing is employed in Kerala for catching fish from water bodies. This can result in accidental electrocution and even fatalities. Even though they are rare, forensic pathologists in Kerala do come across such deaths from time to time. 8 cases of accidental death which occurred during electro-fishing are discussed here.

Accidental deaths in a University Teaching Hospital 1990-2009

Objective: The aim of this study is to describe the pattern of accidental deaths seen in University Benin Teaching Hospital (UBTH) and to highlight the need for implementation of preventive measures. Materials and Methods: This is a retrospective study of all cases of accidental deaths in which autopsy was performed at University of Benin Teaching Hospital (UBTH), Benin City, Edo state, Nigeria, from January 1990 to to December 2009. The major source of information was the autopsy registers of the DDepartment of Histopathology, UBTH. Result: A total of 35,914 bodies were received into the mortuary of UBTH during the study period; autopsy was performed on 5035 bodies out of which 4481 cases were medicolegal autopsies. Accidental deaths accounted for 1285 cases (26.8%): 1,016 cases were male's and269 cases were females, giving a male to female ratio of 3.8:1. The youngest victim was an infant and the oldest 100 years old, with a a mean age of 35.46 years and 2SD of 5.81. The mean age for males and females were 34.67 years and 33.80 years, respectively. Of the 1136 cases of road traffic accidentss, 927 (81.6%) were of of males and 209 (18.4%) were of of females. Road traffic accident death victims were drivers and passengers (48%), pedestrians (30.2%), and bike riders/passengers (21.8%). Conclusion: The pattern of accidental deaths in Benin shows that road traffic accidents is the major cause of death. Efforts must be made to improve our roads so as to reduce the number of lives lost.

Huffing Air Conditioner Fluid

"Huffing," the form of substance abuse involving inhalants, is growing in popularity because of the ease and availability of chemical inhalants in many household products. The purpose in huffing is to achieve euphoria when the chemicals in question interact with the central nervous system in combination with oxygen displacement. The abuser is lulled into a false sense of safety despite the well-documented potential for lethal cardiac arrhythmia and the effects of chronic inhalant abuse, including multisystem organ failure, and brain damage. Huffing air conditioner fluid is a growing problem given the accessibility to outdoor units and their fluid components, such as difluorochloromethane(chlorodifluoromethane, Freon), and we have classified multiple cases of accidental death due to the toxicity of difluorochloromethane. Given the ubiquity of these devices and the vast lack of gating or security devices, they make an inviting target for inhalant abusers. Acute huffing fatalities have distinct findings that are present at the scene, given the position of the decedent and proximity to the air conditioner unit. The purpose of the autopsy in these cases is to exclude other potential causes of death and to procure specimens for toxicological analysis.

Kasuistik - Reanimation unter Hypothermie nach suizidaler Butangasintoxikation

In the emergency medicine field cases of intoxication by sniffing agents do not occur very often. Nevertheless, considering the easy availability of butane the option of abuse especially by adolescent persons cannot be ignored. Although many cases of accidental death caused by malignant arrhythmia are described ("Sudden sniffing death syndrome"), suicide attempts using butane are a rarity. In this case the emergency treatment has to allow for special pathophysiological changes explained by physicochemical characteristics of butane. The following case report describes the symptomatology and pre-hospital treatment of an intoxication by butane with a suicidal intention.

Postmortem Whole-Body MRI in Traumatic Causes of Death

The aim of this study was to determine the sensitivity and specificity of postmortem whole-body MRI for typical injuries resulting from traumatic causes of death. Forty cases of accidental death were evaluated with postmortem whole-body MRI. Imaging was conducted according to a standard protocol, and each examination had an average duration of 90 minutes. The imaging findings were correlated with the autopsy findings, which served as the reference standard. MRI showed the main pathologic process leading to death in 39 of the 40 cases. The sensitivity of postmortem MRI ranged from 100% (pneumothorax) to 40% (fractures of the upper extremities). In general, MRI had a high level of performance for depicting soft-tissue lesions, such as subcutaneous hematoma (e.g., galeal hematoma with a sensitivity 95%). The sensitivity of MRI was remarkably lower for lesions of the upper abdominal organs (liver, 80%; spleen, 50%; pancreas, 60%; kidneys, 66%). Postmortem whole-body MRI had overall good performance for depicting traumatic findings in corpses and therefore may serve an important role as an adjunct to classic autopsy for the forensic examination of cases of traumatic cause of death. However, the reduced sensitivity of postmortem MRI for lacerations of the upper abdominal organs and the observed superimposition of antemortem findings and postmortem findings (e.g., in the pulmonary tissue) in this retrospective study suggest that whole-body postmortem MRI not be recommended as a replacement for classic autopsy.

Parental Grief after a Child'S Drug Death Compared to other Death Causes: Investigating a Greatly Neglected Bereavement Population

This comparative survey contrasted 571 parents who lost children to various death causes: 48 to drug-related deaths and overdoses, 462 to suicide, 24 to natural death cases, and 37 to mostly accidental death cases. Groups were compared in terms of grief difficulties, mental health problems, posttraumatic stress, and stigmatization. Results did not show any appreciable differences in these respects between the suicide bereaved parents and those losing children to drug-related deaths. However, when the suicide and drug-related death survivors were specifically contrasted against accidental and natural death loss cases, a consistent pattern emerged showing the former group was consistently more troubled by grief and mental health problems than the latter two sub-groups. These differences remained when controls of time since the loss and gender differences were employed as covariates. These findings suggest that the powerful and intense stigma against drug use and mental illness, shared among the public-at-large, imposes challenges in healing of immense proportion for these parents as they find less compassionate responses from their significant others, following their losses.

An Unusual Case of Accidental Poisoning: Fatal Methadone Inhalation*

In this report, the authors present a case of unusual, accidental methadone intoxication in a 40-year-old man, who had inhaled methadone powder. The drug dealer was a pharmacy technician; methadone had been stolen from a pharmacy and sold as cocaine. After having inhaled methadone powder, he suffered cardiopulmonary arrest. He was admitted to hospital where he died after 24 h of intensive care. The autopsy revealed congestion of internal organs and cerebral and pulmonary edema. Microscopically, the heart showed no changes. The toxicological analyses performed on blood and urine taken at the hospital revealed methadone, cannabinoids, and ethanol. The blood methadone concentration was 290 μg/L. The urine methadone concentration was 160 μg/L. Midazolam and lidocaine, which were administered to the patient at the hospital, were also detected in the blood. The cause of death was determined to be methadone intoxication. The literature has been reviewed and discussed. To date, and to our knowledge, only very few cases of accidental death resulting from methadone inhalation have been described up to the case presented herein.

Parental Substance Abuse and Accidental Death in Children

In this report, the authors present two cases of accidental death in children of addicted parents. In the first case, the child was left unattended at home while the mother went out to buy cocaine. She was arrested and detained with no mention of the unsupervised child. The cause of death in this case was determined to be starvation and dehydration. In the second case, a child mistakenly received a methadone suppository by her father instead of an antipyretic suppository. Toxicological analysis of the femoral blood revealed methadone at a concentration of 1.2 mg/L. The cause of death was determined to be methadone intoxication. The literature is reviewed and discussed. We report these cases to illustrate the risk of harm to children from illicit drugs and prescription medications at home and because there is no mention of accidental death in children following a methadone suppository administration in the current literature.