A5071773960- Autopsy Techniques and Outcomes
- Cardiac Arrhythmias and Treatments
- Atrial Fibrillation Management and Outcomes
- Eosinophilic Disorders and Syndromes
- Infective Endocarditis Diagnosis and Management
- Medical Malpractice and Liability Issues
- Cardiac tumors and thrombi
- Cardiac electrophysiology and arrhythmias
- Amyloidosis: Diagnosis, Treatment, Outcomes
- Adrenal and Paraganglionic Tumors
- Grief, Bereavement, and Mental Health
- Restraint-Related Deaths
- Pericarditis and Cardiac Tamponade
- Electrostatic Discharge in Electronics
- Cardiac Imaging and Diagnostics
- Child Abuse and Related Trauma
- IgG4-Related and Inflammatory Diseases
- Forensic Toxicology and Drug Analysis
- Streptococcal Infections and Treatments
- Aortic Disease and Treatment Approaches
- Aortic aneurysm repair treatments
- Neuroscience of respiration and sleep
- Virus-based gene therapy research
- Fungal Infections and Studies
- Healthcare cost, quality, practices
Cuyahoga County Juvenile Court
2023-2025
Primary Source
2024
Barro Colorado Island
2024
Cleveland Clinic
2021-2023
University of Vermont Medical Center
2015-2020
University of Vermont
2016-2017
Burlington College
2017
MT-45 (1-cyclohexyl-4-(1,2-diphenylethyl)piperazine) is just one of the many novel psychoactive substances (NPS) to have reached recreational drug market in twenty-first century; it however, first designer opioids achieve some degree popularity, a currently dominated by synthetic cannabinoids and stimulants. A single fatality involving etizolam described. method for quantitation whole blood using liquid chromatography–tandem mass spectrometry was developed validated. The linear range...
Background: Pulsed-field ablation (PFA) is a nonthermal energy with higher selectivity to myocardial tissue in comparison radiofrequency (RFA). We compared the effects of PFA and RFA on heterogeneous ventricular scar swine model healed infarction. Methods: In 9 swine, infarction was created by balloon occlusion left anterior descending artery. After survival period 8 10 weeks, or performed at infarct border zones identified abnormal electrograms. group (4 swine), lattice catheter (Sphere-9,...
Comparative efficacy and safety data on radiofrequency ablation (RFA) versus pulsed field (PFA) for common idiopathic left ventricular arrhythmia (LV-VAs) locations are lacking. This study sough to compare RFA with PFA of LV-VAs locations. Ten swine were randomized or LV interventricular septum, papillary muscle, summit via distal coronary sinus, epicardium subxiphoid approach. Ablations delivered using an investigational dual-energy (RFA/PFA) contact force (CF) local impedance-sensing...
Forensic investigation of intrauterine and perinatal deaths can be challenging, given their relative infrequency the possible involvement maternal substance use, trauma, socioeconomic factors. Intrauterine investigated by Cuyahoga County Medical Examiner's Officer between 2013-2023 were reviewed. One hundred twenty-eight cases identified (83 stillborn 45 live births). The predominant indications for referral concern use (57.8%) or trauma (35.2%). Gestational ages ranged from 11.5 to 42.5...
Transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized disease, in which atrial fibrillation (AF) has been shown to be prevalent. Cardiac scintigraphy with technetium-99m-pyrophosphate (99mTc-PyP) labeled bone-seeking tracers used noninvasively make the diagnosis of ATTR-CA, based on ventricular myocardial uptake. Assessment wall uptake (AU) 99mTc-PyP currently not clinical setting Methods: We analyzed a cohort patients referred for scan at tertiary center explore AU and...
Endocardial bipolar voltage amplitude is largely derived from endocardial and subendocardial wall layers. This may result in situations of low despite the presence mid-myocardial including epicardial (ie, intramural-epicardial) viable myocardium. study examined utility unipolar mapping for detection intramural-epicardial atrial myocardium.In 15 swine, an intercaval ablation line with intentional gap was created. Animals survived 6 to 8 weeks before electroanatomical followed by sacrifice....
Context.— Despite the importance of accurate death statistics for epidemiologic studies and public health initiatives, there remains a high frequency errors in certification. This deficiency can be addressed by hospital autopsy service. Objectives.— To improve quality accuracy certificates issued resident clinician education initiating certificate review process, performed pathology residents while on their rotation. Design.— A reviewed all daily through state electronic filing system...
The distinction between self-inflicted blade wounds and inflicted by another can be difficult in situations where there is little available history or context. We reviewed homicides suicides the past 10 years at Vermont Office of Chief Medical Examiner to define characteristics homicidal suicidal wounds. All involving wounds, not just those which were cause death, included. Information regarding victim demographics, location type injuries, toxicology, evidence suicidality was gathered. Blade...
Distinguishing true antemortem thrombus (AMT) from artifactual postmortem clot (PMC) can occasionally be challenging at autopsy. Lines of Zahn are cited as pathognomonic AMT, but review literature reveals heterogeneous definitions the term. Neutrophil karyorrhexis and CD61 immunohistochemistry also used to define there has been no systematic study determining specificity these features.To identify features that distinguish AMT PMC, clarify definition lines Zahn.PMC heart was collected in 50...
Invasive cardiac aspergillosis has been rarely described in immunocompromised patients. This disease is difficult to diagnose by conventional laboratory, microbiologic, and imaging techniques, often recognized only post-mortem. The authors present the case of a 60-year-old woman admitted with an exacerbation eosinophilic granulomatosis polyangitiis (EGPA) who subsequently died from
Retiform purpura has been described as a relatively frequent cutaneous finding in patients with coronavirus disease 2019 (COVID-19). The etiology is hypothesized to be related thrombotic vasculopathy based on lesional biopsy specimen findings, but the pathogenesis of not completely understood. Here, we present case retiform purpuric patch sacrum/buttocks hospitalized patient prior subsequent diagnosis COVID-19 and an eventual fatal course. Two specimens at different time points course...
Abstract Determining the age of a subdural hematoma at autopsy is great interest for medicolegal purposes. The appearance pigment‐laden macrophages often referenced as evidence that 3–4 days old. However, understanding significance and hemosiderin requires histology infant dura. Samples grossly unremarkable dura taken from 17 pediatric autopsies were identified histologically confirmed to lack neomembrane. CD 68 immunostaining Prussian blue staining was performed. 68‐positive cells per...
Increasing rates of infectious endocarditis (IE) are well-described in the United States and worldwide, yet forensic literature regarding IE is sparse. Autopsy databases may help identify subsets patients at increased risk mortality. We reviewed all deaths due to our office between 2010 2022 (with full autopsy performed) found 29. The average age was 44 years. Manners death included natural (69%), accident (28%), homicide (3%). For accidental deaths, acute intoxication either part I or II....
Abstract Stillborn and perinatal deaths may be referred to medical examiners coroners for investigation determination of cause and/or manner death. One the key questions is determining a live birth from stillbirth. We surveyed 147 forensic pathologists assess their investigative practices these ability diagnose The results this survey demonstrate wide variability policies between offices within United States. Clinical history, maceration fetus, food in stomach were only 3 factors considered...
The diagnosis of adrenal insufficiency is often delayed, as the presenting symptoms fatigue, abdominal pain, and anorexia are vague nonspecific. However, timely treatment with replacement steroids needed to prevent fatal crisis. While most common cause primary in childhood congenital hyperplasia, a significant minority (13-23%) caused by autoimmune destruction gland. We present case 4-year-old, previously healthy child who had one-day history nausea vomiting, was found unresponsive her...
A 24-year-old man presented with a nonischemic cardiomyopathy of unknown etiology, apical aneurysm, and secondary mitral regurgitation. Computer tomography-derived 3-dimensional model the patient's heart was an essential step in guiding surgical management for optimal outcome. (Level Difficulty: Advanced.).