Mild Traumatic Brain Injury (Concussion) in Infants, Toddlers, Children and Adolescents
In the Forensic Science Newsletter of May 15, we discussed Mild Traumatic Brain Injury (Concussion) in adults. In this issue of the Forensic Science Newsletter we are going to discuss mild TBI (concussion) in infants, toddlers, children and adolescents.
Continue reading Forensic Science Newsletter July 2016: Concussions in Children & Adolescents
In this Forensic Science Newsletter we will discuss the safety of newborn infants being breastfed by mothers who are on a methadone maintenance therapy program. To further this understanding we will explore the chemistry of methadone, its’metabolism, genetic polymorphism and the clinical aspects of methadone maintenance programs.
Forensic Science Newsletter-June 1, 2016
In this issue of the Forensic Science Newsletter we will address the most recent scientific information regarding the acute effects of traumatic brain injury as represented by concussion in adults.
Concussion refers to an immediate, usually reversible episode of brain dysfunction following traumatic brain injury (TBI), typically, but not always, with sudden brief impairment of consciousness and loss of memory. Concussion represents the mildest form of TBI. TBI comprises a clinical spectrum that extends from mild concussion, in which consciousness is often retained, to severe diffuse traumatic axonal injury (TAI) causing an unresponsive wakefulness state (UWS), which was formally referred to as a vegetative state. Patients with UWS have sleep wake cycles, intact cardiorespiratory function and primitive responses to stimuli but without evidence of inner or outer awareness present for at least one month.
Continue reading Forensic Science Newsletter May 2016: Effects of Traumatic Brain Injury
Forensic Science Newsletter: April 15, 2016
In this issue of Forensic Science Newsletter we will discuss under the section of Forensic Pathology the Dieulafoy Lesions, an Uncommon Cause of Sudden Massive Gastrointestinal Hemorrhage.
Under the section of Neuropathology is a discussion of Invasive Intracranial Pressure Monitoring and its complications.
Forensic Science Newsletter: March 15, 2016
In the January issue of the Journal of Forensic Science an article was published entitled “A Case of Sudden Infant Death Due to Incomplete Kawasaki Disease.” The cause of death for this infant was acute myocardial infarction due to platelet aggregated emboli, soon after discharge from the hospital, where he had been treated for fever and suppuration at the Bacille de Calmette et Guerin (BCG) vaccination site.
Following a review of this article there are a number of key points which need to be understood in either Kawasaki Disease or Incomplete Kawasaki Disease.
When a specific allergen gains acess to the circulation, the allergen can react with basophils of the blood and mast cells in the tissues located immediately outside the small blood vessels, if the basophils and masts cells have been sensitized by the attachment of IgE reagins. This can be followed by a widespread allergic reaction throughout the vascular system and closely associated tissues, referred to as anaphylaxis, which can lead to forensic consequences.
Continue reading Improving Laboratory Testing for Anaphylaxis for Immediate Pragmatic Benefits
In forensic medicine, critical values established in isolation without appropriate escalation policies or sophisticated algorithms can lead to tragic consequences.
The purpose of this article is not to review the formulation of a critical value list, non-critical “critical values”, setting goals and measuring your laboratory performance, establishing up-to-date, clinically oriented algorithms, escalation policy and how outpatient critical values are reported, but to show what can occur when these goals are not well thought out or implemented, the consequences of which can have a negative impact on patient safety.
For laboratory values to be clinically meaningful, both in Clinical Pathology and Forensic Medicine, an escalation policy and or a sophisticated algorithm should be in place, which interpret laboratory values, that on face are not in themselves critical, but taken in concert with other values, and if provided, the patients underlying medical condition, will recognize these values are ‘critical’ for they portend a life-threatening situation for the patient. The following case will illustrate what can occur when these goals are not met.
Click on the link below to download the document.