Academic Forensic Pathology

The Official Publication of the National Association of Medical Examiners

Journal Cover
  • Editor-In-Chief:  J. Keith Pinckard MD PhD
  • Associate Editor-In-Chief:   Nicholas I. Batalis MD
  • Publisher:   Emma O. Lew MD
  • Executive Director:   Evan W. Matshes MD FRCPC
  • Director of Operations:   Don Downey BA PMT
  • Editorial Director:   Lori Selanders BSc MSc
  • ISSN:   1925-3621
  • Frequency:   Quarterly
  • Issue:   March 2017
  • Title:   The Opioid Crisis
  • Volume 7 Issue 1
  • Guest Editor:   Thomas P. Gilson
Scientific Content
Contents of the entire issue
The Opioid Crisis

Author(s): Academic Forensic Pathology International

ABSTRACT:   This file contains the contents of the entire March 2017 issue. Higher resolution versions of the individual articles are available for separate download.

Invited Review
Drug Intoxication and the Need to Autopsy: A Diagnosis of Exclusion?

Author(s): Fowler David

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):2-6.

ABSTRACT:   The recent surge in drug deaths has focused attention on the diagnosis of drug intoxication as a cause of death. In Maryland, the Department of Vital Records has shown...

Confronting an Upsurge in Opiate Deaths With Limited Resources

Author(s): Andrew ThomasDuval Jennie V.

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):7-18.

ABSTRACT:   The dramatic increase in drug-related deaths in the last decade has presented fiduciary and logistical difficulties to medicolegal jurisdictions of all types and...

Opioid Toxicity

Author(s): Dolinak David

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):19-35.

ABSTRACT:   In recent years, there has been a substantial increase in opioid use and abuse, and in opioid-related fatal overdoses. The increase in opioid use has resulted at least...

Emerging Synthetic Fentanyl Analogs

Author(s): Schueler Harold E.

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):36-40.

ABSTRACT:   Hundreds of synthetic substances have been introduced into the illicit drug market over the last ten years, but none of these drugs has had as poisonous a consequence...

The Evolution of the Opiate/Opioid Crisis in Cuyahoga County

Author(s): Gilson ThomasShannon HughJaime Freiburger

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):41-49.

ABSTRACT:   The United States continues to grapple with an epidemic of opiate/opioid drugs. This crisis initially manifested itself in the use and abuse of opioid pain relievers...

Opioid Drug Death Investigations

Author(s): Morgan Daniel

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):50-59.

ABSTRACT:   Opioid-related deaths have transitioned over the past 15 years, beginning with a steady increase in the incidence of fatal prescription overdoses, followed by a...

Drug Overdose Surveillance and Information Sharing Via a Public Database: The Role of the Medical Examiner/Coroner

Author(s): Williams Karl E.Freeman Michael D.Mirigian Lynn

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):60-72.

ABSTRACT:   The medical examiner/coroner (ME/C) death scene investigation systems of the United States play a pivotal role in the current public health crisis created by the...

The Utility of a Prescription Monitoring Program in Death Investigation: The Virginia Experience

Author(s): Tharp-Myers Amy M.Hobron KathrinOrr Ralph

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):73-79.

ABSTRACT:   The Virginia Prescription Monitoring Program (VPMP) has been in effect since 2002, providing reports for prescribers, pharmacists, and other stakeholders in the...

County Coroners and Their Role in the Heart of the Opioid Epidemic

Author(s): Robinson Renee

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):80-86.

ABSTRACT:   As drug- and opiate/opioid-related deaths continue to rise in the Midwest, we must look at how the type of death investigation in these areas is affected and taxed by...

Rules for Establishing Causation in Opiate/Opioid Overdose Prosecutions — The Burrage Decision

Author(s): Gilson ThomasRendon CarolePinjuh Joseph

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):87-90.

ABSTRACT:   As the opiate/opioid crisis has worsened in the United States, one of the law enforcement responses has involved increased efforts to prosecute the individuals...

Original Article
Common Findings and Predictive Measures of Opioid Overdoses

Author(s): Pelletier Danielle E.Andrew Thomas

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):91-98.

ABSTRACT:   Purpose:This research examines autopsy findings from fatal opiate/opioid intoxications in New Hampshire for cerebral edema, pulmonary edema, and urinary bladder...

Gabapentin in Mixed Drug Fatalities: Does This Frequent Analyte Deserve More Attention?

Author(s): Finlayson GrantChavarria MichaelChang StephanieGardner TylerGrande AbigailMacCallum ColleendeJong Joyce L.Quesnelle Kelly

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):99-111.

ABSTRACT:   From 2000 to 2014, drug overdose deaths increased 137% in the United States, and 61% of these deaths included some form of opiate. The vast majority of opiate-related...

Primary Cardiac Tumors in Infancy: A Case Report and Literature Review

Author(s): Dominguez CarolinaPerkins AshleyDuque AlexandraBravo Viagnney

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):112-118.

ABSTRACT:   Sudden death in infants due to primary cardiac tumors is extremely rare. Herein we describe a case of an 8-month-old male infant, without any previous medical history,...

Blastomycosis in Wisconsin: Beyond the Outbreaks

Author(s): Thompson KatrinaSterkel Alana K.Brooks Erin G.

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):119-129.

ABSTRACT:   In the summer of 2015, many individuals visiting the Little Wolf River in Waupaca County were exposed to the pathogenic fungus, Blastomyces. Over time, 59 confirmed...

Case of the Month
Fatal Rotavirus Infection in a 4-Year-Old with Unsuspected Autoimmune Adrenal Insufficiency

Author(s): Krywanczyk AlisonBundock Elizabeth A.

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):130-135.

ABSTRACT:   The diagnosis of adrenal insufficiency is often delayed, as the presenting symptoms of fatigue, abdominal pain, and anorexia are vague and nonspecific. However, timely...

A Case of Previously Unsuspected Huntington Disease Diagnosed at Autopsy

Author(s): Miller Catherine R.Dong Jianli

Citation: Acad Forensic Pathol. 2017 Mar; 7(1):136-144.

ABSTRACT:   Huntington disease (HD) is a neurodegenerative disorder with a worldwide prevalence of four to ten per 100 000. It is characterized by choreiform movements,...


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Last Modified Date: March 17, 2017