Massive systemic fat embolism detected by postmortem imaging and biopsy*

Postmortem computed tomography (pmCT) and pmCT angiography (pmCTA) provide a minimally invasive method to determine the cause of death. Postmortem image-guided biopsy allows for precise sampling of histological specimens. This case study describes the findings of lethal systemic fat embolism (FE) on whole-body unenhanced pmCT, pmCTA, and image-guided biopsy, with autopsy and histopathologic correlation. Unenhanced pmCT revealed a distinct fat level on top of sedimented layers of corpuscular blood particles and serum in the arterial system and pulmonary trunk. Subsequent pmCTA showed reproducible results, and image-guided biopsy confirmed fatal FE. pm CT/pmCTA combined with image-guided biopsy established the cause of death as right heart failure as a result of systemic fatal FE prior to autopsy. All imaging findings were consistent with traditional autopsy and histological specimens. This unique case demonstrates new imaging findings in massive, fatal FE and highlights that postmortem imaging, supplemented by image-guided biopsy, may detect the cause of death prior to traditional autopsy.     

Advice about Life Plans from Mothers,Fathers, and Siblings in Always-Married and Divorced Families during Late Adolescence

The frequency of advice about life plans that older adolescents in always-married and divorced families received from mothers, fathers, and siblings was examined. Also, a pattern-analytic approach that grouped adolescents according to the amount of advice about life plans received from each parent and a sibling was employed to explore the connections between patterns of advice and adolescents' future occupational, educational, and family plans. The sample included 544 and 95 older adolescents in always-married and divorced families, respectively. Findings suggested that while adolescents relied on mothers for advice in both always-married and divorced families, adolescents in divorced families depended on fathers and siblings for advice less often than did adolescents in always-married families. Although there was some evidence of family context differences in the connections between patterns of advice and life plans, overall, adolescents in both family contexts who received more advice from a parent and, in some cases, a sibling compared to other adolescents were the most positive about their future life plans.