Coronary thrombus and peracute myocardial infarction visualized by unenhanced postmortem MRI prior to autopsy

Sudden cardiac deaths are common within the community. They also constitute a substantial part of daily pathologic and forensic case work. However, macroscopic myocardial findings indicating acute ischemia are often absent. Then, diagnosis is based on coronary status in combination with indirect signs of acute cardiac failure. We present a case of sudden cardiac death where diagnosis was based on cardiac postmortem magnetic resonance imaging (pmMRI) findings already prior to autopsy: the heart's anterior basal ventricular septum showed hypointensities in T2-weighted images that raised suspicion of peracute ischemia. The lumen of the left anterior descending artery (LAD) exhibited a lack of otherwise discernible postmortem sedimentation of cellular blood components. Instead of a sharp border between serum and erythrocytes a homogeneous signal was seen within the narrowed lumen of the beginning LAD over a length of 1cm. Based on this, a thrombotic occlusion was assumed. Subsequent autopsy confirmed peracute septal myocardial ischemia secondary to a thrombotic occlusion of the LAD as concluded from the pmMRI.     

The Phenomenon of the Urban Mummy

The environmental mummification of a body in an urban setting is an unusual event. Florida is known for its high temperatures and humidity, which typically result in the rapid putrefaction of bodies. However, under certain circumstances, Florida's climate provides an environment suitable for mummification, typically in isolated areas. We previously reported a case of a homicide/suicide in a residential neighborhood in which the mummified remains were undetected for several years. We have subsequently encountered two additional cases in which mummified bodies were discovered in urban settings. Presented in the historical context of the environmental conditions and postmortem processes involved in mummification, these cases illustrate the particular constellation of human behaviors and scenarios, as well as environmental conditions, which must coincide for this phenomenon to occur and highlight the necessity of the multidisciplinary approach to the medicolegal investigation of such deaths and the determination of the cause and manner of death.     

Daily Stress and Use of Aggressive Discipline by Parents during the COVID-19 Pandemic

Journal of Family Violence - To assess the relationship between stress throughout the day and aggressive discipline practices by parents during COVID-19 stay at home orders. For this study,...