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Biomedical subjects

R Hanzlick

Publications and source records attributed to R Hanzlick.

At least 19 recordsLinked to original sources
PubMed1992

Gunshot wounds of the female breast: a risk for intra-abdominal injury.

We report the results of a clinical study of female patients sustaining gunshot wounds to a breast. Thirteen homicides were reviewed by the Fulton County Medical Examiner. A prospective series of patients treated by the Grady Memorial Hospital Trauma Service included eight additional cases. Ten (48%) of the combined series of 21 patients had significant intra-abdominal injury; of these, five (24%) had injuries confined to the abdomen as a result of a missile striking a breast. A wound pattern consisting of a superior breast entrance wound, an inferior breast exit wound, and an inframammary thoracoabdominal reentry wound was noted in five patients, four of whom had intra-abdominal injuries and three only intra-abdominal injuries. Careful examination for this wound pattern should alert the clinician to the possibility of intra-abdominal injury. One should anticipate a 50% incidence of intra-abdominal injury in female patients sustaining gunshot wounds to a breast.

Abdominal Injuries↗
PubMed1991

Cocaine metabolite detection in homicide victims.

We analyzed the blood of homicide victims for the presence of cocaine's major metabolite, benzoylecgonine. During 1989 in Fulton County, Georgia, 81% of 275 homicide victims were tested for benzoylecgonine; 40% tested positive. The proportions of blacks and victims of firearm injuries who tested positive for benzoylecgonine were significantly larger than the respective proportions for whites and victims of injuries not involving firearms. The data show overall proportions of benzoylecgonine positivity much larger than those previously reported in the literature. The relationships between homicide, race, firearms, and cocaine use deserve further study.

Black or African American↗
PubMed1991

A simple dictation device.

A simple device for autopsy and scene dictation uses a small cassette recorder with a built-in microphone attached to a remote push-button switch worn on the belt or waistband. The recorder is carried in a shirt or scrub suit pocket and is functional under a protective apron or gown. The components, construction, advantages, and disadvantages of the device are presented.

Autopsy↗
PubMed1990

Heart weights of white men 20 to 39 years of age. An analysis of 218 autopsy cases.

Review of autopsy data for 218 white men between 20 and 39 years of age who died of injuries or suddenly and unexpectedly indicated a mean heart weight of 371 g. The mean for those dying of external causes was 364 g whereas the mean for those dying of natural causes was 446 g. A coefficient for heart weight expressed as a percentage of body weight was lower in heavy individuals than lightweight individuals; it ranged between 0.38% and 0.55%, with a mean of 0.48%. Heart weight, including epicardial fat, increased with age and body weight. These data may be useful to those who are called upon to investigate sudden and unexpected deaths.

Adult↗
PubMed1990

Suicide by jumping from high-rise hotels. Fulton County, Georgia, 1967-1986.

During a 20-year period from 1967 through 1986, 19 suicidal jumps from high-rise hotels (HRHs) accounted for 24% of all fatal jumping episodes and 1% of all suicides in Fulton County, Georgia, U.S.A. The rate of suicidal jumps from HRHs did not increase during the study period. The number of fatal jumps per hotel-year correlated with the height of the interior hotel atrium. The mean age for all victims was 34 years, and 63% of victims were white males. The majority of victims were local residents who were alone when they jumped and were not registered hotel guests. Registered guests tended to jump from the floor on which their room was located whereas nonregistered individuals tended to jump from the upper-most floors in the hotel. Of 19 HRH jumps, 13 occurred from the inside. Suicide notes were found in 37% of cases. HRH jumps were least common between 6 p.m. and midnight, all decedents were dressed in street clothing, only one was heard to have screamed, and all but one were dead on the scene. Alcohol and drug involvement was minimal. We hope that this information will be useful to those who investigate such deaths and to those who study the behavioral manifestations of suicide.

Adolescent↗
PubMed1989

Postmortem tricyclic antidepressant concentrations. Lethal versus nonlethal levels.

Evidence has accumulated that postmortem release of tissue-bound tricyclic antidepressants (TCAs) may cause falsely elevated postmortem blood levels, thus rendering it more difficult to determine if the cause of death was an overdose. This study, a review of 24 TCA-related deaths, is aimed at defining the practical significance of such a problem and providing a workable approach to interpreting postmortem TCA levels. Deaths clearly due to TCA drugs were compared with deaths that were not caused by TCA drugs, but in which the decedent's postmortem blood tested positive for TCA medications. There is little evidence that postmortem elevations in blood TCA levels cause frequent problems in differentiating lethal from nonlethal levels (overdose from nonoverdose cases). The data suggest that using a heart blood level of 0.100 mg/dl as an indicator of lethality is practical at the present time and poses little likelihood of error. Isolated cases suggest that postmortem TCA increases can occur; further work is needed in this area to clarify more fully the significance and frequency of such cases. At present, it seems prudent to utilize peripheral blood samples for TCA testing on autopsy material, if a conservative estimate of TCA concentration is desired, possibly augmented by liver TCA levels and parent-metabolite ratios if money, facilities, and time permit.

Antidepressive Agents, Tricyclic↗
PubMed1989

Health care history and utilization for Atlantans who died homeless.

A limited study of 18 deaths among homeless persons in Atlanta, Georgia, has shown that about two-thirds had utilized public health care facilities prior to their death, often over a period of many years. Utilization of two available, specific clinics for the homeless could not be demonstrated. The county hospital and alcoholism treatment center accounted for all documented episodes of health care. Formal, medical documentation of significant alcohol-related morbidity was shown in 50% of those who died homeless. Other common medical problems included seizure disorders, hypertension, pneumonia, chronic pulmonary disease, and non-lethal trauma. These data may be used practically during medico-legal death investigation and by public health agencies when planning policy and procedure relevant to the homeless population. Paucity of data concerning mortality in the homeless should prompt additional, region-specific studies to determine risk factors in areas where homelessness is manifest.

Adult↗
PubMed1988

Death certificates, natural death, and alcohol. The problem of underreporting.

Previous studies have identified an apparent underreporting of alcohol-related natural deaths on death certificates. This survey consists of a review of death certificates in one urban county, and provides further evidence that alcohol-caused natural deaths are underreported by physicians who sign death certificates.

Alcoholism↗
PubMed1988

Pleural pearl. An immature pleural ball?

An incidental, pearl-like body was attached to the visceral pleura of a young man who committed suicide. The lesion consisted of concentric laminations of collagen and mesothelial type cells, and was associated with a resolved pleurisy. The possible relationship of this lesion to previously reported "pleural balls" is discussed.

Adult↗
PubMed1988

Minocycline-related black thyroid.

Black pigmentation of the thyroid gland has been observed in patients chronically taking minocycline antibiotics. Pigment changes of the skin, blood vessels, and bone have also been reported. Some of these changes may be caused by traumatic or toxic etiologies, therefore persons conducting forensic death investigations need be aware of minocycline-related changes. This article reviews pigment changes of the thyroid gland and discusses the potential forensic import of such findings.

Forensic Medicine↗
PubMed1988

A "back door" approach to analysis of ethanol-associated risks and behavior.

Ethanol has been detected in the majority of medical examiner cases involving nonnatural death and in a substantial number of natural deaths. The higher the serum alcohol concentration (SAC), the greater were the odds that death was due to external (traumatic) causes. We identified 149 medical examiner cases that were positive for ethanol and negative for 11 major drug of abuse groups, and studied those cases to further clarify ethanol-related risk factors and behaviors. Based on terms of frequency of occurrence, the data identify SACs of 201 mg% to 300 mg% as a particularly high risk factor for sudden, unexpected, traumatic death. Traumatic deaths associated with SACs below 100 mg% were infrequent, and attendant opinions concerning the contributory role of ethanol must be made with circumspection. SACs below 150 mg% could not be used to predict whether or not the decedents had been engaged in active or sedentary behavior prior to death because both situations occurred with equal frequency. At SACs between 151 mg% and 350 mg%, active situations were observed three times as often as sedentary situations. When SACs were 350 mg%, sedentary situations were observed twice as often as active situations. Suicide victims and driver fatalities rarely showed SACs above 350 mg%; therefore finding such SACs in apparent suicidal or driver fatality situations should prompt a thorough investigation to rule out other possibilities.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents↗
PubMed1988

Deaths in custody. Atlanta City Jail and Fulton County Jail, 1974-1985.

A total of 53 in-custody deaths that occurred in Atlanta-Fulton County, Georgia, between 1974 and 1985 are reviewed. Custody deaths showed characteristics similar to those described in other geographical areas. The majority of deaths were due to natural causes, about one-fourth were suicides, and homicides were rare. For jails that housed a daily population of about 1,000 prisoners, an average of 4.4 deaths were observed annually. Men predominated, and racial makeup paralleled the general prison population. Seizures, alcohol-related illness, and cardiovascular disease caused over half of the natural deaths. All suicides were accomplished by hanging. Over two-thirds of the incidents that led to death occurred in the prisoner's cell, and about one-half of the victims were found dead in their cells. Two-thirds of those who died in custody had been arrested for crimes in which persons were not harmed, while nearly two-thirds of those committing suicide had been arrested for crimes against persons. Deaths in custody are expected events, and familiarity with the circumstances under which they occur should be helpful in enabling prison managers to establish policies and procedures to minimize their occurrence.

Adult↗
PubMed1987

Suicide by hanging. A review of 56 cases.

Fifty-six consecutive cases of suicide by hanging are reviewed. The data provide some evidence for associations between suicide by hanging and youth, incarceration, black males, and clustering. Evidence was noted of low incidence in females, rarity of white female hangings at home, a preference to hang oneself away from home if there have been previous suicide attempts, and possible seasonal trends which may differ from suicide overall. Thus, aside from the method chosen, hanging victims as a group displayed some differences from suicides in general.

Adult↗
PubMed1987

An evaluation of the use of medical examiner data for epidemiologic surveillance.

To assess the value of medical examiner (ME) data bases for use in epidemiologic surveillance, we compared data from non-injury deaths that became ME cases to all non-injury deaths occurring in 1984 among Fulton County, Georgia residents. The decedents in the ME series were younger and included a large proportion of Black males. Although not representative of all deaths in a community, ME data bases include demographic and medical information that is often difficult to collect in community studies and in other surveillance systems.

Adolescent↗