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Biomedical subjects

Roger W Byard

Publications and source records attributed to Roger W Byard.

11 recordsLinked to original sources
PubMed2003

Sudden infant death syndrome: overview and update.

The past decade and a half has seen marked changes in the epidemiology of sudden infant death syndrome (SIDS). The avoidance of certain risk factors such as sleeping prone and cigarette smoke exposure has resulted in the death rate falling dramatically. Careful evaluation of environmental factors and endogenous characteristics has led to a greater understanding of the complexities of the syndrome. The development and implementation of death scene and autopsy protocols has led to standardization in approaches to unexpected infant deaths with increasing diagnoses of accidental asphyxia. Despite these advances, there is still confusion surrounding the diagnosis, with deaths being attributed to SIDS in many communities and countries where death scene investigations and autopsies have not been conducted. The following review provides a brief overview of the historical background, epidemiology, pathology, and pathogenesis of SIDS. Contentious issues concerning the diagnosis and current problems are discussed. Despite calls to abandon the designation, SIDS remains a viable term for infants who die in their sleep with no evidence of accident, inflicted injury, or organic disease after a full investigation has been conducted according to standard guidelines.

Asphyxia↗
PubMed2003

Dancing with "death": p-methoxyamphetamine overdose and its acute management.

Para-methoxyamphetamine (PMA) is a substituted synthetic amphetamine used in the recreational drug scene. It is unusual because of the high incidence of significant morbidity and mortality in overdose. We report a case of PMA overdose in South Australia, and review our experience with the drug. We review the literature on PMA overdose and offer suggestions on the management of overdose with this dangerous drug.

Acute Disease↗
PubMed2002

Clinicopathologic features of fatal self-inflicted incised and stab wounds: a 20-year study.

The files of the Forensic Science Center in Adelaide, South Australia, were examined for all cases listed as suicide in which death had been caused by the use of a sharp instrument during the 20-year period from January 1981 to December 2000. Fifty-one cases were identified, consisting of 35 men and 16 women. The age range was 23 to 83 years (mean 49 years) representing 1.6% of total suicides (51/3182). Fatal injuries included incised wounds to the arms in 51.4% of men (n = 18/35) compared with 87.5% of women (n = 14/16), incised and stab wounds to the neck in 40% of men (n = 14/35) and 25% of women (n = 4/16), and stab wounds to the chest or abdomen in 28.6% of men (n = 10/35) and 12.5% of women (n = 2/16). In 8 cases, multiple sites were involved. The use of sharp instruments in suicide was favored by older, rather than younger, individuals, with a tendency for women to incise their wrists. Hesitation marks were present in 23 cases (54%) and scarring of the wrists from previous suicide attempts in 5 cases. Although this study demonstrated a higher number of men than women committing suicide by using sharp objects, this method of suicide remains uncommon.

Abdominal Injuries↗
PubMed2002

Gasoline exposure in motor vehicle accident fatalities.

Three cases are described in which deaths after motor vehicle accidents occurred as a result of positional asphyxia associated with exposure to gasoline. The deceased individuals were aged 16, 34, and 35 years, respectively (M:F = 1:2) and had all been in the back seat of motor vehicles involved in rollover accidents that had resulted in spilling of gasoline with contamination of the cabins. Major components of gasoline were detected in blood and tissues by headspace gas chromatography. Postmortem toxicologic investigations of such cases, which include analyses for volatile hydrocarbons, may therefore produce additional significant information.

Accidents, Traffic↗
PubMed2002

Infanticide: is its incidence among postneonatal infant deaths increasing?: an 18-year population-based analysis in California.

The decline in the incidence of sudden infant death syndrome (SIDS) and recent recommendations regarding the differentiation of SIDS and child abuse has generated speculation that some cases of infanticide were misdiagnosed as SIDS. The aims of this study were to determine the change in incidences and proportions of postneonatal deaths from all causes, SIDS, and infanticide in California over an 18-year interval encompassing years before and after the Back to Sleep campaign. Selected postneonatal mortality data from 1981 through 1998 obtained from the California Department of Health Services were analyzed and graphically displayed. The total postneonatal mortality and incidence of SIDS deaths per 100,000 live births decreased 45% and 66%, respectively, during the study interval; the incidence of infanticide remained low. The ratio of infanticide to SIDS increased from 4.3 per 100 in 1981 to 10.2 per 100 in 1998. Infanticide deaths, as a percentage of the total number of postneonatal deaths, increased slightly from the first to the second half of the study interval but never rose above 3.2%. It is concluded that this increased percentage is due to a decrease in SIDS deaths and not to an actual increase in infanticide deaths.

California↗
PubMed2002

Diagnostic problems associated with cadaveric trauma from animal activity.

Analysis of a series of deaths between 1986 and 2001 resulting from natural disease, accidents, suicides, and homicide, where postmortem animal activity had traumatized bodies, was undertaken at the Forensic Science Center in Adelaide to demonstrate the range of lesions that may occur and problems in interpretation that result. Tissue damage had been caused by a variety of animals, including fly larvae, ants, birds, dogs, rodents, sea lice, and sharks. Postmortem animal activity had disguised injuries, modified wounds, and created the appearances of inflicted injury. Problems with identification occurred after postmortem facial trauma, and loss of organ parenchyma had interfered with, or precluded, the precise determination of the manner of death in some cases. Specific kinds of tissue and organ damage may occur after death, necessitating careful assessment of lesions in a search for characteristic features of animal activity. The pattern of lesions may enable identification of the particular species of animal involved.

Adolescent↗
PubMed2002

Cervical fracture, decapitation, and vehicle-assisted suicide.

Two cases of vehicle-assisted suicides are described in males aged 33 and 24 years, respectively. In both cases the victims had tied ropes between stationary objects and their necks and then attempted to drive their vehicles away. The speed with which the vehicles were driven resulted in forces great enough to cause fracture--dislocation of the cervical spine in Case 1 and virtual decapitation in Case 2. Although inadvertent alteration of the death scene in Case 1, with removal of the rope, complicated the initial assessment, the extent of soft tissue and bony injuries was such that ligature strangulation appeared unlikely.

Adult↗
PubMed2002

Unexpected death due to infectious mononucleosis.

A 14-year-old boy with infectious mononucleosis died unexpectedly in hospital. The most significant finding at autopsy was the presence of marked bilateral tonsillar enlargement with considerable narrowing of the upper airway. There were no other underlying organic diseases that could have caused or contributed to death. Narcotic analgesia had been administered less than 2 h before death and may have contributed to respiratory compromise. The blood morphine level was 0.08 mg/L. Toxicological evaluation of individuals with obstructive lesions of the upper airway may, therefore, be a useful adjunct to the autopsy assessment of such cases as it may reveal factors exacerbating mechanical blockage.

Adolescent↗