Safranin O without fast green is the best staining method for testing the degradation of macromolecules in a cartilage extracellular matrix for the determination of the postmortem interval
AbstractMethods for the determination of the postmortem interval (PMI) include methods that monitor the postmortem changes of cells and molecules in different tissues. The rate of pathological degradation of macromolecules in the extracellular matrix (ECM) of hyaline cartilage could be verified by assessing the intensity of collagen and proteoglycan (PG) staining. In the presented in vitro pilot study, this methodology was used for the first time to determine PMI. The osteochondral samples of three donors were stored at 11  °C and 35 °C and analyzed on day 1, day 12, and day 36 postmortem. The intensity o...
Source: Forensic Science, Medicine, and Pathology - December 10, 2019 Category: Forensic Medicine Source Type: research

A retrospective study of death scene investigation practices for sudden unexpected death of infants (SUDI) in Cape Town, South Africa
This study assessed DSI practices at one of the largest mortuaries in Cape Town (Salt River Mortuary) to assess the scope of these practices within a resource-constrained context. Data were collected by retrospectively reviewing medico-legal case files (n = 454) from SUDI cases investigated at Salt River Mortuary over a two-year period. The results showed that SUDI death scenes were visited in 59.2% of cases at Salt River Mortuary, with poor and inconsistent levels of documentation. Death scenes were never investigated in cases where the infant was pronounced dead on arrival at a medical facility. The finding...
Source: Forensic Science, Medicine, and Pathology - December 5, 2019 Category: Forensic Medicine Source Type: research

Quantitative analysis of aconitine in body fluids in a case of aconitine poisoning
AbstractAconitine belongs to theAconitum alkaloids and is a natural toxic substance. Aconitine has been used as a traditional medicine in East Asian culture. Today, aconitine is still in use with or without a prescription, in the Republic of Korea. Here we present a case report of accidental death due to acute aconitine poisoning. An 81-year-old woman ingested liquid that had been heat extracted from the root of theAconitum plant; she presented to the emergency room 1  h after ingestion. Her electrocardiogram showed irregular ventricular arrhythmias including ventricular tachycardia; she progressed to cardiac arrest. ...
Source: Forensic Science, Medicine, and Pathology - December 4, 2019 Category: Forensic Medicine Source Type: research

Using freely-available 3D software to reconstruct traumatic bone injuries detected with post mortem computed tomography
AbstractUse of post-mortem computed tomography (PMCT) scanning to investigate natural and unnatural death has increased dramatically in recent years. Powerful software exists to allow detailed analysis of the scanned anatomy and pathology, and users of PMCT and other medical imaging will already be familiar with both two-dimensional and three-dimensional (3D) representations of this data. However, standard medical image viewing programs do not allow direct manipulation of the visible anatomy. By extracting anatomical features from medical images, this data can be exported into 3D manipulation software to enhance pathologic...
Source: Forensic Science, Medicine, and Pathology - December 3, 2019 Category: Forensic Medicine Source Type: research

Bizarre use of log splitter: a case of decapitation
AbstractDecapitation is well-documented as an immediately lethal injury that is encountered in medicolegal autopsies. It can be due to an accident, suicide, or homicide. Literature on decapitation reveals that suicide is committed by decapitation using domestic or industrial tools, such as electric saws and drills, and improvised guillotines. Decapitation can also be the result of railway or other bizarre incidents. In this particular case, a man committed suicide by decapitation using a log splitter. This has not been reported earlier. Death investigation, including a medicolegal autopsy and scene visit, was conducted. Th...
Source: Forensic Science, Medicine, and Pathology - November 21, 2019 Category: Forensic Medicine Source Type: research

Intimomedial mucoid arterial degeneration, a rare arterial disorder of forensic significance
AbstractThe body of a 43-year-old African woman with a history of aortic aneurysm and hypertension was forensically investigated after her sudden death. The cause of death was related to a cardiac tamponade due to a ruptured aneurysm of the ascending aorta. Post-mortem gross examination showed an abnormal whitish discoloration of the intima with fibrous thickening of the aortic wall. Several arteries (left main and circumflex coronaries, carotid, renal and iliac arteries) showed similar features. Upon histological examination, the aortic aneurysm as well as the other arteries sampled showed mucoid degeneration, excess muco...
Source: Forensic Science, Medicine, and Pathology - November 21, 2019 Category: Forensic Medicine Source Type: research

Positional asphyxia in a work-related fatality
We report on the case of a 42-year-old man found unresponsive while working on farmland. The upper part of his body (head and upper limbs) was trapped in the highest and largest opening of the atomizer of a high-volume sprayer tank while his legs were hanging down. Bruises and abrasions were found on both suprascapular regions. Tramline bruises encircled the body between the abdominal and thoracic regions in line with the morphology of the tank ’s opening where the body was found. Cyanosis and petechial hemorrhages were found on his face, conjunctives, neck, and superior chest; the lungs were edematous. Toxicological...
Source: Forensic Science, Medicine, and Pathology - November 21, 2019 Category: Forensic Medicine Source Type: research

Medico-legal considerations for Morel-Lavall ée lesions
We describe the case of a 24-year-old motorcycle driver who was hit by a car. Clinically, the right lumbar region had a large 16 × 15 cm ecchymosis with subcutaneous fluid swelling found by palpation. A body scan revealed a Morel-L avallée lesion among other lesions. On day 7, its thickness was decreased by half. Morel-Lavallée lesions are specifically induced by shearing force with moderate-to-high kinetics in an anatomical area with an underlying fascia. The associated functional disability is globally moderate, but a larg e lesion or recurrences can extend the time needed to recove...
Source: Forensic Science, Medicine, and Pathology - November 21, 2019 Category: Forensic Medicine Source Type: research

Protocols, practices, and needs for investigating sudden unexpected infant deaths
AbstractUnderstanding case identification practices, protocols, and training needs of medical examiners and coroners (MEC) may inform efforts to improve cause-of-death certification. We surveyed a U.S.-representative sample of MECs and described investigation practices and protocols used in certifying sudden unexpected infant deaths (SUID). We also identified MEC training and resource needs. Of the 377 respondents, use of the SUID Investigation Reporting Form or an equivalent was 89% for large, 87% for medium, and 52% for small jurisdictions. Routine completion of infant medical history, witness interviews, autopsy, photos...
Source: Forensic Science, Medicine, and Pathology - November 18, 2019 Category: Forensic Medicine Source Type: research

Presumed adverse events in health care are a frequent indication for medico-legal autopsy in Finland
In conclusion, the frequency of presumed adverse events was quite high in this data set, but in the majority of the cases, the suspicion of an adverse event causing death was disproved by an autopsy. Nonetheless, proper investigation of these cases is essential to ensure legal protection of the deceased, next of kin and health care personnel, as well as to support clinical risk management. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - November 18, 2019 Category: Forensic Medicine Source Type: research

Cardiac conduction devices in the radiologic comparative identification of decedents
AbstractCardiac conduction devices (CCDs), including pacemakers and implantable cardioverter-defibrillators (ICDs), are implanted in a significant part of the population, especially as the population becomes older. CCDs play an important role in forensic medicine; they are a valuable identification tool as the manufacturer information and unique serial numbers of the device can be matched with the medical records of the person of suspected identity after the device has been removed from the body. Radiological examinations such as X-ray or computed tomography (CT) can illustrate specific CCD features. A series of 12 selecte...
Source: Forensic Science, Medicine, and Pathology - November 14, 2019 Category: Forensic Medicine Source Type: research

Mass grave complexity effects on the minimum number of individuals estimation
This study analyses the accuracy of the minimum number of individuals (MNI) estimation in the context of commingled human remains recovered from secondary mass graves related to the war in Bosnia in 1995. It is based on data from five secondary mass grave sites of different sizes and different numbers of unassociated body parts. The study is centered on a comparison of MNI estimation from original excavations with the actual number of individuals buried in particular graves, obtained via DNA identification of excavated remains. The aim was to investigate how the complexity of a mass grave reflects on MNI estimation accurac...
Source: Forensic Science, Medicine, and Pathology - November 14, 2019 Category: Forensic Medicine Source Type: research

Natural cardiac death after stent implantation with iatrogenic injury of a coronary artery
We report a case of a 75-year-old woman with a complaint of intermittent angina pectoris who underwent cardiac catheterization. Intra-interventionally, coronary artery dissection occurred and was stabilized by the placement of two stents. After this procedure, the patient suffered from chest pain. At 5.5  h after the procedure ended, the woman suddenly and unexpectedly died. At forensic autopsy, a hemopericardium with cardiac tamponade was found to have been caused by the rupture of a myocardial infarction that was several days old and had remained clinically unrecognized. This case report illustra tes the importance ...
Source: Forensic Science, Medicine, and Pathology - November 12, 2019 Category: Forensic Medicine Source Type: research

The effect of chemical compromise on the recovery of DNA from skeletonized human remains: A study of three World War II era incidents recovered from tropical locations
AbstractThe use of DNA extracted from skeletonized human remains is a common challenge for those working in human identification. Thermal age and chemical compromise should be considered prior to performing DNA testing on skeletonized remains. Both heat and chemical contamination may cause damage to the DNA present in the osseous materials and a subsequent increase in both the difficulty and expense of DNA testing. For this study, three World War II era mass fatality events involving the US military, the USSOklahoma, the Battle of Tarawa, and the Cabanatuan Prison Camps, were examined for the overall success of DNA testing...
Source: Forensic Science, Medicine, and Pathology - November 12, 2019 Category: Forensic Medicine Source Type: research

Exsanguination from iatrogenic puncture of arteriovenous fistula
(Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - November 11, 2019 Category: Forensic Medicine Source Type: research

Does the medical autopsy still have a place in the current diagnostic process? A 6-year retrospective study in two French University hospitals
AbstractMedical autopsies have been in considerable decline for several decades, in France and worldwide. We aimed to determine whether a medical autopsy still currently has a role to play in diagnosis, by analyzing its performance and diagnostic limitations. This dual-centre retrospective descriptive study included all medical autopsies performed in the university hospitals of Lille and Marseille, France, between January 2007 and December 2012. Autopsies of fetuses or stillborn infants, or those related to sudden infant deaths and research protocols were excluded. 412 medical autopsies were included. The male:female ratio...
Source: Forensic Science, Medicine, and Pathology - November 9, 2019 Category: Forensic Medicine Source Type: research

Sudden death in a case of recurrent Takotsubo syndrome
AbstractHerein we report an unusual case of sudden death occurring in a 65 year old woman during a minor oral surgery. The subject, who had a medically treated anxiety, had a history of two reversible left ventricle dysfunction episodes consistent with recurrent Takotsubo Syndrome that had occurred seven and six years before, respectively. She also suffered from moderate, well treated post-menopausal systemic hypertension. Post-mortem examination showed apical biventricular ballooning of the heart with no cardiac rupture, coronary artery lesion or other cardiac/extra-cardiac disease. Toxicological tests and forensic invest...
Source: Forensic Science, Medicine, and Pathology - November 9, 2019 Category: Forensic Medicine Source Type: research

An autopsy case of massive pulmonary tumor embolism due to undiagnosed prostatic adenocarcinoma
The objective of this study was to provide a review of clinical, histopathological and immunohistochemical features of poorly differentiated prostatic adenocarcinoma, emphasizing the relevance of undiagnosed malignancy as a cause of pulmonary embolism. The current study describes the case of a 78-year-old male who experienced remarkable clinical symptoms suggestive of pulmonary embolism. Following several diagnostic examinations, the patient was diagnosed with pulmonary embolism, which led to the detection of prostatic adenocarcinoma. Poorly differentiated adenocarcinoma with a Gleason ’s score of nine was set as a d...
Source: Forensic Science, Medicine, and Pathology - November 5, 2019 Category: Forensic Medicine Source Type: research

Patterned bruising indicating a complete renal artery transection in a fatal occupational accident
AbstractBlunt renal artery injury (BRAI) is a rare finding with incidence ranging from 0.05% to 0.08% among blunt abdominal trauma patients. BRAI occurs in 1% to 4% of patients with renal injury, and the most common cause is motor vehicle accidents. An unusual case of BRAI in a 47-year-old man at work is reported. The victim accidentally fell from a scaffold (approximately 3  m in height). He was transported to the hospital where he was intubated, but he died after 30 min despite the cardio-pulmonary resuscitation. Surveillance cameras showed the man falling from the scaffold, but his impact with the ground was n...
Source: Forensic Science, Medicine, and Pathology - November 2, 2019 Category: Forensic Medicine Source Type: research

Sudden death in acrogeria Gottron type
AbstractIn this paper, we describe the case of a 29-year-old Caucasian male who was reported dead in his home. In 2010, a diagnosis of acrogeria, Gottron type was obtained by genetic analysis of a COL3A1 gene mutation. External examination showed typical characteristics of acrogeria, Gottron type. Autopsy showed a full-thickness laceration in the inferior vena cava wall, which caused hemorrhage and death. Samples of inferior vena cava were processed by Masson trichrome staining, which revealed a reduction in vessel wall thickness and a decrease in the amount of elastic fibers. An antibody reaction with BCL-2 was intensely ...
Source: Forensic Science, Medicine, and Pathology - October 31, 2019 Category: Forensic Medicine Source Type: research

Comparison of hippocampal volume measurement by autopsy and post-mortem magnetic resonance imaging
This study presents a validated segmentation algorithm that can be used to determine the hippocampal volume using post-mortem MR and anatomical landmarks. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - October 30, 2019 Category: Forensic Medicine Source Type: research

Methods in population study of orofacial injuries in Victorian family violence homicides
This study standardized the methods used in the determination of orofacial injuries in Victorian family violence homicides and informed potential control selection for an analytic study. Dental service contacts with family violence victims may be intervention avenues due to the presence of abusive injuries in the orofacial region. All Victorian family homicides from January 2000-September 2018 were identified by determining the kinship/relationship and grouped by age. A 20% random sample of adult cases, aged 18 –64 years was selected. The median number of orofacial injuries in categories of injury mechanisms/age...
Source: Forensic Science, Medicine, and Pathology - October 22, 2019 Category: Forensic Medicine Source Type: research

Obstructive uropathy and unexpected death
AbstractA 66-year-old man was found dead at his home address. He had a history of poor nutrition with recent episodes of vomiting. At autopsy the decedent was cachexic with a body mass index (BMI) of 16.1. The major findings were of marked prostatomegaly (165  g) with obstruction to urine outflow resulting in dilatation and trabeculation of the bladder and bilateral hydroureteronephrosis. The bladder contained 1.5 l of yellow urine and the kidneys weighed only 109 g on the left and 125 g on the right (N = 140–160 g). Histological examination of the prostate revealed benign nodular...
Source: Forensic Science, Medicine, and Pathology - October 22, 2019 Category: Forensic Medicine Source Type: research

Exsanguination from arteriovenous fistula: suicide or chronic wound?
(Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - October 22, 2019 Category: Forensic Medicine Source Type: research

Mandatory reporting of child physical abuse and dental neglect by Australian dentists
AbstractChild protection measures are organized into three major themes: laws; service programs; and status of outcomes of these interventions. Contextually, mandatory reporting of child abuse and neglect is governed by a complex system of State legislation across Australia. The purpose of this review was to investigate the evidence base for the legislative obligations of Australian dentists as mandatory reporters; the functionality of dental practice in the determination of orofacial signs of abuse and neglect; and, relevant knowledge and practice demonstrated by the Australian dental work force. Our research question exp...
Source: Forensic Science, Medicine, and Pathology - October 21, 2019 Category: Forensic Medicine Source Type: research

Is voluntary envenomation from the kamb ô ritual therapeutic or toxic?
(Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - October 19, 2019 Category: Forensic Medicine Source Type: research

Two autopsy cases of siblings with alveolar capillary dysplasia: clinical and post-mortem issues
We report the case of two siblings, both of whom died a few hours after birth because of severe pulmonary failure. Post-mortem histology confirmed ACD/MPV as the cause of death in both cases, and genetic analysis identified the same 16p13.3 deletion. ACD/MPV can occur suddenly in apparently healthy newborns after a regular pregnancy, and always leads to death. Nevertheless, an autopsy is not always performed after the death of an infant. For these reasons ACD/MPV represents a challenge for diagnosis and therapeutic management with medicolegal implications. Prenatal assessment of ACD/MPV is very difficult, and it should be ...
Source: Forensic Science, Medicine, and Pathology - September 11, 2019 Category: Forensic Medicine Source Type: research

Inconsistent classification of unexplained sudden deaths in infants and children hinders surveillance, prevention and research: recommendations from The 3rd International Congress on Sudden Infant and Child Death
This report details the proceedings and conclusions from the 3rd International Congress on Unexplained Deaths in Infants and Children, held November 26 –27, 2018 at the Radcliffe Institute at Harvard University. The Congress was motivated by the increasing rejection of the diagnosis Sudden Infant Death Syndrome (SIDS) in the medical examiner community, leading to falsely depressed reported SIDS rates and undermining the validity and reliability o f the diagnosis, which remains a leading cause of infant and child mortality. We describe the diagnostic shift away from SIDS and the practical issues contributing to it. Th...
Source: Forensic Science, Medicine, and Pathology - September 9, 2019 Category: Forensic Medicine Source Type: research

Trepanation in archaic human remains – characteristic features and diagnostic difficulties
AbstractThree trepanned skulls originated from a medieval archeological site at St. Pantelejmon Church, located in Serbia, all showing characteristic depressions and perforations of the vault of the skull from trepanning. Trepanation refers to the process of creating a defect in the skull by drilling, cutting or scraping and is one of the oldest known surgical procedures. Anthropological assessment of possible cases of trepanation in archaic material is complicated by a differential diagnosis that includes both congenital/developmental lesions such as parietal fenestrae, and acquired conditions such as trauma, infection an...
Source: Forensic Science, Medicine, and Pathology - September 2, 2019 Category: Forensic Medicine Source Type: research

Magnetic resonance imaging of the proximal tibial epiphysis: could it be helpful in forensic age estimation?
This study involved retrospective MRI analysis of 335 cases (217 males and 118 females) whose ages ranged from 8 to 28  years (yrs). We assessed the degree of ossification of the proximal tibial epiphysis depending on the classifications of Schmeling and Kellinghaus used for the main stages (I, II, III, IV& V) and substages (IIa, b, c& IIIa, b, c). Significant differences between males and females at stages IIIc, IV and V (p 
Source: Forensic Science, Medicine, and Pathology - August 9, 2019 Category: Forensic Medicine Source Type: research

Differential intimal staining of the aortic root and pulmonary trunk following pulmonary thromboembolism
AbstractA 68-year-old woman with a history of osteoarthritis and morbid obesity (BMI 48.1) who collapsed at her home address was found at autopsy to have to bilateral pulmonary thromboemboli. In addition, she had striking red staining of the aortic outflow tract intima with a normal cream/white pulmonary outflow tract. Although such differential staining of the lining of the great vessel is a feature of fresh water drowning associated with hypo-osmolarity of aortic blood, this case clearly demonstrates that this, along with other features that may be characteristic of drowning, are neither specific nor diagnostic. (Source:...
Source: Forensic Science, Medicine, and Pathology - August 9, 2019 Category: Forensic Medicine Source Type: research

Penile carcinoma – a rare cause of sudden death
We present a case in which a man died due to severe blood loss from an amputated penis. It was initially regarded as a violent death with an external cause. Autopsy found irregular defects with smooth edges in the external genital area and on both sides of the groin, with yellowish-gray callus-like structures and dried blood at the base of where the penis would have been located. Histological examination revealed the presence of squamous cell carcinoma with signs of keratinization. Subsequent investigation, along with information from the autopsy, revealed that the man suffered from penile carcinoma, thus death was attribu...
Source: Forensic Science, Medicine, and Pathology - August 9, 2019 Category: Forensic Medicine Source Type: research

Differentiation between perimortem trauma and heat-induced damage: the use of perimortem traits on burnt long bones
AbstractBurnt human remains present a difficult interpretative dilemma to forensic pathologists and anthropologists. Distinguishing postmortem damage in long bones as a result of fire damage from perimortem fractures is an important challenge in trauma analysis. During our case investigation of a burnt body from a fiery car crash, distinct perimortem traits on long bone fractures were still distinguishable along the charred areas. Next to timing of fractures and shortening the perimortem time gap suggesting that the fractures occurred when soft tissue was still present, the traits make it possible to distinguish blunt trau...
Source: Forensic Science, Medicine, and Pathology - August 9, 2019 Category: Forensic Medicine Source Type: research

Death due to external compression of the trachea in a patient with multinodular hemorrhagic goiter
AbstractIn this paper we describe the case of an 81-year-old Caucasian female (142  cm tall, weighing 45 kg) who suffered from a multinodular goiter for approximately 40 years. Following the onset of a clinical condition characterized by acute respiratory failure, she was transported to the emergency room by ambulance, where she died within a few hours after admission. A recent cardiac examination showed the absence of risk factors for cardiovascular disease, sinus tachycardia with a heart rate of 131 bpm, negative objectivity for signs of cardiocirculatory failure, a blood pressure of 120/80 mmHg ...
Source: Forensic Science, Medicine, and Pathology - August 9, 2019 Category: Forensic Medicine Source Type: research

Pregnancy-related and maternal deaths in Hamburg, Germany: an autopsy study from 1984 – 2018
AbstractMaternal deaths are rare events in industrial nations due to high quality medical services. These are often unexpected deaths occurring during pregnancy and labor, thus often requiring forensic autopsies. Our analysis will provide an overview of the expected range of causes of death. A retrospective analysis was carried out on all autopsies performed at the Department of Legal Medicine in Hamburg, Germany, over the last 34  years. Autopsies were carried out on 57 cases of maternal death over the 34- year period, i.e. 1 or 2 cases per year. The average age of women was 30 years. Approximately two thirds of...
Source: Forensic Science, Medicine, and Pathology - August 1, 2019 Category: Forensic Medicine Source Type: research

An investigation on annular cartilage samples for post-mortem interval estimation using Fourier transform infrared spectroscopy
This study demonstrates the feasibility of cartilage-based FTIR analysis for PMI estimation. Further work will introduce advanced algorithms for more accurate and precise PMI prediction. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - August 1, 2019 Category: Forensic Medicine Source Type: research

Occult cardiac amyloidosis: the last chapter of a 2-year long story
AbstractAmyloidosis is characterized by deposition of insoluble fibrillar proteins in organs and tissues. The prognosis depends on where in the body amyloid deposition occurs, the amount of deposition, and the symptoms, which are often unspecific. Cardiac involvement is commonly associated with the immunoglobulin light-chain amyloidosis (AL) and may lead to sudden death. The case of a 53-year-old man ’s death due to unsuspected, undiagnosed AL predominantly involving the myocardium has been reported. His medical history had begun with gastroenterological symptoms. Angina pectoris and brain stroke occurred in the foll...
Source: Forensic Science, Medicine, and Pathology - July 31, 2019 Category: Forensic Medicine Source Type: research

Post-mortem computed tomography as part of dental identification – a proposed guideline
ConclusionIn our casework, we are currently using the guidelines proposed herein. The use of PMCT has allowed us to target our clinical examinations, greatly improving their efficiency. Furthermore, PMCT allows the storage of data for later documentation and research. Further research is needed to validate the proposed guideline. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - July 30, 2019 Category: Forensic Medicine Source Type: research

The role of voluntary and involuntary drug and alcohol consumption and premorbid mental health factors in drug-facilitated sexual assault
AbstractIn order to better understand risk factors associated with drug-facilitated sexual assault (DFSA), this study examined complainant-specific and contextual factors, as well as the toxicological profile of DFSA in Victoria, Australia. Clinical files and toxicological analysis results collected by the Victorian Institute of Forensic Medicine (VIFM) for all cases of alleged DFSA in Victoria that occurred between 1st January 2011 – 31st December 2013 were reviewed. Two hundred and four cases of alleged DFSA were identified; complainants were predominately female (93%), and their median age was 26 years (range...
Source: Forensic Science, Medicine, and Pathology - July 29, 2019 Category: Forensic Medicine Source Type: research

Death related to epiglottitis
This report presents a case of epiglottitis-related death occurring in a middle-aged diabetic man. He initially presented to an emergency department with complaints of a sore throat and bilateral ear pain. Although a quick test forStrep pneumoniae was negative, the work-up was not extensive enough to exclude epiglottitis. He was discharged with a prescription for a decongestant and instructed to drink plenty of fluids. He subsequently collapsed in respiratory distress while waiting to fill his prescription at a pharmacy. He was admitted to the hospital and eventually diagnosed with anoxic brain injury, dying 4  days f...
Source: Forensic Science, Medicine, and Pathology - July 29, 2019 Category: Forensic Medicine Source Type: research

Immunodeficiency as a side effect of anabolic androgenic steroid abuse: a case of necrotizing myofasciitis
AbstractEven if there are well-known consequences of anabolic androgenic steroid (AAS) abuse, their full pathway of action is still being investigated. In this context, the presented case report aims to discuss and provide evidence of unusual adverse effects linked to immunodeficiency in an AAS abuser. In fact, this kind of chronic complication, even if not usually considered, may lead sudden death. In this case a 31-year-old aesthetic weightlifter, who presented to the emergency department due to an accidental fall that resulted in left thigh trauma. This subsequently developed into left thigh necrotizing myofasciitis in ...
Source: Forensic Science, Medicine, and Pathology - July 29, 2019 Category: Forensic Medicine Source Type: research

Mortality from neonatal herpes simplex viremia causing severe hepatitis
We report a fatal case of herpes simplex virus with severe herpes hepatitis in a 14-day old male neonate. The clinical history was limited and nonspecific, however there was no prenatal care and a known history of drug abuse in the family. Autopsy revealed extensive necrosis and hemorrhage of the liver and cerebellum. Histologically, the liver revealed viral intranuclear ground glass inclusions, characteristic of herpes virus. Immunohistochemistry for herpes simplex virus performed on the both the liver and cerebellum showed strong diffuse staining in the liver and negative staining in the cerebellum. Neonatal herpes simpl...
Source: Forensic Science, Medicine, and Pathology - July 25, 2019 Category: Forensic Medicine Source Type: research

Minimizing aerosol bone dust during autopsies
AbstractWhen sawing bone for medical or medico-legal procedures, fine, airborne dust is produced (aerosols) that can pose a health hazard when inhaled. The aim of this study was to determine the influence of saw blade frequency and contact load, bone condition, test environment, and saw blade type, on the production of aerosol particles. A custom test setup was designed, manufactured and used in 8 bone sawing experiments, using a particle counter to determine the production of aerosol particles while varying the 5 chosen parameters. The number of counted particles was highest with higher saw blade frequencies, lower saw bl...
Source: Forensic Science, Medicine, and Pathology - July 24, 2019 Category: Forensic Medicine Source Type: research

Quantification of odontological differences of the upper first and second molar by 3D-3D superimposition: a novel method to assess anatomical matches
AbstractPurposeThe introduction of modern 3D image acquisition systems has enabled researchers to develop novel procedures for personal identification. The present study aimed to assess differences between dental scans belonging to the same or different subjects, through an innovative 3D-3D superimposition and registration method.MethodsTwelve subjects (6 males and 6 females) with pre- and post-orthodontic treatment dental casts were recruited. A 3D scan from each cast was obtained through a laser scanner and the 3D model of the upper first and second molar on the post-treatment cast was superimposed on the pre-treatment s...
Source: Forensic Science, Medicine, and Pathology - July 20, 2019 Category: Forensic Medicine Source Type: research

Optical coherence tomography in forensic sciences: a review of the literature
AbstractOptical coherence tomography (OCT) is an interferometric imaging technique that has revolutionized clinical ophthalmology since the first half of the 1990 ’s. Despite this approach being successfully employed in ophthalmology and having great potential in forensic cases, its use in different forensic fields appears to be quite limited. In this review we reviewed the scientific literature regarding the application of OCT in forensic science and legal medicine from 1995 to 2019. Our research showed the usefulness of this approach for the study of coronary injuries, postmortem ocular changes, forensic entomology...
Source: Forensic Science, Medicine, and Pathology - July 18, 2019 Category: Forensic Medicine Source Type: research

Massive subcutaneous emphysema mimicking anaphylaxis - pathological and radiological correlations
This report details the pathological and radiological findings in a rare case of massive subcutaneous emphysema. A 74-year-old male presented with sudden onset dyspnea and facial swelling following a fall. His symptoms were refractory to treatments for anaphylaxis, which was suspected clinically, and he quickly succumbed. Autopsy, including post mortem CT scan revealed the underlying etiology to be multiple rib fractures with rupture of the parietal pleura, bilateral pneumothoraxes and massive subcutaneous emphysema involving the face, torso and upper limbs. Multiple frothy air bubbles were observed throughout the mediasti...
Source: Forensic Science, Medicine, and Pathology - July 17, 2019 Category: Forensic Medicine Source Type: research

Sex determination in cremated human remains using the lateral angle of the pars petrosa ossis temporalis : is old age a limiting factor?
AbstractThe significant role of the petrous bone in sex assessment of skeletal human remains has been highlighted by several studies. In previous work we applied the method of the measurement of the lateral angle of the petrous bone to a sample of cremated human remains of known age and sex from an Italian crematorium; the low accuracy of sex classification obtained was probably due to the high number of elderly individuals in our sample. In this paper we investigate the relationship between age and alterations of the petrous bone, by applying the same methodology we used previously, measuring the lateral angle of the petr...
Source: Forensic Science, Medicine, and Pathology - July 11, 2019 Category: Forensic Medicine Source Type: research

Medical and pathologic characteristics of fatal anaphylaxis: a Spanish nationwide 17-year series
We report on the medicolegal, demographic and histopathological characteristics of a series of sudden deaths which were investigated for anaphylaxis at the Spanish National Institute of Toxicology and Forensic Sciences (INTCF) over a 17-year period (1998 –2015). A total of 122 undetermined sudden deaths from a high percentage of Spanish regions (81.5% of the total population) were sent to the INTCF with anaphylaxis as the suspected cause of death for histological, biochemical, and medicolegal investigation. Two certified allergists confirmed that 46 of the 122 cases were fatal anaphylaxis. The results indicated a med...
Source: Forensic Science, Medicine, and Pathology - July 11, 2019 Category: Forensic Medicine Source Type: research

Commentary on Leth PM. Homicide by drowning. Forensic Sci Med Pathol. 2019;15:233 –8
(Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - July 8, 2019 Category: Forensic Medicine Source Type: research

Fatal poisoning with diethylene glycol in an unusual setting
In conclusion, death was due to fatal intoxication by DEG. While most DEG intoxications have been mass poisoning incidents attributed to pharmaceutical products, the present case describes an unusual example of a single decedent. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - July 1, 2019 Category: Forensic Medicine Source Type: research