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Unexpected findings and misdiagnoses in coroner ’s autopsies performed for trauma at the University of the West Indies, Kingston, Jamaica
This study aimed to identify misdiagnoses and missed (unexpected) findings documented during complete coroner ’s autopsies performed for trauma at the University of the West Indies (UWI) and evaluate their influence on patient outcome. We retrospectively reviewed the reports of all coroner’s autopsies performed for trauma, between 2003 and 2012, at the UWI. For each case, we extracted age, gender, traum a type, mechanism and topography, clinical and postmortem diagnoses and hospitalization duration. The data were used to calculate frequencies, proportions and discrepancy rates. 955 coroner’s autopsies wer...
Source: Forensic Science, Medicine, and Pathology - May 9, 2018 Category: Forensic Medicine Source Type: research

Homicide victims concealed in a freezer
We report here a homicide case in which three bodies were concealed in a freezer. This presented the pathologist with the problem of how to thaw the bodies and simultaneously avoid decomposition of the uppermost body. The problem was solved by slow thawing in a refrigerated morgue and by removing the bodies one after the other from top to bottom. The victims were a 27-year old mother and her two daughters, 7 and 9  years of age. The perpetrator was the 34-year old now-divorced husband and father. All were refugees from Syria. The perpetrator fled back to Syria. He was later arrested in Syria, confessed the crime and w...
Source: Forensic Science, Medicine, and Pathology - May 9, 2018 Category: Forensic Medicine Source Type: research

Thoracic trauma in fatal falls from height — Traumatic pneumopericardium correlates with height of fall and severe injury
AbstractPneumopericardium (PPC) describes the collection of gas in the pericardial sac. In tension Pneumopericardium (tPPC), this collection of gas may lead to cardiac tamponade. PPC following blunt trauma is considered a rare finding, as reflected by the low number of case reports on the topic. We analyzed the prevalence and pathophysiology of PPC and the associated trauma in 44 cases of falls from height. We retrospectively analyzed postmortem CT data and autopsy reports of fatal falls in the period March 2014 –2017. A valid estimation of the height of the fall and a documented impact on an even and hard surface we...
Source: Forensic Science, Medicine, and Pathology - May 3, 2018 Category: Forensic Medicine Source Type: research

Aspartic acid racemization of root dentin used for dental age estimation in a Polish population sample
AbstractPrecise age determination of unidentified bodies and human remains is one of the essential tasks of forensic science. The aim of this study was to assess the applicability of using the enantiomeric composition of aspartic acid racemization in root and crown dentin for dental age estimation using a Polish population sample. Coronal and root dentin from four teeth groups from the mandible were studied using gas chromatography with mass spectrometry. The results demonstrated a very high correlation between the chronological age and enantiomeric composition in both of the dentin samples. Individual linear equations of ...
Source: Forensic Science, Medicine, and Pathology - May 2, 2018 Category: Forensic Medicine Source Type: research

Single stab injuries
AbstractDetermining the manner of death in cases involving multiple stab injuries from a knife is generally straightforward. The medico-legal investigation of a stabbing death caused by a single stab injury from a knife comprises a smaller but potentially more problematic subset of forensic cases. We reviewed our institute ’s experience with single stab injuries and endeavored to identify features identified at the post-mortem examination which may aid in the differentiation between cases of homicide, suicide and accidental death. The single stab injury was to the left chest in the majority of deaths from homicide a ...
Source: Forensic Science, Medicine, and Pathology - May 1, 2018 Category: Forensic Medicine Source Type: research

Review of autopsy reports of deaths relating to fire in South Australia 2000 –2015
This study has confirmed that presence of soot in the respiratory tract and cherry-red coloration of a body retrieved from a fire are both linked to an increased level of blood carboxy hemoglobin. These findings significantly contribute to the documentation of fire deaths in Australia. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - April 28, 2018 Category: Forensic Medicine Source Type: research

Point-of-care hemoglobin A1c testing in postmortem examination
This study evaluated HbA1c levels in the capillary and cardiac venous blood of postmortem specimens as well as the usefulness of evaluating HbA1c levels as POC testing in postmortem examinations. For HbA1c testing performed on 103 autopsy cases, a portable SD A1cCare (test) was used for the POC testing, along with a Cobas Integra 800 (comparative). There was a strong correlation between HbA1c levels from postmortem capillary and cardiac venous blood (regression equation, 0.000  + 1.000×), and between HbA1c levels of cardiac venous blood measured using the portable SD A1cCare as a POC test and the Cobas ...
Source: Forensic Science, Medicine, and Pathology - April 25, 2018 Category: Forensic Medicine Source Type: research

Differentiation of dental restorative materials combining energy-dispersive X-ray fluorescence spectroscopy and post-mortem CT
AbstractToday, post-mortem computed tomography (CT) is routinely used for forensic identification. Mobile energy-dispersive X-ray fluorescence (EDXRF) spectroscopy of a dentition is a method of identification that has the potential to be easier and cheaper than CT, although it cannot be used with every dentition. In challenging cases, combining both techniques could facilitate the process of identification and prove to be advantageous over chemical analyses. Nine dental restorative material brands were analyzed using EDXRF spectroscopy. Their differentiability was assessed by comparing each material ’s x-ray fluoresc...
Source: Forensic Science, Medicine, and Pathology - April 24, 2018 Category: Forensic Medicine Source Type: research

Evaluating the potential of housekeeping genes, rRNAs, snRNAs, microRNAs and circRNAs as reference genes for the estimation of PMI
AbstractThe precise estimation of postmortem interval (PMI) is a critical step in death investigation of forensic cases. Detecting the degradation of RNA in tissues by real time quantitative polymerase chain reaction (RT-qPCR) technology provides a new theoretical basis for estimation of PMI. However, most commonly used reference genes degrade over time, while previous studies seldom consider this when selecting suitable reference genes for the estimation of PMI. Studies have shown microRNAs (miRNAs) are very stable and circular RNAs (circRNAs) have recently emerged as a novel class of RNAs with high stability. We aimed to...
Source: Forensic Science, Medicine, and Pathology - April 24, 2018 Category: Forensic Medicine Source Type: research

Diagnostic role of serum tryptase in anaphylactic deaths in forensic medicine: a systematic review and meta-analysis
In this study, we made a retrospective study and presented a systematic review and meta-analysis that aims to summarize the diagnostic significance of postmortem serum tryptase in the deceased with and without anaphylactic shock and to calculate a cutoff value for future reference in the identification of deaths due to anaphylactic shock. A complete literature search in the PubMed, Cochrane Library, CNKI and Embase databases (published prior to March 1st, 2017) was performed. The quality of the eligible literature was evaluated according to the Newcastle-Ottawa Quality Assessment Scale (NOS), and the relevant data was extr...
Source: Forensic Science, Medicine, and Pathology - April 21, 2018 Category: Forensic Medicine Source Type: research

Regarding “Fatal air embolism in hospital confirmed by autopsy and postmortem computed tomography”
(Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - April 17, 2018 Category: Forensic Medicine Source Type: research

Anesthetized by chloroform before hanging
We present a unique case of suicidal hanging. The deceased was a 31-year-old male who was found hanging from a tree in a dense thicket, with his lower limbs in contact with the ground (partial suspension). There was an apparatus similar to a facial mask placed around his nose and mouth. A strong chemical smell was emanating from the apparatus, which was identified as chloroform (Formyl trichloride/CHCl3). A ligature with a soft cloth beneath it was around his neck. A ligature mark was present around the neck. The decedent ’s blood alcohol levels were 112 mg/dl. The blood and stomach contents were negative for ch...
Source: Forensic Science, Medicine, and Pathology - April 16, 2018 Category: Forensic Medicine Source Type: research

A posttraumatic pseudoaneurysm of the left radial artery as a result of a stab wound in an 8-year-old girl
AbstractPseudoaneurysms arise from a disruption of arterial wall continuity and are most commonly related to a penetrating trauma, an arterial wall inflammation or iatrogenic causes. They differ from real aneurysms due to a lack of one or more layers of the arterial wall. The frequency of peripheral artery pseudoaneurysms in the upper extremities is less than in the lower extremities and its most common cause is a gunshot or a stab wound. The risk of a rupture is higher than in true aneurysms due to a lack of wall layers, therefore requiring surgical treatment in most cases. Here we describe an unusual case of an 8-year-ol...
Source: Forensic Science, Medicine, and Pathology - April 11, 2018 Category: Forensic Medicine Source Type: research

Distortion of the temporary cavity and its influence on staining in firearm barrels
This study was conducted t o investigate the role of the sustaining base of the gelatin blocks during contact shots, and its influence on the staining result inside firearm barrels. Eighteen contact shots were performed using 22 LR, 32 ACP (7.65 Browning) and 9 mm Luger semi-automatic pistols. With each pistol, shots were fi red onto six gelatin cubes; three placed upon a rigid platform and three upon an elastic underlay. The shots were recorded by a high-speed video camera as they penetrated the gelatin cube. Any staining present inside the firearm barrels after the shots were fired was documented by endoscopy. Cross...
Source: Forensic Science, Medicine, and Pathology - April 3, 2018 Category: Forensic Medicine Source Type: research

CXCL1 and CXCR2 as potential markers for vital reactions in skin contusions
This study investigated mRNA and protein levels of CXCL1 and CXCR2 in skin wounds in mice and humans. Western blot analysis of CXCL1 and CXCR2 protein levels showed no difference between wounded and intact skin. However, mRNA levels demonstrated higher expression of CXCL1 and CXCR2 in contused mouse and human skin, compared with intact skin. At postmortem there were no remarkable changes in CXCL1 and CXCR2 mRNA levels in contused mouse skin. Increased mRNA expression was observed in contused mouse skin up to 96  h and 72 h after death for CXCL1 and CXCR2 respectively. In human samples of wounded skin, increased C...
Source: Forensic Science, Medicine, and Pathology - April 2, 2018 Category: Forensic Medicine Source Type: research

The remains at Lethbridge ’s Pocket – the case against the Kenniff brothers
AbstractOn 30th March 1902 Police Constable George Doyle and Carnarvon Station manager Albert Dahlke were allegedly gunned down at Lethbridge ’s Pocket in Central Queensland. Approximately 90 kg of ash and burnt human remains with articles belonging to the two men were later found in saddle bags left at the scene on a police horse. Subsequently two local cattle and horse thieves, Patrick and James Kenniff, were convicted in the Queensl and Supreme Court of the wilful murder of Constable Doyle. Patrick was executed by hanging on 12th January 1903 and James had his sentence reduced to life imprisonment with hard l...
Source: Forensic Science, Medicine, and Pathology - March 29, 2018 Category: Forensic Medicine Source Type: research

Surprising origin of two carved bones donated to the Buchenwald Memorial Museum
AbstractUnidentified bones were donated to the Buchenwald Memorial Museum in Weimar, Germany. The donor thought the bones may have belonged to internees of the concentration camp and had been decoratively carved by camp personnel. Non-destructive forensic anthropological examination was carried out on the bones to identify their possible origin. Comparative human and non-human bones samples were used to determine the provenance of the bones and the anatomical region they may have come from. Literature and internet searches were conducted to trace the origin of the carved motifs on the bones. The bones were determined to be...
Source: Forensic Science, Medicine, and Pathology - March 28, 2018 Category: Forensic Medicine Source Type: research

Fatal methemoglobinemia complicating alkaptonuria (ochronosis): a rare presentation
AbstractA 61-year-old female died in hospital with multiple organ failure 4 weeks following presentation with acute kidney injury, hemolytic anemia and methemoglobinemia. At autopsy, brown to black discoloration of cartilages was observed. Histology revealed brown pigmentation of the hyaline cartilage, with focal full-thickness erosion of the articular hyaline cartilage, characteristic of alkaptonuria (ochronosis). Although alkaptonuria is rarely fatal, this case illustrates a rare acute fatal complication. Accumulation of circulating homgentisic acid secondary to acute derangement of renal function is believed to have ove...
Source: Forensic Science, Medicine, and Pathology - March 23, 2018 Category: Forensic Medicine Source Type: research

Occult cardiac lymphoma and sudden death
AbstractA 56-year-old man with no previous medical history collapsed and was not able to be resuscitated. The major findings at autopsy were enlargement of the heart (weight  = 527 g) which contained an infiltrating firm, homogeneous tumor in an epicardial location adjacent to the left anterior descending and right coronary arteries, with further extension into the right ventricular outflow tract, the interventricular septum and left ventricular free wall. Sections showed sheets of small lymphoid cells with scattered large lymphocytes amounting to a low-grade follicular non-Hodgkin lymphoma, as tumor cel...
Source: Forensic Science, Medicine, and Pathology - March 22, 2018 Category: Forensic Medicine Source Type: research

Fatal falls involving stairs: an anthropological analysis of skeletal trauma
AbstractThe skeletal blunt force trauma resulting from fatal falls involving stairs is complex. There are countless ways an individual may fall when stairs are involved, and thus a variety of ways the skeleton may fracture. Therefore anecdotally, it may be said that there is no specific skeletal trauma characteristic of this fall type. In order to scientifically investigate this anecdotal understanding, this study provides a detailed investigation of the skeletal fracture patterns and morphologies resulting from fatal falls involving stairs. Skeletal trauma was analyzed using the full-body postmortem computed tomography sc...
Source: Forensic Science, Medicine, and Pathology - March 21, 2018 Category: Forensic Medicine Source Type: research

Lethal endomyocarditis caused by chronic “Krokodil” intoxication
Abstract“Krokodil” is a home-made opioid drug obtained by synthesizing desomorphine from codeine and combining it with other low-cost additives. Initially introduced in the former Soviet countries, it was then imported to Western Europe as a heroin substitute. To our knowledge, this is the first report of an Italian case of lethal krokodil abuse, that occurred in a 39-year-old man, who died suddenly after transportation to the Emergency Department (ED) for hyperthermia associated with sweating, dyspnoea and tachycardia. Post-mortem examination revealed extensive necrotic ulcerative lesions on the forearms, and ...
Source: Forensic Science, Medicine, and Pathology - March 19, 2018 Category: Forensic Medicine Source Type: research

Regarding the editorial “The autopsy evaluation of ‘straightforward’ fire deaths”
(Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - March 8, 2018 Category: Forensic Medicine Source Type: research

Clinical forensic aspects of self-inflicted neck injuries
AbstractThe distinction between self-inflicted injuries and other types of injuries is crucial in forensic medicine, and relevant features of wounds should be identified by pathologists, even when they are observed at atypical sites. Herein we report two cases of self-inflicted injuries of the neck involving two young women who had reported being attacked by men. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - March 1, 2018 Category: Forensic Medicine Source Type: research

A case of chronic asymptomatic central pontine myelinolysis with histological evidence of remyelination
We describe an unusual post-mortem case of extensive but asymptomatic CPM in a chronic alcoholic patient with normonatremia. The affected part of the pons contained thinly myelinated axons with appearances supporting remyelination. We suggest that remyelination may account for the subclinical nature of this patient's CPM. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - February 28, 2018 Category: Forensic Medicine Source Type: research

Unusual accidental decapitation in a road traffic incident
We report, for the first time, a case of a complete decapitation of a pedestrian as a consequence of a traffic accident. Due to a thorough medico-legal investigation of the body and the involved vehicle, we were able to reconstruct the unique dynamics of the accident and the mechanism of injury. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - February 28, 2018 Category: Forensic Medicine Source Type: research

Pekka Saukko, Bernard Knight: Knight ’s forensic pathology 4th ed.
(Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - February 28, 2018 Category: Forensic Medicine Source Type: research

Patent foramen ovale, paradoxical embolism and fatal coronary obstruction
AbstractA 75-year-old woman was admitted to the emergency room with chest pain and vomiting. An electrocardiogram and laboratory results were suggestive for myocardial infarction of the posterior cardiac wall. Echocardiography was indicative of aortic dissection, and a CT scan of the thoracic arteries showed a massive pulmonary thromboembolism and thrombotic occlusion of the right coronary artery (RCA). The woman died shortly after admission. Autopsy confirmed the presence of thromboemboli in the right pulmonary artery and its lobar branches. Also, the anterior aortic sinus was filled with a 9  cm long thromboembolus ...
Source: Forensic Science, Medicine, and Pathology - February 27, 2018 Category: Forensic Medicine Source Type: research

Fatal intoxication with antidepressants: a case with many culprits
AbstractSerotonin-specific reuptake inhibitors (SSRIs) are generally considered safe drugs but fatal adverse effects do sometimes occur, often as a consequence of interactions with other serotonin active drugs. Polypharmacy is usually a problem that the elderly encounter, but it can also have dire consequences for young people, especially when an underlying heart condition is present. Thus, failure to diagnose heart disease and the use of contraindicated medications can be a lethal combination, irrespective of age. Here we present a case of a young adult suffering from bipolar disorder who used a combination of two SSRIs (...
Source: Forensic Science, Medicine, and Pathology - February 27, 2018 Category: Forensic Medicine Source Type: research

The utility of plastinates in court: a case of firearm homicide
AbstractPlastination is a technique renowned for its use in the preservation of human tissues or organs, and is mainly employed in anatomical training and in research regarding various scientific fields. The advantages of this method are related to the natural appearance, absence of odor, and easy-handling of the plastinated products. The use of plastinates in forensic sciences, their potential role in personal identification, and their usefulness in interpretation of post-mortem findings has been described, although literature on this topic is poor. The present paper is the first report of a firearm homicide where the bra...
Source: Forensic Science, Medicine, and Pathology - February 24, 2018 Category: Forensic Medicine Source Type: research

“The pen is mightier than the sword” – suicidal trans-orbital intracranial penetrating injury from a pencil
AbstractA 40-year-old drug addict, who was being treated with methadone and occupational therapy, committed suicide by striking a wooden pencil into his right eye socket. While still conscious, he hit his head hard against a table, jamming the pencil even deeper into his head. The autopsy showed that the pencil missed the globe and lodged in the inner part of the right eye socket. It pierced the orbital part of the right ethmoid bone, the right ethmoid cells, and the right superior nasal concha, then passed through the body of the sphenoid bone and the clivus of the occipital bone before stopping in the brain tissue. The b...
Source: Forensic Science, Medicine, and Pathology - February 24, 2018 Category: Forensic Medicine Source Type: research

Neuronal apoptosis in the brainstem medulla of sudden unexpected death in infancy (SUDI), and the importance of standardized SUDI classification
AbstractThe purpose of this study was to examine the neuronal expression of apoptotic markers in the rostral medulla of a newly characterized dataset of sudden unexpected death in infancy (SUDI), and to determine the impact of diagnostic groupings on these findings and whether they pertain to the intrinsic apoptotic pathway. Immunohistochemical staining was quantified to determine the percentage of neurons positive for active caspase-9 (specific to the intrinsic apoptotic pathway), active caspase-3 (common to the intrinsic and extrinsic apoptotic pathways) and Terminal deoxynucleotidyl transferase mediated dUTP nick-end la...
Source: Forensic Science, Medicine, and Pathology - February 19, 2018 Category: Forensic Medicine Source Type: research

Diagnosis of arterial gas embolism in SCUBA diving: modification suggestion of autopsy techniques and experience in eight cases
AbstractThe purpose of this study was to suggest modifications of autopsy techniques in order to improve post-mortem diagnosis of arterial gas embolism (AGE) based on multidisciplinary investigation of SCUBA diving fatalities. Five adult human cadavers from the voluntary donation program of the Human Anatomy Laboratory, and eight judicial autopsied bodies of SCUBA divers from the Forensic Pathology Service were assessed. Before performing any autopsies, we accessed the diving plan and the divers ’ profiles for each case. We then introduced a new dissection procedure that included identification, isolation, and manipu...
Source: Forensic Science, Medicine, and Pathology - February 19, 2018 Category: Forensic Medicine Source Type: research

“Defense” type wounds in suicide
Abstract“Defense” type wounds are sustained when a victim is attempting to ward off an attacker, or a weapon. A 39-year-old woman is reported who was found deceased with incised wounds to the dorsa of both hands that resembled defense wounds. Examination of the flexor surfaces of both wrists, however, r evealed horizontal incised wounds typical of self-infliction. Perfusion of the subclavian arteries produced leakage of water from peripheral veins within wounds on both hands and the right wrist. Death was due to exsanguination from incised wounds of the hands and right wrist; manner suicide. This c ase demonstr...
Source: Forensic Science, Medicine, and Pathology - February 17, 2018 Category: Forensic Medicine Source Type: research

Double-chambered left ventricle – a “heart within a heart”
AbstractA 20-year-old previously well man drowned after performing a back-flip off a bridge into a river. At autopsy no significant injuries or organic illness were identified. An unusual incidental finding was a double chambered left ventricle, or so-called “heart within a heart”, with the left ventricle subdivided into two separate chambers by a muscular septum. Awareness of this entity in forensic casework is important as this anomaly, despite its dramatic appearance, is not associated with anomalous conduction tracts or arrhythmogenic conditions , and so is usually a completely incidental finding at autopsy...
Source: Forensic Science, Medicine, and Pathology - February 13, 2018 Category: Forensic Medicine Source Type: research

Internal patterned injuries in trauma
We report the suicide of a 23-year-old man by jumping off a bridge. At autopsy, an unusual finding was “tramline” bruising of the right liver lobe. The “blunt objects” that inflicted the bruising were determined to be the right ribs which were pushed against the liver capsule as a consequence of the extensive thoracic and vertebral trauma after a fall from a height with intermediate impact. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - February 13, 2018 Category: Forensic Medicine Source Type: research

Rapid and reliable detection of previous freezing of cerebral tissue by computed tomography and magnetic resonance imaging
AbstractDue to slowing or even inhibition of postmortem processes, freezing may make an estimation of the time-since-death very difficult. This is also true in previously frozen and subsequently thawed bodies. Knowledge of prior freezing is important, as it may lead to a different assessment of the time since death. Twelve pig heads were frozen at −20 °C, and 6 heads were either kept at room temperature (approximately 20 °C) or in a cooling cell (approximately 5 °C). The frozen brains and cadavers were thawed at either room temperature or in a cooling cell. All specimens underwent repeated ...
Source: Forensic Science, Medicine, and Pathology - February 12, 2018 Category: Forensic Medicine Source Type: research

Pandora ’s box
AbstractSuitcases or other containers are occasionally involved in forensic investigations. If there is a suspicion that human remains are hidden inside such a container, medico-legal examinations are required. However, these containers are occasionally locked. Forced opening of a locked suitcase or container may cause damage to its contents. Additionally, the safety of the investigator has to be considered as such containers may be booby-trapped or contain other hazardous material. An overview of the contents before opening is desirable in order to avoid the possibility of encountering a Pandora ’s box. In forensic ...
Source: Forensic Science, Medicine, and Pathology - February 8, 2018 Category: Forensic Medicine Source Type: research

A homemade furnace. Influence of occupational skills in a fire-related planned complex suicide
AbstractThe term “planned complex suicide” means the combination of more than one method of suicide, planned to prevent failure of the first method to ensure a fatal outcome. Professional skills and tools are sometimes used to plan and perpetrate the suicide. A case of planned complex suicide of a mechanical eng ineer working with furnaces in a tube factory is herein reported. The suicide was committed in a rudimental furnace set up in the victim’s apartment using his professional skills, by assembling furniture, mattresses, books and flammable liquid present in the house. Three-dimensional models of the ...
Source: Forensic Science, Medicine, and Pathology - February 8, 2018 Category: Forensic Medicine Source Type: research

Postmortem radiological case series of acetabular fractures after fatal aviation accidents
AbstractThe purpose of this study was to describe radiological fracture patterns of the acetabulum sustained after fatal small aircraft aviation accidents, aiming at facilitating a better understanding of trauma mechanisms in a forensic setting. Postmortem conventional radiographs or CT scans of 29 victims of 20 small aircraft aviation accidents were analyzed for skeletal acetabular trauma. Among the 29 fatalities (27 males and 2 females, median age 55  years (range: 21–76 years)), 20 victims had pelvic fractures (69%), of which 19 victims (66%) had one or more acetabular fractures. Bilateral acetabular fra...
Source: Forensic Science, Medicine, and Pathology - February 5, 2018 Category: Forensic Medicine Source Type: research

The autopsy and diagnosis of pulmonary thrombo-embolism
AbstractPulmonary thrombo-embolism (PTE) is a common cause of death but is frequently undetected by clinicians in spite of advanced diagnostic techniques. The autopsy has traditionally been used to identify the rate of PTE in hospital patients, but the decline in autopsy rates – especially in hospitals – has led to insufficient recent data from which to comment with confidence on the true rate of death from latent PTE. Widespread prophylactic anticoagulation regimens against venous thrombosis may induce complacency amongst clinicians. PTE continues to occur and to kil l, and autopsies should be performed more f...
Source: Forensic Science, Medicine, and Pathology - February 5, 2018 Category: Forensic Medicine Source Type: research

Regarding “Lethal hypothermia – a sometimes elusive diagnosis”
(Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - January 23, 2018 Category: Forensic Medicine Source Type: research

Point-of-care hemoglobin testing for postmortem diagnosis of anemia
AbstractAn autopsy involves examination of a body using invasive methods such as dissection, and includes various tests using samples procured during dissection. During medicolegal autopsies, the blood carboxyhemoglobin concentration is commonly measured using the AVOXimeter ® 4000 as a point-of-care test. When evaluating the body following hypovolemic shock, characteristics such as reduced livor mortis or an anemic appearance of the viscera can be identified, but these observations arequite subjective. Thus, a more objective test is required for the postmortem diagnos is of anemia. In the present study, the AVOXimeter...
Source: Forensic Science, Medicine, and Pathology - January 22, 2018 Category: Forensic Medicine Source Type: research

Singleplex quantitative real-time PCR for the assessment of human mitochondrial DNA quantity and quality
AbstractMitochondrial DNA (mtDNA) can provide a means for forensic identity testing when genotyping of nuclear DNA (nuDNA) targets is not possible due to degradation or lack of template. For degraded samples, an indication of the quantity and quality of mtDNA is essential to allow selection of appropriately sized targets for hypervariable region (HVR) analysis, which may conserve sample and resources. Three human-specific mtDNA targets of increasing length (86, 190 and 452 base pairs) were amplified by singleplex quantitative real-time PCR (qPCR), capable of providing an index of mtDNA degradation from fragment length info...
Source: Forensic Science, Medicine, and Pathology - January 20, 2018 Category: Forensic Medicine Source Type: research

Species diversity and tissue specific dispersal of necrophagous Diptera on human bodies
AbstractIn forensic entomology, many studies analyze fly activity and succession on dead bodies by using pig cadavers and a variety of small baited traps. Data on real human bodies are very rare. To address this shortcoming, we analyzed the fly fauna of 51 human bodies in Germany. Sex, age, place of discovery, and presumed time of death were noted. Larvae were sampled during autopsy according to body region or tissue. For every infested region, the total number of fly larvae were estimated and classified into categories of 1 –10, 11–50, and 50+. All samples were identified to the species level. Besides a descri...
Source: Forensic Science, Medicine, and Pathology - January 18, 2018 Category: Forensic Medicine Source Type: research

Bystin (BYSL) as a possible marker of severe hypoxic-ischemic changes in neuropathological examination of forensic cases
AbstractBystin (BYSL) is a 306-amino acid protein encoded in humans by the BYSL gene located on the 6p21.1 chromosome. It is conserved across a wide range of eukaryotes. BYSL was reported to be a sensitive marker for the reactive astrocytes induced by ischemia/reperfusion and chemical hypoxia in vitro and is considered to be one of the common characteristics of astrogliosis. In our study we examined whether BYSL could be used as a marker for hypoxic-ischemic changes in forensic cases. Groups suspected of acute hypoxic-ischemic changes presented strong BYSL expression in the cytoplasm of neocortical neurons especially in la...
Source: Forensic Science, Medicine, and Pathology - January 18, 2018 Category: Forensic Medicine Source Type: research

Regarding Vadyshinghe AN, Sivasubramanium M, Jayasooriay RP (2017): A tree branch instead of a ligature: an unusual accidental hanging. Forensic Sci Med Pathol. 13: 441 –443
(Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - January 9, 2018 Category: Forensic Medicine Source Type: research

Differentiation of antemortem pulmonary thromboembolism and postmortem clot with unenhanced MRI: a case report
We report a case of a 39-year-old woman who died of fulminant pulmonary thromboembolism (PE). Autopsy showed classical findings of fulminant PE with occlusion of the bilateral main stem pulmonary arteries. Ancillary testing revealed inherited thrombophilia (Prothrombin 20,210  G >  A and MTHFR 677 C >  T mutation). Pre-autopsy postmortem computed tomography was used to test whether virtual imaging studies alone (virtual autopsy) would be sufficient to detect PE. Our studies show that computed tomography (CT) can differentiate antemortem clots from a postmortem clot in certain cases, p...
Source: Forensic Science, Medicine, and Pathology - January 4, 2018 Category: Forensic Medicine Source Type: research

Double suicidal gunshot wounds to the heart
AbstractA case of double gunshot wounds to the heart is reported, where police investigations determined the manner of death to be suicide. In addition, the autopsy findings supported this conclusion. The localization, appearance, and mutual relations of the inflicted wounds, as well as the direction of the bullet trajectories, helped to determine the most probable sequence of events. The victim had been able to act after the first shot and inflict the second shot as the conduction system of the heart was at least partially preserved. Even when the circumstances indicate the most probable manner of death, multiple gunshot ...
Source: Forensic Science, Medicine, and Pathology - December 18, 2017 Category: Forensic Medicine Source Type: research

Why is a prone sleeping position dangerous for certain infants?
AbstractThe prone (face down) sleeping position is known to be associated with a significantly increased risk of sudden and unexpected death in infancy (sudden infant death syndrome or SIDS), however, the reasons for this are unclear. Suggested mechanisms have involved suffocation from occlusion of the external airways by soft bedding/pillows or from flattening of the nose with backward displacement of the tongue, rebreathing of carbon dioxide, blunting of arousal responses with decreased cardiac responses to auditory stimulation, diaphragmatic splinting or fatigue, lowering of vasomotor tone with tachycardia, nasopharynge...
Source: Forensic Science, Medicine, and Pathology - December 14, 2017 Category: Forensic Medicine Source Type: research

Injury potential of thrown sharp kitchen and household utensils
We examined the possibility of inflicting serious injuries with sharp objects in an experimental setting by throwing four sharp objects from different distances and with different throwing techniques. Using an overarm-handle (OA/H), overarm-blade (OA/B), underarm-handle (UA/H), underarm-blade (UA/B) and thrust (T/H) throwing technique, 10 adults (sex ratio 1:1) threw a chef ’s knife, a skinning knife, a paring knife and office scissors from 4 m and 2 m distance at synthetic abdomen models made of 10% gelatin covered with synthetic skin. The amount of hits and penetrations of the target and their penetration...
Source: Forensic Science, Medicine, and Pathology - December 2, 2017 Category: Forensic Medicine Source Type: research