Classical syphilitic lesions from the museum
AbstractSyphilis is an increasingly diagnosed venereal disease which has four distinctive stages that may last over decades if appropriate treatment is not given. Review of the files of the Pathology Museum in the Faculty of Medicine at The University of Adelaide revealed three cases with classical cardiovascular and neurological findings. Case 1: An 80-year-old man with a large syphilitic aneurysm of the ascending aorta with a smaller aneurysm of the proximal descending aorta. Case 2: A 56-year-old man with chronic syphilitic meningoencephalitis with cerebral atrophy. Case 3: A 77-year-old man with tabes dorsalis. Given t...
Source: Forensic Science, Medicine, and Pathology - August 7, 2018 Category: Forensic Medicine Source Type: research

Intestinal obstruction as a cause of death in the mentally disabled
AbstractTwo cases of intestinal obstruction in the mentally disabled are reported. The first case concerns 61-year-old oligophrenic woman who resided in a nursing home, where she was found hypotensive and unresponsive. Upon opening the peritoneal cavity at autopsy, extremely dilated (measuring on average 12  cm in diameter) loops of the colon emerged– they compressed the small intestine and other intraperitoneal organs, lifting both hemidiaphragms deep into the pleural cavity. Lodged firmly into the rectum, a partly disintegrated sanitary pad was found. In the second case, young man with Down syndro me was found...
Source: Forensic Science, Medicine, and Pathology - August 4, 2018 Category: Forensic Medicine Source Type: research

Stab wounds of the chest caused by penetration of duralumin rods
We present the case of a young man who presented with stab and cut injuries due to a duralumin rod embedded in his chest. Examination of the body revealed that death was due to penetration of the thoracic aorta by a duralumin rod. Careful investigation of the circumstances surrounding the death was able to confim a case of accidental death due to falling from a ladder onto tomato seedlings that were supported by duralumin rods. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - August 3, 2018 Category: Forensic Medicine Source Type: research

The Swedish Agency for health technology-report about traumatic shaking: much ado about nothing?
AbstractThe 2016 Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) systematic review deals with the role of the ‘triad’ (subdural hematoma, retinal hemorrhages, and various forms of brain symptoms) in the medical investigation of suspected traumatic shaking. In this commentary we will not discuss the methodological shortcomings of the SBU-review but will concentrate on the effects of the review on the dai ly practice of protecting children and families in court procedures. In our opinion the report did not add anything to what was already known in clinical and forensic medi...
Source: Forensic Science, Medicine, and Pathology - August 1, 2018 Category: Forensic Medicine Source Type: research

Lethal small intestinal herniation through a congenital mesenteric defect
AbstractA three-year-old boy with mild symptoms of an upper respiratory tract infection and recent onset vomiting collapsed at home. Resuscitative attempts in hospital were eventually unsuccessful. At autopsy an obstruction of the small intestine, with ischemia, was identified. It had been caused by strangulation of the small intestine through a congenital mesenteric defect. Moderate mesenteric lymphadenopathy, with enlarged lymph nodes in the region of the herniated small intestine, were associated with positive testing for human metapneumovirus and enterovirus. Transmesenteric hernias are a very rare form of internal her...
Source: Forensic Science, Medicine, and Pathology - August 1, 2018 Category: Forensic Medicine Source Type: research

The detection and identification of saliva in forensic samples by RT-LAMP
We report on a novel method for saliva identification by reverse transcription-loop-mediated isothermal amplification (RT-LAMP). In our previous report, real-time RT-LAMP was used for blood identification by using HBB detection as a model but in this advanced study, this method was refined for the identification of the more challenging body fluid of saliva. Expression of the18S rRNA gene was used as the internal control and the Statherin (STATH) gene as the saliva-specific marker. A turbidimeter was used for real-time detection of the RT-LAMP products, and confirmation was obtained that the real products were generated usi...
Source: Forensic Science, Medicine, and Pathology - July 30, 2018 Category: Forensic Medicine Source Type: research

Rhabdomyolysis observed at forensic autopsy: a series of 52 cases
This study analyzed 52 cases with rhabdomyolysis and applied myoglobin immunohistochemistry to kidney, urine and blood samples. We found that blunt force injuries were the most common cause of rhabdomyolysis across all age groups, and drugs were the second most common cause. The drugs included ketamines, amphetamines, synthetic cathinones, entheogens, benzodiazepines, opioid analgesics, and anesthesia. Less than 60% of our cases had biochemical data, including myoglobin (92.5~416,978  ng/mL), creatine kinase (220~774,015 U/L), potassium (1.6~10.3 meq/L), calcium (2.7~29.2 mg/dL), and phosphorus (2.6~14....
Source: Forensic Science, Medicine, and Pathology - July 28, 2018 Category: Forensic Medicine Source Type: research

An unusual case of mycobacterium tuberculous coronary arteritis and thrombosis resulting in acute myocardial infarction
AbstractTuberculosis (TB) is a prevalent infection worldwide and an endemic infection in Singapore. The most common presentation is that of pulmonary tuberculosis. Extra pulmonary tuberculosis usually involves the lymph nodes, pleura, central nervous system, or abdominal cavity. Involvement of the heart is rare (0.14 –2% of TB cases), and when it is involved, it tends to be in the pericardium or myocardium. Here, a rare case of sudden death due to tuberculous coronary arteritis with tuberculous coronary thrombosis resulting in acute myocardial infarction is presented. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - July 10, 2018 Category: Forensic Medicine Source Type: research

Investigation into the potential for post-mortem formation of carboxyhemoglobin in bodies retrieved from fires
AbstractThe forensic investigation of a deceased person retrieved following a fire includes measuring carboxyhemoglobin. A carboxyhemoglobin saturation above 10% is considered indicative of respiration during a fire, implying the person had been alive. This relies on the assumption that carbon monoxide will not diffuse into blood used for toxicological analysis. This project investigated the potential for carbon monoxide to passively diffuse into a body and if carboxyhemoglobin levels could become elevated post-mortem. Stillborn piglets with intact skin were exposed to carbon monoxide. Carboxyhemoglobin formed in the hypos...
Source: Forensic Science, Medicine, and Pathology - July 4, 2018 Category: Forensic Medicine Source Type: research

The effectiveness of decontamination procedures used in forensic hair analysis
AbstractHair is a mainstream specimen used in forensic toxicology to determine drug use and exposure. However, the interpretation of an analytical hair result can be complicated by the presence of external drug contamination. Decontamination procedures are included in hair analysis methods to remove external contamination, but the capacity of these washes to completely remove contamination for all drugs is controversial. It is evident that there is no consensus on the most effective decontamination procedure, nor can decontamination procedures consistently remove external drug contamination to less than reportable cut-offs...
Source: Forensic Science, Medicine, and Pathology - July 3, 2018 Category: Forensic Medicine Source Type: research

Cardiac and skeletal muscle effects of electrical weapons
AbstractConducted Electrical Weapons (CEWs) are being used as the preferred non-lethal force option for police and special forces worldwide. This new technology challenges an exposed opponent similarly to the way they would be challenged by physical exercise combined with emotional stress. While adrenergic and metabolic effects have been meta-analyzed and reviewed, there has been no systematic review of the effects of CEWs on skeletal and cardiac muscle. A systematic and careful search of the MedLine database was performed to find publications describing pathophysiological cardiac and skeletal muscle effects of CEWs. For s...
Source: Forensic Science, Medicine, and Pathology - June 28, 2018 Category: Forensic Medicine Source Type: research

Lymphoma in autopsy cases
AbstractLymphoproliferative disorders cause significant morbidity and mortality, either related to the disease itself or therapy complications. Some cases of lymphoma may have vague clinical presentation, especially in the absence of lymphadenopathy, and a clinical work up may not be conclusive. Our study focuses on autopsy cases of lymphoma patients, emphasizing clinically unsuspected cases. Autopsy records from the last 20  years at our institution were searched, and the clinical parameters were recorded. Fifteen cases of lymphoma were identified, and 5 cases were diagnosed at the time of autopsy. Most B-cell lympho...
Source: Forensic Science, Medicine, and Pathology - June 23, 2018 Category: Forensic Medicine Source Type: research

Characteristics of sauna deaths in Korea in relation to different blood alcohol concentrations
AbstractAlthough the benefits of sauna bathing have been demonstrated in epidemiological studies, sauna deaths have been reported. The aim of this study was to determine the demographic and forensic characteristics associated with different blood alcohol concentrations (BACs) in sauna deaths in Korea. In this retrospective analysis, data were collected from a nationwide pool in Korea between January 2008 and December 2015 to determine the role of alcohol intoxication in sauna deaths based on the subjects ’ BAC and to evaluate the demographic and forensic characteristics associated with different BACs. One hundred and...
Source: Forensic Science, Medicine, and Pathology - June 21, 2018 Category: Forensic Medicine Source Type: research

Sudden death from acute epiglottitis in a toddler
AbstractThe bacteriumHaemophilus influenzae type b (Hib) can cause severe and life-threatening infections such as epiglottitis and meningitis. The course of the disease can be very rapid, resulting in sudden death. The incidence of Hib-induced epiglottitis in children has declined since the introduction of vaccinations in countries where such vaccinations are routinely administered. We herein present a case involving a 2.5-year-old boy who died suddenly at home. He had developed acute-onset throat and abdominal pain and a high fever. Despite an emergency cricothyrotomy due to a complicated intubation because of a massively...
Source: Forensic Science, Medicine, and Pathology - June 20, 2018 Category: Forensic Medicine Source Type: research

Neurofibromatosis 1 and massive hemothorax: a fatal combination
We report a fatal case of massive hemothorax due to a spontaneous rupture of the left pulmonary artery branch micro-aneurysm in a NF 1 patient. Indeed, spontaneous rupture of these pathologic vessels is very rare in clinical practice and the literature, but, for its potentially life-threatening complications, there is the need for it to be taken into account in differential diagnosis. The origin of bleeding was first confirmed by computed tomography angiography (CTA). The patient ’s condition worsened suddenly leading to pulmonary hemorrhage and death. A clinical autopsy was required to assess the definitive cause of...
Source: Forensic Science, Medicine, and Pathology - June 20, 2018 Category: Forensic Medicine Source Type: research

Delayed rupture of a vertebral artery laceration: a case report and challenges for the forensic pathologist
AbstractVertebral artery laceration/dissection (VALD) resulting in fatal subarachnoid hemorrhage (SAH) is a rare, but well-known phenomenon encountered in the forensic setting. Delayed ruptures are exceptionally rare, and pose several challenges to the forensic pathologist. In this paper we present a case of a 47-year-old male who collapsed suddenly following recent complaints of a headache and a reported seizure. He had a reported history of potential head trauma that occurred several days prior. Attempts at resuscitation were unsuccessful, and an autopsy examination was ordered. Computer tomography (CT), autopsy, histolo...
Source: Forensic Science, Medicine, and Pathology - June 20, 2018 Category: Forensic Medicine Source Type: research

Feasibility of analysis of the SCN5A gene in paraffin embedded samples in sudden infant death cases at the Pretoria Medico-Legal Laboratory, South Africa
This study shows the significant added value of u sing genetic testing in determining the cause of death in South African SUID cases. Considering the high heritability of these arrhythmic disorders, post mortem genetic testing could play an important role in the understanding of the pathogenesis thereof and could also aid in the diagnosis and treat ment of family members at risk, ultimately preventing similar future cases. (Source: Forensic Science, Medicine, and Pathology)
Source: Forensic Science, Medicine, and Pathology - June 16, 2018 Category: Forensic Medicine Source Type: research

Deep venous thrombosis, pulmonary embolism and long-distance flights
AbstractDeep vein thrombosis resulting in lethal pulmonary thromboembolism is not-infrequently encountered in forensic cases. Predisposing factors include immobility, recent surgery, previous deep venous thromboses/pulmonary thromboembolism, indwelling central venous lines, major trauma, the oral contraceptive pill, pregnancy, congenital cardiac disease, sepsis, malignancy, systemic lupus erythematosus, renal failure and certain inherited thrombophilias. Venous thrombosis associated with air travel was reported in the early 1950 ’s and called the “economy class syndrome”, although it is now recognized tha...
Source: Forensic Science, Medicine, and Pathology - June 11, 2018 Category: Forensic Medicine Source Type: research

Long QT syndrome KCNH2 mutation with sequential fetal and maternal sudden death
We report a case of a woman who experienced intrauterine fetal death at full term pregnancy, and then died suddenly soon after learning about the death of her fetus. At autopsy, previously undiagnosed neurofibromatosis and an adrenal gland pheochromocytoma were discovered in the mother. Genetic screening also revealed a novelKCNH2mutation in both fetus and mother indicating type 2 congenital long-QT syndrome (LQTS). A catecholamine surge was suspected as the precipitating event of fetal cardiac arrhythmia and sudden fetal death, while the addition of emotional stress provoked a lethal cardiac event in the mother. This case...
Source: Forensic Science, Medicine, and Pathology - June 8, 2018 Category: Forensic Medicine Source Type: research

Fatal unexpected death due to familial hemophagocytic lymphohistiocytosis type 3
AbstractFamilial hemophagocytic lymphohistiocytosis is a rare autosomal recessive disorder of immune dysregulation associated with uncontrolled activation of cytotoxic T cells and macrophages. Herein, we report a case of a 14-month-old Chinese boy who presented with fever, abdominal distension and thrombopenia, and died within 3 days of admission to the hospital. Postmortem examination revealed pleuroperitoneal fluid, enlarged mesenteric lymph nodes and hepatosplenomegaly. Histopathological examination showed interstitial pneumonia, hepatonecrosis and hemophagocytosis. Immunohistochemical staining of the spleen, lymph node...
Source: Forensic Science, Medicine, and Pathology - May 12, 2018 Category: Forensic Medicine Source Type: research

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