Forensic Pathology

This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the consequences of their use. Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage or retrieval system, without prior permission in writing from the publisher. The consent of CRC Press LLC does not extend to copying for general distribution, for promotion, for creating new works, or for resale. Specific permission must be obtained in writing from CRC Press LLC for such copying. Direct all inquiries to CRC Press LLC, 2000 Corporate Blvd., N.W.,

This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the consequences of their use. Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage or retrieval system, without prior permission in writing from the publisher. The consent of CRC Press LLC does not extend to copying for general distribution, for promotion, for creating new works, or for resale. Specific permission must be obtained in writing from CRC Press LLC for such copying. Direct all inquiries to CRC Press LLC, 2000 Corporate Blvd., N.W.,

This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the consequences of their use. Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage or retrieval system, without prior permission in writing from the publisher. The consent of CRC Press LLC does not extend to copying for general distribution, for promotion, for creating new works, or for resale. Specific permission must be obtained in writing from CRC Press LLC for such copying. Direct all inquiries to CRC Press LLC, 2000 Corporate Blvd., N.W.,

Traditionally, ethics consultations are conducted one case at a time. This typical approach addresses immediate needs pertinent to the case, but seldom looks toward preventing recurrences. The underlying problem is that clinical ethics and organizational ethics are still often regarded as separate areas with separate concerns. When it comes to ethics in health care, nothing helps clarify ideas like a case study. The autopsy case mentioned in this article demonstrates that clinical cases coming before an ethics committee are impeded in and influenced by a larger organizational context. The authors say that a "systems-oriented" perspective toward ethics consultation would help committee members view cases through the widest possible lens. This would enable committees to look at the larger system and thereby propose strategies for anticipated repeat problems.

For a long time, it has been thought that fresh and frozen tissues are the only possible source of biological material useful to extract nucleic acids suitable for downstream molecular analysis. Recently, for forensic purpose such as personal identification, also fixed tissues have been used to recover DNA molecules, whereas RNA extracted from such material is still considered too degraded for gene expression studies. In the present pilot study, we evaluated the possibility to use forensic formalin-fixed paraffin-embedded (FFPE) samples, collected at autopsy at different postmortem intervals (PMI) from four individuals, to perform advanced molecular analyses. In particular, we performed qualitative and quantitative analyses of total RNAs extracted from different FFPE tissues and put expression profiles in relation with the organ type and the duration of PMI. Different classes of RNA molecular targets were studied by real-time quantitative RT-PCR. We report molecular evidence that small RNAs are the only RNA molecules still detectable in all the FFPE autoptic tissues. In particular, microRNAs (miRNAs) represent a consistent, stable, and well-preserved molecular target detectable even from tissue sources displaying signs of ongoing putrefaction at autopsy. In this pilot study, we show that miRNAs could represent a highly sensitive and potentially useful forensic marker. Amplification of specific miRNAs using paraffin-embedded blocks could facilitate retrospective molecular analysis using specific forensic-archived tissues chosen as most suitable according to PMI, and this approach would address molecular evidence in forensic cases in which fresh or frozen material is no longer available.

Ubiquitin is a member of the heat shock protein family and is rapidly induced by various types of stimuli, including ischemic and mechanical stress. However, its significance in determining wound vitality of neck compression skin in forensic pathology remains unclear. We immunohistochemically examined the expression of ubiquitin in the neck skin samples to understand its forensic applicability in determining wound vitality. Skin samples were obtained from 53 cases of neck compression (hanging, 42 cases; strangulation, 11 cases) during forensic autopsies. Intact skin from the same individual was used as the control. Ubiquitin expression was detected in 73.9% of keratinocytes in intact skin samples, but only in 21.2% of keratinocytes in the compression regions, with statistical differences between the control and compression groups. This depletion in the case of neck compression may be caused by the impaired conversion of conjugated to free ubiquitin and failure of de novo ubiquitin s...

The medicolegal death investigation in Victoria, Australia is a traditional coroner system based on the model in England and Wales in the early 20th Century. In 1985, the first of a series of legislative amendments were made that proved the vanguard of reform of the coroners' jurisdictions in Australia. The Victorian Institute of Forensic Medicine (the Institute) was established by the Coroners Act 1985 (Vic.), now the Victorian Institute of Forensic Medicine Act 1985 (Vic.), to provide forensic pathology, medical, and related scientific services needed by the justice system. In addition to death investigation, other forensic and scientific services are performed by the Institute including: clinical medical examinations and support services for assault victims and perpetrators, forensic toxicology services and molecular biology, and anthropology and odontology services in relation to human identification. Medical and nursing staff provide medical information and support to famil...

This study aimed to provide the first checklist of forensically-important dipteran species in a rainforest environment in Northeastern Brazil, a region exposed to high rates of homicides. Using a decomposing pig, Sus scrofa L. (Artiodactyla: Suidae), carcass as a model, adult flies were collected immediately after death and in the early stages of carcass decomposition. To confirm actual colonization of the carcass, insects that completed their larval development on the resource were also collected and reared until adult stage. A diverse assemblage of dipterans composed of at least 28 species from seven families with necrophagous habits was observed within minutes after death. Besides Calliphoridae and Sarcophagidae, species from forensically-important families such as Phoridae, Anthomyiidae, and Fanniidae were also registered. Eleven species were shown to complete their development on the carcass. The majority of individuals emerged from larvae collected at the dry stage of decomposition. Hemilucilia segmentaria Fabricius (Diptera: Calliphoridae), H. semidiaphana (Rondani), and Ophyra chalcogaster (Wiedemann) (Muscidae) were the dominant species among the colonizers, which supports their importance as forensic evidence in Brazil.

Introduction Post-mortem computed tomography guided placement of co-axial introducer needles allows for the extraction of tissue and liquid samples for histological and toxicological analyses. Automation of this process can increase the accuracy and speed of the needle placement, thereby making it more feasible for routine examinations. To speed up the planning process and increase safety, we developed an algorithm that calculates an optimal entry point and end-effector orientation for a given target point, while taking constraints such as accessibility or bone collisions into account. Technique The algorithm identifies the best entry point for needle trajectories in three steps. First, the source CT data is prepared and bone as well as surface data are extracted and optimized. All vertices of the generated surface polygon are considered to be potential entry points. Second, all surface points are tested for validity within the defined hard constraints (reachability, bone collision as well as collision with other needles) and removed if invalid. All remaining vertices are reachable entry points and are rated with respect to needle insertion angle. Third, the vertex with the highest rating is selected as the final entry point, and the best end-effector rotation is calculated to avoid collisions with the body and already set needles. Discussion In most cases, the algorithm is sufficiently fast with approximately 5-6 s per entry point. This is the case if there is no collision between the end-effector and the body. If the end-effector has to be rotated to avoid collision, calculation times can increase up to 24 s due to the inefficient collision detection used here. In conclusion, the algorithm allows for fast and facilitated trajectory planning in forensic imaging.

BackgroundThe Virtopsy project, a multi‐disciplinary project that involves forensic science, diagnostic imaging, computer science, automation technology, telematics and biomechanics, aims to develop new techniques to improve the outcome of forensic investigations. This paper presents a new approach in the field of minimally invasive virtual autopsy for a versatile robotic system that is able to perform three‐dimensional (3D) surface scans as well as post mortem image‐guided soft tissue biopsies.MethodsThe system consists of an industrial six‐axis robot with additional extensions (i.e. a linear axis to increase working space, a tool‐changing system and a dedicated safety system), a multi‐slice CT scanner with equipment for angiography, a digital photogrammetry and 3D optical surface‐scanning system, a 3D tracking system, and a biopsy end effector for automatic needle placement. A wax phantom was developed for biopsy accuracy tests.ResultsSurface scanning times were significantly redu...

In this paper we present the second prototype of a robotic system to be used in forensic medicine. The system is capable of performing automated surface documentation using photogrammetry, optical surface scanning and image-guided, post-mortem needle placement for tissue sampling, liquid sampling, or the placement of guide wires. The upgraded system includes workflow optimizations, an automatic tool-change mechanism, a new software module for trajectory planning and a fully automatic computed tomography-data-set registration algorithm. We tested the placement accuracy of the system by using a needle phantom with radiopaque markers as targets. The system is routinely used for surface documentation and resulted in 24 surface documentations over the course of 11 months. We performed accuracy tests for needle placement using a biopsy phantom, and the Virtobot placed introducer needles with an accuracy of 1.4 mm (±0.9 mm). The second prototype of the Virtobot system is an upgrade of the first prototype but mainly focuses on streamlining the workflow and increasing the level of automation and also has an easier user interface. These upgrades make the Virtobot a potentially valuable tool for case documentation in a scalpel-free setting that uses purely imaging techniques and minimally invasive procedures and is the next step toward the future of virtual autopsy.

Background Iatrogenic injury to the vertebral artery during posterior cervical fusion is a rare and potentially disastrous complication. Differentiating arterial from brisk venous bleeding would be ideal to assist in the intraoperative management. Definitive angiography is typically not feasible during most routine spine surgery. Case description We describe the case of a patient undergoing an occipitocervical fusion, where brisk bleeding was encountered during dissection of the CB lateral mass. While the dissection was thought to be superficial to critical structures, the nature of the hemorrhage could not be definitely determined by visual inspection by two senior surgeons. The hemorrhage did not readily cease with standard maneuvers such as, the application of various hemostatic agents. Simultaneous blood gas analysis was performed on samples obtained from the patient's radial artery and from the hemorrhage in the operative bed. Comparative analysis concluded that the bleeding encountered in the surgical field was venous in nature. Conclusion Blood gas analysis can be a useful adjunct in determining the nature of hemorrhage from vascular structures in spine surgery when visual inspection is indeterminate.

Background: Abdominal aortic aneurysm is a common disease of the elderly, with a complex etiology. The known risk factors for abdominal aortic aneurysm is age, male gender, presence of family history of AAA, presence of aneurysms elsewhere (especially at the femoral and popliteal artery), smoking, diabetes mellitus, atherosclerosis and hypertension. The aim of this study was to evaluate risk factors associated with operated abdominal aortic aneurysm in our center. Patients and Method: Our study population consisted of 210 patients who had been performed abdominal aortic aneurysm surgery between January 1998 and January 2010 in our clinic. The study was designed in a retrospective manner and all data were collected from hospital records. The patients were searched for diabetes mellitus, hypertension, age, gender, hyperlipidemia, atherosclerosis and smoking. Results: 187 of 210 patients male and 23 of 210 patients female. The mean age was 64,4±8,9. The most common risk factors were di...

Crisper cas 9 is a genome editing technology that can be used to modify Leuconostoc lactis to improve its ability and can also be of used for the production of other lactic acid bacteria to stop the production of lactic acid in a metabolic pathway and can also knock out the other products ' metabolic pathways such as lactate dehydrogenase. This process is done to increase the probiotic function of L. Lactis. For example, the C-T base editor. CBE and A-G b.e A.B.E can be used to inactivate multiple genes. Similarly, IdhD gene knocking and sdh4 introduced genes can be used to produce high optical purity l-lactic acid that has much importance in food , biopharmaceuticals, cosmetics and textiles. It can also be used to produce biodegradable products.

Review article that mentions production of biopharmaceuticals, textiles , probiotics and pharmaceuticals from Leuconostoc lactis species by crisper cas 9 genome editing to promote iso dehydrogenase activity and lactic acid fermentation activity to increase fermentation rate which is very helpful to mankind as it increase its edibles .

The complement system has a significant role in myocardial ischemia/reperfusion injury, being responsible for cell lysis and amplification of inflammatory response. In this context, several studies highlight that terminal complement complex C5b-9, also known as the membrane attack complex (MAC), is a significant contributor. The MAC functions were studied by many researchers analyzing the characteristics of its activation in myocardial infarction. Here, a systematic literature review was reported to evaluate the principal features, advantages, and limits (regarding the application) of complement components and MAC in post mortem settings to perform the diagnosis of myocardial ischemia/infarction. The review was performed according to specific inclusion and exclusion criteria, and a total of 26 studies were identified. Several methods studied MAC, and each study contributes to defining better how and when it affects the myocardial damage in ischemic/reperfusion injury. The articles w...

The post-mortem assessment of sepsis-related death can be carry out by many methods recently suggested as microbiological and biochemical investigations. In these cases, the cause of death is a multiple organ dysfunction due to a dysregulated inflammatory response occurring after the failure of infection control process. It was highlighted also that the heart can be a target organ in sepsis which determines the so-called septic cardiomyopathy characterized by myocardial depression. Several mechanisms to explain the pathophysiology of septic cardiomyopathy were suggested, but very few studies about the structural alterations of cardiac cells responsible for myocardial depression were carried out. The aim of this study was to evaluate whether sarcoglycans (SG) were involved in septic cardiac damage analyzing their expression in sepsis-related deaths and, particularly, if these proteins can be used as markers of septic myocardial dysfunction. Cases of septic-related death confirmed by clinical and autopsy records were investigated and compared to a control group of traumatic deaths. Indirect immunofluorescence analysis was performed to analyze α-SG, β-SG, δ-SG, ζ-SG, ε-SG, and γ-SG. Decrease of fluorescence staining pattern for all tested sarcoglycans was observed in the septic-related deaths compared to normal fluorescence staining pattern of control group. These results provide new findings about the myocytes structural alterations due to sepsis and suggest that these proteins could be used in forensic assessment of septic cardiomyopathy.

Bilateral symmetric bone nodules were observed in the anterolateral first ribs of an infant with shaking injuries at autopsy. The ___location prompted diagnostic considerations of healing fractures versus anomalous articulations with pseudarthroses. The forensic pathologist worked with forensic anthropologists and pediatric radiologists to evaluate autopsy findings and compare premortem and postmortem X‐rays. Gross examination of the bones by the pathologist and anthropologists confirmed bilateral, callus‐like bone nodules in first‐rib locations associated with pseudarthroses. Histologic examination of one of the bones further showed features most consistent with pseudarthrosis, not a healing fracture. Radiologists then compared multiple premortem and postmortem radiographs that showed no remodeling of the bone over a 2‐week interval between the time of injury and death, which would be unexpected for a healing fracture in an infant. This multidisciplinary approach resulted in the appro...

Sharp force trauma research lacks agreement on reported error rates for correctly identifying toolmark characteristics on bone and cartilage. This study provides error rates for determining blade class (serrated, partially serrated, nonserrated) and type of edge bevel (left, right, even). Three analysts examined cuts to a wax medium, cartilage, and bone using two types of microscopes. Additionally, the observers examined impressions taken from the wax medium and the cartilage. Overall, a total of 504 observations were performed. Serrated blades were distinguishable from nonserrated blades due to their patterned striations. Some difficulties were encountered in distinguishing serrated and partially serrated blades; however, when these groups were considered together as one classification type (serrated), classification accuracy improved from 79% to 96%. Classification accuracy for edge bevel was 65%. Error rates were similar when comparing direct observation of the cut marks versus i...

Autopsy is of great significance for elucidating the pathological changes, pathogenesis and cause of death of Coronavirus Disease 2019 (COVID-19) and can provide a theoretical basis for scientific and accurate prevention and control of its outbreak. Based on related laws and regulations, such as the Law of the People's Republic of China on Prevention and Control of Infectious Diseases, clinical manifestations and epidemiological characteristics of COVID-19 and guidelines on the prevention and control of this epidemic, combined with the practical work of forensic pathology examinations, we developed the Guide to Forensic Pathology Practice for Death Cases Related to Coronavirus Disease 2019 (COVID-19) (Trial Draft). This guide describes the background investigation of the death cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy practices and auxiliary examinations, and thus offers a reference for forensic and pathological examination institutions and staff.

Descartes’ın ben kavramı modern rasyonalist düşünce içerisinde bir ayrımın temel nosyonudur. Bu ayrım kökenlerini düşüncenin ben kavramından bağımsız olup olamayacağı konusuna dair aldığı pozisyonlarda kendisini gelişmiştir. Descartes, bu ayrımın bir kutbunu düşüncenin bir benden bağımsız olamayacağını savunarak oluştururken, bu ayrımın diğer kutbunu ise Spinoza, düşüncenin bensiz tözün bir niteliği olarak tasarımlamasıyla oluşturur. Bu ayrım, ben kavramının düşüncedeki rolü noktasında belirirken, özne olmaklık düşünüldüğünde düşüncenin özneye ait bir nitelik olduğu konusunda yok olur. Bu ayrımın daha belirgin kılınması için Spinoza bize düşünce ve ben ilişkisinin bir kritiğini sunmaz, ama tözün özne olarak tasarımlanması ben kavramını içermediği için, ben içermeyen bir düşünen özne kavramını sessizce kabulünün bir olanağını sunar. Bu nedenle Spinoza’da düşünmenin bensiz kavranması gerektiği fikrinin zemini ben kritiği içermediği için Descartes’ın düşünme ve ben ilişkisine eleştirel bir alternatif oluşturma noktasında yetersizdir. Bu eleştiri, modern rasyonalist geleneğin takipçisi bir diğer rasyonalist Hegel tarafından düşüncenin benden yalıtık bir biçimde olması gerektiğinin yeterli ve zorunlu nedenlerini gösterdiği önvarsayımsız felsefe konusundaki fikirleriyle Mantık Bilimi’nde giderilecektir. Bu metin, Spinoza’daki iddia edilen Kartezyen ben kritiği eksikliğinin, Hegel’in önerdiği önvarsayımsız felsefe düşüncesiyle giderilebileceği iddia edilecektir.

The last few decades have seen the emergence of forensic imaging, both clinical and post-mortem. Year after year, the scientific community has refined the radiological tools that can be used for post-mortem and clinical forensic purposes. As a result, scientific societies have published recommendations that are essential for the daily work of forensic imaging.
This third part of the review of the current state of forensic imaging describes these recommended radiological tools and also presents an overview of the various international guidelines dealing with post mortem imaging that can be found in the literature or that have been written by scientific societies.

Over the last few decades, forensic imaging has become an essential part of current forensic practice. The aim of this 4-part review is to provide a comprehensive overview of forensic imaging over the first 25 years of this century. After a brief historic review, this first part details the advantages and limitations of post-mortem imaging for the indications most frequently encountered in daily practice.

This fourth part of the review of the current state of forensic imaging describes the future potential influence of artificial intelligence in forensic imaging. In addition to this important point, training in forensic imaging is discussed in detail, as are the documentation possibilities offered by non-conventional imaging tools such as photography, photogrammetry, 3D surface scanning and 3D print casts.

Medical examiners provide critical diagnostic and testimonial information in abusive head trauma cases. Courtroom challenges to these diagnostic criteria and contested expert testimony have raised concerns about ethical and professional conduct of practitioners. Legal evidentiary standards for expert testimony, ethical guidelines established by medical organizations, and proposed standards for ethical practice provide a background for examination of several common challenges and testimonial claims in these cases.

Introduction: CSI is an investigation into a 'suspicious incident' where there is an alleged criminality. Although the primary investigator is the police, CSI is a team effort and services of various experts are obtained to collect evidence in its pristine state. Objective: To determine the percentage and type of crime scene investigations where medical officers input was obtained and to evaluate the type of contribution by medical experts. Method: A retrospective descriptive study was carried on all CSI of alleged murder cases that Police SOCO Unit Sapugaskanda attended from 1 st of January 2008 to 31 st August 2009. An interviewer administered questionnaire was designed where answering was based on data from case notes, personal experiences of the SOCO officers and one opinion question. The questionnaire was first assessed for face and content validity in 10 cases. Results: Out of 78 CSI conducted 3 incidents had multiple deaths (n-16 & 4) where two were bomb explosions. 23%, 21% & 17% were from sharp force trauma, explosions and firearms respectively. In 13% of cases causative factor was not obvious to SOCO officers. Half of the cases (n-39) were informed during morning hours and police records stated 98% were attended within 30minutes. JMO was called for 11 incidents varying from explosion(1), asphyxia(3), sharp force(2), burn(1), skeletal remains(1) to not known(3). The reason for calling was to get assistance in interpreting injuries and advice on further investigation in 67% of cases. Question on SOCO officer's opinion on expert opinion of JMO resulted 100% satisfaction. The practice of producing CSI photographs to the JMO was not conducted in a uniform manner. CSIs that were attended by JMOs resulted in satisfactory address of issues. If the practice of viewing of digital scene visit photos prior or after autopsy is regularized with routine reviews, quality of medical expert input will increase.

Peripheral quantitative computed tomography (pQCT) has found new fields of application in bone medicine, but none of them concerns the forensic practice. This study exposes the potential of pQCT applied to a penetrating lesion in a vertebral body. A pQCT scanner was used for the measurements (XCT Research SA+; Stratec Medizintechnik GmbH, Pforzheim, Germany). A more precise reconstruction of the path of the lesion within the trabecular bone was reached, with more details concerning the morphological characteristics of the lesion inside the vertebral body, and the elaboration of a 3D model was created, which allowed the operator to define the volume of the lack of tissues related to the lesion. The application of pQCT scan proved to be a potentially useful tool for the assessment of bone lesions, although further studies are needed in order to verify its applicability to forensic context.

Context vital forensic clues can be found in decomposed remains, but their determination is made all the more difficult by the effects of decomposition essentially making it the bad guy in any autopsy of decomposed bodies.
Accurate forensics has suffered, in part, because the means of doing it have always been underfunded and the ways of determining clues, inadequately studied. Yet here is an effort to change that.
For this study, 43 cases of decomposition that had undergone autopsy at
GMCH Sundargarh between June 2022 and May 2024 were analysed. The
identified stages of decomposition in our cases were early, moderate, and
advanced; we then gathered demographic data and other information from
autopsy of each case. We statistically assessed this information, along with findings from the autopsies, to reach some conclusions about our cases. In this study of 43 cases, 74.4% of the individuals were aged 18 60 years, and 79.1% were male. The breakdown of decomposition occurrences revealed that the majority were found in summer (69.8%). Determining the cause of death proved elusive, with 30.2% of cases being undetermined. The next most frequent ascertainable cause was asphyxia, which was listed for 20.9% of the cases; roughly the same number died from non-penetrating, cranio-cerebral injuries. Overall, the most cases of decomposition had been severely invaded by insects and wild animals (79.1%).
This study emphasizes the intricacies associated with determining the cause of death in remains that have undergone decomposition. It underscores the necessity of employing advanced analytic techniques and an interdisciplinary approach to bolster the effectiveness of death investigations when the body has decayed.

Background: Sudden natural death represents a critical area of medical and forensic investigation, encompassing instances where death occurs suddenly without preceding symptoms. Despite advancements in diagnostic techniques, sudden natural deaths continue to pose significant challenges, particularly in understanding their underlying causes and associated risk factors. The study aimed to determine the causes of sudden natural death and assess the epidemiological and sociodemographic parameters linked to it. Methods: A cross-sectional study was conducted. Data were collected from various sources including inquest reports, autopsy records, and histopathological examinations. Results: Among the 250 cases (35.87%) identified as sudden deaths, with males constituting 86% of the cases compared to females at 14%. The demographic distribution showed a predominance of Hindus (60%), followed by Muslims (30%) and Christians (10%). Geographically, approximately two-thirds of cases originated from rural areas. Cardiovascular disease emerged as the leading cause (40%), with myocardial infarction being the most prevalent subtype. Other significant causes included cerebrovascular accidents, pulmonary embolism, respiratory, gastrointestinal, and central nervous system causes. Conclusion: This study provides valuable insights into the demographics, place of occurrence, and causes of sudden natural deaths. Understanding these factors is crucial for implementing effective preventive strategies and improving access to timely medical care, particularly in rural and residential settings. Recommendations: Based on the findings, recommendations include the implementation of targeted preventive measures to address modifiable risk factors for cardiovascular disease, enhancing access to healthcare facilities in rural areas, and promoting awareness about the signs and symptoms of sudden natural death among the general population.

Fire gun euthanasia is a widely used method on Equine Infectious Anemia positive horses in Brazil. Death occurs by massive destruction of brain tissue and the degree of damage depends on the gun, projectile, and shooting precision. Cranial bone lesions of eight horses euthanized and brain lesions on two of those animals were evaluated. This study aimed to verify the applicability and efficiency of the method and to check the lesions features, with emphasis on fatal ones, found mainly in frontal, sphenoid and occipital bones, and on cerebral hemispheres, thalamus, hypothalamus, and brain stem. Difficulties in applying the method for grouped animals were identified. Injuries that caused immediate stunning were related to only one shot and the gun and ammunition used were effective for the purpose.

Aneurysma levé komory je jednou z nejvýznamnějších komplikací infarktu myokardu; předpokládá se, že k jeho tvorbě dochází u 5-10 % všech osob s akutním infarktem myokardu. Kasuistika: Padesátiletý muž s anamnézou chronické nadměrné konzumace alkoholu a rizikovými faktory ischemické choroby srdeční byl dvakrát vyšetřen v krajské nemocnici pro srdeční selhání. V prvním případě nebylo echokardiografi cké vyšetření provedeno. O tři roky později byl dopraven na oddělení urgentního příjmu s bolestí na hrudi jako hlavní zdravotní obtíží. Echokardiografi cké vyšetření prokázalo jizvu zadní stěny levé komory s aneurysmatem na jeho bazální části, kde byl rovněž přítomen trombus. Následné vyšetření transezofageální echokardiografi í potvrdilo rupturu komisurálních šlašinek posteriorního cípu mitrální chlopně spolu s těžkou regurgitací. Vzhledem k těmto nálezům byl pacient odeslán na koronarografi cké vyšetření, které prokázalo ischemické postižení jedné koronární tepny. U pacienta byla následně provedena náhrada nativní mitrální chlopně mechanickou spolu s odstraněním aneurysmatu v levé komoře. Závěr: Vzhledem k anamnéze nadměrné konzumace alkoholu je pravděpodobné, že u nemocného proběhl němý infarkt myokardu zadní stěny (bazální) komplikovaný vznikem aneurysmatu na stěně levé komory.

The National Institute on Drug Abuse has observed an increase in fentanyl deaths in the United States. One epidemic related to the abuse of fentanyl happened in Cook County in 2005-2007 (350 deaths). Another outbreak of fentanyl deaths occurred in 2015-2017 in the same area. The database of the Cook County Medical Examiner's Office was searched for cases of fentanyl deaths between 2015 and 2017: 1244 deaths were found. A comparison was performed with the previous data: an increase in the number of females was observed in 2015 -2017 . Also, in 2005, the majority of deaths occurred among African American, while in 2015-2017, Caucasians were more involved. Within our population, some drug combinations were more common in specific demographic subgroups (male/females; Caucasian/ African American; and certain age groups). The epidemiology and the most significant drug associations found at the toxicology are discussed, highlighting the usefulness of the knowledge about this outbreak for public health.

The use of postmortem computed tomography (PMCT) to support autopsy pathology has increased in recent decades. To some extent, PMCT has also been contemplated as a potential alternative to conventional postmortem examination. The purpose of this study was to investigate the ability of PMCT to detect specific pathologic findings in the head and brain in natural hospital deaths. We examined postmortem CT images and autopsy data from 31 subjects who died at SUNY (State University of New York) Upstate University Hospital between 2013 and 2018. Each subject underwent a noncontrast PMCT and a traditional autopsy. A neuroradiologist analyzed PMCT images for head and brain abnormalities. The autopsies were performed by pathologists who were aware of the radiology results. In our series, PMCT was able to detect the majority of the significant space-occupying lesions, although it was not always reliable in ascertaining their nature. Postmortem computed tomography revealed findings usually cha...

Deaths from sharp force injuries are a significant cause of violent death. While homicides and suicides caused by sharp force wounds are common, accidental injuries are less often described in forensic literature, so their actual incidence or prevalence is not known. This paper presents an accidental death due to massive blood loss which resulted from lesions to the left femoral vessels by glass fragments. The body was found in a pool of blood surrounded by hundreds of glass fragments. Autopsy revealed a near-total transection of the superficial femoral artery, and two wounds of the superficial femoral vein. In case of accidental sharp force injuries, a thorough medico-legal process, including death scene investigation, autopsy examination and toxicological analyses, is always necessary to determine the manner of death.

Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathological relationship in causing death is requested. Hemopericardium and cardiac tamponade can be evaluated in living people using radiological techniques, in particular computer tomography (CT). Only a few studies are reported in literature involving post-mortem (PM) cases, where PMCT imaging has been used in order to investigate acute hemopericardium, and they have shown a good accuracy of this technique. Here we report a case involving a 70-year-old white male found dead on the beach, with a medical history of hepatitis C and chronic hypertension with a poor pharmacological response. A PMCT was performed about 3 h after the discovery of the body. The PMCT examination showed an intrapericardial aortic dissection associated to a periaortic hematoma, a sickle-shaped intramural hematoma, a false lumen, and a hemopericardium consisting in fluid and clotted blo...

The National Institute on Drug Abuse has observed an increase in fentanyl deaths in the United States. One epidemic related to the abuse of fentanyl happened in Cook County in 2005-2007 (350 deaths). Another outbreak of fentanyl deaths occurred in 2015-2017 in the same area. The database of the Cook County Medical Examiner's Office was searched for cases of fentanyl deaths between 2015 and 2017: 1244 deaths were found. A comparison was performed with the previous data: an increase in the number of females was observed in 2015 -2017 . Also, in 2005, the majority of deaths occurred among African American, while in 2015-2017, Caucasians were more involved. Within our population, some drug combinations were more common in specific demographic subgroups (male/females; Caucasian/ African American; and certain age groups). The epidemiology and the most significant drug associations found at the toxicology are discussed, highlighting the usefulness of the knowledge about this outbreak for public health.

The authors present a single case report illustrating on the body of a newborn found on the seashore of the island of Mayotte in the Indian Ocean, the diagnostic difficulties inherent in the detection during the post-mortem scan of a voluminous highly radiopaque foreign body in the upper aerodigestive tract. The internal examination has highlighted black sand in abundance in the upper aerodigestive tract. The CT scanning of a sand sample from the lagoon shore confirmed its high-density radiopaque nature. In a specialized laboratory, the magnetic part of this sample was investigated by means of energy dispersive X-ray spectroscopy (EDS), powder X-ray diffraction (XRD), and Mossbauer spectroscopy. The mineral composition is dominantly magnetite (Fe3O4) but contrary to pure magnetite, a relevant fraction of titanium was detected. This case demonstrates how post-mortem CT may lead to inappropriate diagnosis and highlights the interest of the physicochemical study in the forensic context.

Ischemic heart disease is one of the leading causes of morbidity and mortality worldwide. Diagnosis of myocardial infarction (MI) can be a challenge, especially in the absence of acute coronary occlusion. Accurate histopathological identification and timing of myocardial infarction in humans are of particular importance, especially for clinical practice or for legal medicine. The post-mortem diagnosis requires not only up-to-date knowledge of coronary and myocardial ischemic pathology, but also a correct interpretation of these features in relation to the clinical scenario of the disease. For these reasons, it is important for pathologists to know the different clinical types of MI and to differentiate myocardial infarction from other forms of myocardial injury.

Falanga torture involves repetitive blunt trauma to the soles of the feet and typically leaves few detectable changes. Reduced elasticity in the heel pads has been reported as characteristic sequelae and palpatory testing of heel pad elasticity is therefore part of medicolegal assessment of alleged torture victims. The goal was to test the accuracy of two experienced investigators in determining whether a heel pad model was soft, medium or hard. The skin-to-bone distance in the models varied within the human range. Two blinded investigators independently palpated nine different heel pad models with three different elasticities combined with three different skin-to-bone distances in five consecutive trials and categorized the models as soft, medium or hard. Two experienced investigators were able to identify three known elasticities correctly in approximately two thirds of the cases. The skin-to-bone distance affected the accuracy. The use of clinical examination in documenting alleg...

The article presents results of a study on the correlation of histomorphometric parameters of the heart in case of death from alcoholic cardiomyopathy (ACM), ischemic heart disease (IHD) and mechanical injury (control group) by the method of correlation analysis. The previous studies show that normally with age, the myocardium of the sinoatrial node (SAN) is most worn out and fibrosed. In case of IHD the His bundles are most worn out and fibrosed. In case of ACM, histomorphological changes are uniform in all areas of the myocardium. This indicator can be used in practice when providing differential diagnosis of the above-described types of pathology and causes of death. In addition, the results of our study confirm that myocardial lipomatosis is more typical of ACM, which increases its diagnostic value.

A comprehensive series of tests were performed to determine how the gunshot angle of incidence will affect the amount and density of gunshot residue (GSR) upon a target. Test shots were performed at four different angles (0, 30, 45, and 60 degrees). Two handgun calibers (9mm & .45ACP) were included. Testing was at two distances (9"/23cm and 15"/38cm). All targets were photographed. The amount and density of the GSR was quantified using image analysis software and subjected to statistical analysis. The testing demonstrated that as the shooting angle increases from the orthogonal position, the amount and density of GSR on the target is diminished.