The Titan Submersible Tragedy: physiopathology of the death mechanism and the necessity of prevention for Deep Sea Explorations

This paper examines the physiopathology of death in the tragedy of the Titan submersible in the light of knowledge on barotrauma and established forensic literature. It also offers practical views on preventive measures against such public health risks. The aim of the work is to reconstruct from a medico-legal point of view the plausible manner of death considering the location and the high depth in the sea reached by the submersible. The case shows the significant environmental risks related to the marine environment at great depths, such as barotrauma and hypothermia, emphasizing the need to prevent these events with strict and suitable safety measures

Sudden death due to fulminant lymphocytic myocarditis with atypical prodromal symptoms

Diagnosis of myocarditis is complex because it is not always preceded by clear symptoms. We report the case of a woman who died suddenly. Autopsy and histopathological investigations revealed a lymphocytic myocarditis. Clinical history showed the patient went to the hospital some days before for joint pain and low-grade fever

Violent behaviors and Klinefelter syndrome: Two forensic cases from the past to the future

Klinefelter Syndrome (KS) (XXY) is the most common sex-chromosome aberration among men. The cognitive phenotype includes language learning problems, mental retardation, and psychiatric disorders. Patients can show criminal personality and psychosocial problems. The most common offences reported are sexual abuse, arson, burglary, homicide, drug-related crimes. KS very often goes under-diagnosed. The aim of our study is to verify the hypothesis of correlation between chromosomal abnormalities and criminal behaviors through the analysis of a forensic case of uxoricide/suicide. We report the case of an old man, found dead in his cottage with a gun in the right hand. Judicial inspection demonstrated suicidal single gunshot injuries. Data analysis highlighted a personal story of uxoricide. Autopsy investigation showed the typical KS phenotype. The post-mortem clinical diagnosis was confirmed through the genetic analysis of the karyotype. The retrospective analysis of literature with this case showed a possible correlation between KS and psychiatric traits, with criminal personality and sexual disorders

Morphological and genetic aspects of Marfan Syndrome as demonstrated by a case of death during pregnancy with the discovery of two de novo missense mutations in the FBN1 gene

Marfan Syndrome (MFS) is an autosomal dominant disease caused in most cases by mutations in the FNB1 gene, which encodes for fibrillin 1. MFS does not alway shows typical phenotypic signs. Indeed, the occurrence of sudden death of unknown cause is increasingly seen in young adults without ante mortem preexisting pathology to explain the event. In many cases the diagnosis of Marfan Syndrome (MFS) is carried out post mortem, especially in cases where the disease’s external phenotype is absent. Here is reported a case of a young woman who died during a twin pregnancy investigated with medico-legal and forensic anthropological procedures. The autopsy showed the absence of a typical marfanoid habitus and the presence of a dissecting aneurysm of the aorta with histopathological degeneration of the aortic elastic fibers. The genetic investigation revealed two previously undetected de novo mutations of the FBN1 gene: c.T6181C: p.C2061R and c.G1415A: p.C472Y. This new mutations, together with a comprehensive analysis, demonstrates the existence of a causal relationship between these mutations and the dissecting aneurysm of the aorta. This also stresses the importance of a combined multidisciplinary approach to this condition which includes morphological and genetic studies

Management of the corpse with suspect, probable or confirmed COVID-19 respiratory infection \u2013 Italian interim recommendations for personnel potentially exposed to material from corpses, including body fluids, in morgue structures and during autopsy practice.

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IL RUOLO E LE APPLICAZIONI FORENSI DELLA PROTEOMICA NELLO STUDIO DEL POST MORTEM INTERVAL: DALL’EPOCA ALL’ORA DELLA MORTE. I RISULTATI DI UNO STUDIO SPERIMENTALE PRELIMINARE

Time of death represents a real challenge in forensic research. To date, the PMI (Post Mortem Interval) estimation is still carried out by analyzing abiotic and transformative cadaveric processes. However, the diagnosis of time of death is not always accurate because of multiple variables that can affect its proper retrodation. In order to reduce the degree of approximation of the calculation, many authors suggested the application of various approaches in the fields of biochemistry and molecular biology, including DNA, RNA, microRNA, and protein analysis. In particular, several studies investigated the quantitative and qualitative variations of protein expression on postmortem biological samples at certain time intervals, both on animals and humans. The aim of this review is to examine all the forensic literature published over the last 20 years regarding the application of proteomics in the calculation of PMI. The review was performed according to specific inclusion and exclusion criteria. This review highlights the validity of some markers as "proteic timers", considering the results on the evidences obtained in the early post-mortem interval on the muscle, brain, and blood. This study demonstrates how proteomics can be a valuable tool for estimating the PMI, although there are still technical limits in the analysis performed on humans, mainly due to the inability to obtain samples from the precise moment of death. This limitation would be crucial in achieving high specificity and sensitivity of the markers obtained so far from research in this field

The Effects of COVID-19 Pandemic on Public Mental Health: State of Art and Future Perspectives

The COVID-19 pandemic has radically changed our lives in every way [...

Sexual abuse and mental disorders: The dark side of violence

Rape and sexual violence occur in all social classes and societies. In most cases, the sexual offenders are known to the victim and the majority of rapes happen in intimate relationships. Children are particularly vulnerable to sexual abuse, in particular, the female sex. The sexual abuse of minors is defined as “any sexual activities that an adult carries on or with a person under the age of consent.” Literature evidence that the prevalence of any type of violence among women with disabilities varies between 26.0% and 90.0%, compared to nondisabled women, showing that people with disabilities have an increased risk of suffering physical and sexual violence. Children with intellectual disabilities (ID) show a high risk of sexual victimization. The World Health Organization presently defines mental retardation as “a significantly reduced ability to understand new or complex information and to learn and apply new skills (impaired intelligence). This results in a reduced ability to cope independently (impaired social functioning), and begins before adulthood, with a lasting effect on development.” The aim of this study is to investigate the correct identification of sexual abuse and severe mental retardation through the collaboration of a team of experts (forensic pathologist, psychiatrist, psychologist, gynecologist, pediatrician, and social worker). We present a case of a 12-year-old female child, who suffers from severe mental retardation and was the victim of rape by a 79-year-old man. The study shows the difficulties in discovering episodes of sexual abuse among children affected by ID by evidencing the importance of adequate analysis through a multidisciplinary approach. The work focuses on the need to improve knowledge about medical and forensic investigations through proper protocols, for early recognition and appropriate management of these complicated cases

Hospital Restraints: Safe or Dangerous? A Case of Hospital Death Due to Asphyxia from the Use of Mechanical Restraints

Asphyxia can be defined as an impediment to the influx of air into the respiratory tract, leading to tissue hypoxia. By restraint, we mean the use of physical, pharmacological and/or environmental means to limit the subject’s ability to move. Fall prevention is the main reason restraint is used. Unfortunately, restraint can sometimes be fatal. There are few studies in the literature on this subject. We report the case of a man with Down syndrome in a psychiatric clinic found dead between the bed and the floor of the room where he was hospitalized. The analysis of the scene showed the presence of a means of a restraint, located around the man’s chest and neck, which kept him tied to the bed and applied a constricting mechanical action. There was doubt as to the cause of death. For this reason, an inspection of the scene and an autopsy were carried out. Upon opening the chest, blood infiltration of the left intercostal muscles that was topographically compatible with external cutaneous excoriation (sign of restraint) became evident. In view of the danger of using restraint, it is necessary to evaluate the means of restraint as an extraordinary and not an ordinary procedure in patient management. Each patient undergoing restraint measures must be carefully monitored by specialized personnel. Greater surveillance of the nurse/patient ratio is necessary to reduce the use of restraints. In this case report, we highlight the lack of surveillance of patients subjected to restraint