27 research outputs found

    Bladder irrigation and urothelium disruption: a reminder apropos of a case of fatal fluid absorption

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    Irrigation or washouts of the bladder are usually performed in various clinical settings. In the 1980s Elliot and colleagues argued that urothelial damage could occur after washouts and irrigations of the bladder. The exact mechanism underlying urothelial damage has not yet been discovered. To our knowledge, this is the first report of fatal fluid overload and pulmonary edema, due to urothelium disruption occurring during bladder irrigation, approached performing complete histological and immunohistochemical investigation on bladder specimens. The exposed case deserves attention since it demonstrates that, although very rarely, irrigation or washouts of the bladder may have unexpected serious clinical consequences

    A case of insect colonization before the death

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    Forensic entomology is a branch of forensic science in which insects are used as evidence in legal investigations relating to humans, domestic animals and wildlife. One of the theoretical pillars on which the discipline is based concerns the fact that flies colonize a body after death. However in cases of myiasis, maggots are present before death, with consequences in the correct estimation of the minimum postmortem interval (mPMI). We report here the case of a woman, largely colonized by fly larvae, who has lain alive in her garden for four days prior to being rescued. Larvae were found on the conjunctivae, the bronchi, the rectum and vagina. The woman's death, two months later, was caused by tetanus. The consequences of myiasis on mPMI estimation are here discussed. In fact, despite she was still alive larvae, indicated and estimated age of 1.5–2.5 days, based on environmental and body temperature

    Best Practice in Forensic Entomology - The sampling and storage of living blow fly larvae

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    Forensic entomology (FE) is one of the most important tools for estimating the time since death by analyzing the species composition and age of the necrophagous fauna on the dead body. Sampling, transferring and killing/storing of this insect evidence is a very important task in forensic entomology because different methods can influence survival and further rearing of the living samples in the laboratory or bias the morphological examination of the dead specimens. The majority of “Best Practices” and “Guidelines” in forensic entomology recommend that fly larvae, the most important group in FE, should kept under controlled or at least known conditions, most suitable at 2-6°C. They suggest in addition that larvae should be stored in vials with an air-permeable lid and that these vials should be equipped with coarse sawdust or paper for taking e.g. excretion liquids. Living samples should be then transport to an expert within 24 hours. While keeping the latter window of time is a realistic approach, cooling the samples or catering them during storage can be a difficult task for crime scene technicians or forensic pathologists. But neglecting guidelines or best practice recommendations could lead to a weakening of the entomological evidence at court or even its exclusion. However, so far it is not always clear whether and which of these recommendations are based on experiences, opinions or scientific proofed evidence. What happens if there was no ventilation or no appropriate cooling and catering? Is there any unusual mortality or altered development when reared in the laboratory for estimating their age? We stored all developmental stages of larvae (L1, L2 and L3) of the forensically relevant blow flies Lucilia sericata and Calliphora vicina at room temperature (~20°C) or in the refrigerator (5°C) for 16 hours without air, supply of food and sawdust. After that they were kept at 2-6°C in a Styrofoam box for 8 hours, simulating a transport situation. At the end of this treatment mortality rate was calculated and 25% of the surviving larvae were killed in hot but not boiling water, length measured and the remaining specimens were reared (25 °C) until all adults were hatched. A control group was created for every treatment. Results showed that the mortality rate is higher in room temperature groups vs fridge groups and L2-L3 vs L1 and they could suggest that if it is strongly necessary storing alive samplings without air conditions or food, they should be stored in fridge instead of room temperature and the latter is recommended only for larvae with size L1-L2 stages (~ 1 cm)

    Accidental Injury or “Shaken Elderly Syndrome”? Insights from a Case Report

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    Subdural haemorrhage (SDH) as result of a traumatic brain injury (TBI) is a common cause of death in cases of fatal physical abuse. Since intracranial bleeding is a common finding in elderly due to age-related intracranial changes or increasing prevalence of anticoagulant medication, differential diagnosis between inflicted and non-inflicted head injury is challenging. A case of an elderly woman’s death caused by TBI is reported. Autopsy showed multiple polychromatic bruises and a frontoparietal hematoma with bilateral subacute SDH. History excluded paraphysiological or pathological non-traumatic conditions that could justify SDH, while iatrogenic factors only played a contributory role. Since polychromatic bruises distributed on the face, the upper extremities and the chest were consistent with forceful grasping/gripping or repeated blows and SDH can form in absence of impact or by mild/minor blows, SDH was considered the result of repeated physical abuses. Differential diagnosis between traumatic and non-traumatic SDH is still challenging for forensic pathologists. As largely accepted in the pediatric population and occasionally described also in adults, however, violent shaking should be also considered as a possible mechanism of SDH—especially in elderly who do not have any sign of impact to the head

    L'apporto dell'entomologia alle scienze forensi: aspetti generali ed esperienza casistica

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    L'entomologia forense comprende tutti gli aspetti applicativi dello studio degli insetti che siano in qualche modo correlati a questioni di carattere legale. Dopo una breve introduzione a carattere storico-esplicativo della materia in esame e degli aspetti piĂą strettamente medico-legali, si procede alla discussione e all'approfondimento dell'esperienza casistica sviscerando le varie applicazioni e implicazioni dell'entomologia forense concludendo con la relativa discussione final

    Assessment of Cervical Skeletal Trauma: The Synergistic Contribution of Forensic and Clinical Medicine to a Case of Corpse Concealment

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    Fatal neck injuries represent a major challenge in forensic pathology because the anatomical complexity and high variability of neck structures make it often extremely difficult to differentiate true pathological findings from artifacts at autopsy. This topic becomes even more relevant when the forensic pathologist is required to make a pathophysiological evaluation of bone fractures in the absence of soft tissue to support the diagnosis. We report a case of unidentified, stone-covered, skeletonized human remains found within a pit below an abandoned building with bony lesions of the cervical spine and ribs, including a full-thickness fracture of the right lateral mass of the atlas (C1). After a careful study of the fractures was carried out by screening forensic literature and anthropological studies, clinical neurosurgical expertise was called upon to provide a reliable explanation. A rapid and violent twisting of the neck in the opposite direction from the fracture site by an attacker who pinned the victim’s torso is the scenario that most likely occurred in our case. This case report shows that the diagnosis of cervical spine injuries in skeletal remains should be the result of a multidisciplinary approach that integrates forensic, anthropological, and clinical expertise

    Assessment of Cervical Skeletal Trauma: The Synergistic Contribution of Forensic and Clinical Medicine to a Case of Corpse Concealment

    No full text
    Fatal neck injuries represent a major challenge in forensic pathology because the anatomical complexity and high variability of neck structures make it often extremely difficult to differentiate true pathological findings from artifacts at autopsy. This topic becomes even more relevant when the forensic pathologist is required to make a pathophysiological evaluation of bone fractures in the absence of soft tissue to support the diagnosis. We report a case of unidentified, stone-covered, skeletonized human remains found within a pit below an abandoned building with bony lesions of the cervical spine and ribs, including a full-thickness fracture of the right lateral mass of the atlas (C1). After a careful study of the fractures was carried out by screening forensic literature and anthropological studies, clinical neurosurgical expertise was called upon to provide a reliable explanation. A rapid and violent twisting of the neck in the opposite direction from the fracture site by an attacker who pinned the victim’s torso is the scenario that most likely occurred in our case. This case report shows that the diagnosis of cervical spine injuries in skeletal remains should be the result of a multidisciplinary approach that integrates forensic, anthropological, and clinical expertise
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