Forensic aspects of non-traumatic intracerebral hemorrhage: a case report

Grigore T. Popa University of Medicine and Pharmacy, Iasi, RomaniaBackground. Cases when unexpected death occurs, when the patient is in apparent health or the event comes during presumably normal activity, especially when it is unwitnessed or when the victim is found without apparent signs of foul play, may pose a significant challenge to the coroner in reaching a proper determination of the cause and the manner of death. Spontaneous intracerebral hemorrhage (ICH) is a bleeding into the parenchyma of the brain and accounts for approximately 10 % to 20 % of all strokes. ICH is a multi-factorial disease caused by several interacting and overlapping risk factors and etiologies. When massive ICH, not connected with head trauma, has occurred, and it is multifocal or not located in one of the typical sites for hypertensive hemorrhage, one of a multitude of other causes must be suspected. High alcohol intake increases the risk of all stroke subtypes and of the development of liver diseases and may induce hypertension, by affecting brain function and producing a series of alcohol-related or alcohol caused diseases and is associated with changes in the coagulation system. Liver cirrhosis is a well-known risk factor for ICH, due to impaired coagulation, despite the relatively rare occurrence of ICH in cirrhotic patients

Homicidal Act Commited by an Elderly Person with Sexual Dysfunction - Case Report

Sexual dysfunctions (SDs) are highly prevalent with aging. Studies reported an interactive correlation between psychiatric morbidity and SD. Also, SDs have significant influence on patients` self-esteem, body image, interpersonal relationships, and physical health in general. The aim of the present research is to present an intimate partner homicide case and to discuss a possible correlation between SDs of elderly patients and their inclination towards aggressive behavior from intimate partner violence (IPV).A forensic psychiatric assessment was performed on a married male patient, aged 61. He was diagnosed and treated for BPH and he could no longer have sexual intercourse. Using a knife, he provoked over 20 stab wounds to his wife, who died following the attack. He admitted that he was jealous, due to his wife having an affair. The psychiatric forensic expertise found that the killing was committed with discernment.Psychological states found in IPV perpetrators are partly like those met in SDs patients. The relation between SDs in older adults and aggressive behavior, especially IPV, requires further research. In the case discussed, a complex of negative emotions and aggressiveness could be determined equally by infidelity of the spouse or by the perpetrator’s SD, but we can assume that SD played a relevant role in the causal chain.</em

Implications in Forensic Medicine - an Exploratory Lumbar Spine Analysis of Sex and Age for the Romanian Population

The attribution of biological sex and age are important aspects in forensic medicine investigations in establishing the identity of unknown skeletal remains. Where remains are incomplete or have been compromised by damage or fragmentation, this can affect the accuracy to which sex and age can be determined and require the development of other tecniques using different bone elements or isolateed bone elements. The objective of the paper was to conduct a descriptive and inferential analysis on certain parameters studied on the lumbar spine with implication in estimating sex and age. The present study used 149 images of magnetic resonance of the vertebral lumbar column, on which the authors perfomed a large-scale analysis of three parameters measured on the RM images from a modern Romanian population. The results of the study found that mostly all variables analysed are involved in evaluation of sexual dismorphism. Regarding age prediction, in this study we conclude that some analyzed parameters are important in providing significant age differences. The present work is a novelty in the field and brings more originality, as it took into account all 5 lumbar vertebrae. The lumbar vertebrae can reliably providing an additional element to the growing list of postcranial skeletal elements that can aid in developing the biological profile of unidentified human remains. However, we need further studies with a larger number of images and to derive population-specific discriminant and regression functions.</p

Evaluation of Hydrogen Cyanide in the Blood of Fire Victims Based on the Kinetics of the Reaction with Ninhydrin

An original kinetic spectrophotometric procedure was developed for the determination of hydrogen cyanide (HCN) in the whole blood of fire victims. Cyanide poisoning by smoke inhalation is common in forensic medicine, but the blood HCN of fire victims has not been studied in detail so far. In this research project, we developed a simple, fast, sensitive, and selective quantification method for both free and metabolized HCN based on the kinetics of cyanide reaction with ninhydrin. The method was linear in range, from 0.26 to 2.6&thinsp;&mu;g mL&minus;1, with a coefficient of determination of r = 0.994. A high molar absorptivity of 4.95 &times; 105 L mol&minus;1 cm&minus;1 was calculated under the reaction conditions. The limit of quantification was 0.052&thinsp;&mu;g mL&minus;1; the detection limit was 0.012&thinsp;&mu;g mL&minus;1 and the standard error was &plusmn;2.7%. This micro method proved to be accurate, sensitive, and selective and has been successfully applied to the analysis of blood samples, allowing rapid monitoring of blood cyanide in several fire victims

Evaluation of Hydrogen Cyanide in the Blood of Fire Victims Based on the Kinetics of the Reaction with Ninhydrin

An original kinetic spectrophotometric procedure was developed for the determination of hydrogen cyanide (HCN) in the whole blood of fire victims. Cyanide poisoning by smoke inhalation is common in forensic medicine, but the blood HCN of fire victims has not been studied in detail so far. In this research project, we developed a simple, fast, sensitive, and selective quantification method for both free and metabolized HCN based on the kinetics of cyanide reaction with ninhydrin. The method was linear in range, from 0.26 to 2.6 μg mL−1, with a coefficient of determination of r = 0.994. A high molar absorptivity of 4.95 × 105 L mol−1 cm−1 was calculated under the reaction conditions. The limit of quantification was 0.052 μg mL−1; the detection limit was 0.012 μg mL−1 and the standard error was ±2.7%. This micro method proved to be accurate, sensitive, and selective and has been successfully applied to the analysis of blood samples, allowing rapid monitoring of blood cyanide in several fire victims

Toxic Blood Hydrogen Cyanide Concentration as a Vital Sign of a Deceased Room Fire Victim—Case Report

Carbon monoxide (CO) and hydrogen cyanide (HCN) are two common toxic products of combustion. HCN concentrations of fire victims are not routinely determined in most legal medicine services in Romania. We present the case of a room fire victim in which we evaluated the concentrations of HCN and carboxyhemoglobin (COHb), their contribution to the mechanism of death, and the possibility that HCN concentration can be interpreted as vital sign. COHb was determined by spectrophotometry. HCN was spectrophotometrically determined with ninhydrin in postmortem blood samples after its removal with 20% phosphoric acid and uptake into a solution of potassium carbonate. The presence of ethyl alcohol was determined by gas chromatography. The COHb concentration was 6.15%, while the blood HCN concentration was 1.043 µg × mL−1 and the total HCN was 1.904 µg × ml−1. A blood alcohol content of 4.36 g‰ and a urine alcohol content of 5.88 g‰ were also found. Although the fire produced a considerable amount of soot, and there were signs of inhalation of soot particles, the COHb level cannot be interpreted as a vital sign. Toxic concentrations of HCN and total HCN can be interpreted as a vital sign and indicates a contributive effect of HCN in the mechanism of death

The Vital Role of Thanatochemistry in the Postmortem Diagnostic of Diabetic Ketoacidosis—Case Report

Diabetic ketoacidosis (DKA) is a lethal acute hyperglycemic complication of diabetes mellitus (DM) and it represents the initial manifestation of DM in about 15–20% of cases in adults and about 30–40% of cases in children. Postmortem diagnosis of DKA can only be made by applying thanatochemistry. Biochemistry applied postmortem is viewed with skepticism by many practitioners in the forensic field, completely lacking in many forensic services around the world, and especially in the national ones. This article aims to underline the importance of the postmortem application of biochemistry by reviewing the case of a person in the third decade of life who died suddenly at home due to diabetic ketoacidosis (DKA), whose autopsy was performed at an early PMI of approximately 24 h. Routine postmortem examinations (macroscopic, anatomopathological, and toxicological) could not establish a clear cause of death. When attention was turned to biochemical determinations (i.e., determination of glycated hemoglobin, glucose and ketone bodies (acetone, beta-hydroxybutyrate) in the blood, vitreous humor, and cerebrospinal fluid), the identified values clarified the thanatogenic mechanisms by establishing the diagnosis of DKA