Premortal data in the process of skeletal remains identification

Background/Aim. The basic task of a forensic examiner during the exhumation of mass graves or in mass accidents is to establish identity of a person. The results obtained through these procedures depend on the level of perceptibility of post mortal changes and they are compared with premortal data obtained from family members of those missing or killed. Experience with exhumations has shown significant differences between the results obtained through exhumation and the premortal data. The aim of the study was to suggest the existance of the difference between premortal data and the results obtained by exhumation regarding the some parameters, as well as to direct premortal data colection to the specific skeletal forms. Methods. We performed comparative analysis of the results of exhumation of skeletal remains in a mass grave and the premortal data concerning the identified persons. The least number of individuals in this mass grave was calculated according to the upper parts of the right femur and it helped in calculating the smallest number of individuals in mass graves to be 48. A total of 27 persons were identified. Sex was determined by metrics and morphology of the pelvis. Personal age in the moment of death was determined by morphology features of groin symphisis and morphology of sternal edge of ribs and other parts of scelets observations. The hight was calculated as average results of length of long bones and Rollet coefficients. Results. There was a complete match in terms of sex and age matched within an interval that could be established based on the skeletal remains. All the other parameters were different, however, which made identification significantly more difficult. Conclusion. The premortal data is an important element of identification process and it should be obtained by the forensic doctor and directed towards more detailed examination of the skeletal system

Biomaterials and their application in preprosthetic surgical procedure

The loss of teeth and damage to the jaw bone occur under different circumstances. The deficit may be the result of wearing inadequate dentures, residual ridge resorption, osteoporosis, periodontal disease, trauma, tumors, radiation, etc. The deficit of bone tissue can be a substantial problem because it prevents adequate prosthetic patient care and restoration of disturbed functions of stomatognathic system. With such patients, there is often a need for preprosthetic surgical procedure through the application of various techniques and materials in order to resolve aftermentioned bone shortcomings. The most appropriate biological materials for the reconstruction are autogenous bone graft and artificial bone. With the development of technology and specific\ud biomaterials it is tried to avoid situations that require autogenous bone grafting, since it involvs long surgical procedure with the possibility of postoperative complications. The application of synthetic biomaterials, whose properties are similar to natural hydroxyapatite, promotes the biological potential for bone tissue repair. Synthetic biomaterials have great biocompatibility and sterility and do not act antigenicaly. The disadvantages of this material are overcome by the addition of organic polymers. Thanks to the stability and flexibility of hydroxyapatite structure, a large number of ionic changes are possible, both cationic and anionic, which improve the characteristics of synthetic hydroxyapatite. Biomaterials that include different drugs, such as antibiotics, vitamins and other preparations, could be used for the treatment of complications after surgical procedures and infection of bone tissue. Our experimental studies indicate that biomaterials based on hydroxyapatite are valuable materials that can be used for preprosthetic surgical preparation

Correlation between the lenghts of the long bones of the forearm and the fibula with body height in our population

Background/Aim. The task of a forensic examiner during exhumation of skeletal remains is to calculate antemortem height of a person whose skeletal remains were found. Anthropological investigations which provided formulae for calculating ante-mortem body height date back from XIX or from the first half of XX centuries. The most commonly used formulae are those of Trotter- Gleser, which were used to investigate skeletal remains from the World War II. Those investigations were conducted on skeletal remains of various ages and degrees of decay. Our experience with exhumation have shown that the present formulae do not deliver reliable values of antemortem height. The aim of this study was to investigate if there is a correlation of the length of long bones of leg and forearm with body height within our population and to establish the formulae for calculating ante-mortem body height within our population based on the obtained values. Methods. The lengths of ulna, radius, fibula and tibia were determined precisely by measuring bones on living individuals using a digital X-ray system. The height of individuals whose bones were measured was determined using an anthropometer. Results. The highest degree of correlation between bone length and body height was found for tibia in males (r = 0.859, p < 0.005) and ulna in females (r = 0.679, p < 0.05). We calculated the regression formulae for determination of ante-mortem body height that differ from the current body height formulae. Conclusion. In our population the length of long bones of the forearm and the leg are characterized by various degree of correlation with body height. The formulae that we set, make less distinction between the measured and the calculated body height as compared with the Trotter-Gleser formulae. We do hope that their implementation will facilitate identification of sceletal remains in our population

Morphological and histopathological heart changes in autopsies of heroin abusers

Backround/Aim. Heroin is a semisynthetic opioid that may cause morphological and histopathological changes in heart: ventricular hypertrophy, myocardial fibrosis, hypertrophy of cardiomyocytes, myofibrils contraction band necrosis, loss of myocytes nuclei and cross-striation, perivascular bleeding, inflammatory cells infiltrate. The aim of the study was to show morphological and histopathological heart changes in autopsies of the long-time heroin abusers with positive toxicological analysis for 6-monoacetylmorphine (6-MAM) and morphine in blood and urine. Methods. Retrospective study was done at the Institute of Pathology and Forensic of the Medicine Military Medical Academy in Belgrade between 2010 and 2014 and included forensic autopsies of 27 examinees aged between 18 and 60. Heart ventricles thicknesses was analysed and histopathological myocard findings from processed material stained by hematoxyline-eosine (H&E) and trichrome stains (Masson) were examined. 6-MAM and morphine concentration in blood and urine using high-performance liquid chromatography coupled with photodiode (HPLC-PDA) and ultraviolet (UV) detector were analysed. Results. Heart ventricles thickness was increased in all persons (27/27; 100%) left 1.74 ± 0.17 cm and right 0.6 ± 0.09 cm. Myocardial fibrosis affected 27/27 (100%) of the examined persons including perivascular one in 24/27 (88.89%) and interstitial focal fibrosis in 3/27 (11.11%); hypertrophy of cardiomyocytes was present in 22/27 (81.48%); myofibril contraction band necrosis in 22/27 (81.48%); loss of myocytes nuclei and cross-striation in 10/27 (37.04%); fresh perivascular bleeding in 23/27 (85.19%); focal inflammatory cells infiltrate in 14/27 (51.85%). In toxicological findings, in 27/27 (100%), 6-MAM and morphine were found in urine. Both 6-MAM and morphine in blood were found in 3/27 (11.11%) and only morphine in blood in 16/27 (59.26%) persons subjected to an autopsy. Conclusion. Our results indicate both morphological (left and right ventricle hypertrophy) and histopathological heart changes (myocardial fibrosis, hypertrophy of cardiomyocytes, contraction-band necrosis, loss of myocytes nuclei and cross-striation, fresh perivascular bleeding and focal inflammatory infiltrate) in long-term heroin obusers. These changes are non-specific and could be caused either by long-term heroin abuse or by other factors. Having in mind a lack of medical histories of examined we could not exclude other factors besides long-term heroin abuse as cause of heart changes

Successful usage of intravenous lipid emulsion in treatment of acute verapamil poisoning: A case report

Introduction. During the last few years, intravenous lipid emulsions have been effectively used in treatment of acute poisonings with lipophilic substances, including verapamil. Case report. A 37-year-old women presented 1 hour after ingestion of 2.8 g verapamil with hypotension and complete heart block. Because of the applied standard therapy failure and further patients impairment, Intralipid® 20% was used. Sinus rhythm was restored, arterial blood pressure increased and verapamile concentrations, both total and free decreased. Conclusion. Intravenous lipid emulsion can be important in treatment of severe acute intoxication and cardiotoxicity caused by verapamil