Criminological and Medico-legal Aspects in Homicidal and Suicidal Sharp Force Fatalities

The interpretation of sharp force fatality dynamics may be difficult in some cases, but a contribution to analysis of the phenomenon may be provided by case studies. Therefore, the purpose of our study is focused on identifying, in observed sharp force fatalities, reliable parameters that can differentiate a homicidal and suicidal manner of death, with particular reference to criminological parameters. Data derived from sharp force fatality cases in Padua and Venice from 1997 to 2019, anonymized and collected in Excel, included personal, circumstantial, clinical, and psychopathological\u2013criminological data, as well as crime scene investigation, necroscopic, and toxicological data. Statistical analyses were performed using chi-square and Wilcoxon rank-sum tests. Possible predictors of homicide were analyzed by logistic regression. Six parameters (bloodstains distant from the body, clothing lacerations, hesitation/defense wounds, number of injuries, and potential motives) were significantly different in the two groups (p\ua0<\ua00.05). An independent statistical association between potential motives explaining the crime (p\ua0<\ua00.001; OR 27.533) and homicide on multiple logistic regression analysis was highlighted. The absence of clothing lacerations was inversely related to homicide (p\ua0=\ua00.002, OR 0.092). To the best of our knowledge, this is one of very few Italian studies concerning the differential diagnosis between homicidal and suicidal sharp force fatalities. The dynamics of the event is established in most cases by the integrated evaluation of data from crime scene investigation and the autopsy. Nevertheless, in an atypical scenario, a psychopathological\u2013criminological analysis may provide essential elements, and particular attention should be given to the identification of potential explanatory motives

Low blood alcohol concentrations and driving impairment. A review of experimental studies and international legislation.

While noting that there is no international scientific or legislative uniformity in blood alcohol concentration (BAC) levels admissible for driving motor vehicles, the authors analyse problems concerning the effects of low levels of ethyl alcohol on driving ability. A summary of the international literature on this subject reveals: - the existence of contrasting assumptions, with scientific evidence clearly demonstrating altered psychomotor functions; - the need to adopt sufficiently complex psychometric tests to reveal the effects of low BACs; - the need to improve standardization of experimental studies on man-machine interaction; - the need to investigate the following areas: tolerance to alcohol; low BACs with inexperienced, infrequent drinkers and chronic, heavy drinkers; hangover effects; alcohol-gender-age interactions, and specific effects on young drivers; alcohol-drug combinations. The analysis of legislation and enforcement policies also reveals the need for: - re-evaluation of the international legal BAC threshold and standardization of procedures for ascertaining the degree of driving disability; - further scientific research to compare and evaluate selected legislative initiatives currently in place in most states; to identify the best strategies and procedures to detect and arrest impaired drivers; to determine the optimum random testing rate to maximize deterrent effects in the workplace at minimal cost; to design innovative and comprehensive approaches to rehabilitation programs needed for subgroups of offenders and of workers; to study the effectiveness of new legislations and policies

Onset and progression of fatal coronary dissection during angiography.

Coronary angiography was performed in a 43-year-old man admitted to hospital for chest pain. The first frames after the injection of contrast medium showed plaque in the left main coronary artery and subtotal stenosis of the mid-left anterior descending coronary artery. Dissection of the left main coronary artery appeared, with intimal flaps at the proximal segment of the main trunk and the origin of the left anterior descending artery. Dissection rapidly progressed into the circumflex artery and left anterior descending coronary artery. Although two stents were deployed in the left main coronary artery, the patient died of ventricular fibrillation

Alcohol, drugs and driving in Italy. Current status, future prospects, and the Veneto Region experience [Alkohol, drogen und medikamente im strassenverkehr in Italien: Derzeitiger stand, zukunftsaussichten und die erfahrungen der Veneto Region]

Since 1992, a specific legislation on driving under the influence (DUI) of alcohol and psychoactive substances is existing in Italy (Art. 186 and 187 respectively of Law 285/1992, the New Highway Code). It covers alcohol (BAC limit 80 mg/100 ml) and stupefying and psychotropic substances. Ascertainments for DUI of alcohol are made by police through a breathlyser test with two determinations made at 5 min interval. As regards DUI of psychoactive substances, the Police, in case of road accidents or suspicion of physical and psychic alteration may accompany the driver to health facilities where samples of biological fluids for toxicological analyses are obtained. Clinical and toxicological checks have been organized since 1994 by the CBFT of Padova University in collaboration with the Highway Police of North-East Italy and Italian Red Cross, during Saturday and/or Sunday mornings, on the roads of the Provinces of the Veneto Region. During the above checks, rapid clinical screenings were carried out on 7,957 drivers and 1,534 of them were subjected to complete clinical and toxicological ascertainments. 30.4% of the final population were drunk and 15.7% of subjects were DUI of drugs. Cannabinoids represented the most frequent abused drugs, followed by psychostimulants like cocaine and amphetamines, and then opiates

Fire death of two lovers: an immunohistochemical and toxicological study

After attending this presentation, attendees will understand investigation of deaths due to phosgene intoxication and the importance of an integrated analysis of histological and toxicological data to determine the manner and the cause of death in such cases. This presentation will impact the forensic science community by underlining the importance of sampling and analyzing burned materials when phosgene intoxication is suspected. This compound is not detectable in body fluids and tissues due to its rapid conversion to hydrochloric acid. The rate of annual deaths related to fire is about 13 per million inhabitants in the United States and Canada. These are mostly accidents followed by suicides. Homicides with subsequent burning of the victim or killings by burning are comparatively rare in Europe just as in the United States and Japan and are reported more often from India or South Africa. The morphological findings in burned bodies may cover a broad spectrum. They can range from minor, local, superficial burns of the skin to calcined skeletal remains without any soft tissue left and total incineration. In most cases the effects of heat on the body continue beyond death, consequently, the changes found are largely of postmortem origin. The forensic investigation of deaths related to fire is important in order to determine the manner and cause of death and the vitality of the findings. The issues of vitality and cause of death are closely linked: the basis of the assessment is a careful evaluation of autopsy findings to distinguish morphological consequences of the effects of heat during life and after death. A case will be presented where two burned bodies found early in the morning inside a joust (largely made of polyvinyl chloride \u2013 PVC and named \u201cWrestling labyrinth\u201d), that burned in a town square after a festival. The victims were reportedly lovers (the boy 20 and the girl 16- years-old). At external examination the corpses showed a typical boxer\u2019s attitude with general incineration, exposure of body cavities, bone fractures and partial amputation of extremities. To analyze the morphology of the fractures and their location a high-resolution computed tomography (CT) was performed, indicating that all fractures were a result of thermal effect. Major internal findings consisted of hemorrhagic pulmonary edema and \u201cpuppet organs.\u201d Foam and soot particle depostis were detected inside the respiratory tract of both victims. At histological examination of the lungs, ninety-five percent of the alveoli were flooded with edema and erythrocytes. There was no evidence of fibrin and inflammatory infiltrates. Immunohistochemistry, using epithelial (epithelial membrane antigen and cytokeratin) and endothelial (CD-34 and F-VIII) markers, revealed severe alveolar necrosis without endothelial damage of the vessels. Systematic toxicological analyzes, performed on postmortem blood and urine, excluded alcohol and drugs intoxication. Monoxidehemoglobin (CO-Hb) and cyanides concentrations were well below lethal values. The presence of soot deposits and mucus inside the respiratory tract (not occluding the airways) along with a heat damage of the mucosa of the upper respiratory tract (edema, mucosal bleeding and vesicular detachment) suggest that the victims were alive during the fire and breathed fire-fumes. The combined analysis of histological and immunohistochemical findings led us to identify the origin of the lung damage in the inhalation of an irritative gas. Laboratory tests, performed on burned samples of the joust (collected at death scene) and on samples of a similar undamaged joust, demonstrated an extensive production of phosgene during experimental burning. Phosgene is a combustion, thermal decomposition or photodecomposition product of certain volatile chlorinated hydrocarbons (for example, trichloroethylene or perchloroethylene). These chlorinated hydrocarbon compounds can evolve phosgene if they come into contact with very hot metal, flame, or ultraviolet light. Phosgene is a colorless, extremely volatile gas which, at low concentrations, smells sweet, like freshly mown hay, whereas at high concentration has a pungent and objectionable odor. When aspirated, it combines with the water of the mucous membranes being rapidly converted to hydrochloric acid, with subsequent injury to the lungs (hemorrhagic pulmonary edema). In this cases, even in the presence of extensive direct thermal injuries, the integration of histological and immunohistochemical findings suggests as principal mechanism of death an asphyxia by airway submersion related to the inhalation of phosgene (called \u201cdry land drowning\u201d). Indeed, the detected hemorrhagic pulmonary edema was of such an extension (involving more than ninety five percent of the alveolar space) to be clearly incompatible with life, and capable of causing a rapid death. In conclusion, the reported cases highlight the following teaching messages: 1. Histological and immunohistochemical investigations may enhance the identification of the real cause and mechanism of death in fire accidents. 2. Sampling and analyzing burned materials may be of valuable importance when dealing with phosgene intoxications. This compound is not detectable in body fluids and tissues due to its rapid conversion to hydrochloric acid

Opiate-related death: morphometric study of neurons from the dorsal motor nucleus of the vagus nerve.

The aim of this work is to verify the presence of objectively observable morphological alterations caused by the direct action of opiates on brain structures controlling respiration in cases of drug-related deaths. A computer-assisted morphometric study was carried out on the Dorsal Motor Nucleus of the Vagus Nerve (DMNV) in seven subjects (four of whom died of drug overdose, and 3 controls). Serial sections 10-15 microns thick were stained according to Nissl. The sections were then examined under the optical microscope and 200 fields per subject were digitalized. The resulting images, regarding at least 700 neurons per subject were segmented using a semi-automatic procedure and analysed by the Optilab software. The data obtained were subjected to cluster analysis to identify the neuron classes in the DMNV. Each subject was characterized with a vector of percentages indicating the fraction of neurons falling in each of these classes. Discriminant analysis was then applied to verify to what extent the variables discriminated between the two populations. Results indicated that: the statistical methods adopted have a good power of discrimination; in subjects who died of opiate overdose, the neurons are distributed to a greater extent in classes composed of smaller neurons than in controls