A fatal and unusual genital mutilation in an elderly man as a result of sharp force injuries and domestic dog predation

Cases of genital amputation require a careful investigation, since they may be the result of self-inflicted injuries, assaults, animal predation, or post-mortem body mutilation. In the present case, an 81-year-old man affected by liver cirrhosis and dementia and suffering from sexual disinhibition was found lying half-naked and unconscious in his courtyard; profuse bleeding in the perineal area and the absence of the external genitalia were observed. The victim was transferred to hospital and underwent surgical emergency treatment, but he died 2 days later. No sharp tools were found on the scene. Moreover, the autopsy did not reveal any defense or tentative wound on the body and no blood stains on the hands of the victim. Several linear scratches were detected close to the edges of the wound; according to the surgical report, these scratches were clean-cut in the lower part and crenated and infiltrated by blood in the cranial part. Although the medical history of the man could be consistent with self-mutilation, it was not possible to rule out the involvement of other people, including the possibility of an attempt by his relatives to cover up what may have been a self-amputation. Furthermore, the victim’s dog vomited parts of the man’s genitalia while being transported to a dog shelter. Similar cases have rarely been published in the current forensic literature

Gastric mucosal tears and wall micro perforations after cardiopulmonary resuscitation in a drowning case

A fifty year-old woman died after drowning in a swimming-pool. Rescue and ambulance paramedic teams started resuscitation attempts followed by a medical care helicopter team. Acute haematemesis, mucosal tears and gastric micro perforations occurred, due to the cardiorespiratory resuscitation manoeuvres. Death occurred seven days later due to the cerebral anoxia and multiorgan failure. Forensic investigations excluded possible malpractice during external cardiac massage as responsible for the woman's death, while Judicial Authority considered the death as the consequence of the delayed intervention of the swimming-pool rescue team

Neck injury patterns resulting from the use of petrol and electric chainsaws in suicides. Report on two cases.

Suicides due to neck injuries caused by chainsaws are uncommon events. The cutting elements of petrol and electric chainsaws produce different features in lethal neck injuries. The accurate evaluation of the death scene, of the power and mechanical characteristics of the chainsaw and of wound morphology are all essential in distinguishing a case of suicide. \ua9 2014 Elsevier Ltd. All rights reserved

Fatalities resulting from falls from height in agricultural contexts

Agricultural work encompasses a variety of activities which carry with them different risks. One such activity is working at height, a frequent cause of fatal accidents. The aim of this work is to describe and discuss a typical case of a fall from height in order to understand the traumatic consequences of such accidents, to analyze the dynamics and lesions, and highlight the dangers of working at height. These falls, which may involve farm workers who are officially or unofficially employed, can produce injuries whose seriousness is not always strictly correlated to the height of the fal

Definition of a methodology for gradual and sustainable safety improvements on farms and its preliminary applications

In many productive sectors, ensuring a safe working environment is still an underestimated problem, and especially so in farming. A lack of attention to safety and poor risk awareness by operators represents a crucial problem, which results in numerous serious injuries and fatal accidents. The Demetra project, involving the collaboration of the Regional Directorate of INAIL (National Institute for Insurance against Accidents at Work), aims to devise operational solutions to evaluate the risk of accidents in agricultural work and analyze the dynamics of occupational accidents by using an observational method to help farmers ensure optimal safety levels. The challenge of the project is to support farmers with tools designed to encourage good safety management in the agricultural workplaces. \ua9 2018 by the authors. Licensee MDPI, Basel, Switzerland

Brainstem lesions in permanent vegetative state

Vegetative state has mainly been associated with widespread damage of cortex, white matter and/or thalamus, whereas brainstem findings are usually absent or include focal, slight and non-haemorrhagic lesions. Functional integrity of the brainstem is considered to be necessary for preservation of sleep/wake cycle (arousal and wakefulness), particularly midline structures of the upper pons and midbrain. Awareness, instead, mainly relies on the integrity of the cerebral cortex, white matter, basal ganglia and thalamus. We present here the neuroanatomical study of a case of post-traumatic permanent vegetative state which is characterized by a quite complex damage also at the level of the brainstem. After a car accident a young woman was referred to Neurosurgical Unit in coma and paraplegia due to head injury and C2 fracture. Spontaneous sleep/wake cycle recovered in the following months. Magnetic resonance, performed one month after the trauma, showed injuries of midbrain, thalamus and left frontal lobe. The patient died more than 15 years after the trauma. Macroscopic examination showed generalized hypotrophy of cerebral hemispheres, cerebellum and brainstem. Partial degeneration of the basal ganglia and severe volumetric reduction of the hemispheric white matter were observed. Wide and bilateral thalamic necrosis and degeneration was found. Transverse sections of the brainstem showed degeneration of the descending and ascending systems of motor and sensitive fibres, and neuronal loss in the inferior olivary complex, pontine nuclei, red nucleus and substantia nigra. In the midbrain, areas of necrosis with reactive astrogliosis extended from the mesencephalic aqueduct towards the interpeduncular fossa, affecting the periaqueductal grey matter, and the dorsal and median raphe nuclei. On the basis of the neuroanatomic description of the damaged areas, we discuss the role of the midbrain reticular activating system and possible plasticity responses in the mechanisms of arousal/wakefulness