1,721,036 research outputs found
Biochemical markers and microbiology in post-mortem diagnosis of sepsis: A systematic review
No full textIn many circumstances the forensic pathologist can question whether the dead person experienced sepsis, which caused or contributed to death. The autopsy of a death related to sepsis is a difficult task for the forensic pathologist due to the lack of typical pathological factors as well as clinical and circumstantial information about death. Several authors underlined how forensic biochemistry and microbiology could help in diagnosing a death related to sepsis. The research we carried out analyses the main scientific studies in literature, primarily tracing biochemical markers evaluated to help diagnosing a death related to sepsis. This review analyses the main problems linked to forensic microbiology investigations, whose results are burdened by heavy issues concerning their interpretation, above all when clinical and circumstantial data are lacking
Ipoacusia neurosensoriale causata da scoppio di petardo. Aspetti medico-legali
No full textGli Autori illustrano un caso di ipoacusia neurosensoriale permanente rilevata all’orecchio di sinistra con un deficit uditivo pantonale pari a 70 dB. La lesione è stata determinata dallo scoppio di un petardo, lanciato in vicinanza della persona lesa. Vengono valutati i risvolti medico-legali in ambito penale e civile. Per quanto concerne la sfera penalistica l’ipotesi di reato è quella di lesione personale grave, in ragione dell’indebolimento permanente della funzione uditiva; relativamente al contesto civilistico, si pone particolare attenzione alla questione inerente al risarcimento cui il soggetto danneggiante è obbligato, considerando in particolar modo gli effetti che la lesione ha determinato nei confronti dell’integrità psicofisica e del contesto economico della persona lesa
A fatal gastric perforation secondary to ulcerated metastasis in undiagnosed breast cancer: pathological aspects and review of literature
No full textThe authors describe a fatal case of gastric perforation secondary to an ulcerated metastasis in a woman with undiagnosed breast cancer. The 48-year-old woman, with no significant medical history, presented with weight loss, persistent dyspepsia and pain in the epigastric and mesogastric region. She was treated by her primary care physician with proton-pump inhibitors and antispasmodics. The following day she was found dead at her home. External examination showed a tumefaction in the lateral region of her left breast, near the axilla. Autopsy revealed 1000 ml of turbid, light-brown peritoneal fluid in the abdominal cavity and a perforated gastric wall. Histological examination of the breast mass showed an infiltrating, poorly-differentiated breast carcinoma. Microscopical analysis of the stomach wall revealed a perforated metastatic gastric ulcer. Immunohistochemistry was required to confirm the neoplastic involvement of the stomach due to metastatic breast cancer
Forensic pathological study of complex and complicated suicides: A twelve-year case series in Genoa (Italy)
No full textGenerally, the term complex suicide refers to a form of suicide in which more than one traumatic method is applied, simultaneously or consecutively, through multiple self-injurious actions using different methods and involving various bodily sites. A distinctive feature of complicated suicides is the failure of the initial attempt of the self-suppressive method that, nonetheless, results in death due to a subsequent accidental occurrence. In such cases, forensic pathologists and coroners are faced with the challenging differential diagnosis that generally includes homicide as well as suicide. We retrospectively analyzed autopsies from complex and complicated suicides registered at the Medicolegal bureau of Genoa (Italy) from 2006 to 2017. In the considered period, nineteen cases of complex suicides were identified and with only one case of a complicated suicide. In our series, the most frequent method of complex suicide was the cutting of the wrists followed by (unplanned) hanging for a total of eight cases (42.1%). The next most common cause (21% of cases) involved the jumping from a height after wrist cutting. In each case, it was necessary to meticulously examine the crime scene, reconstruct the chain of events, confirmed by the testimonies of relatives or eyewitnesses, review any medical history, particularly for psychiatric conditions, and perform a thorough autopsy so as to firmly establish the methods and causes of death
Immunohistochemistry in postmortem diagnosis of acute cerebral hypoxia and ischemia: A systematic review
No full textBackground: Discovery of evidence of acute brain ischemia or hypoxia and its differentiation from agonal hypoxia represents a task of interest but extremely difficult in forensic neuropathology. Generally, more than 50% of forensic autopsies indicate evidence of brain induced functional arrest of the organ system, which can be the result of a hypoxic/ischemic brain event. Even if the brain is the target organ of hypoxic/ischemic damage, at present, there are no specific neuropathological (macroscopic and histological) findings of hypoxic damage (such as in drowning, hanging, intoxication with carbon monoxide) or acute ischemia. In fact, the first histological signs appear after at least 4 to 6 hours. Numerous authors have pointed out how an immunohistochemical analysis could help diagnose acute cerebral hypoxia/ischemia.Data sources: This review was based on articles published in PubMed and Scopus databases in the past 25 years, with the following keywords "immunohistochemical markers," "acute cerebral ischemia," "ischemic or hypoxic brain damage," and "acute cerebral hypoxia".Objectives: Original articles and reviews on this topic were selected. The purpose of this review is to analyze and summarize the markers studied so far and to consider the limits of immunohistochemistry that exist to date in this specific field of forensic pathology.Results: We identified 13 markers that had been examined (in previous studies) for this purpose. In our opinion, it is difficult to identify reliable and confirmed biomarkers from multiple studies in order to support a postmortem diagnosis of acute cerebral hypoxia/ischemia. Microtubule-associated protein 2 (MAP2) is the most researched marker in the literature and the results obtained have proven to be quite useful.Conclusion:Immunohistochemistry has provided interesting and promising results, but further studies are needed in order to confirm and apply them in standard forensic practice
Forensic pathological study of 334 cases of sudden cardiac death in Genoa ( Italy) district. A seven-year report
No full textBackground. Sudden cardiac death (SCD) is one of the main causes of death worldwide. The analysis of such cases is a complex and delicate task, which is invariably carried out by the forensic pathologist.Methods. We conducted a retrospective analysis of cases of SCD identified among cases of sudden death on the basis of complete autopsy study at the Institute of Legal Medicine from 2011 to 2017.Objectives. Our aim was to analyze the epidemiological data and etiological distribution. This review is the first study to analyze the etiological distribution and epidemiological data of SCD in an arca of north-western Italy from the perspective of forensic identification.Results. In the period considered, 334 cases of SCD were identified; the mean age of the subjects was 65.4 years, and males were clearly predominant (78.14%). In 91.62% of our overall series, the cause of SCD was coronary atherosclerotic disease (CAD), the highest occurrence of which was found in subjects aged over 60 years (98.02%). In over 85% cases of CAD, the left anterior descending artery (LAD) presented sclerotic degeneration and stenosis. A markedly lower percentage of CAD (28.58%; 4 cases) was found in subjects aged less than 40 years, in whom the leading cause of SCD was hypertrophic cardiomyopathy (35.72%; 5 cases).Conclusions. That the leading cause of SCD was CAD. In subjects aged less than 40 years, hypertrophic cardiomyopathy was the most frequent pathology. LAD was the coronary branch most often involved in CAD-related SCD
A comparative digital morphometric study of lung tissue in saltwater and freshwater drowning
No full textAcute pulmonary emphysema (APE) is describedin cases of drowning and can be considered as a sign of vitality. In our experience, however, APE is not very evident in cases of saltwater drowning. The present study aims at investigating whether APE is present in both fresh and saltwater drowning by means of digital morphometric analysis of lung tissue. We investigated and compared a group of saltwater drowning and a group of freshwater drowning, while cases of acute external bleeding were investigated as negative control group. Tissue samples from each pulmonary lobe were collected during autopsy and examined by optical microscope. The area of alveolar spaces was calculated by means of image analysis software, recording the mean alveolar area (MAA) for each group. MAA was 24,852 μm 2 in the saltwater drowning group, 34,133 μm 2 in the freshwater drowning group and 21,871 μm 2 in the negative control group. The MAA in freshwater drowning was significantly higher than in saltwater drowning and controls. No statistical differences were observed between saltwater drowning and controls. The results of this study suggest that APE is not a typical sign of death by saltwater drowning
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
- …
