55 research outputs found
An Autopsy-Based Analysis of Fatal Road Traffic Collisions: How the Pattern of Injury Differs with the Type of Vehicle
No full textIn Italy, in only 2018, 3310 people died in road traffic accidents, more than in any other European country. Since the revelation of this occurrence, the authors carried out an analysis aimed at investigating if there was a difference in the injury patterns among different road users. A retrospective post-mortem study on road traffic fatalities was performed, which had been autopsied at the Institute of Forensic Medicine of Milan. First, the authors analyzed the epidemiological data of all the 1022 road traffic accidents subjected to an autopsy from 2007 to 2019. Secondly, further analysis of individual autopsy reports was carried out. For this purpose, 180 autopsies belonging to 5 different categories were analyzed: car, pedestrian, motorbike, bicycle, and truck. Seventy-six percent of road traffic fatalities were male, 54% were between 10 and 49 years of age, and 62% of the patients died before arriving at a hospital. “Multiple injuries” was the main cause of death. Traumatic brain injuries were particularly high in pedestrians and cyclists. In car, motorbike, and truck fatalities, thoracic and abdominal injuries were the most frequent. Therefore, pedestrians and cyclists had a higher prevalence for traumatic head injuries, while car, motorcycle, and truck occupants, on the other hand, had a higher prevalence for thoracic and abdominal injuries
A narrative review of astrocytes and suicide in psychiatric disorders
No full textSuicide is a real public health problem today, and in recent decades its possible neurobiological basis has been intensively studied. One particular strand of research has focused on suicide deaths and psychiatric disorders, with ample evidence for molecular mechanisms related to astrocytic abnormalities. The scope of the articles and their compilation over a period of many years has resulted in old, current and new knowledge being scattered across a large number of sources. The purpose of this narrative literature review is therefore to bring all this information together and summarize it in a single work that can be useful for those approaching this topic for the first time, for those looking for current evidence, and finally for those interested in exploring new frontiers of research. A comprehensive literature search has clearly shown that there are numerous converging findings indicating astrocyte changes in various biomarkers, particularly in the dorsolateral prefrontal cortex of suicidal individuals suffering from major depressive disorder. There is very little evidence for other brain regions and psychiatric disorders. Although these are preliminary results, they are encouraging and future studies could gradually overcome the limitations in the currently available literature and contribute to a better understanding of the etiopathological mechanisms of the occurrence of some of the main psychiatric pathologies leading to suicide
055 MORPHOMETRIC ANALYSIS OF RUN-OVER INJURIES IN FATAL PEDESTRIAN-MOTOR VEHICLE CRASHES
No full textPreliminary suicide trends during the COVID-19 pandemic in Milan, Italy
No full textEurope was the second most affected continent by the 2019 coronavirus disease (COVID-19) pandemic, with Italy paying very high death tolls, especially in Lombardy, a region in Northern Italy. The pandemic profoundly impacted mental health and the world's rates of suicide since its outbreak. COVID-19-related suicide rates nonetheless followed a non-linear trend over the pandemic, decreasing after the COVID-19 outbreak, then raising during an extended follow-up period. Thus, we aimed to further assess the suicide rates in Lombardy. We carried out a retrospective analysis of all the autopsies performed in the year 2020 and within the first four months of the year 2021 through the database of the Institute of Forensic Medicine in Milan. In the year 2020, the recorded suicides decreased in comparison to 2016-2019 (21.19-22.97% of the autopsies), being 98 (18.08% out of 542 autopsies), while, in the first 4 months of the year 2021, 35 suicides were documented (185 autopsies, overall). Since the region of Lombardy was severely affected by COVID-19 since the early months of the year 2020, the extended retrospective follow-up allowed for firmer conclusions and insights about the need to extend the follow-up of COVID-19 pandemic beyond the first months after the outbreak, worldwide. This is with special emphasis towards the need to allocate the proper funds for mental health prevention for the general population as well as the most vulnerable ones, such as people with severe mental illness and caregivers, frontline health workers, and others bereaved by COVID-19
Diagnosi differenziale tra amiloidosi cardiaca e cardiomiopatia microfibrillare: importanza del ruolo sinergico di diverse indagini forensi
No full textIntroduzione
Il cuore è l’organo bersaglio di numerose patologie infiltrative che possono esitare in cardiopatie, spesso letali: amiloidosi, sarcoidosi, patologie da accumulo di metaboliti, e una recente cardiomiopatia, definita microfibrillare. Quest’ultima, caratterizzata da deposizione di microfibrille interstiziali Congo Red negative, si pone inevitabilmente in diagnosi differenziale con forme amiloidosiche non consuete [1]. Lo scopo della presente segnalazione è esporre le difficoltà interpretative e diagnostiche nella caratterizzazione di materiale eosinofilo intramiocardico, ponendo in luce come, solo grazie alla sinergica attività di più competenze professionali, si sia formulata la corretta diagnosi della causa di morte.
Il caso
Un’anziana signora di 95 anni fu rinvenuta semincosciente nel proprio letto dalla badante, la quale immediatamente allertava i Soccorsi, che ne constatarono il decesso. I familiari della defunta, al riconoscimento della salma dichiararono che la propria congiunta fosse affetta da Alzheimer e ipoacusia, negando l’esistenza di altre patologie. Come unico reperto significativo alla dissezione autoptica, fu la presenza nel cuore di macroscopiche e plurifocali aree più chiare, di aspetto “ceroso” e consistenza “gommosa” alla palpazione. Non essendo emerso alcun reperto letale in grado di giustificare l’exitus, fu disposta l’esecuzione di indagini tossicologiche e istologiche.
Risultati
Le indagini tossicologiche evidenziarono la presenza nel sangue di dosaggi terapeutici di Lorazepam e le indagini istologiche, all’Ematossilina-Eosina e nelle sole sezioni cardiache, numerose aree interstiziali irregolari di materiale ialino eosinofilo e aspetto fibrillare, suggestivo di amiloidosi. Alla classica colorazione con Congo RED, e sue modifiche (Bancroft Gamble e Bancroft 2012), non si evidenziò positività, analogamente all’osservazione in luce polarizzata, la quale non mostrò la tipica birinfrangenza color verde mela dell’amiloide.
Diagnosi Differenziale
Sulla base delle indagini istologiche, si suppose potesse trattarsi di un’altra entità patologica sconosciuta, caratterizzata anch’essa dalla deposizione di materiale eosinofilo intramiocardico Congo Red negativo, ossia la cardiomiopatia microfibrillare [1]. Ulteriori sezioni di organi e cuore, furono sopposte a colorazione con Congo Red modificata per cadavere [2] e Alcian Blu Sodio Solfato [3]; infine si eseguirono indagini Immunoistochimiche. In tutti i casi si ottenne positività per la presenza di amiloide A e P.
Conclusione
La colorazione Congo Red è il gold standard per evidenziare l’amiloide di colore arancio, tuttavia, quando cimentata su tessuti fissati in formalina e inclusi in paraffina, può presentare minore tingibilità e visibilità dell’amiloide stessa. La negatività al Congo Red, dunque, non escludendo la possibilità di una malattia amiloidosica occulta, impone in ambito forense, ulteriori approfondimenti. Il riscontro microscopico di materiale eosinofilo intramiocardico, la cui natura non è facilmente definibile come amiloide con la classica colorazione Congo Red – come nel caso presentato- solleva numerose difficoltà interpretative e diagnostiche e richiede una diagnosi differenziale con altre entità patologiche. Nel nostro caso, l’attività sinergica di differenti competenze professionali e la convergenza dei dati emersi dalle indagini, hanno permesso di escludere nel determinismo della morte, la cardiomiopatia microfibrillare, formulando diagnosi di amiloidosi letale, a sola localizzazione cardiaca, nel post-mortem
Porencephalic cyst in adult
No full textWe presented this case of death finding it of interest both for the rarity of the cerebral anomaly detected and for the survival of the man until adulthood in the absence of severe symptoms despite being a carrier of porencephalic cyst. In fact, the first diagnosis occurred only post mortem and the histopathological analysis confirmed the porencephalic nature of the large cerebral cavitated defect
Forensic Diatom Analysis: Where Do We Stand and What Are the Latest Diagnostic Advances?
No full textBackground: diatoms are unicellular algae that have been used for more than a century for forensic purposes to diagnose drowning, with more or less success depending on the historical era. Although many years have passed, scientific research on diatoms has never ceased, which testifies to their enduring allure in forensics. Of course, diatom research has evolved and expanded over time, changing with the availability of new techniques and technologies. The volume of articles and their production over a period of many years has resulted in old, current, and new knowledge on diatoms being scattered over a large number of books and articles. Objectives: the purpose of this narrative literature review is, therefore, to summarize all this information and bring it together in a single work that can be useful for those who are studying diatoms and their usefulness for forensics for the first time, for those who are looking for proven methods of analysis, and finally for those who are interested in exploring new frontiers of research. Methods: a comprehensive literature search that included all studies dealing with the applications of diatoms in forensic science was performed in the most popular electronic databases. Results: traditional methods have been complemented by molecular and imaging methods and, more recently, by artificial intelligence. In addition, new biological substrates have been found for the analysis of diatoms. Conclusions: all this has led, on the one hand, to the consolidation of a whole body of knowledge on diatoms, on which this forensic analysis is still based, and, on the other hand, has opened up numerous new research directions
Letter to the Editor Regarding the Article "Complex (Multimodality) Suicides in New York City: 2008-2017"
No full textPostmortem Diagnosis of Invasive Disseminated Aspergillosis After Tongue Piercing
No full textSevere fungal infections caused by highly invasive fungi such
as Aspergillus are not easy to diagnose and often have a poor prognosis. In
these cases, the nonspecific symptomsmaymake clinical diagnosis challenging,
and consequently, the autopsy and postmortem histological investigations
acquire a crucial role.We report the case of a youngman in good health
who died of septic shock 3 weeks after having had a tongue piercing. Intravitam
investigations did not identify the etiology of the rapidly fatal infectious
condition. The autopsy revealed flaccid organs of uniformly diminished
consistency with abscesses and granulomatous foci with central necrosis.
Histological examination showed the presence of septate mycotic hyphae,
with a dichotomous 45-degree bifurcation, typical for Aspergillus, in all the
examined organs, including the tongue. The molecular identification confirmed
the presence of Aspergillus fumigatus. The observed macroscopic
framework and the laboratory findings made it possible to diagnose
pseudomembranous invasive tracheobronchial aspergillosis and to attribute
the death to fatal invasive disseminated aspergillosis. The consistency and
concordance of all the findings in our possession led us to suspect the practice
of piercing as the triggering cause of the man's pathology
Letter to the Editor regarding the article “Double suicide in Japan in the post-war reconstruction period, with reference to contemporary Japan”
No full text- …
