Pneumonia is one of the most common causes of children's hospitalization and death. The aim of the study was a medico-legal analysis of children who died suddenly due to pneumonia undiagnosed in their lifetime. The resea...Pneumonia is one of the most common causes of children's hospitalization and death. The aim of the study was a medico-legal analysis of children who died suddenly due to pneumonia undiagnosed in their lifetime. The research was of a retrospective character and consisted in an analysis of prosecution files. The study included 47 children who died between 2011-2018 in whom pneumonia after post-mortem examination was indicated as the cause of death, as well as children in whom the cause of death, despite additional post-mortem examinations, including histopathological tests, was not established. In some cases, under additional post-mortem examinations, additional targeted immunohistochemical staining of selected lung sections was performed to establish the diagnosis. In children with prodromal symptoms, histopathological examination showed significantly more frequent atelectasis than in children without prodromal symptoms. Pneumonia is a significant clinical problem. Especially in young children, it may proceed with- out any symptoms that would cause such a diagnosis to be made. A properly conducted post-mortem diagnosis supplemented by immunohistochemical examinations allows to reduce the number of unexplained deaths in children.
BACKGROUND: The literature reports cases of ventricular rupture in blunt chest trauma following motor vehicle accidents. It rarely describes cardiac tamponade due to rupture of the heart following blunt thoracic trauma i...BACKGROUND: The literature reports cases of ventricular rupture in blunt chest trauma following motor vehicle accidents. It rarely describes cardiac tamponade due to rupture of the heart following blunt thoracic trauma in a physical assault. There are rare cases where fatal cardiac tamponade results from a ruptured ventricle without externally visible injuries to the chest. It is also rare for the cardiac rupture to occur on the posterior side. In our case series, the first case involved a direct blow to the left side of the chest by a projectile (brick), causing rupture of the left ventricle's base with intact pericardium. In the second case, a direct blow to the left side of the chest led to rupture of the right ventricle's posterior wall. CASE PRESENTATION: Here, we report two autopsy-based case series of isolated right and left ventricular rupture with cardiac tamponade in blunt thoracic trauma with a specific history and background information of assault. The first case is a 35-year-old male assaulted with a brick thrown at his chest in a moving bus; he was declared dead on arrival after a one-hour journey. The second case is a 55-year-old male assaulted with double punches in his chest and declared dead on arrival at the hospital after 30 minutes. A medicolegal autopsy and thorough investigation, in both cases, revealed cardiac tamponade due to ventricular rupture with no underlying pathology. CONCLUSION: This case series underlines the importance of systematic and complete cardiac examination in all death cases following blunt chest trauma even with minimal or no evidence of a visible injury to the chest. Rarely cardiac rupture is noticed on the posterior surface or apex of the heart. The case series illustrates a rare occurrence of cardiac rupture that requires apt investigation and certification of medicolegal causes of death to determine how the death was caused.
In medicolegal practice, rare cases involving suicidal, criminal, or accidental insulin overdose are both analytically and forensically challenging. The aim of this study is to present a model procedure in such cases, de...In medicolegal practice, rare cases involving suicidal, criminal, or accidental insulin overdose are both analytically and forensically challenging. The aim of this study is to present a model procedure in such cases, developed at the Department of Forensic Medicine and Toxicology of the Medical University of Silesia in Katowice, with particular emphasis on the possibility of additional confirmation of insulin intake by its immunohistochemical detection at the injection site. In the example case presented here, an immunohistochemical examination using FLEX Polyclonal Guinea Pig Anti-Insulin antibody (code IR002, Dako) confirmed the presence of insulin in the subcutaneous tissue of the victims. In our opinion, the method of immunohistochemical detection of insulin at the injection site can and should be used routinely in such cases.
Donor DNA profiling can serve at least two purposes: 1) to enhance the evidential value of DNA deposited on garments/ items and 2) to provide valuable tactical information during crime scene investigation. In this review...Donor DNA profiling can serve at least two purposes: 1) to enhance the evidential value of DNA deposited on garments/ items and 2) to provide valuable tactical information during crime scene investigation. In this review, different types of methods for the recovery of the contact DNA traces have been summarized. Additionally, with the available techniques, the unique characteristics and limitations thereof have been overviewed. The aim of this paper is to review the techniques of touch traces collection.
Genetic markers for the prediction of biogeographical ancestry have proved to be effective tools for law enforcement agencies for many years now. In this study, we attempted to assess the potential of insertion-deletion...Genetic markers for the prediction of biogeographical ancestry have proved to be effective tools for law enforcement agencies for many years now. In this study, we attempted to assess the potential of insertion-deletion markers (InDel) and microsatellites (STRs) as subsidiary polymorphisms for inference of Slavic population ancestry. For that purpose, we genotyped Slavic-speaking populations samples from Belarus, the Czech Republic, Poland, Serbia, Ukraine and Russia in 46 InDels and 15 STRs by PCR and capillary electrophoresis and analyzed for between-population differentiation with the use of distance-based methods (FST, principal component analysis and multidimensional scaling). Additionally, we studied a sample from a Polish individual of well-documented genealogy whose biogeographic ancestry had previously been inferred by commercial genomic services using autosomal single nucleotide polymorphisms (SNPs), mitochondrial DNA and Y-SNP markers. For comparative purposes, we used genotype data collected in the "forInDel" browser and allele frequencies from previously published papers. The results obtained for InDels and STRs show that the Slavic populations constitute a genetically homogeneous group, with the exception of the Czechs differing clearly from the other tested populations. The analysis of the known Polish sample in the Snipper application proves the usefulness of the InDel markers on the continental level only. Conversely, microsatellites not only improve prediction, but are also informative if considered as an independent set of ancestry markers.
BACKGROUND: Environmental and genetic (in approximately 50%) factors are responsible for the development of alcohol abuse and dependence. The main genes responsible for the risk of harmful alcohol consumption are the gen...BACKGROUND: Environmental and genetic (in approximately 50%) factors are responsible for the development of alcohol abuse and dependence. The main genes responsible for the risk of harmful alcohol consumption are the genes encoding the enzymes of ethanol metabolism in the human body. Ethyl alcohol is oxidized to acetaldehyde by alcohol dehydrogenases found in the liver (ADH1B, ADH1C and ADH4) and stomach (ADH7). Gastric metabolism of ethanol is able to reduce the amount of alcohol reaching the bloodstream by up to 10% of the dose taken. ADH7 gene variations could be associated as the risk of developing alcohol abuse and dependence. AIM: Analysis of tag SNPs in the ADH7 gene and determination of the relationship between those variants and the risk of developing alcohol abuse and dependence in the Polish population. MATERIAL AND METHODS: Blood samples from 159 autopsies from alcohol abusers and/or addicts and 201 buccal swabs taken from controls. Genotyping was performed using the Real Time PCR method with TaqMan probes on 3 tag SNPs: rs284786, rs1154470 (within the ADH7 gene) and rs7690269 (from the intergenic region). The obtained genotypes were randomly verified by Sanger sequencing. RESULTS AND CONCLUSIONS: The results of the performed statistical analyses of the obtained genotypes did not confirm the relationship between the above-mentioned variants and a risk of developing problems with alcohol consumption, based on samples from the Polish population.
Methadone is a diphenylpropylamine derivative that binds to opioid receptors and has been used in drug abstinence and substitution treatment programs. The aim of the study is to describe a case of sudden death of a priso...Methadone is a diphenylpropylamine derivative that binds to opioid receptors and has been used in drug abstinence and substitution treatment programs. The aim of the study is to describe a case of sudden death of a prisoner during methadone substitution therapy from the authors' medico-legal consulting practice and to review the literature. A 41-year-old male with a long history of abuse of psychoactive substances, especially heroin, serving a prison sentence, after consultation in the addiction treatment clinic, started methadone substitution therapy. In the following days he took two doses of the drug (50 mg each). The prisoner was pronounced dead during the night. Blood toxicology tests showed the presence of methadone at the therapeutic concentration of 816 ng/ml. Currently, it is believed that even the therapeutic concentration of methadone increases the risk of sudden cardiac death, especially in predisposed patients (e.g. with structural pathologies of the myocardium, cardiac arrhythmias, hypokalemia, and liver failure).
AIM: Analysis of suicides on the basis of forensic post mortem examinations conducted at the Department of Forensic Medicine in Bydgoszcz in comparison with data from previous years and other centers. MATERIAL AND METHOD...AIM: Analysis of suicides on the basis of forensic post mortem examinations conducted at the Department of Forensic Medicine in Bydgoszcz in comparison with data from previous years and other centers. MATERIAL AND METHODS: The assessment included 6,564 forensic medical opinions from the post mortem examinations carried out in 2011-2020, including 1,073 cases of suicide, taking into account the sex and age of the victims, the place where the suicide was committed, the influence of alcohol or other intoxicants, methods of committing suicides and date (month and year). RESULTS: Suicides accounted for 16.34% of all post mortem examinations. The most common method of suicide was hanging - 73%. The second most common way to take your own life was fall from height - 8%. The most numerous age group among those committing suicide are people between 51 and 60 years of age. In most cases, the suicide victims were sober. There is a significant difference between the state of sobriety and the gender of the victim. Male victims were much more often under the influence of alcohol during the suicide. 14% of all suicides were committed by women, and 86% by men. Death as a result of suicide took place somewhat more often within the boundaries of large urban agglomerations than in towns and villages. CONCLUSIONS: The research showed an increase in the suicide rate compared to the previous years. Hanging is still the most common form of suicide. There has been an increase in the number of suicides in the elderly and an increase in the number of so-called combined suicides.
AIM: Bendiocarb is used against a wide range of insects but has already been withdrawn from the market in some countries. It poses a high risk to birds as they can accidentally ingest it while searching for food, followe...AIM: Bendiocarb is used against a wide range of insects but has already been withdrawn from the market in some countries. It poses a high risk to birds as they can accidentally ingest it while searching for food, followed by toxic effects. This paper presents the results of toxicological and histopathological studies of 48 cases of intentional birds of prey poisoning with bendiocarb in Eastern Europe, specifically Poland. MATERIAL AND METHODS: A novel ultra-high-performance liquid chromatography-triple quadrupole-tandem mass spectrometry (UHPLC-ESI-MS/MS) method for bendiocarb determination in animal liver samples was developed and fully validated. The sample preparation technique was based on one-step precipitation of proteins with cold acetonitrile. The internal standard used was carbaryl-d7. Full time of analysis was less than 10 minutes. The application of the UHPLC-ESI-MS/MS method allowed us to achieve the lowest LOQ (1 ng/g) of bendiocarb in biological samples to date. RESULTS: Necropsies and histopathological examinations of common ravens (Corvus corax), western marsh harriers (Circus aeruginosus), red kites (Milvus milvus), and a white-tailed eagle (Haliaeetus albicilla) revealed multi-organ toxicity manifested as congestion, oedema, or stagnation of blood. An analytical investigation confirmed the presence of bendiocarb in liver in the 1808-7721 ng/g range. Furthermore, the presence of this compound was qualitatively confirmed in the stomach and beak contents and also in the bait located near the deceased animals. CONCLUSIONS: A comprehensive forensic examination is crucial to monitor wildlife fatalities, especially applying a combined analytical and histopathological approach to identify and eliminate highly toxic substances which pose a threat to the ecosystem.
Human facial morphology is a combination of many complex traits and is determined by a large number of genes and enhancers. Here, we report a Copy Number Variation (CNV) study of enhancer hs1431 in populations of Central...Human facial morphology is a combination of many complex traits and is determined by a large number of genes and enhancers. Here, we report a Copy Number Variation (CNV) study of enhancer hs1431 in populations of Central European and South Siberian ancestry. Central European samples included 97 Poles, while South Siberian samples included 78 Buryats and 27 Tuvinians. CNVs were detected by real-time PCR, using ViiA™ 7 Real-Time PCR System (Applied Biosystems). We revealed significant differences in CNV of hs1431 enhancer between Polish and Buryat population (p=0.0378), but not between Central European and South Siberian population (p=0.1225). Our results suggest that an increase in copy number variation of hs1431 enhancer is associated with biogeographic ancestry. However, this result needs extending and replicating in larger cohorts. This is the first study revealing the presence of copy number variation of enhancer hs1431 in humans.
Modern molecular biology and clinical genetics have the ability to diagnose many diseases, the presence or absence of which is important in various areas of forensic medical opinion. The aim of the study is to present ex...Modern molecular biology and clinical genetics have the ability to diagnose many diseases, the presence or absence of which is important in various areas of forensic medical opinion. The aim of the study is to present examples of possible non-standard application of clinical molecular-genetic tests in forensic medicine. From among all the opinions prepared so far at the Department of Forensic Medicine in Katowice, three were selected two of which concerned post-autopsy conclusions relating to the cause of death, and in one case - opinion based on the files of a case related to the suspicion of a maltreated child syndrome in an infant. In all these cases, the results of the molecular and genetic tests were negative, which was taken into account by the experts when formulating the final conclusions of the opinion. The use of clinical molecular and genetic tests in forensic medicine is possible and always brings important additional information that broadens the possibilities of opinion-making and facilitates diagnosis. The areas in which this type of research may be particularly useful are: diagnostics of the basis of thromboembolic complications, modern integrated morphological and molecular diagnostics of neoplasms and diagnostics of genetic defects of connective tissue in children suspected of having abused child syndrome.
The case report presents an identification process based on DNA isolated from personal belongings, including a filter mask. In May 2021, an unidentified 65-year-old male corpse was revealed by the city's outskirts road....The case report presents an identification process based on DNA isolated from personal belongings, including a filter mask. In May 2021, an unidentified 65-year-old male corpse was revealed by the city's outskirts road. Since it was impossible to use material from living relatives for comparative analysis, the samples of personal belongings of the alleged victim were used instead: clippings of the filtering face piece type 2 (FFP2) face mask (parts adhering to the nose and the earlobes, the central part of the mask), swabs from the razor (blade and shaft), toothbrush shaft, and toothbrush filaments clippings. The presented case indicates the need for collecting a wide range of samples for genetic analyses, including filter masks as an alternative item of personal belonging.
This article is a synthesis of the history of medicolegal opinions in France in the 17th century. Mainly two research methods were used in the work - the historical method and the descriptive method. The article aims to...This article is a synthesis of the history of medicolegal opinions in France in the 17th century. Mainly two research methods were used in the work - the historical method and the descriptive method. The article aims to present the knowledge of French forensic medicine in a historical and legal context. It shows the pioneering research of medics and surgeons, presents the legal regulations of that time, and emphasizes the high level of French science compared to other European countries. It is worth adding that from the earliest times the issues with the assessment of health and life were assigned to medical experts - jurors (the edict of 1603 médecins jurés et chirurgiens jurés). During this period, forensic and medical examinations became a duty. People became interested in the mental health of the accused, as well as in the inspection of the reproductive organs in the event of a divorce. Italian surgery had a huge impact on the history of medicolegal opinions in the French territories. Interestingly, France was the first country to separate judicial and medical issues from tasks related to the medical police.
Recent years saw frequent media reports of young people who die while they are being arrested by the police. Death in these circumstances affects people who are agitated and restrained with the use of force, with their a...Recent years saw frequent media reports of young people who die while they are being arrested by the police. Death in these circumstances affects people who are agitated and restrained with the use of force, with their autopsies indicating no unequivocally traumatic cause of death. The goal of this study was to identify the mechanism and circumstances of sudden deaths in agitated individuals who are being restrained. Ten cases evaluated at our center since 2010 were included in this study: nine involved forensic postmortem examination and one involved casefile analysis. In each case there was sudden cardiac arrest or at least a loss of consciousness, and the cardiopulmonary resuscitation proved ineffective. In six cases the cause of agitation was acute psychosis, in four it was an effect of narcotics, usually in high concentration. Conjunctival petechiae were detected in only five cases. The most probable cause of death in the evaluated cases was the combination of physical exertion caused by pathological psychomotor agitation and forcible restraint, hindering the function of the respiratory system. This mechanism is known as restraint asphyxia.
AIM: The paper presents the basic principles of judicial review in cases of shooting people or animals on hunting with rifled long weapons, including deaths with a fatal outcome. MATERIAL AND METHODS: Such opinions are i...AIM: The paper presents the basic principles of judicial review in cases of shooting people or animals on hunting with rifled long weapons, including deaths with a fatal outcome. MATERIAL AND METHODS: Such opinions are issued on the basis of the collected evidence and the knowledge of an expert in the field of weapons and ammunition, ballistics as well as in the field of anatomopathological medicine. RESULTS: This type of comprehensive analysis allows for the issuance of a detailed and at the same time precise opinion as a special means of evidence, having the most important importance in the course of the entire trial. Therefore, it is extremely important to properly secure the evidence in the form of a bullet or its fragments and to confront these elements with the assessment of the gunshot wound, and above all the shape and size of the gunshot canal and the momentary gunshot cavity. These types of proceedings are quite complicated, as they require a broad spectrum of knowledge from an expert, therefore, in order to solve the complicated subject matter of the opinion, it is often necessary to issue an opinion even by several experts. CONCLUSIONS: Forensic opinions in cases related to gunshots, including fatal ones, require an expert to have interdisciplinary specialist knowledge. All analyzes in this regard should be based on ballistic expertise in the aspect of gunshot wound assessment. The combination of these two elements determines the issuance of an objective and unquestionable interpretation.
The history of humanity is closely related to the use of various poisons, different in each epoch. They served different purposes for centuries. In addition to being a remedy for various ailments and diseases, they also...The history of humanity is closely related to the use of various poisons, different in each epoch. They served different purposes for centuries. In addition to being a remedy for various ailments and diseases, they also helped to bear the hard life of a person thanks to the possibility of causing mental elation, making it more bearable. They were also used to kill other people, most often for very low motives. The number of poisons existing in particular stages of civilization has been systematically increasing, reaching the number of 100,000 - 500,000 toxicologically active compounds in modern times, with the generally estimated number of known chemical compounds at the level of about 240 million. The research work of thinkers and people of progress is a counterbalance to the evil deeds of poisoners in antiquity and the Middle Ages. These works appeared in the late Middle Ages and are continued in various forms until the present day. As a result of these works, modern toxicological forensic expertise has been developed. However, before it appeared in its modern shape, it had to go through a very difficult development path, which lasted continuously for several centuries. Modern toxicological expertise, based on a highly specialized instrumental methodology, operating with high methodological standards, is the achievement of many generations. These standards have now become a requirement for expert works of our times, and failure to comply with them is treated as a malpractice. This work is a review of the types of poisons and reports in terms of the development and application of toxicological forensic expertise for the purposes of the judiciary.
A significant increase in the number of suicides with the use of helium has been observed in recent years. Deaths with its use are quick and are not accompanied by a feeling of breathlessness. This paper presents the res...A significant increase in the number of suicides with the use of helium has been observed in recent years. Deaths with its use are quick and are not accompanied by a feeling of breathlessness. This paper presents the results of a post-mortem examination of a woman who committed suicide by inhaling helium. Conventional postmortem examination did not reveal any post-traumatic changes, while a computed tomography (CT) scans showed the presence of a large amount of gas in the veins and arteries of the whole body and in the heart chambers. In the assessment of postmortem computed tomography (PMCT) images, changes resulting from putrefaction were also taken into account. The results of the diagnostics carried out confirm the results of previous reports, which indicated that inhalation of large amounts of helium leads to death not only (as previously thought) in the oxygen displacement mechanism, but also through the formation of gas embolisms.
BACKGROUND: After unprecedented demand for ethanol in the pandemic, profiteers used methanol for making illegal alcoholic drink. MATERIAL AND METHODS: Final judgements passed by criminal divisions of common courts of law...BACKGROUND: After unprecedented demand for ethanol in the pandemic, profiteers used methanol for making illegal alcoholic drink. MATERIAL AND METHODS: Final judgements passed by criminal divisions of common courts of law in cases where death or grievous bodily harm was caused by injuries to the facial and cerebral parts of the skull resulting solely from punches to the facial area of the skull. Assessment of individual cases within each group to determine similarities and differences. Comparative analysis of both groups. METHODS: This cross-sectional descriptive-analytical study investigated the effects of methanol poisoning on 400 patients who referred to hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences from March 20 to September 20, 2020. RESULTS: Ninety-eight-point five percent of patients had consumed alcohol for social reasons and only 0.3% had used it as a measure to avoid COVID-19. Eighty-seven percent of the patients used homemade alcohol bought from peddlers. The most common clinical symptom was gastrointestinal disorders (64.8%) and the most common complications were vision problems (12.3%). Ten-point-six percent (42 patients) of the patients died. The most important factors affecting mortality risk were dyspnea, neuropathic problems, abnormal radiological findings, dialysis, abnormal blood pressure, vision problems and dizziness. CONCLUSIONS: Informing the public about the risks of using homemade alcoholic beverages is essential if the associated disability and mortality has to be avoided.