Legal medicine
-
Previous studies suggested that serum catecholamines are useful for investigating stress responses in the death process. The present study analyzed postmortem urinary adrenaline (Ad), noradrenaline (Nad) and dopamine (DA) in serial forensic autopsy cases (n=199: 154 males and 45 females; age >9years; survival time <0.5-168h; within 10days postmortem) to investigate the differences among the causes of death with special regard to hyperthermia (heatstroke; n=11) and hypothermia (cold exposure; n=10); other cases included fatalities from injury (n=47), mechanical asphyxiation (n=18), drowning (n=14), intoxication (n=31), fire fatality (n=33) and natural death (n=35). Each catecholamine level in urine was independent of the age or gender of the subjects, postmortem interval over 10days or survival time, and did not correlate with the blood level. ⋯ Adr and Nad were higher in blunt head injury, methamphetamine abuse, hypothermia (cold exposure) and hyperthermia (heat stroke), but were low in mechanical asphyxia, drowning, fire fatality, sedative-hypnotic intoxication and acute cardiac death. DA was higher in injury, drowning, fire fatality, methamphetamine abuse and acute cardiac death, but was lower in mechanical asphyxiation and sedative-hypnotic intoxication. These profiles were quite different from those of serum levels, involving a predominant increase of DA, and may be useful for differentiating hyperthermia (heatstroke) and hypothermia (cold exposure) from drowning, sedative-hypnotic intoxication and sudden cardiac death.
-
Case Reports
Post mortem computed tomography: useful or unnecessary in gunshot wounds deaths? Two case reports.
Post-mortem computer tomography (PMCT) is currently an useful procedure that can elucidate patterns of injuries, providing strong medical evidence that is very useful during litigation and at trial. This technique is especially useful in gunshot wounds cases, allowing an easier location and retrieval of the bullet and/or its fragments inside the body. In such cases, the use of 3D rendering can be very useful in order to obtain essential information, such as: accurate depict of the wound track, discerning between entrance and exit wounds, show bone's fracture and its fragments course inside the body. ⋯ The crime scene reconstruction was performed using the software Poser Debut® on a Mac OS X computer. In both cases, PMCT showed multiple advantages: objectivity, reproducibility, ease visualization of the wound paths, easy localization of bullet and their fragments, allowing us to clarify the cause of death before the traditional autopsy. PMCT should became a standard in forensic practice as an aid to the tradition postmortem examination to obtain as much information as possible in order to clarify the cause and manner of death.
-
Asphyxia related-death is a common incident in forensic practice, since they can be related to suicide, homicide and accident. The deep structures of the neck can be very difficult to reach using the traditional neck dissection when no certain information about potential injuries are obtained. ⋯ In cases of asphyxia related-death (with special regards to homicidal strangulation) the PMCT with 3D documentation can be very helpful in revealing injuries on the small structures of the neck, that can be also masked by soft tissues and surrounding bleedings and provides a useful guide for the pathologist to choose the right dissecting technique and avoid artifacts or iatrogenic injury to delicate structures, such as hyoid bone or thyroid cartilage. The case of a homicide by ligature strangulation using two items (electric wire and cotton bed sheet) is presented, in which the PMCT was performed before the autopsy, showing helpful features concerning the mechanism of death.