The story of an unknown defender of the homeland: Identification of the remains of an unnamed person – forensic medical analysis and historical context = Historia nieznanego obrońcy ojczyzny: identyfikacja szczątków N.N. osoby – analiza sądowo-lekarska i kontekst historyczny

The article presents the results of forensic medical examinations of human remains discovered in 2021 in a forest near the village of Wapiennik (Lipie commune). Preliminary findings indicated that they may have belonged to Józef Kiedos, alias “Kulawy,” who was shot by German soldiers in September 1939. Anthropological analysis revealed that the individual was a man over the age of 50, approximately 171–172 cm tall, with visible pathological changes in the right femur, which could correspond to witness accounts of limping. No gunshot wounds were identified, and the present bone damage was postmortem in nature; however, this does not exclude a traumatic cause of death. Based on the collected evidence and historical context, it was concluded that the remains belonged to Józef Kiedos, a civilian murdered in the early days of World War II. The study highlights the role of forensic medicine in clarifying cases of historical significance.

Increased reduction in exsanguination rates leaves brain injury as the only major cause of death in blunt trauma

EMBO Reports (2019) e48380 Invasive autopsy has been crucial to determine the cause of death—as part of a criminal investigation or for public health purposes—but the vivisection of the corpse often meets resistance from relatives or certain religious or ethnic groups. To address religious objections or feelings that invasive autopsy violates the dignity of the deceased, pathologists have been using non‐invasive scanning techniques, originally developed for medical diagnosis, either as alternatives to, or to complement traditional autopsies. The use of computer tomography and magnetic resonance imaging in places where they are readily available not only appeals to relatives who object to vivisection but it also provides additional information or helps to confirm conclusions about the cause of death. > … the rate of autopsy has been declining […], partly out of growing opposition to what is often considered unnecessary mutilation of the bodies of loved ones. Autopsy has a long history dating back to at least 3,000 years BC in ancient Egypt. Julius Caesar was subjected to an official autopsy in 44 BC after his murder in the Roman senate. In the modern era, autopsies are routinely used to determine causes of death, especially when people die unexpectedly or under suspicious circumstances. Yet, the rate of autopsy has been declining in almost every developed country and many developing ones, partly out of growing opposition to what is often considered unnecessary mutilation of the bodies of loved ones. For example, autopsies were performed on 40–60% of all people who died in hospital in the United States before 1970, but that rate has now fallen to below 5% [1]. This comes at a time when autopsies for reasons other than establishing cause of death have become increasingly valuable: to evaluate the extent of human disease in patients and the effectiveness of …

Sudden Unexpected Death after a mild trauma: The complex forensic interpretation of cardiac and genetic findings

Postmortem cardiac troponin T levels in the blood and pericardial fluid. Part 1. Analysis with special regard to traumatic causes of death

Every year Russia performs about 700’000 forensic medical examinations and postmortem assessments which is about a third of all deaths. In line with the current legislation, suspected violent deaths (due to external causes) are the reason for a forensic medical exam. Determination of the presence and quantitative content of exogenous ethanol in the corpse’s biological fluids is mandatory in all cases of violent death. In turn, alcohol consumption is one of the leading risk factors affecting mortality in Russia, especially among working-age men. Calculating alcohol consumption in population is challenging, since part of the available alcohol is unregistered (moonshine, alcoholic surrogates), yet there are many indicators that are considered reliable and characterize the level of alcohol consumption in population. This study has attempted to analyze causes of death of those with exogenous ethanol in biological fluids. These indicators are necessary for developing and implementing the most effective health policy, saving health and increasing life expectancy in Russia. The purpose of the study is to analyze causes of death based on the results of forensic medical examinations of corpses with ethanol in biological fluids. Material and methods. The material of this paper is data on forensic medical examinations collected by the Russian center of forensic medical examination of the Ministry of Health of the Russian Federation using the statistical observation form #42 “Forensic pathologist’s report, the Burau of forensic medical examination”. The study uses the method of descriptive statistics and correlation analysis. The share of deaths from various causes with ethanol in biological fluids was analyzed based on the results of forensic medical examinations by region and cause of death in 2003-2022. Results. The share of deaths with ethanol in biological fluids equaled to 46% of all forensic medical examinations in 2003, followed by a gradual decrease to 19% in 2022. The maximum was registered in external causes of death. Over the study period (2003-2022) the share of deaths with ethanol in biological fluids among deaths due to external causes decreased from 60% to 47, and from 31% to 14% among non-violent deaths. The share ranged from 36% to 45% among deaths attributed to symptoms, signs and ill-defined conditions without a tendency towards decreasing. For a number of external causes of death, this indicator consistently accounted for more than half of all forensic medical exams. Over the period under study, most regions of Russia witnessed a noticeable decrease in the share of deaths with ethanol in biological fluids, however, in some regions like the Republic of Buryatia, Sakhalin Region, Trans-Baikal Territory, Magadan Region, Nenets Autonomous Area and Murmansk Region, there is no noticeable decrease. The minimum was registered in the Chechen Republic and Republic of Ingushetia. However, in the North Caucasian republics, in general, there are low rates of forensic medical examinations of all deaths (less than 10%). Conclusion. Results of forensic medical examinations can potentially supplement and refine complex estimates of the contribution of alcohol consumption to the Russian mortality.

A prospective autopsy study of firearms-related death was carried out by the authors in the Niger Delta region of Nigeria. The purpose of the study was to evaluate the pattern, frequency, and anatomical sites of wounds, also the cause of death and the age and sex distribution of victims. The autopsies were performed after being served with the coroner's inquest forms. In all cases standard autopsy procedures were adopted and reports issued. A total of 136 consecutive firearm deaths were autopsied. There were 122 (89.7%) males and 14 (10.3%) females, giving a male to female ratio of 8.7:1. The highest number of deaths, 95 (69.8%), occurred in the age group of 10-39 years with a peak of 51 (37.5%) deaths at 20-29 years. In 112 (82.4%) cases death occurred from homicidal gunshot wounds. The commonest targets of gunshot wounds were the head, 58 (42.6%); multiple anatomical sites, 30 (22.1%); chest, 16 (11.8%); abdomen, 11 (8.1%) and neck, 10 (7.4%). Haemorrhagic shock was the cause of death in 131 (96.3%) cases. Significant causes of traumatic death in the Niger Delta region of Nigeria are gunshot wounds and associated complications. Stringent laws on illegal firearms handling should be passed and enforced by the government to reduce the frequency of such deaths.

Introduction: In the medicolegal daily practice, electrocution is a traumatic cause of death owing to wide use of electricity and electrical devices in different activities of modern life at home and workplaces. Electrical current passage through tissues elaborates different types of energy (the electrical, thermal, and mechanical energies) which can cause skin lesions, multiorgan damage, and even death. The severity and extent of tissue injuries depend on the current type (alternating current [AC] or direct current), its strength (amperage), voltage (low or high), frequency, tissue resistance, duration of exposure, and its pathway through the body. Microscopic examination of tissue samples from the heart may show nonspecific findings to electrocution, but sometimes none is detected by conventional hematoxylin and eosin stains (H and E). Therefore, immunohistochemical studies could help the forensic pathologists in their diagnosis, especially cases with less typical findings or obscure circumstances. Heart-type fatty acid-binding protein 3 (H-FABP3) is a small cytoplasmic protein of (15 kDa), composes of 133 amino acids, involves in active fatty acid metabolism, and transports fatty acids from the cell membrane to mitochondria for oxidation. Due to its cytoplasmic location and small molecular weight, it released from cardiac myocytes into the circulation following an ischemic episode. Objective: This study was conducted to evaluate the effect of electric current on the expression of H-FABP3 in human heart tissue autopsy samples. Methods: Human heart tissue samples were collected during the period from January 1 2016 to June 30, 2016, through autopsy of 30 medicolegal cases of electrocution as well as 30 cases of fatal head injuries which were used as control. They were examined by conventional histopathological H and E stain and immunohistochemical technique so that H-FABP3 was detected using FABP3 polyclonal antibody and demonstrated by ready to use biotin-free, one-step horseradish peroxidase polymer anti-mouse, rat, and rabbit immunoglobulin G with 3,3'-diaminobenzidine to achieve the aim of this study. Results: This study shows that electric shock was the fifth cause of traumatic death, being responsible for death of only 4.5% of cases referred to the medicolegal directorate in Baghdad during the period of study. It is almost accidental death in Iraqi society with higher incidence to be due to contact with low-voltage household AC sources with young males at the age of (15–20 years old) are being more vulnerable to fatal electrical injury than females during their early productive life (with male:female ratio = 6:1). Heart tissue ischemia is a major cause of death following electrocution, especially when victim being in contact with household low-voltage AC in the presence of transthoracic pathway to the ground and low body resistance due to skin wet which can cause death within a minute in association with mild if any electrical skin burns. Electrocution has a significant effect on H-FABP3 stain total index as it causes depletion of FABP3 total stain index with mean of 0.28 ± 0.149177SD for tissue sections of the heart muscle in the affected areas of human cases. Conclusions: Immunohistochemical heart tissue samples' examination which shows dramatic depletion in H-FABP3 total stain index in affected area(s) is of value in detecting heart tissue injury caused by electrocution during the early period after death even in the absence of grossly and microscopically visible lesion(s).

Epidemiology and pattern of paediatric and adolescent trauma deaths in a level 1 trauma centre in Benin city, Nigeria

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.

Fulminant pulmonary fat embolism - undetected silent killer.

To analyze and report on the changes in epidemiology traumatic causes of death in the USA. Data were extracted from the annual National Vital Statistics Reports (2008-2017) from Center for Disease Control and analyzed for trends during the time period given. Generalized additive model was applied to evaluate the significance of trend using R software. Firearm deaths (39,790) and firearm death rate (12.2/100,000) in 2017 were the highest reported, and this increasing trend was significant (p < 0.001) the last ten years. Deaths from motor vehicle crash (MVC) and firearm homicides did not change significantly during the same time period. Firearm deaths were lower than MVC deaths by 21% (8,197/39,790) in 2008, but after 10years, the difference was only 1% (458/40,231). Years of life lost from firearms is now higher than MVC. Suicides by firearm in 2017 were the highest reported at 23,854/39,773 (60%). In 2017, suicides by firearm victims were predominantly white 20,328/23,562 (85%), men 20,362/23,562 (86%), and the largest group was between the ages of 55-64. Death from firearms in the USA is increasing and endemic. They were the highest ever reported in 2017 by the CDC. While deaths from MVC used to be the main cause of traumatic death in the USA, deaths from firearms now almost equal it. Calculated years of life lost from firearms is now more than from MVC. Most firearm deaths are not from homicides but are from suicides, and they are predominantly in white older males of the baby boomer generation (born 1946-1964).

Non-traumatic subdural hematoma secondary to septic brain embolism: A rare cause of unexpected death in a drug addict suffering from undiagnosed bacterial endocarditis

Nerium oleander is a very popular urban ornamental plant in Europe, but it is also extremely dangerous because it contains several types of glycosides, accidental ingestion of which can cause cardiac arrhythmias and even deaths. The rarity of such cases makes it difficult to think of oleander poisoning without evidences that suggest this possibility as the cause of the unexpected death. This report concerns the discovery of the bodies of 2 young people, a man and a woman, in a forest in conditions of extreme malnutrition. Medicolegal investigations showed neither pathologic nor traumatic causes of death, but the presence of vegetal remains in the stomach was noticed. A common toxicological analysis resulted negative, but the implementation of more detailed investigations showed the presence of digoxin in the blood of both cadavers, excluding the possibility of a pharmaceutical provenience of digoxin, this laboratory result was interpreted as evidence of ingestion of oleander, which contains oleandrine, the cross reaction of which with digoxin is widely described in the literature. Identification of the 2 subjects, which occurred after 4 years, strengthened the hypothesis of accidental poisoning by oleander because it was ascertained that the 2 young people were vegans--extreme vegetarians who reject the ingestion of foods of animal origin and live by eating only what they find in nature.

The aim of this study was to determine the sensitivity and specificity of postmortem whole-body MRI for typical injuries resulting from traumatic causes of death. Forty cases of accidental death were evaluated with postmortem whole-body MRI. Imaging was conducted according to a standard protocol, and each examination had an average duration of 90 minutes. The imaging findings were correlated with the autopsy findings, which served as the reference standard. MRI showed the main pathologic process leading to death in 39 of the 40 cases. The sensitivity of postmortem MRI ranged from 100% (pneumothorax) to 40% (fractures of the upper extremities). In general, MRI had a high level of performance for depicting soft-tissue lesions, such as subcutaneous hematoma (e.g., galeal hematoma with a sensitivity 95%). The sensitivity of MRI was remarkably lower for lesions of the upper abdominal organs (liver, 80%; spleen, 50%; pancreas, 60%; kidneys, 66%). Postmortem whole-body MRI had overall good performance for depicting traumatic findings in corpses and therefore may serve an important role as an adjunct to classic autopsy for the forensic examination of cases of traumatic cause of death. However, the reduced sensitivity of postmortem MRI for lacerations of the upper abdominal organs and the observed superimposition of antemortem findings and postmortem findings (e.g., in the pulmonary tissue) in this retrospective study suggest that whole-body postmortem MRI not be recommended as a replacement for classic autopsy.