Forensic Science International Supplement Series最新文献

{"title":"Identification and analyses of female civilian victims of the 1991 war in Croatia from the Glina and Petrinja areas","authors":"M. Slaus ,&nbsp;D. Strinovic ,&nbsp;V. Petrovecki ,&nbsp;D. Mayer ,&nbsp;V. Vyroubal ,&nbsp;Z. Bedic","doi":"10.1016/j.fsisup.2009.09.006","DOIUrl":"10.1016/j.fsisup.2009.09.006","url":null,"abstract":"<div><h3>Introduction</h3><p>The process of recovering and identifying human remains from individual and mass graves has proven to be the most effective method of resolving the fate of missing individuals in the former Yugoslavia. These efforts have two primary objectives: medicolegal—to identify the cause of death, and humanitarian—to bring closure to living family members, thus supporting the human rights of both the living and the deceased. From 1996 to the present, the remains of 388 individuals killed during the 1991 War in Croatia were recovered from the Glina and Petrinja areas (Sisačko–Moslovačka County). The purpose of this paper is to report on the demographic and taphonomic characteristics of the recovered remains, and identify factors responsible for the discrepancy in the identification ratios.</p></div><div><h3>Methods</h3><p>To identify factors potentially responsible for the noted discrepancy, data were collected on the taphonomic characteristics of the recovered remains, the types of burials, as well as the factors responsible for positive identification. These factors included: forensic DNA testing, dental criteria, special signs (healed fractures, etc.), clothing and personal artifacts.</p></div><div><h3>Results</h3><p>The age distributions between males and females in the sample are significantly different. The mean age-at-death for males is 51.6 years, for females 67.0 years. In both sexes the majority of identifications (62.9% in females and 45.9% in males) were established through a combination of biological and non-biological features. In terms of the types of graves from which the bodies were recovered, positive identification in both sexes was lowest in mass graves (61.2% for males, and 84.2% for females). Females from mass graves were, however, better preserved than males—36.6% of males recovered from mass graves were completely skeletonized, while the same was true for only 19.3% of females (<em>χ</em>² <!-->=<!--> <!-->7.06, <em>P</em> <!-->&lt;<!--> <!-->0.029). Completely skeletonized remains were identified in only 65.1% of cases, while partially skeletonized and saponified bodies were identified in 80.1% of cases.</p></div><div><h3>Conclusion</h3><p>Since positive identification in both sexes is strongly correlated with preservation of the bodies, the reason why female identification frequencies in the Glina and Petrinja regions are higher than male frequencies lies in the fact that females recovered from mass graves were better preserved than males recovered from mass graves. Identification of the factors responsible for this is a challenge that needs to be resolved in future studies.</p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 69-71"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.09.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87924715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toxicological investigations for drugs of abuse in arrested drivers: A 2-year retrospective study (2005–2006) in Strasbourg, France","authors":"A. Tracqui ,&nbsp;E. Szwarc ,&nbsp;C. Jamey ,&nbsp;B. Ludes","doi":"10.1016/j.fsisup.2009.07.005","DOIUrl":"10.1016/j.fsisup.2009.07.005","url":null,"abstract":"<div><p><span><span>Driving under the influence of </span>drugs of abuse (DRUID) is prosecuted in France since 2001. Biological controls are performed according to a 2-step procedure: urine immunoscreening followed, in case of positivity, by a blood analysis using a separative technique coupled to mass spectrometry. This paper presents a 2-year (2005–2006) retrospective review of blood analyses performed in this framework at the Medico-Legal Institute of Strasbourg, France. Over this period 611 subjects were controlled on request of the authorities. Of this population, 532 (87.1%) were male. Mean age was 31.7</span> <!-->±<!--> <span><span>14.4 years, 57.9% of subjects were in the range 15–29 and 31.1% in the range 20–24. On the 611 drivers, 296 (48.4%) were found positive for at least 1 drug using a preliminary blood immunoassay<span> (ELISA). Among them, 254 were positive for cannabis, 81 for opiates, 22 for cocaine and 8 for amphetamine derivatives. Psychoactive medications were additionally tested in 278 drivers, and detected in 53 (19.1%). </span></span>Benzodiazepines<span> were the most frequently identified. On the 254 subjects tested positive for cannabis by ELISA, 202 had detectable levels of THC in blood (which is mandatory for engaging prosecution against the drivers). THC concentrations were in the range 0.1–49.9</span></span> <!-->ng/ml. Our results clearly illustrate the huge prominence of cannabis among substances involved in DRUID. This study also highlights some pitfalls of the DRUID repression policy currently followed by France, especially interpretation of low concentrations of drugs of abuse (in our study, 28.2% of drivers found positive for cannabis at the immunoassay screening had blood THC levels<!--> <!-->&lt;<!--> <!-->1<!--> <!-->ng/ml): since no minimum threshold for blood concentrations has been defined in our country the fate of arrested drivers is prone to vary depending on the sensitivity of techniques employed from one laboratory to another, which might contradict the principle of equality of citizens before the law.</p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 17-19"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84718956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tractor driving and alcohol—A highly hazardous combination","authors":"J.L. Gassend ,&nbsp;M. Bakovic ,&nbsp;D. Mayer ,&nbsp;D. Strinovic ,&nbsp;J. Skavic ,&nbsp;V. Petrovecki","doi":"10.1016/j.fsisup.2009.09.010","DOIUrl":"10.1016/j.fsisup.2009.09.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Approximately half of all injury-related fatalities in the agricultural industry are associated with farm tractors. Skill-based psychomotor tasks, such as driving and operating such machines, are easily impaired as a consequence of the use of alcohol. We have analyzed characteristics of fatal traffic accidents involving tractors in Zagreb County, with special accent to prevalence of alcohol use among drivers.</p></div><div><h3>Subjects and methods</h3><p>The material comprised all fatal accidents involving tractor drivers in Zagreb County between the years 2001 and 2005 where a medicolegal autopsy had been performed and samples taken for subsequent forensic toxicological analysis. The total of 47 cases were included. Data were collected on characteristics of the fatally injured as well as on circumstances and dynamics of the accident itself. The results are presented with absolute and relative frequencies.</p></div><div><h3>Results</h3><p><span>Ninety-one percent (43 out of 47 cases) of fatally injured were males. No person was under the age of 18, 70% were between 18 and 65 years of age and 30% were above 65 years of age. Blood alcohol reading was negative in only 13 out of 47 analyzed cases (28%). Six cases (13%) had blood alcohol concentration (BAC) below 0.50</span> <!-->mg/mL, further 6 between 0.50 and 1.49<!--> <!-->mg/mL, 16 (34%) between 1.50 and 2.49<!--> <!-->mg/mL and the remaining six had BAC between 2.50 and 3.49<!--> <!-->mg/mL. Median BAC among 34 fatalities with positive blood alcohol level was 1.80<!--> <!-->mg/mL, while the highest concentration observed was 3.49<!--> <span>mg/mL. Multiple injuries were the most common cause of death (43%) followed by crush asphyxia (26%). Most of the victims (81%) died at the scene of the accident and all of them died within the first 24</span> <!-->h. In the majority of accidents (79%), the tractor operator was a victim of the vehicle rollover.</p></div><div><h3>Conclusion</h3><p>High percentage of farm tractor users driving under influence and high median BAC indicates that legislation alone is not sufficient in preventing accidents. Further effort should be directed toward education aimed to increase awareness of the obvious risk that alcohol use represents to driving and workplace safety. Taking into account that the overwhelming majority of fatalities occurred from rollovers, strong encouragement should be given to implementation of rollover protecting structure (ROPS) devices in order to prevent such type of fatalities.</p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 76-79"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.09.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76253927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low blood alcohol levels. Experimental study on attention and body sway control functions","authors":"Massimo Montisci ,&nbsp;Giovanni Cecchetto ,&nbsp;Guido Viel ,&nbsp;Donata Favretto ,&nbsp;Giorgia Ducolin ,&nbsp;Raffaele Giorgetti ,&nbsp;Santo Davide Ferrara","doi":"10.1016/j.fsisup.2009.09.008","DOIUrl":"10.1016/j.fsisup.2009.09.008","url":null,"abstract":"<div><h3>Objective</h3><p><span>Attempting to prevent alcohol-related road accidents requires sensitive, reliable and easy-to-use methods and instruments for ascertaining drivers’ state of intoxication. This paper examines the scientific validity of a method for assessing psychomotor performance combining measurement of neurosensory functions with the effect of low </span>blood alcohol levels: body sway control and attention functions.</p></div><div><h3>Methods</h3><p>A double-blind, placebo-controlled study, with cross-over and random distribution on the effects of low blood alcohol levels. Psychomotor performance and body sway control were studied in 16 healthy volunteers after they had drunk a small dose of ethyl alcohol (0.5<!--> <span>g/kg) or placebo<span>. Neurosensory and psychomotor functions were assessed by a Divided Attention Test (DAT), composed of the association between one test exploring short-term memory (Memory Test) and one exploring attention (Response Competition Test). Alterations in body sway were recorded by stabilometry. Tests were administered at 30, 60, 120 and 180</span></span> <!-->min after intake of alcohol. After a wash-out period of at least one week, subjects repeated the test after taking a second dose of alcohol or placebo. Blood alcohol concentrations were monitored by analysis of concentrations in expired air.</p></div><div><h3>Results</h3><p>A BAC under 50<!--> <!-->mg/dL did not reveal statistically significant impaired memory capacities or motor coordination. Instead, statistically significant oscillations of body sway were measured (<em>p</em>-values<!--> <!-->=<!--> <!-->0.0001), especially when stabilometry was associated with deviant stimuli like those of the DAT (<em>p</em>-values<!--> <!-->=<!--> <!-->0.0001).</p></div><div><h3>Conclusions</h3><p><span>This study showed: (1) impaired performance, at the limits of statistical significance, on a complex psychometric test like the DAT; (2) some cognitive, attentive and visual perceptive functions are not compromised or at least not in a statistically significant manner; (3) a considerable alteration in the capacity for control of body sway after intake of alcohol becomes further and massively impaired when deviant stimuli are given; (4) this impairment appeared early and was more marked 1 and 2</span> <!-->h after intake of alcohol.</p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 63-65"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.09.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86731079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal yew ingestion","authors":"P. Roll ,&nbsp;Ch. Beham-Schmid ,&nbsp;A. Beham ,&nbsp;M. Kollroser ,&nbsp;B. Reichenpfader","doi":"10.1016/j.fsisup.2009.08.005","DOIUrl":"10.1016/j.fsisup.2009.08.005","url":null,"abstract":"<div><p>A 41-year-old man was found dead, lying in prone position<span> on the ground near a parking area, where the car of the person was parked. Remarkable were the spasm-like hands of the decedent, cause of death was unknown. Primary an epileptical attack was assumed. A medicolegal autopsy was performed followed by histological and forensic toxicological analysis. Furthermore a plant anatomical investigation was applied. Autopsy revealed fragments of greenish needle-like leaves in the stomach and the intestines, but not in the colon. Plant anatomical investigation indicated the presence of yew. Histological findings were in concordance with the literature, in addition the investigation of bone marrow was performed for the first time. Forensic toxicological analysis revealed the presence of 3,5-dimethoxyphenol, the marker for intoxication with taxus baccata.</span></p><p>This case reports the importance of medicolegal examinations in order to avoid misdiagnosis. Here the suspection of an epileptical attack as a possible cause of death was excluded by an autopsy, in addition an intoxication by yew leaves was proved.</p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 20-21"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.08.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79339980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The toxicological challenges in the European research project DRUID","authors":"Kristof Pil ,&nbsp;Elke Raes ,&nbsp;Alain G. Verstraete","doi":"10.1016/j.fsisup.2009.08.001","DOIUrl":"10.1016/j.fsisup.2009.08.001","url":null,"abstract":"<div><p>Within the epidemiological studies of the integrated European research project DRUID (Driving Under the Influence of Drugs, alcohol and medicines), 13 laboratories from across Europe will analyse whole blood, oral fluid (OF) or urine from the general driving population and injured drivers. To ensure the comparability of toxicological results from the different studies, the collection of samples, analytical methods, target analytes and analytical cut-offs have been standardized for all laboratories involved.</p><p><span>Target analytes were selected based on suspected impairing effects and prevalence. Twenty-three drugs are included in the ‘core list’ for which analysis is mandatory: ethanol, amphetamine<span><span>, MDMA, MDA, </span>MDEA<span>, methamphetamine, cocaine, benzoylecgonine<span>, THC, THC-COOH, 6-acetylmorphine, diazepam, </span></span></span></span>flunitrazepam<span><span><span>, alprazolam, clonazepam<span>, oxazepam<span>, nordiazepam, </span></span></span>zolpidem<span>, zopiclone, </span></span>lorazepam<span>, morphine, codeine and methadone. Additionally, 28 other drugs will be analysed in 1–12 countries.</span></span></p><p><span><span><span>All whole blood samples are collected in glass Vacutainer-type tubes containing sodium fluoride and potassium </span>oxalate. Based on a </span>comparative study of 10 collection devices, it was decided to collect oral fluid using the Statsure™ device. Since only a small sample volume is available (5–10</span> <!-->mL blood and 1<!--> <!-->mL oral fluid), all laboratories have to develop methods for simultaneous detection of the target analytes. All laboratories agreed to use either LC–MS–MS or GC–MS in SIM-mode. Proficiency testing for both blood and oral fluid are organized.</p><p>Analytical cut-offs were established for the core list based on those used in ROSITA-2, SAMHSA cut-off values for oral fluid and recommendations from an expert meeting in Talloires.</p><p>Because of practical and legal considerations, different sample types are used: whole blood, serum/plasma and oral fluid. Literature on correlation between analyte concentrations in these body fluids is limited, which makes several comparisons of study results difficult: (1) comparison of epidemiological (blood, oral fluid and urine) and experimental studies (serum and plasma) performed in DRUID and (2) comparisons within the epidemiological studies themselves (most countries: oral fluid in road-side survey, blood in hospital studies).</p><p>A combination of literature findings, new findings from DRUID and semi-quantitative results will likely have to be used to solve these problems.</p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 29-32"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88969658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drunk drivers—Chances for and difficulties in giving medico-legal opinions on drivers’ alcohol intoxication levels, on the basis of the material analyzed in the Forensic Medicine Department, Medical University of Silesia, Katowice in the years 2003–2007","authors":"K. Rygol,&nbsp;M. Chowaniec,&nbsp;Cz. Chowaniec,&nbsp;K. Droździok,&nbsp;A. Nowak","doi":"10.1016/j.fsisup.2009.08.007","DOIUrl":"10.1016/j.fsisup.2009.08.007","url":null,"abstract":"<div><p>The authors have conducted a statistical analysis of 340 court files investigated in the Forensic Medicine Department Medical University of Silesia, Katowice in the years 2003–2007 with regard to chances for as well as difficulties in giving medico-legal opinions on drivers’ alcohol intoxication levels, which would be valid for court purposes.</p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 27-28"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.08.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75917791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of lethal methadone intoxication of a 3-week-old infant","authors":"M. Kobek ,&nbsp;C.H. Jabłoński ,&nbsp;J. Kulikowska ,&nbsp;D. Pieśniak ,&nbsp;C.Z. Chowaniec ,&nbsp;Z. Gąszczyk-Ożarowski","doi":"10.1016/j.fsisup.2009.07.008","DOIUrl":"10.1016/j.fsisup.2009.07.008","url":null,"abstract":"<div><p><span><span>The authors describe a rare case of lethal methadone intoxication of a 3-week-old infant. Born of a drug-addicted mother who was undergoing methadone substitution therapy, the newborn presented withdrawal symptoms and was immediately admitted to a </span>paediatric ward where it was treated for 3 weeks, without administration of methadone. The infant died during bottle feeding within 24</span> <!-->h following discharge home.</p><p>A post-mortem examination was performed as well as histopathological, toxicological and genetic tests were carried out in order to establish the cause and mode of death.</p><p><span>The autopsy revealed obstruction of the lower air passages by stomach contents along with classical features of asphyxia. Toxicological tests revealed high concentrations of methadone and its metabolite in blood and urine as well as presence of methadone in stomach contents, and the DNA polymorphism analysis of the (sex-specific) </span>amelogenin locus gave a negative result.</p><p>On the basis of the results of the post-mortem examination, the laboratory tests and the police investigation, it was concluded that the drug<span> was ingested with the bottle milk, and the possibility of administration of methadone at the hospital or its ingestion with the breast milk was precluded. Though both the cause and mode of death were established, the public prosecutor discontinued proceedings in the case due to inability to find the perpetrator.</span></p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 88-90"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.07.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85152381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Upper Silesia (Poland) population and forensic usefulness of 15 autosomal STR loci","authors":"K. Droździok,&nbsp;J. Kabiesz,&nbsp;A. Nowak,&nbsp;Cz. Chowaniec,&nbsp;J. Nowicka","doi":"10.1016/j.fsisup.2009.08.002","DOIUrl":"10.1016/j.fsisup.2009.08.002","url":null,"abstract":"<div><p><span>Allele frequencies, forensic parameters for the 15 STR loci in the AmpFlSTR</span>^®<span> Identifiler Kit (Applied Biosystems), D8S1179, D21S11, D7S820, CSF1PO, D3S1358, TH01, D13S317, D16S539, D19S433, VWA, TPOX, D18S51, D5S818 and FGA were determined in a sample of 150 unrelated dead and alive adults from the Upper Silesia region (Poland). The values of heterozygosity (Ht), polymorphic information content (PIC), power of discrimination (PD), matching probability (PM), mean exclusion chance (MEC) and mean exclusion probability (MEP) were calculated. Possible divergence from HWE was determined. Comparison of allele frequencies for examined STR loci between the Upper Silesia population and other Polish populations was carried out.</span></p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 101-103"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76359640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of post-mortem examination of the cardiac conduction system","authors":"G. Haring,&nbsp;E. Kralj,&nbsp;J. Balažic,&nbsp;B. Ermenc","doi":"10.1016/j.fsisup.2009.08.009","DOIUrl":"10.1016/j.fsisup.2009.08.009","url":null,"abstract":"<div><h3>Introduction (Aim)</h3><p><span>Sudden unexplained death (SUD) is a common problem in forensic pathology. In many of these cases, the autopsy findings, toxicological examinations and patient history are inconclusive. Many studies suggest that in such cases, the </span>cardiac conduction system (CCS) should be histologically examined. We decided to determine the diagnostic value of histological examination of the CCS.</p></div><div><h3>Methods</h3><p><span>We reviewed autopsy files from the period 2005–2007 and selected those cases in which the CCS had been sampled. These were divided into two groups, the first comprising cases with an obvious cardiac pathology (e.g. severe </span>coronary disease, myocardial infarction, significant myocardial hypertrophy/dilatation, valvular disease, etc.) and the second comprising cases without obvious cardiac pathology (i.e. fatal injuries, intoxications and deaths unexplainable by routine procedures). The CCS was sampled according to a detailed protocol and examined under a light microscope. On the basis of the findings of histological examination of CCS, we formed subgroups of the aforementioned main groups.</p></div><div><h3>Results</h3><p>We analyzed 118 cases, of which 83 were males and 35 females. In 57% of cases, autopsy revealed gross pathological abnormalities of the heart. In 10 (15%) of them, examination of the CCS showed significant pathological changes (narrowing of the nodal artery and its branches, moderate to severe interstitial fibrosis<span><span>, calcifications in the central fibrous body impinging upon CCS). In some, especially those with no acute findings, CCS disease can be considered to have been the cause of fatal </span>arrhythmias. In 43% of cases, autopsy revealed no gross abnormalities of the heart, while histological examination of the CCS disclosed significant pathological changes in 4 (8%). Among them, CCS disease was regarded as the cause of death in one case and as a possible cause in another case.</span></p></div><div><h3>Conclusion</h3><p>As with other similar studies, our study showed that examination of the CCS can provide valuable information on the cause of death. We therefore consider that examination of the CCS should be performed in all SUD cases, especially those in which the cause of death cannot be established by routine procedures. Although we had only 1 confirmed cause of death linked to CCS disease and one possible, we had 14 cases with significant pathological CCS changes. This leads us to the conclusion that post-mortem examination of the CCS is of diagnostic value.</p></div>","PeriodicalId":100550,"journal":{"name":"Forensic Science International Supplement Series","volume":"1 1","pages":"Pages 72-75"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.fsisup.2009.08.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73723708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}