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Trevissoi F, Franchetti G, Fais P, Gabbin A, Giovannini E, Martini N, Sech M, Todesco G, Pizzi M, De Conti G, Giraudo C, Viel G, Cecchetto G. Detection of butterfly fractures of long bones through multi-slice computed tomography and micro-computed tomography. Leg Med (Tokyo) 2024; 67:102394. [PMID: 38217997 DOI: 10.1016/j.legalmed.2024.102394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
Motor-vehicle accidents often result in lower limb injuries with biosseous fractures. The present study aimed at comparing multi-slice computed tomography (MS-CT), micro-computed tomography (micro-CT) and external fractography for the analyses of experimentally produced biosseus leg fractures. Briefly, 48 human legs amputated for medical reasons were defleshed and then experimentally fractured using a 3-point dynamic bending model (70,6 J of impact energy at the middle of the anterior surface of the tibia) producing 38 biosseous and 10 mono-osseous fractures with a total of 86 fractured bones. External fractography detected 63 (73,2%) "butterfly" fractures (24 (27,9%) complete and 39 (45,3%) incomplete), 14 (16,3%) "oblique" fractures, 6 (7,0%) "comminuted" fractures and 3 (3,5%) "transverse" fractures. Forty-three (43) of the 48 included legs displayed at least one butterfly fracture located at the tibia or fibula. MS-CT correctly detected and classified 16 complete and 20 incomplete butterfly fractures, failing to properly classify 27 fractures; 19 of these misclassifications led to an interpretative error on the trauma direction (i.e., 16 incomplete butterfly fractures classified as oblique fractures and 3 incomplete butterfly fractures classified as transverse). Micro-CT correctly detected and classified 22 complete and 37 incomplete butterfly fractures, failing to properly classify 4 fractures; two of these misclassifications led to an interpretative error on the trauma direction (i.e., two incomplete butterfly fractures classified as oblique fractures). Although further studies evaluating a wider number of fractures and fracture patterns are required to drive any definitive conclusions, this preliminary experimental investigation showed that MS-CT and micro-CT represent useful tools for reconstructing the morphology of leg fractures and could be crucial for trauma analysis in the forensic context. MS-CT could be used as a screening tool, micro-CT as second level analysis and external/internal fractography as third level, confirmatory analysis.
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Affiliation(s)
- Federica Trevissoi
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100, Padova, Italy
| | - Giorgia Franchetti
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100, Padova, Italy
| | - Paolo Fais
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126, Bologna, Italy
| | - Andrea Gabbin
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100, Padova, Italy
| | - Elena Giovannini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126, Bologna, Italy
| | - Nicolò Martini
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100, Padova, Italy
| | - Maria Sech
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126, Bologna, Italy
| | - Giorgia Todesco
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100, Padova, Italy
| | - Marco Pizzi
- Radiology Unit, University-Hospital of Padova, Via Giustiniani 2, 35100 Padova, Italy
| | - Giorgio De Conti
- Radiology Unit, University-Hospital of Padova, Via Giustiniani 2, 35100 Padova, Italy
| | - Chiara Giraudo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Radiology, University of Padova, Via Giustiniani 2, 35100, Padova, Italy
| | - Guido Viel
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100, Padova, Italy
| | - Giovanni Cecchetto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100, Padova, Italy.
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Secco L, Padalino P, Franceschetto L, Viero A, Pizzi M, De Conti G, Viel G, Fais P, Giraudo C, Cecchetto G. Micro-CT evaluation of morphological degenerative features of sterno-clavicular joint for age-at-death estimation in forensic anthropology - A qualitative analysis. Leg Med (Tokyo) 2024; 67:102374. [PMID: 38157674 DOI: 10.1016/j.legalmed.2023.102374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
The analysis of the sternoclavicular joint holds significant importance in forensic anthropology, especially through the evaluation of medial clavicular ossification stage, which, however, is helpful only in subjects younger than 30 years of age. Given this limitation, the aim of the present work was to examine, through micro-CT, the surface of sternoclavicular joints of deceased individuals across various age groups, aiming to identify age-related degenerative changes applicable to age estimation in adults over 30 years old. A total of 41 deceased subjects were categorized into three age groups (20-39 years; 40-59 years; ≥60 years) for the analysis. Degenerative morphological features on both clavicular and sternal articular surfaces, including topography, porosity, and presence of osteophytes, were evaluated using a composite scoring system based on a modified "Falys-Prangle method.", which assigns to each parameter specific score ranges: 1-3 for surface topography (smooth, slightly irregular, markedly irregular), 1-6 for porosity (absent, micro- and macroporosity for <50 % or >50 % of surface, surface breakdown), 1-3 for osteophytes (absent, present, not evaluable). The findings revealed a positive correlation between degenerative morphological features and age for both clavicular (rs = 0.719) and sternal articular surfaces (rs = 0.750). Additionally, the combined assessment of the clavicle and sternum, or the evaluation of the clavicle alone, exhibited better differentiation among the three age groups. The micro-CT evaluation of degenerative alterations affecting the sternoclavicular joint proves to be a reliable and efficient method for age estimation in adults.
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Affiliation(s)
- Laura Secco
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy
| | - Pasquale Padalino
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy
| | - Lisa Franceschetto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy
| | - Alessia Viero
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy
| | - Marco Pizzi
- Radiology Unit, University-Hospital of Padova, Via Giustiniani 2, 35100 Padova, Italy
| | - Giorgio De Conti
- Radiology Unit, University-Hospital of Padova, Via Giustiniani 2, 35100 Padova, Italy
| | - Guido Viel
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy
| | - Paolo Fais
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy
| | - Chiara Giraudo
- Radiology Unit, University-Hospital of Padova, Via Giustiniani 2, 35100 Padova, Italy
| | - Giovanni Cecchetto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy.
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Giovannini E, Franchetti G, Ridolfi M, Berardi D, Pelletti G, Gualandi A, Giraudo C, Cecchetto G, Fais P. An unusual case of corpse concealment driven by emotional distress. Leg Med (Tokyo) 2024; 67:102379. [PMID: 38183946 DOI: 10.1016/j.legalmed.2023.102379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/08/2024]
Abstract
Corpse concealment involves hiding a body for criminal purposes for many different reasons, such as destroy evidence of a murder or avoid the discovery of the victim. Although defendants could argue that they did not conceal the corpse with any criminal intent, but rather to spare themselves or others from emotional distress or to honor the wishes of the deceased. However, these arguments are often challenging to substantiate, and defendants may encounter significant legal obstacles when attempting to justify their actions. Herein, we report a case involving the concealment of a woman's corpse by her father. Autopsy and histological investigations were significantly limited due to the advanced decomposition of the body. Nevertheless, by integrating these data with radiological findings obtained from total body CT and micro-CT of the larynx-hyoid complex, hanging was deemed the cause of death. Additionally, the psychological evaluation of the father indicated that the act of concealment was motivated by emotions rather than criminal intent.
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Affiliation(s)
- Elena Giovannini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Giorgia Franchetti
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal, Medicine and Toxicology, University of Padova, Via Falloppio 50, Padova, Italy.
| | - Marcello Ridolfi
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
| | | | - Guido Pelletti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Alberto Gualandi
- Institute of Pathology, DAME, University Hospital of Udine, 33100 Udine, UD, Italy.
| | - Chiara Giraudo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal, Medicine and Toxicology, University of Padova, Via Falloppio 50, Padova, Italy.
| | - Giovanni Cecchetto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal, Medicine and Toxicology, University of Padova, Via Falloppio 50, Padova, Italy.
| | - Paolo Fais
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
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Callegari E, Agnolucci J, Angiola F, Fais P, Giorgetti A, Giraudo C, Viel G, Cecchetto G. The Precision, Inter-Rater Reliability, and Accuracy of a Handheld Scanner Equipped with a Light Detection and Ranging Sensor in Measuring Parts of the Body-A Preliminary Validation Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:500. [PMID: 38257593 PMCID: PMC10820714 DOI: 10.3390/s24020500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Anthropometric measurements play a crucial role in medico-legal practices. Actually, several scanning technologies are employed in post-mortem investigations for forensic anthropological measurements. This study aims to evaluate the precision, inter-rater reliability, and accuracy of a handheld scanner in measuring various body parts. METHODS Three independent raters measured seven longitudinal distances using an iPad Pro equipped with a LiDAR sensor and specific software. These measurements were statistically compared to manual measurements conducted by an operator using a laser level and a meterstick (considered the gold standard). RESULTS The Friedman test revealed minimal intra-rater variability in digital measurements. Inter-rater variability analysis yielded an ICC = 1, signifying high agreement among the three independent raters. Additionally, the accuracy of digital measurements displayed errors below 1.5%. CONCLUSIONS Preliminary findings demonstrate that the pairing of LiDAR technology with the Polycam app (ver. 3.2.11) and subsequent digital measurements with the MeshLab software (ver. 2022.02) exhibits high precision, inter-rater agreement, and accuracy. Handheld scanners show potential in forensic anthropology due to their simplicity, affordability, and portability. However, further validation studies under real-world conditions are essential to establish the reliability and effectiveness of handheld scanners in medico-legal settings.
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Affiliation(s)
- Enrica Callegari
- Unit of Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35100 Padova, Italy; (E.C.); (J.A.); (F.A.); (G.V.)
| | - Jacopo Agnolucci
- Unit of Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35100 Padova, Italy; (E.C.); (J.A.); (F.A.); (G.V.)
| | - Francesco Angiola
- Unit of Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35100 Padova, Italy; (E.C.); (J.A.); (F.A.); (G.V.)
| | - Paolo Fais
- Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni 33, 40126 Bologna, Italy; (P.F.); (A.G.)
| | - Arianna Giorgetti
- Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni 33, 40126 Bologna, Italy; (P.F.); (A.G.)
| | - Chiara Giraudo
- Unit of Radiology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35100 Padova, Italy;
| | - Guido Viel
- Unit of Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35100 Padova, Italy; (E.C.); (J.A.); (F.A.); (G.V.)
| | - Giovanni Cecchetto
- Unit of Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35100 Padova, Italy; (E.C.); (J.A.); (F.A.); (G.V.)
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Šoša I. Quetiapine-Related Deaths: In Search of a Surrogate Endpoint. TOXICS 2024; 12:37. [PMID: 38250993 PMCID: PMC10819769 DOI: 10.3390/toxics12010037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/30/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024]
Abstract
Quetiapine is a second-generation antipsychotic drug available for two and half decades. Due to increased misuse, prescription outside the approved indications, and availability on the black market, it is being encountered in medicolegal autopsies more frequently. For instance, it has been linked to increased mortality rates, most likely due to its adverse effects on the cardiovascular system. Its pharmacokinetic features and significant postmortem redistribution challenge traditional sampling in forensic toxicology. Therefore, a systematic literature review was performed, inclusive of PubMed, the Web of Science-core collection, and the Scopus databases; articles were screened for the terms "quetiapine", "death", and "autopsy" to reevaluate each matrix used as a surrogate endpoint in the forensic toxicology of quetiapine-related deaths. Ultimately, this review considers the results of five studies that were well presented (more than two matrices, data available for all analyses, for instance). The highest quetiapine concentrations were usually measured in the liver tissue. As interpreted by their authors, the results of the considered studies showed a strong correlation between some matrices, but, unfortunately, the studies presented models with poor goodness of fit. The distribution of quetiapine in distinct body compartments/tissues showed no statistically significant relationship with the length of the postmortem interval. Furthermore, this study did not confirm the anecdotal correlation of peripheral blood concentrations with skeletal muscle concentrations. Otherwise, there was no consistency regarding selecting an endpoint for analysis.
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Affiliation(s)
- Ivan Šoša
- Department of Anatomy, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
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Boulos I, Jabbour J, Khoury S, Mikhael N, Tishkova V, Candoni N, Ghadieh HE, Veesler S, Bassim Y, Azar S, Harb F. Exploring the World of Membrane Proteins: Techniques and Methods for Understanding Structure, Function, and Dynamics. Molecules 2023; 28:7176. [PMID: 37894653 PMCID: PMC10608922 DOI: 10.3390/molecules28207176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/13/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023] Open
Abstract
In eukaryotic cells, membrane proteins play a crucial role. They fall into three categories: intrinsic proteins, extrinsic proteins, and proteins that are essential to the human genome (30% of which is devoted to encoding them). Hydrophobic interactions inside the membrane serve to stabilize integral proteins, which span the lipid bilayer. This review investigates a number of computational and experimental methods used to study membrane proteins. It encompasses a variety of technologies, including electrophoresis, X-ray crystallography, cryogenic electron microscopy (cryo-EM), nuclear magnetic resonance spectroscopy (NMR), biophysical methods, computational methods, and artificial intelligence. The link between structure and function of membrane proteins has been better understood thanks to these approaches, which also hold great promise for future study in the field. The significance of fusing artificial intelligence with experimental data to improve our comprehension of membrane protein biology is also covered in this paper. This effort aims to shed light on the complexity of membrane protein biology by investigating a variety of experimental and computational methods. Overall, the goal of this review is to emphasize how crucial it is to understand the functions of membrane proteins in eukaryotic cells. It gives a general review of the numerous methods used to look into these crucial elements and highlights the demand for multidisciplinary approaches to advance our understanding.
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Affiliation(s)
- Imad Boulos
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli P.O. Box 100, Lebanon; (I.B.); (J.J.); (S.K.); (N.M.); (H.E.G.); (Y.B.); (S.A.)
| | - Joy Jabbour
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli P.O. Box 100, Lebanon; (I.B.); (J.J.); (S.K.); (N.M.); (H.E.G.); (Y.B.); (S.A.)
| | - Serena Khoury
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli P.O. Box 100, Lebanon; (I.B.); (J.J.); (S.K.); (N.M.); (H.E.G.); (Y.B.); (S.A.)
| | - Nehme Mikhael
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli P.O. Box 100, Lebanon; (I.B.); (J.J.); (S.K.); (N.M.); (H.E.G.); (Y.B.); (S.A.)
| | - Victoria Tishkova
- CNRS, CINaM (Centre Interdisciplinaire de Nanosciences de Marseille), Campus de Luminy, Case 913, Aix-Marseille University, CEDEX 09, F-13288 Marseille, France; (V.T.); (N.C.); (S.V.)
| | - Nadine Candoni
- CNRS, CINaM (Centre Interdisciplinaire de Nanosciences de Marseille), Campus de Luminy, Case 913, Aix-Marseille University, CEDEX 09, F-13288 Marseille, France; (V.T.); (N.C.); (S.V.)
| | - Hilda E. Ghadieh
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli P.O. Box 100, Lebanon; (I.B.); (J.J.); (S.K.); (N.M.); (H.E.G.); (Y.B.); (S.A.)
| | - Stéphane Veesler
- CNRS, CINaM (Centre Interdisciplinaire de Nanosciences de Marseille), Campus de Luminy, Case 913, Aix-Marseille University, CEDEX 09, F-13288 Marseille, France; (V.T.); (N.C.); (S.V.)
| | - Youssef Bassim
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli P.O. Box 100, Lebanon; (I.B.); (J.J.); (S.K.); (N.M.); (H.E.G.); (Y.B.); (S.A.)
| | - Sami Azar
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli P.O. Box 100, Lebanon; (I.B.); (J.J.); (S.K.); (N.M.); (H.E.G.); (Y.B.); (S.A.)
| | - Frédéric Harb
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli P.O. Box 100, Lebanon; (I.B.); (J.J.); (S.K.); (N.M.); (H.E.G.); (Y.B.); (S.A.)
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Sacco MA, Gualtieri S, Calanna L, Ricci P, Aquila I. Exploring the Potential of Proteome Analysis as a Promising Tool for Evaluation of Sudden Cardiac Death (SCD) in Forensic Settings: A Literature Review. Int J Mol Sci 2023; 24:14351. [PMID: 37762655 PMCID: PMC10531952 DOI: 10.3390/ijms241814351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Sudden cardiac death (SCD) represents a global emergency, with a high number of cases affecting all age groups every year. The prevention of these fatal events requires an accurate knowledge of etiology and pathogenesis, which can vary. Autopsy is an indispensable tool in cases of SCD for diagnostic purposes, as well as for judicial and preventive purposes for family members. Despite the completion of all routine post-mortem investigations, it is often complicated for the forensic pathologist to define the triggering cause of these events. The study of the proteome is proving to be extremely promising in the field of human cardiovascular disease. This paper aims to offer a literature review on the study of the proteome in post-mortem cadaveric biological samples obtained from SCD cases. The aim of this work is to outline the state of the art of the scientific advances that protein analysis can offer in the diagnosis of SCD and the limits that various studies have traced up to now. In conclusion, the work defines the future perspectives of this field in SCD, suggesting strategies to overcome the reported limits and improve the diagnostics of these events.
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Affiliation(s)
| | | | | | | | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (L.C.); (P.R.)
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Cecchetto G, De Leo D, Pancheri A, Franchetti G, Proto S, Cocchio S, Furlan P, Corlianò P, Baldo V, Viel G, Feltrin G. Organ procurement requiring the authorization of the judicial authority. An epidemiological investigation in the Veneto region (Italy). Leg Med (Tokyo) 2023; 61:102218. [PMID: 36796174 DOI: 10.1016/j.legalmed.2023.102218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND When death occurs through a mechanism requiring a forensic investigation, consent for organ harvesting must be sought from the Judicial Authority (JA). AIM To perform a retrospective study of potential organ donors in the Veneto region over a six-year period (2012-2017), analysing any differences between cases in which the JA approved or denied organ harvesting. MATERIAL AND METHODS Both non-heart beating (NHB) and heart beating (HB) donors were included. For HB cases, personal and clinical data were collected. To evaluate the correlation between the JA response and the circumstantial and clinical data a logistic multivariate analysis was performed, estimating the adjusted odds ratios (adjORs). RESULTS Between 2012 and 2017, 17,662 organ and/or tissue donors were included, of which 16,418 were NHB donors and 1,244 HB-donors. Among the 1,244 HB-donors, JA authorization was asked in 200 cases (16.1%), approved in 154 cases (77.0%), limited in 7 cases (3.5%) and denied in 39 cases (19.5%). The JA denied the authorization for organ harvesting in 53,3% of cases with hospitalizations of less than 1 day and in 9,4% of cases with hospitalization exceeding one week [adjOR(95%CI) = 10.67 (1.92-59.22)]. The performance of an autopsy was linked to a higher chance of denied outcome from the JA [adjOR(95%CI): 3.45 (1.42-8.39)]. CONCLUSIONS Improvements in the communication between organ procurement organizations and the JA through efficient protocols furnishing detailed information on the cause of death might lead to a better procurement process with an increase in the number of transplanted organs.
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Affiliation(s)
- Giovanni Cecchetto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy.
| | - Domenico De Leo
- Department of Diagnostics and Public Health - Unit of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Anna Pancheri
- Department of Diagnostics and Public Health - Unit of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Giorgia Franchetti
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy
| | - Sara Proto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy
| | - Silvia Cocchio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padova, Via Loredan 18, 35131 Padova, Italy
| | - Patrizia Furlan
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padova, Via Loredan 18, 35131 Padova, Italy
| | - Pantaleo Corlianò
- Regional Centre for Transplant Coordination of Veneto Region, Via Giustiniani 2, 35128 Padova, Italy
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padova, Via Loredan 18, 35131 Padova, Italy
| | - Guido Viel
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Via Falloppio 50, 35100 Padova, Italy
| | - Giuseppe Feltrin
- Regional Centre for Transplant Coordination of Veneto Region, Via Giustiniani 2, 35128 Padova, Italy
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Franchetti G, Viel G, Fais P, Fichera G, Cecchin D, Cecchetto G, Giraudo C. Forensic applications of micro-computed tomography: a systematic review. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00510-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
Purpose
The aim of this systematic review was to provide a comprehensive overview of micro-CT current applications in forensic pathology, anthropology, odontology, and neonatology.
Methods
A bibliographic research on the electronic databases Pubmed and Scopus was conducted in the time frame 01/01/2001–31/12/2021 without any language restrictions and applying the following free-text search strategy: “(micro-computed tomography OR micro-CT) AND (forensic OR legal)”. The following inclusion criteria were used: (A) English language; (B) Application of micro-CT to biological and/or non-biological materials to address at least one forensic issue (e.g., age estimation, identification of post-mortem interval). The papers selected by three independent investigators have been then classified according to the investigated materials.
Results
The bibliographic search provided 651 records, duplicates excluded. After screening for title and/or abstracts, according to criteria A and B, 157 full-text papers were evaluated for eligibility. Ninety-three papers, mostly (64) published between 2017 and 2021, were included; considering that two papers investigated several materials, an overall amount of 99 classifiable items was counted when referring to the materials investigated. It emerged that bones and cartilages (54.55%), followed by teeth (13.13%), were the most frequently analyzed materials. Moreover, micro-CT allowed the collection of structural, qualitative and/or quantitative information also for soft tissues, fetuses, insects, and foreign materials.
Conclusion
Forensic applications of micro-CT progressively increased in the last 5 years with very promising results. According to this evidence, we might expect in the near future a shift of its use from research purposes to clinical forensic cases.
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10
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Viero A, Biehler-Gomez L, Messina C, Cappella A, Giannoukos K, Viel G, Tagliaro F, Cattaneo C. Utility of micro-CT for dating post-cranial fractures of known post-traumatic ages through 3D measurements of the trabecular inner morphology. Sci Rep 2022; 12:10543. [PMID: 35732857 DOI: 10.1038/s41598-022-14530-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 06/08/2022] [Indexed: 11/09/2022] Open
Abstract
Fracture dating is an issue at the forefront of forensic sciences. While dating fracture is crucial to understanding and verifying the chronology of events in cases of abuse and violent death, its application is the subject of considerable discussion in the scientific community, filled with limitations and difficulties. Current methods for fracture dating are mainly based on a qualitative assessment through macroscopy, microscopy, and imaging and subject to variations depending on the experience of the observer. In this paper, we investigated the potential of quantifiable micro-CT analysis for fracture dating. Five histomorphometric parameters commonly used for the study of the 3D bone trabecular microarchitecture with micro-CT were calculated based on nine fractures of known post-traumatic ages, including the degree of anisotropy, connectivity density, bone volume fraction, trabecular thickness, and trabecular separation. As a result, trends in the evolution of the microarchitecture of the bone relative to age of the callus could be identified, in particular concerning anisotropy, trabecular separation and connectivity density, consistent with the healing bone process. The findings obtained in this pilot study encourage further research in quantifiable parameters of the bone microarchitecture as they could represent useful features for the construction of objective models for fracture dating.
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Affiliation(s)
- Alessia Viero
- Legal Medicine and Toxicology Unit, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy.,Unit of Forensic Medicine, Department of Diagnostics and Public Health, University of Verona, P.le Scuro, 10, 37134, Verona, Italy.,Laboratorio Di Antropologia E Odontologia Forense (LABANOF), Sezione Di Medicina Legale, Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Mangiagalli 37, 20133, Milan, Italy
| | - Lucie Biehler-Gomez
- Laboratorio Di Antropologia E Odontologia Forense (LABANOF), Sezione Di Medicina Legale, Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Mangiagalli 37, 20133, Milan, Italy.
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Annalisa Cappella
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Laboratorio Di Morfologia Umana Applicata, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Konstantinos Giannoukos
- Elettra-Sincrotrone Trieste S.C.P.A., SYRMEP Group, AREA Science Park, Strada Statale 14, 34149, Basovizza, Trieste, Italy
| | - Guido Viel
- Legal Medicine and Toxicology Unit, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Franco Tagliaro
- Unit of Forensic Medicine, Department of Diagnostics and Public Health, University of Verona, P.le Scuro, 10, 37134, Verona, Italy.,World-Class Research Center "Digital Biodesign and Personalized Healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
| | - Cristina Cattaneo
- Laboratorio Di Antropologia E Odontologia Forense (LABANOF), Sezione Di Medicina Legale, Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Mangiagalli 37, 20133, Milan, Italy
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11
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Buja LM, Zhao B, Segura A, Lelenwa L, McDonald M, Michaud K. Cardiovascular pathology: guide to practice and training. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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12
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Bohnert S, Reinert C, Trella S, Schmitz W, Ondruschka B, Bohnert M. Metabolomics in postmortem cerebrospinal fluid diagnostics: a state-of-the-art method to interpret central nervous system-related pathological processes. Int J Legal Med 2021; 135:183-191. [PMID: 33180198 PMCID: PMC7782422 DOI: 10.1007/s00414-020-02462-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/05/2020] [Indexed: 12/16/2022]
Abstract
In the last few years, quantitative analysis of metabolites in body fluids using LC/MS has become an established method in laboratory medicine and toxicology. By preparing metabolite profiles in biological specimens, we are able to understand pathophysiological mechanisms at the biochemical and thus the functional level. An innovative investigative method, which has not yet been used widely in the forensic context, is to use the clinical application of metabolomics. In a metabolomic analysis of 41 samples of postmortem cerebrospinal fluid (CSF) samples divided into cohorts of four different causes of death, namely, cardiovascular fatalities, isoIated torso trauma, traumatic brain injury, and multi-organ failure, we were able to identify relevant differences in the metabolite profile between these individual groups. According to this preliminary assessment, we assume that information on biochemical processes is not gained by differences in the concentration of individual metabolites in CSF, but by a combination of differently distributed metabolites forming the perspective of a new generation of biomarkers for diagnosing (fatal) TBI and associated neuropathological changes in the CNS using CSF samples.
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Affiliation(s)
- Simone Bohnert
- Institute of Forensic Medicine, University of Wuerzburg, Versbacher Str. 3, 97078, Wuerzburg, Germany.
| | - Christoph Reinert
- Institute of Forensic Medicine, University of Wuerzburg, Versbacher Str. 3, 97078, Wuerzburg, Germany
| | - Stefanie Trella
- Institute of Forensic Medicine, University of Wuerzburg, Versbacher Str. 3, 97078, Wuerzburg, Germany
| | - Werner Schmitz
- Institute of Biochemistry and Molecular Biology I, Biozentrum - Am Hubland, 97074, Wuerzburg, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany
| | - Michael Bohnert
- Institute of Forensic Medicine, University of Wuerzburg, Versbacher Str. 3, 97078, Wuerzburg, Germany
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13
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Buja LM, Barth RF, Krueger GR, Brodsky SV, Hunter RL. The Importance of the Autopsy in Medicine: Perspectives of Pathology Colleagues. Acad Pathol 2019; 6:2374289519834041. [PMID: 30886893 PMCID: PMC6410379 DOI: 10.1177/2374289519834041] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/12/2019] [Accepted: 01/18/2019] [Indexed: 12/17/2022] Open
Abstract
This article presents a perspective on the importance of the autopsy in medical practice and science based on experiences of the authors as physician-scientists involved in autopsy practice. Our perspectives are presented on the seminal contributions of the autopsy in the areas of cardiovascular disease, including congenital heart disease, atherosclerosis, coronary artery disease, and myocardial infarction, and infectious disease, including tuberculosis and viral infections. On the positive side of the future of the autopsy, we discuss the tremendous opportunities for important research to be done by application of advanced molecular biological techniques to formalin-fixed, paraffin-embedded tissue blocks obtained at autopsy. We also note with concern the countervailing forces impacting the influence of pathology in education and clinical practice at our academic medical centers, which also present impediments to increasing autopsy rates. Our challenge as academic pathologists, whose careers have been molded by involvement in the autopsy, is to counter these trends. The challenges are great but the benefits for medicine and society are enormous.
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Affiliation(s)
- Louis Maximilian Buja
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Rolf F. Barth
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Gerhard R. Krueger
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Sergey V. Brodsky
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Robert L. Hunter
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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14
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Methodology for the identification of vulnerable asylum seekers. Int J Legal Med 2017; 131:1719-1730. [DOI: 10.1007/s00414-017-1645-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/04/2017] [Indexed: 12/28/2022]
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