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Leković A, Vukićević A, Nikolić S. Assessing the knot in a noose position by thyrohyoid and cervical spine fracture patterns in suicidal hangings using machine learning algorithms: A new insight into old dilemmas. Forensic Sci Int 2024; 357:111973. [PMID: 38479057 DOI: 10.1016/j.forsciint.2024.111973] [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: 12/15/2023] [Revised: 02/08/2024] [Accepted: 02/29/2024] [Indexed: 03/21/2024]
Abstract
Hanging is one of the most common suicide methods worldwide. Neck injuries that occur upon such neck compression - fractures of the thyrohyoid complex and cervical spine, occupy forensic pathologists for a long time. However, research failed to identify particular patterns of these injuries corresponding to the force distribution a ligature applies to the neck: the issue of reconstructing the knot in a noose position persists. So far, machine learning (ML) models were not utilized to classify knot positions and reconstruct this event. We conducted a single-institutional, retrospective study on 1235 autopsy cases of suicidal hanging, developed several ML models, and assessed their classification performance in a stepwise manner to discriminate between: 1. typical ('posterior) and atypical ('anterior' and 'lateral') hangings, 2. anterior and lateral hangings, and 3. left and right lateral hangings. The variable coding was based on the presence/absence of fractures of greater hyoid bone horns (GHH), superior thyroid cartilage horns (STH), and cervical spine. Subject age was considered. The models' parameters were optimized by the Genetic Algorithm. The accuracy of ML models in the first step was very modest (c. 60%) but increased subsequently: Multilayer Perceptron - Artificial Neural Network and k-Nearest Neighbors performed excellently discriminating between left and right lateral hangings (accuracy 91.8% and 90.6%, respectively). The latter is of great importance for clarifying probable hanging fracture biomechanics. Alongside the conventional inferential statistical analysis we performed, our results further indicate the association of the knot position with ipsilateral GHH and contralateral STH fractures in lateral hangings. Moreover, odds for unilateral GHH fracture, simultaneous GHH and STH fractures, and cervical spine fracture were significantly higher in atypical ('anterior' and 'lateral') hangings, compared to typical ('posterior') hangings.
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Affiliation(s)
- Aleksa Leković
- Institute of Forensic Medicine, University of Belgrade - Faculty of Medicine, Belgrade, Serbia
| | - Arso Vukićević
- Faculty of Engineering, University of Kragujevac, Serbia
| | - Slobodan Nikolić
- Institute of Forensic Medicine, University of Belgrade - Faculty of Medicine, Belgrade, Serbia.
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2
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Hu Y, Han L, Zhang H, Li W, Wu T, Ma J, Zhang D, Ma K, Xiao B, Yu Y, Xu H, Tian L, Liao X, Chen L. The down-regulation of STC2 mRNA may serve as a biomarker for death from mechanical asphyxia. Leg Med (Tokyo) 2024; 67:102382. [PMID: 38159418 DOI: 10.1016/j.legalmed.2023.102382] [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: 08/17/2023] [Revised: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
Death from mechanical asphyxia (DMA) is a common cause of death in forensic pathology. However, due to the lack of biomarkers, the authentication of DMA now relies on a series of non-specific signs, which may cause troubles in the judicial trials, especially when the criminal scene is not fully elucidated. To search for the potential biomarkers for DMA, brain samples of DMA and craniocerebral injury groups were screened by microarray. The obtained mRNAs were validated by animal and human samples. Primary cell culture was conducted to explore the biochemical changes under hypoxia. 415 differentially expressed mRNAs between two groups were discovered. Ten mRNAs were examined in both human and animal samples died of different causes of death. Stanniocalcin-2 (STC2) showed significant down-regulation in DMA samples compared to other groups, regardless of PMI, age, or temperature. Cellular experiments indicated that ROS level peaked after 15-min-hypoxic culture, when the expression level of STC2 was significant down-regulated simultaneously. The ER-stress-related proteins also showed potential connection with STC2. In general, it is indicated that the down-regulation of STC2 may serve as a biomarker for DMA.
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Affiliation(s)
- Yikai Hu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Liujun Han
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Heng Zhang
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China; Department of Pathology, Anhui Medical University, Hefei 230032, China
| | - Wencan Li
- Institute of Criminal Scientific Technology, Shanghai Municipal Public Security Bureau Pudong Branch, Shanghai 200125, China
| | - Tianpu Wu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Jianlong Ma
- Institute of Criminal Science and Technology, Investigation Department of Shenzhen Municipal Public Security Bureau, Key Laboratory of Forensic Pathology, Ministry of Public Security, Shenzhen 518040, China
| | - Dongchuan Zhang
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Municipal Public Security Bureau, Shanghai 200082, China
| | - Kaijun Ma
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Municipal Public Security Bureau, Shanghai 200082, China
| | - Bi Xiao
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Municipal Public Security Bureau, Shanghai 200082, China
| | - Yangeng Yu
- Institute of Forensic Science, Guangdong Provincial Public Security Department, Key Laboratory of Forensic Pathology, Ministry of Public Security, Guangzhou 510050, China
| | - Hongmei Xu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Lu Tian
- Institute of Criminal Scientific Technology, Shanghai Municipal Public Security Bureau Pudong Branch, Shanghai 200125, China.
| | - Xinbiao Liao
- Institute of Forensic Science, Guangdong Provincial Public Security Department, Key Laboratory of Forensic Pathology, Ministry of Public Security, Guangzhou 510050, China.
| | - Long Chen
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
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Işın A, Peden AE. The burden, risk factors and prevention strategies for drowning in Türkiye: a systematic literature review. BMC Public Health 2024; 24:528. [PMID: 38378496 PMCID: PMC10877921 DOI: 10.1186/s12889-024-18032-9] [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: 06/24/2023] [Accepted: 02/07/2024] [Indexed: 02/22/2024] Open
Abstract
INTRODUCTION Drowning is a public health problem in Türkiye, as in the rest of the world. This study aims to systematically review the literature on drowning in Türkiye with a focus on data sources, epidemiology, risk factors and prevention strategies. METHODS Literature searches were conducted using PubMed, SPORTSDiscus, Scopus, Web of Science, Turk MEDLINE, Google Scholar and Google Akademik (Turkish language). Studies (limited to original research written in English and Turkish) reporting drowning (unintentional and intentional; fatal and non-fatal) of residents and tourists in Türkiye were independently dual screened at the title and abstract and full text stages. Study quality was assessed using JBI checklists and evidence level assessed based on study design. RESULTS From a total of 917 studies, 49 met the inclusion criteria. Most (51%) focused on unintentional fatal drowning. Included studies were most commonly analytical cross-sectional studies (n = 23) and case series (n = 20) meaning the evidence level was low or very low for 48 (98%) studies. Fifteen studies examined drowning at the national level, while sub-national studies (n = 30) focused on urban areas across three provinces: Antalya (n = 6), Istanbul (n = 6), Izmir (n = 4). There was little consensus on risk factors beyond male drowning risk, and no data reported on implemented or evaluated drowning prevention interventions. DISCUSSION There is a need for more national-level studies to identify the causes of drowning and to guide intervention implementation and evaluation to inform policy makers and donors. Currently official data is limited in its detail, providing age and gender data only, hampering efforts to identify, and thus address, causal factors for drowning. PRACTICAL APPLICATIONS There is currently very little evidence to inform investment in effective drowning prevention interventions in Türkiye. To improve this, data collection systems on drowning in Türkiye need to be strengthened via the development a national drowning registry. TRIAL REGISTRATION #CRD42022382615.
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Affiliation(s)
- Ali Işın
- Department of Coaching Education, Faculty of Sports Sciences, Akdeniz University, 07070, Antalya, Türkiye.
| | - Amy E Peden
- School of Population Health, UNSW Sydney, Kensington, NSW, 2052, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
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Crudele GDL, Amadasi A, Franceschetti L, Cattaneo C. Pathological Findings in Hanging: Is the Traditional Knowledge Correct? Diagnostics (Basel) 2024; 14:318. [PMID: 38337834 PMCID: PMC10855091 DOI: 10.3390/diagnostics14030318] [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: 12/26/2023] [Revised: 01/20/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND In forensic pathology, asphyxia presents a problem as frequently as it is thorny and challenging. Some knowledge in forensic pathology is still considered to be traditionally acquired and is not critically assessed with modern statistical or technical tools. In this study, we seek to examine the injuries that are considered to be typical of cases of hanging (neck lesions, haemorrhages, and pleural and epicardial petechiae). METHODS We evaluated whether there was, indeed, a statistically significant association between these injuries and deaths from hanging as compared to non-hanging deaths. We collected 399 cases (32 deaths by hanging and 367 cases of non-hangings), built contingency tables and performed chi-square tests for each variable (lesion) examined; we also analysed this association in various subgroups of the sample (according to sex, age and weight ranges). RESULTS Our results did not deviate from the expected outcome based on traditional knowledge, although they do provide a more detailed demonstration and clarification of traditional knowledge regarding this topic. CONCLUSIONS These findings provide valuable insights for future discussion, examination and deepening of knowledge that is traditionally accepted but often undersupported in the literature.
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Affiliation(s)
- Graziano Domenico Luigi Crudele
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milan, Italy (C.C.)
| | - Alberto Amadasi
- Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charité, University of Berlin, Turmstr. 21, Building N, 10559 Berlin, Germany
| | - Lorenzo Franceschetti
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milan, Italy (C.C.)
| | - Cristina Cattaneo
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milan, Italy (C.C.)
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D'Elia F, Simonit F, Desinan L. A case of complex asphyxia sheds light on problems in the classification of asphyxias. Leg Med (Tokyo) 2024; 66:102368. [PMID: 38039659 DOI: 10.1016/j.legalmed.2023.102368] [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: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023]
Abstract
Death from positional asphyxia is often an accidental event occurring when the victim's body assumes a position which can compromise an effective respiration. Its diagnosis is usually not simple, because it needs to know the exact circumstance in which the body was found and the original positioning of all the body segments. In this case, a 41-year-old man with a history of opioid drugs abuse was found dead in a knee-chest position; the head was down on the floor with the face resting on a plastic bag. Pictures of the scene of death was taken while the body was still in its original position. At first, the main suspicion was that of a fatal overdose. Following the autopsy examination, completed by histological and toxicological examinations, the cause of death was determined as postural asphyxia secondary to intoxication by methadone, in the presence of ischemic heart disease. Some features, moreover, were typical of the death in head down position, and the prolonged knee-chest position was also associated with the obstruction of mouth and nose by the plastic bag, which may have contributed to the asphyxiation. These cases of "combined" asphyxia represent a challenge for the current classifications of asphyxia, which are very variable and not standardized, as we observe from a brief review of the literature. The elaboration of new systems of classification for asphyxias, which must be clear, simple and shareable, is necessary to avoid confusion in categorizing cases that present overlapping between several types of asphyxiation modalities.
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Affiliation(s)
- Francesco D'Elia
- University of Trieste, Clinical Department of Medical Surgical and Health Sciences, School of Legal Medicine, Ospedale di Cattinara, Strada di Fiume 447, 34149 Trieste, TS, Italy.
| | - Francesco Simonit
- Department of Medicine, Legal Medicine, University of Udine, Piazzale Santa Maria della Misericordia 15, 33100 Udine, UD, Italy.
| | - Lorenzo Desinan
- Department of Medicine, Legal Medicine, University of Udine, Piazzale Santa Maria della Misericordia 15, 33100 Udine, UD, Italy.
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Zheng Z, Zhang L, Zhao C, Xiong H, Li J. Identification of differentially expressed proteins in heart of mouse death from smother based on label-free proteomics. Leg Med (Tokyo) 2023; 65:102302. [PMID: 37549592 DOI: 10.1016/j.legalmed.2023.102302] [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: 05/31/2023] [Revised: 07/18/2023] [Accepted: 07/28/2023] [Indexed: 08/09/2023]
Abstract
Identification of mechanical asphyxia deaths without obvious injuries is a difficult problem for forensic medicine. This study aimed to identify molecular biological markers to predict death from mechanical asphyxia (smother). We established a smother model of mice by over the head with plastic bag tightly until the mice died and applied label-free proteomic technology to identify differentially expressed proteins (DEPs) in heart. A total of 3307 proteins were quantified, and a Fold Change (FC) > 1.2 (or <1/1.2) and Q value < 0.05 were considered as DEPs. Through comparative analysis, we identified 606 DEPs compared to the control group, comprising 219 upregulated and 387 downregulated proteins. Bioinformatics analysis (MCODE analysis) showed that the candidate proteins were mainly involved in regulation of ribosome function, myocardial contraction and calcium regulation, regulation of coagulation and regulation of mitochondrial oxidative respiration. Seven of these proteins were validated using parallel reaction monitoring (PRM), including fibrinogen alpha chain (FIBA), fibrinogen gamma chain (FIBG), Calsequestrin-2 (CASQ2), NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 11 (NDUAB), NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 3 (NDUA3), NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 13 (NDUAD) and Rab7 (RAB7A). CASQ2 and FIBG were further validated by immunohistochemistry. In conclusion, our results may provide some auxiliary indices for identifying the death from mechanical asphyxia.
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Affiliation(s)
- Zhe Zheng
- Department of Basic Medicine and Forensic Medicine, Henan University of Science and Technology, Luoyang, Henan 471023, China; Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China
| | - Li Zhang
- Department of Basic Medicine, Chongqing College of Traditional Chinese Medicine, Chongqing 402760, China
| | - Congcong Zhao
- Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China
| | - Hongli Xiong
- Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China
| | - Jianbo Li
- Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China.
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7
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Mathur A, Sharma C, Shukla V, Agrawal Y. Estimation of time since death using cardiac troponin I in case of death due to asphyxia and cardiotoxicity of acebutolol. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00719-x. [PMID: 37804400 DOI: 10.1007/s12024-023-00719-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/09/2023]
Abstract
The objective of this study was to investigate the degradation pattern of cardiac troponin I in rats in vivo, and to determine whether the pattern was dependent on the cause of death, for the purpose of estimating the postmortem interval. The rats were categorized into three distinct groups depending on the factors leading to their demise: the control group, the group experiencing acebutolol-induced cardiotoxicity, and the group affected by asphyxia. The analysis encompassed the isolation and segregation of the protein, subsequently employing Western blotting as a means of visualizing the results. The results revealed a distinct degradation pattern of cTnI into smaller fragments over time, indicating that cardiac troponin I can serve as a reliable marker for estimating the postmortem interval. Furthermore, noteworthy variations were noted in the degradation pattern of cardiac troponin I among the different causes of death, which suggests that this method can also be used to determine whether cardiac failure was the cause of death or not.
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Affiliation(s)
- Aashima Mathur
- Global Network for Sustainable Development, Noida, Uttar Pradesh, India
| | - Chandramauly Sharma
- Department of Chemistry, LJ School of Applied Sciences, LJ University, Ahmedabad, 382210, Gujarat, India.
| | - Viral Shukla
- Department of Microbiology, LJ School of Applied Sciences, LJ University, Ahmedabad, 382210, Gujarat, India
| | - Yadvendra Agrawal
- Centre of Excellence in Macromolecules & Nanotechnology, LJ University, Ahmedabad, 382210, Gujarat, India
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Zhang K, Liu R, Tuo Y, Ma K, Zhang D, Wang Z, Huang P. Distinguishing Asphyxia from Sudden Cardiac Death as the Cause of Death from the Lung Tissues of Rats and Humans Using Fourier Transform Infrared Spectroscopy. ACS OMEGA 2022; 7:46859-46869. [PMID: 36570197 PMCID: PMC9773813 DOI: 10.1021/acsomega.2c05968] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
The ability to determine asphyxia as a cause of death is important in forensic practice and helps us to judge whether a case is criminal. However, in some cases where the deceased has underlying heart disease, death by asphyxia cannot be determined by traditional autopsy and morphological observation under a microscope because there are no specific morphological features for either asphyxia or sudden cardiac death (SCD). Here, Fourier transform infrared (FTIR) spectroscopy was employed to distinguish asphyxia from SCD. A total of 40 lung tissues (collected at 0 h and 24 h postmortem) from 20 rats (10 died from asphyxia and 10 died from SCD) and 16 human lung tissues from 16 real cases were used for spectral data acquisition. After data preprocessing, 2675 spectra from rat lung tissues and 1526 spectra from human lung tissues were obtained for subsequent analysis. First, we found that there were biochemical differences in the rat lung tissues between the two causes of death by principal component analysis and partial least-squares discriminant analysis (PLS-DA), which were related to alterations in lipids, proteins, and nucleic acids. In addition, a PLS-DA classification model can be built to distinguish asphyxia from SCD. Second, based on the spectral data obtained from lung tissues allowed to decompose for 24 h, we could still distinguish asphyxia from SCD even when decomposition occurred in animal models. Nine important spectral features that contributed to the discrimination in the animal experiment were selected and further analyzed. Third, 7 of the 9 differential spectral features were also found to be significantly different in human lung tissues from 16 real cases. A support vector machine model was finally built by using the seven variables to distinguish asphyxia from SCD in the human samples. Compared with the linear PLS-DA model, its accuracy was significantly improved to 0.798, and the correct rate of determining the cause of death was 100%. This study shows the application potential of FTIR spectroscopy for exploring the subtle biochemical differences resulting from different death processes and determining the cause of death even after decomposition.
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Affiliation(s)
- Kai Zhang
- Department
of Forensic Pathology, College of Forensic Medicine, Xi’an Jiaotong University, Xi’an 710061, People’s
Republic of China
| | - Ruina Liu
- Department
of Forensic Pathology, College of Forensic Medicine, Xi’an Jiaotong University, Xi’an 710061, People’s
Republic of China
| | - Ya Tuo
- Department
of Biochemistry and Physiology, Shanghai
University of Medicine and Health Sciences, Shanghai 201318, People’s Republic of China
| | - Kaijun Ma
- Shanghai
Key Laboratory of Crime Scene Evidence, Institute of Criminal Science
and Technology, Shanghai Municipal Public
Security Bureau, Shanghai 200042, People’s Republic
of China
| | - Dongchuan Zhang
- Shanghai
Key Laboratory of Crime Scene Evidence, Institute of Criminal Science
and Technology, Shanghai Municipal Public
Security Bureau, Shanghai 200042, People’s Republic
of China
| | - Zhenyuan Wang
- Department
of Forensic Pathology, College of Forensic Medicine, Xi’an Jiaotong University, Xi’an 710061, People’s
Republic of China
| | - Ping Huang
- Shanghai
Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, People’s Republic of China
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Zhang K, Tuo Y, Liu R, Yan H, Xiang P, Wang Z, Huang P. The use of untargeted and widely targeted metabolomics to distinguish between asphyxia and sudden cardiac death as the cause of death in rats: A preliminary study. ARAB J CHEM 2022. [DOI: 10.1016/j.arabjc.2022.104322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Pefferkorn E, Lossois M, Le Gallo A, Loire C, Bascou A, Berthezène JM. Forensic diagnostic approach of peri-volcanic area fatalities: About two cases at piton de la Fournaise. J Forensic Sci 2022; 67:2497-2503. [PMID: 35900076 DOI: 10.1111/1556-4029.15111] [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: 04/21/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 11/27/2022]
Abstract
The Piton de la Fournaise, located on the island of Reunion, is a particularly active volcano that gathers many observers during its eruptions. However, this activity, if not supervised, can involve many risks. During the eruption of Piton de la Fournaise in April 2021, two geology students camped in the peri-eruptive zone. They were found dead 48 h later on the surface and were not in the immediate vicinity of a fumarole. The autopsy revealed superficial traumatic injuries, which did not explain the death. Internal examination of both victims showed a nonspecific asphyxia syndrome and hemorrhagic pulmonary edema, with no cause of death identified. Microscopic analysis confirmed the autopsy findings without providing new diagnostic elements. Toxicological analysis revealed abnormally high levels of sulfurous gases (H2 S and SO2 ) in the blood and lungs of both victims. The interpretation of all the forensic data allows us to conclude that the death was secondary to volcanic sulfur gas poisoning, despite the atypical context of this event. However, the meteorological conditions of the night of the event may have caused a stagnation of toxic volcanic gases on the ground, with concentrations high enough to cause fatal intoxication in these two persons, although they were not in a confined environment as is usually the case in cases of sulfur poisoning. The dramatic outcome of this event required a rigorous forensic diagnostic approach and reminds us of the need to respect safety conditions in peri-volcanic areas.
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Affiliation(s)
| | - Maisy Lossois
- Département de Médecine Légale, CHU de Montpellier, Montpellier, France
| | - Arnaud Le Gallo
- Institut de Médecine Légale, CHU de La Réunion, Saint-Denis, France
| | - Christophe Loire
- Institut de Médecine Légale, CHU de La Réunion, Saint-Denis, France
| | - Agathe Bascou
- Institute of Legal Medicine, Rangueil-Larrey Hospital, Toulouse, France
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Balcı Y, Göçeoğlu ÜÜ, Kıymet ME, Seçkin Ç. Autopsy findings of suicidal hanging in Mugla, Turkey. MEDICINE, SCIENCE, AND THE LAW 2022; 62:105-112. [PMID: 34723688 DOI: 10.1177/00258024211049594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Introduction: External and internal autopsy findings of suicidal hanging were evaluated retrospectively in Muğla, Turkey. The relations between macroscopic autopsy findings and age, gender, nature of the ligature, position of the knot, and the ligature marks were assessed. The aim of this study was to describe autopsy findings of the hangings and discuss the regional differences. Method: The reports of 175 hanging autopsies between 2013 to 2018 were evaluated retrospectively. Macroscopic external and internal findings were evaluated and compared statistically. Results: Among the 2534 autopsies, the cause of death was suicide by hanging in 175 cases (6.9%). The male-to-female ratio was 3:1, 76%(n = 133) of the cases were male, 24% (n = 42) were female, the mean age was 44.9(SD = 19.3) years. Suicide by hanging was most prevalent in the 25-44 age group and among men. Complete hanging was more common than incomplete hanging, and softer materials were more commonly used in incomplete hangings. Females utilized soft materials more than males. Males used atypical hanging more than females. Bilateral hemorrhage in the neck muscles was more common with typical hanging. There was a significant relationship between tongue protrusion and hemorrhage at the clavicular head of sternocleidomastoid muscle. Conclusion: In this study, which includes a large series, some regional and gender differences were observed. Careful and detailed macroscopic examination was important to diagnose antemortem vitality findings.
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Affiliation(s)
- Yasemin Balcı
- Medical Faculty, Forensic Medicine Department, Muğla, Turkey
| | - Ümit Ünüvar Göçeoğlu
- Muğla Sıtkı Koçman Universty, 52986Medical Faculty, Forensic Medicine Department, Muğla, Turkey
| | - M Elçin Kıymet
- Muğla Sıtkı Koçman Universty, 52986Medical Faculty, Forensic Medicine Department, Muğla, Turkey
| | - Çetin Seçkin
- Institute of Forensic Medicine, 52986Muğla Branch, Muğla, Turkey
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12
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Barranco R, Tettamanti C, Bonsignore A, Ventura F. Otorrhagia in strangulations: An important but often underestimated finding in forensic pathology. J Forensic Sci 2022; 67:1739-1742. [DOI: 10.1111/1556-4029.15030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/19/2022] [Accepted: 03/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Rosario Barranco
- Department of Legal and Forensic Medicine University of Genova Genoa Italy
| | - Camilla Tettamanti
- Department of Legal and Forensic Medicine University of Genova Genoa Italy
| | | | - Francesco Ventura
- Department of Legal and Forensic Medicine University of Genova Genoa Italy
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13
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Asphyxia. FORENSIC IMAGING 2022. [DOI: 10.1007/978-3-030-83352-7_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Anand A, Kumar S, Panga SK, Ashraf L, Sharma D, Tandon S. Socio-demographic profile of suicidal hanging deaths in Delhi and the National Capital Region - a retrospective study. Med Leg J 2021:258172211053697. [PMID: 34763550 DOI: 10.1177/00258172211053697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this retrospective socio-demographic analysis is to identify those at higher risk of suicidal hanging in the region of Delhi and the National Capital Region. All deaths due to suicidal hanging from January 2016 to December 2019 reported in the Vardhman Mahavir Medical College and Safdarjung Hospital were included. Suicidal hanging accounted for 2.67% of total autopsied cases; 21-30 years old represented 42.62% of the victims. Male:female ratio was 1.7:1 and 38.37% of cases were from the adjoining areas of Vasant Kunj and Vasant Vihar. Therefore, a preventive strategy should focus concern on young adults, the male sex, and areas of Vasant Kunj and Vasant Vihar.
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Affiliation(s)
- Aditya Anand
- Department of Forensic Medicine and Toxicology, Vardhaman Mahavir Medical College & Safdarjung Hospital (Guru Gobind Singh Indraprastha University), New Delhi, India
| | - Sanjay Kumar
- Department of Forensic Medicine and Toxicology, Vardhaman Mahavir Medical College & Safdarjung Hospital (Guru Gobind Singh Indraprastha University), New Delhi, India
| | - Surya Kiran Panga
- Department of Forensic Medicine and Toxicology, Vardhaman Mahavir Medical College & Safdarjung Hospital (Guru Gobind Singh Indraprastha University), New Delhi, India
| | - Laiba Ashraf
- Department of Forensic Science, Amity University, Noida, India
| | - Dibya Sharma
- Department of Forensic Medicine and Toxicology, Vardhaman Mahavir Medical College & Safdarjung Hospital (Guru Gobind Singh Indraprastha University), New Delhi, India
| | - Sarvesh Tandon
- Department of Forensic Medicine and Toxicology, Vardhaman Mahavir Medical College & Safdarjung Hospital (Guru Gobind Singh Indraprastha University), New Delhi, India
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Zhang K, Yan H, Liu R, Xiang P, Deng K, Zhang J, Tuo Y, Wang Z, Huang P. Exploring metabolic alterations associated with death from asphyxia and the differentiation of asphyxia from sudden cardiac death by GC-HRMS-based untargeted metabolomics. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1171:122638. [PMID: 33744599 DOI: 10.1016/j.jchromb.2021.122638] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/06/2021] [Accepted: 02/27/2021] [Indexed: 11/29/2022]
Abstract
The determination of cause of death is one of the most important tasks in forensic practice. However, asphyxia is a difficult cause of death to determine, especially when the deceased has an underlying disease that can lead to a sudden unexpected death, such as coronary atherosclerotic heart disease (CAHD, which is the leading cause of sudden cardiac death, SCD), because its determination is currently still based on an exclusion strategy. In this study, gas chromatography coupled with high-resolution mass spectrometry (GC-HRMS)-based untargeted metabolomics was employed to obtain the pulmonary metabolic profiles of rats who died from asphyxia and SCD. First, fourteen metabolites were identified to investigate the mechanism of death from asphyxia, and we proposed some explanations that may account for these metabolic alterations, including the perturbation of amino acid metabolism, lipid metabolism, and energy metabolism (TCA cycle). Second, we discovered eight potential biomarkers to differentiate between asphyxia and SCD as the cause of death. The excellent classification performances of the eight individual biomarkers and their combination in fresh lung tissue were observed. Third, we also explored the relative change in the concentration of the eight metabolites and their classification performance in decomposed tissue (at 24 h postmortem). Lactic acid, pantothenic acid, and the combination of the eight biomarkers can be recognized as perfect classifiers to discriminate asphyxia from SCD even when decomposition has occurred. Our results showed that GC-HRMS-based untargeted metabolomics can be used as a promising tool to explore the metabolic alterations of the death process and to determine the cause of death.
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Affiliation(s)
- Kai Zhang
- Department of Forensic Pathology, College of Forensic Medicine, Xi'an Jiaotong University, Xi'an 710061, China; Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Hui Yan
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Ruina Liu
- Department of Forensic Pathology, College of Forensic Medicine, Xi'an Jiaotong University, Xi'an 710061, China
| | - Ping Xiang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Kaifei Deng
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Ji Zhang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Ya Tuo
- Department of Biochemistry and Physiology, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Zhenyuan Wang
- Department of Forensic Pathology, College of Forensic Medicine, Xi'an Jiaotong University, Xi'an 710061, China.
| | - Ping Huang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China.
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Han L, Li W, Hu Y, Zhang H, Ma J, Ma K, Xiao B, Fei G, Zeng Y, Tian L, Chen L. Model for the prediction of mechanical asphyxia as the cause of death based on four biological indexes in human cardiac tissue. Sci Justice 2021; 61:221-226. [PMID: 33985670 DOI: 10.1016/j.scijus.2021.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/01/2021] [Accepted: 02/21/2021] [Indexed: 11/17/2022]
Abstract
Determination of mechanical asphyxia as the cause of death has always been difficult for forensic pathologists, particularly when signs of asphyxia are not obvious on the body. Currently, depending on only physical examination of corpses, pathologists must be cautious when making cause-of-death appraisals. In a previous study, four biomarkers-dual-specificity phosphatase 1 (DUSP1), potassium voltage-gated channel subfamily J member 2 (KCNJ2), miR-122, and miR-3185-were screened in human cardiac tissue from cadavers that died from mechanical asphyxia compared with those that died from craniocerebral injury, hemorrhagic shock, or other causes. Expression of the markers correlated with death from mechanical asphyxia regardless of age, environmental temperature, and postmortem interval. However, a single biological index is not an accurate basis for the identification of the cause of death. In this study, receiver operating characteristic curves of the ΔCq values of the four indexes were generated. The diagnostic accuracy of the indexes was judged according to their area under the curve (DUSP1: 0.773, KCNJ2: 0.775, miR-122: 0.667, and miR-3185: 0.801). Finally, a nomogram was generated, and single blind experiment was conducted to verify the cause of death of mechanical asphyxia.
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Affiliation(s)
- Liujun Han
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Wencan Li
- Institute of Criminal Scientific Technology, Shanghai Public Security Bureau Pudong Branch, Shanghai 200125, China
| | - Yikai Hu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Heng Zhang
- Department of Pathology, Anhui Medical University, Hefei 230032, China
| | - Jianlong Ma
- Criminal Investigation Department of Shenzhen Public Security Bureau, Shenzhen Institute of Criminal Science and Technology, Shenzhen 518000, China
| | - Kaijun Ma
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, Shanghai 200082, China
| | - Bi Xiao
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, Shanghai 200082, China
| | - Geng Fei
- Shanghai Police College, Shanghai 200137, China
| | - Yan Zeng
- Children's Hospital of Fudan University, Shanghai 201102, China
| | - Lu Tian
- Institute of Criminal Scientific Technology, Shanghai Public Security Bureau Pudong Branch, Shanghai 200125, China.
| | - Long Chen
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
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Goceoglu UU, Balci Y. Gender differences in completed suicidal hangings from 2013 to 2018 in Muğla, Turkey. Ann Saudi Med 2021; 41:43-50. [PMID: 33550904 PMCID: PMC7868624 DOI: 10.5144/0256-4947.2021.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Hanging is the most preferred among suicide methods. Although methods vary based on age groups and social and cultural conditions, many studies have reported it as the most common suicide method in Turkey. OBJECTIVE Assess autopsy findings of suicidal hangings according to gender differences. DESIGN Retrospective, cross-sectional. SETTING Local morgue. SUBJECTS AND METHODS The autopsy reports of hanging autopsies between 2013-2018. Data was retrospectively collected from autopsy reports. Sociodemographic features, reasons, suicide notes, the news media, and macroscopic autopsy findings were evaluated. Findings were statistically compared by gender. MAIN OUTCOME MEASURE Gender differences in autopsy findings. SAMPLE SIZE AND CHARACTERISTICS 175 autopsy reports of suicide by hanging. RESULTS Among 2534 autopsies, 175 (6.9%) cases involved hanging. Most (76%, n=133) were males; the median (interquartile range) age was 42.0 (29.5), the male/female ratio was 3:1. Suicide notes were found in 42 cases; 81 (24%) were from men. The most common reason for suicide was a mental illness (n=51, 29.2%), followed by family problems (n=26, 14.9%), but the cause was unknown in 42 cases (24.0%). More than half of the events were covered in the news media (58.9%). Rope was most commonly used with women preferring a softer material. Men were more frequently single than women. Men were more frequently single and not actively working than women (P=.026 and P≤.001, respectively). The incidence of atypical hanging was higher for males than females (P<.05). CONCLUSION The findings showed that there were some statistically significant differences in socioeconomic and mental health factors between men and women in hanging suicide. This study may serve as the basis for more comprehensive studies to investigate the causes of suicide. LIMITATIONS Single-center, retrospective. CONFLICT OF INTEREST None.
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Affiliation(s)
- Umit Unuvar Goceoglu
- From the Department of Forensic Medicine, Muğla Sitki Koçman Üniversitesi Tip Fakültesi, Muğla, Turkey
| | - Yasemin Balci
- From the Department of Forensic Medicine, Muğla Sitki Koçman Üniversitesi Tip Fakültesi, Muğla, Turkey
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18
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Chisnall RC. Distinguishing between homicide and suicide knots and ligatures: A comparative analysis of case and survey data. J Forensic Sci 2020; 66:209-228. [PMID: 32966611 DOI: 10.1111/1556-4029.14567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/03/2020] [Accepted: 08/12/2020] [Indexed: 11/30/2022]
Abstract
Distinguishing between suicide and homicide can be challenging owing to ambiguous and confusing case details. In particular, there is a paucity of useful information comparing homicide and suicide knots and ligatures in the literature. Multiple knot and ligature characteristics have not been recognized previously because complete and accurate information has been lacking. Ninety external tying cases (mainly homicide) and 56 cases involving self-tying (mainly suicide) were reviewed to compare multiple knot and ligature characteristics. Additionally, 189 survey volunteers performed four standardized external tying tasks and two self-tying tasks, yielding comparison data from more than 1500 knots. Using all available data, it was determined that the differences between external and self-tying included types of knots, ligature configurations, ligature tensions, wrist gaps, wend lengths, knot access, external anchoring, and other indicators. These differences are presented in a proposed analysis checklist inspired by medical and psychiatric protocols. The checklist contains 14 potential characteristics for head and neck bindings, 14 potential characteristics for wrists and arms, nine ankle and leg characteristics, and four linkage details. The proposed checklist can be expanded and fine-tuned as more data are accumulated. It offers experienced knot analysts an additional tool to assist in drawing conclusions, which then can be related to other case evidence by investigators.
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19
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Trotta S, Mandarelli G, Ferorelli D, Solarino B. Patricide and overkill: a review of the literature and case report of a murder with Capgras delusion. Forensic Sci Med Pathol 2020; 17:271-278. [PMID: 32946065 PMCID: PMC8119279 DOI: 10.1007/s12024-020-00314-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 12/01/2022]
Abstract
Despite being an infrequent crime, parental homicide has been associated with schizophrenia spectrum disorders in adult perpetrators and a history of child abuse and family violence in adolescent perpetrators. Among severe psychiatric disorders there is initial evidence that delusional misidentification might also play a role in parricide. Parricides are often committed with undue violence and may result in overkill. The authors present the case of an adult male affected by schizoaffective disorder and Capgras syndrome who committed patricide. Forensic pathologists classify such cases as overkill by multiple fatal means comprising stabbing, blunt trauma and choking. Accurate crime scene investigations coupled with psychiatric examinations of perpetrator allow reconstruction of the murder stages. This overkill case is discussed in the context of a broad review of the literature.
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Affiliation(s)
- Silvia Trotta
- Institute of Legal Medicine, Department of Interdisciplinary Medicine (DIM), Policlinico di Bari Hospital, University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Gabriele Mandarelli
- Section of Criminology and Forensic Psychiatry, Department of Interdisciplinary Medicine (DIM), University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy
| | - Davide Ferorelli
- Institute of Legal Medicine, Department of Interdisciplinary Medicine (DIM), Policlinico di Bari Hospital, University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy
| | - Biagio Solarino
- Institute of Legal Medicine, Department of Interdisciplinary Medicine (DIM), Policlinico di Bari Hospital, University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy
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20
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de Bakker HM, Warmbrunn MV, van den Biggelaar P, Soerdjbalie-Maikoe V, de Bakker BS. Correction to: Fracture patterns of the hyoid-larynx complex after fatal trauma on the neck: retrospective radiological postmortem analysis of 284 cases. Int J Legal Med 2020; 135:1105-1113. [PMID: 32870356 DOI: 10.1007/s00414-020-02382-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Henri M de Bakker
- Department of Radiology, Groene Hart Hospital, Bleulandweg 10, 2803 HH, Gouda, Netherlands
| | - Moritz V Warmbrunn
- Department of Medical Biology, Section Clinical Anatomy & Embryology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Peggy van den Biggelaar
- Department of Medical Biology, Section Clinical Anatomy & Embryology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Vidija Soerdjbalie-Maikoe
- Division of Special Services, Section Forensic Pathology, Netherlands Forensic Institute, P.O. Box 24044, 2490 AA, The Hague, Netherlands
| | - Bernadette S de Bakker
- Department of Medical Biology, Section Clinical Anatomy & Embryology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
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21
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Han L, Zhang H, Zeng Y, Lv Y, Tao L, Ma J, Xu H, Ma K, Shi Q, Xiao B, Chen L. Identification of the miRNA-3185/CYP4A11 axis in cardiac tissue as a biomarker for mechanical asphyxia. Forensic Sci Int 2020; 311:110293. [PMID: 32320934 DOI: 10.1016/j.forsciint.2020.110293] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 12/19/2022]
Abstract
Death by mechanical asphyxia is one of the most difficult conclusions to make in forensic science, especially in corpses displaying slight or no trauma to the surface of the body. Therefore, death by mechanical asphyxia is difficult to prove in medico-legal practice. MicroRNAs (miRNAs) are a class of small, non-coding RNAs involved in the regulation of numerous physiological and pathological cellular processes. In the present study, we demonstrate that significantly increased expression of miR-3185 in cardiac tissues was detected among cases of mechanical asphyxia compared to case of craniocerebral injury, hemorrhagic shock, sudden cardiac death and poisoning. We observed no correlation between the expression of miR-3185 and postmortem interval, age or temperature. Further work indicated that CYP4A11 is a putative target gene of miR-3185 and expressed at a relatively low level in cardiac tissue specimens from cases of mechanical asphyxia compared with specimens from cases of craniocerebral injury, hemorrhagic shock, sudden cardiac death and poisoning. Our results suggest that the miRNA-3185/CYP4A11 axis is associated with mechanical asphyxia-induced death and may provide new insight into asphyxial death investigations.
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Affiliation(s)
- Liujun Han
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Heng Zhang
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Yan Zeng
- Children's Hospital of Fudan University, Shanghai 201102, China
| | - Yehui Lv
- Shanghai University of Medicine & Health Sciences, Shanghai 201318, China
| | - Li Tao
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Jianlong Ma
- Criminal Investigation Department of Shenzhen Public Security Bureau, Shenzhen Institute of Criminal Science and Technology, Shenzhen 518000, China
| | - Hongmei Xu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Kaijun Ma
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, Shanghai 200082, China
| | - Qun Shi
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, Shanghai 200082, China
| | - Bi Xiao
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, Shanghai 200082, China.
| | - Long Chen
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
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22
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Mosek DP, Sperhake JP, Edler C, Püschel K, Schröder AS. Cases of asphyxia in children and adolescents: a retrospective analysis of fatal accidents, suicides, and homicides from 1998 to 2017 in Hamburg, Germany. Int J Legal Med 2020; 134:1073-1081. [PMID: 31955241 PMCID: PMC7181425 DOI: 10.1007/s00414-020-02248-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/08/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Injury-related asphyxia is one of the most common causes of death in children in Germany. However, only a few systematic studies have analyzed the causes and circumstances of asphyxia in children and adolescents. METHODS All cases of asphyxia in children and adolescents (0-21 years of age) among the Hamburg Legal Medical Department's autopsy cases from 1998 to 2017 were retrospectively analyzed with special focus on how often external findings were completely absent. RESULTS Among 249 cases of fatal asphyxia, 68% were accidents, 14% were suicides, and 13% were homicides. Most of the cases involved boys. Adolescents and young adults aged 15-21 years represented the main age group. Drowning was the leading mechanism of asphyxia. Younger age was associated with less frequent detection of external signs of asphyxia in the postmortem external examination. Petechial hemorrhages were the most common visible external indication of asphyxia. No external findings indicative of asphyxia were present in 14% of the cases. CONCLUSION Asphyxia in children and adolescents often involves accidents. However, postmortem external examination alone is insufficient to identify asphyxia and the manner of death.
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Affiliation(s)
- Dieu Phuong Mosek
- Department of Internal Medicine, Wilhelmsburger Hospital Groß-Sand, Groß-Sand 3, 21107, Hamburg, Germany
| | - Jan Peter Sperhake
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany
| | - Carolin Edler
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany
| | - Ann Sophie Schröder
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany.
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23
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de Bakker HM, Warmbrunn MV, van den Biggelaar P, Soerdjbalie-Maikoe V, de Bakker BS. Fracture patterns of the hyoid-larynx complex after fatal trauma on the neck: retrospective radiological postmortem analysis of 284 cases. Int J Legal Med 2020; 134:1465-1473. [PMID: 31912213 DOI: 10.1007/s00414-019-02241-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Fatal trauma on the neck occurs frequent in forensic cases and often results in fractures of the hyoid-larynx complex. The aim of the present study is to provide an overview of fractures in the hyoid-larynx complex that occur due to fatal trauma on the neck and can be observed by radiological evaluation. METHODS Radiological images from a forensic radiological database created in -BLINDED- were used for analysis. Hyoid-larynx complexes were explanted in 284 individuals who accordingly to the forensic pathologist allegedly died from fatal trauma on the neck. These explants were imaged with conventional X-rays in eight directions and a CT scan. Radiological images were analyzed for fractures, dislocations, joints, and anatomical variations by a trained analyst and a radiologist. RESULTS In 281/284 cases, the hyoid bone and, in 252/284 cases, the thyroid cartilage could be assessed. In 56 victims (20%), the hyoid bone was fractured, 55 times in the greater horn, 1 fracture in the body. The calcified superior horn of the thyroid showed a fracture in 101 victims (40%). The calcified cricoid cartilage was fractured in one case. Multiple fractures were found in 31/284 cases (11%). Joints between the greater horn and body of the hyoid were present in 74%. CONCLUSION Trauma on the neck leads most frequently to fractures of the superior horn of the thyroid cartilage and second most to fractures in the greater horn of the hyoid bone. (Forensic) radiologists should be aware of uncommon fracture locations, anatomical variations, and dislocations in the hyoid-larynx complex.
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Affiliation(s)
- Henri M de Bakker
- Department of Radiology, Groene Hart Hospital, Bleulandweg 10, 2803 HH, Gouda, Netherlands
| | - Moritz V Warmbrunn
- Department of Medical Biology, Section Clinical Anatomy & Embryology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Peggy van den Biggelaar
- Department of Medical Biology, Section Clinical Anatomy & Embryology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Vidija Soerdjbalie-Maikoe
- Division of Special Services, Section Forensic Pathology, Netherlands Forensic Institute, P.O. Box 24044, 2490 AA, The Hague, Netherlands
| | - Bernadette S de Bakker
- Department of Medical Biology, Section Clinical Anatomy & Embryology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
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24
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Oluwaseun WO, Francis FA, Sunday SS, John OO. Fatal suffocation: A 7-year autopsy study in Lagos, Nigeria. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2019. [DOI: 10.1016/j.fsir.2019.100033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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25
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Reisch T, Hartmann C, Hemmer A, Bartsch C. Suicide by hanging: Results from a national survey in Switzerland and its implications for suicide prevention. PLoS One 2019; 14:e0220508. [PMID: 31532773 PMCID: PMC6750587 DOI: 10.1371/journal.pone.0220508] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 07/17/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Hanging is a frequent suicide method, but developing measures to prevent suicide by this method is particularly challenging. The aim of this study is to gain new knowledge that would enable the design of effective of measures that would help prevent suicide by hanging. METHODS A total of 6,497 suicides registered across the eight Swiss Forensic Institutes (IRM) were analysed. Of these, 1,282 (19.7%) persons hung themselves. T-test and chi-square tests. and chi-square tests were used to analyse …(or determine, or investigate) …group differences regarding sociodemographic variables and triggers. FINDINGS Men and women who hung themselves showed no significant differences in sociodemographic variables. However, women were significantly more likely to have a psychiatric illness history, whereas men were more likely to have somatic diagnoses. In controlled environments, people used shelves, plumbing and windows more often than beams, pipes, bars and hooks to hang themselves. Compared with other suicide methods, hanging was more likely to have been triggered by partner and financial problems. CONCLUSIONS Suicide by hanging can be best prevented in institutions (e.g. psychiatric hospitals, somatic hospitals, prisons). These institutions should be structurally evaluated and modified with a primary focus on sanitary areas, windows and shelves. Otherwise, it is important to use general suicide prevention measures, such as awareness raising and staff training in medical settings, low-threshold treatment options and regular suicide risk assessment for people at risk.
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Affiliation(s)
- Thomas Reisch
- Hospital of Psychiatry Muensingen, Department of Psychiatry, Muensingen, Switzerland
- Hospital of Psychiatry, Department of Psychiatry, University of Bern, Bern, Switzerland
| | - Chantal Hartmann
- Hospital of Psychiatry Muensingen, Department of Psychiatry, Muensingen, Switzerland
| | - Alexander Hemmer
- Hospital of Psychiatry Muensingen, Department of Psychiatry, Muensingen, Switzerland
| | - Christine Bartsch
- Alfred Wegener Institute, Helmholtz Association, Department of Infrastructure/Administration / Operations and Research Platforms, Bremerhaven, Germany
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Ossei PPS, Ayibor WG, Agagli BM, Aninkora OK, Fuseini G, Oduro-Manu G, Ka-Chungu S. Profile of unnatural mortalities in Northern part of Ghana; a forensic-based autopsy study. J Forensic Leg Med 2019; 65:137-142. [PMID: 31154091 DOI: 10.1016/j.jflm.2019.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Bereavement is usually difficult to come to terms with. However, sudden, violent or traumatic death can be particularly hard to accept for any family, group or nation as a whole. A retrospective study of all autopsies on unnatural and traumatic deaths of medico-legal importance was made at the Komfo Anokye Teaching Hospital from 2008 to 2016. METHODS Information on cause of death and other relevant detail as well as demographics were extracted from the Autopsy Log Book of the department of pathology, Komfo Anokye Teaching Hospital where data on cause of death from autopsy findings and other relevant data were gathered and kept secured. The data was then analyzed using SPSS version 22. RESULTS Findings from the study showed that Road Traffic Accidents (RTA) contributed to 58.51% of the total forensic death cases of a total of the 1470 registered unnatural deaths. Males accounted for 75.37% of deaths as compared to 24.63% for females. The mean age for the various cause of unnatural deaths was 34 years. The age ranges from a minimum of 0.02 year (1 week) to a maximum of 97 years with median age of 33. The modal age is 30 years with 75 cases. 1108 males and 362 females were involved, resulting in a gender ratio of 3:1. The age group 30-39 recorded the highest percentage of deaths due to Hanging, Gunshots, RTA and Falls with 22.45%, 34.69%, 21.75% and 25.44% respectively. Children aged ≤9 recorded the highest number of deaths due to chemical poisoning and drowning with 25.5 8% and 40.00% of cases respectively. People in the extremes of ages (≤9 and ≥ 70) recorded the least number of death cases by percentage. CONCLUSION Road traffic accident is therefore the leading cause of unnatural traumatic deaths as it accounted for more than half of all unnatural traumatic death cases reported in the forensics department. Men, especially the youth are also more prone to violent unnatural deaths compared to women in general. It is shown that, men die more in the various categories than women. Males are likely to die on the average, 3 times more than the females by any of the manner of deaths.
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Affiliation(s)
- P P S Ossei
- Department of Pathology, KSMD, Kwame Nkrumah University of Science and Technology, Kumasi and Komfo Anokye Teaching Hospital, Ghana.
| | - W G Ayibor
- Department of Molecular Medicine, KSMD, Kwame Nkrumah University of Science and Technology, Ghana
| | - B M Agagli
- Department of Pathology, KSMD, Kwame Nkrumah University of Science and Technology, Kumasi and Komfo Anokye Teaching Hospital, Ghana
| | - O K Aninkora
- Department of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - G Fuseini
- Department of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - G Oduro-Manu
- Department of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - S Ka-Chungu
- Department of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
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Ishigami A, Kubo SI, Hara K, Waters B, Tokunaga I, Nishimura A. Fatal accidental asphyxia in the reverse jack-knife position on a chair with wheels. Leg Med (Tokyo) 2018; 36:81-84. [PMID: 30448602 DOI: 10.1016/j.legalmed.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 09/13/2018] [Accepted: 11/02/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Akiko Ishigami
- Department of Forensic Medicine, Graduate School of Biomedical Sciences, Tokushima University, Japan.
| | - Shin-Ichi Kubo
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Japan
| | - Kenji Hara
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Japan
| | - Brian Waters
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Japan
| | - Itsuo Tokunaga
- Department of Forensic Medicine, Graduate School of Biomedical Sciences, Tokushima University, Japan
| | - Akiyoshi Nishimura
- Department of Forensic Medicine, Graduate School of Biomedical Sciences, Tokushima University, Japan
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Zátopková L, Janík M, Urbanová P, Mottlová J, Hejna P. Laryngohyoid fractures in suicidal hanging: A prospective autopsy study with an updated review and critical appraisal. Forensic Sci Int 2018; 290:70-84. [DOI: 10.1016/j.forsciint.2018.05.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 05/19/2018] [Accepted: 05/26/2018] [Indexed: 11/25/2022]
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Vester MEM, Bilo RAC, Nijs HGT, van Rijn RR. Pediatric constrictive asphyxia a rare form of child abuse: A report of two cases. Forensic Sci Int 2018; 285:e17-e20. [PMID: 29370956 DOI: 10.1016/j.forsciint.2018.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 11/15/2017] [Accepted: 01/04/2018] [Indexed: 10/18/2022]
Abstract
We present two cases of infants who died under suspicious circumstances. After clinical and legal investigations, non-accidental constrictive asphyxia inflicted by one of the parents was established. The first case presents a to date not yet reported, unique mechanism of trauma. In order to stop his daughter from crying, the father admitted that he sometimes sat on his baby while she was lying on the bed. Occasionally increasing his force by pulling with his hands on the bottom of the bed. In the second case tight swaddling and encircling chest compression was the causative mechanism. In both cases the father was sentenced to imprisonment with mandate psychiatric care. Only two previous reports of this uncommon and relatively unknown cause of child abuse, called constrictive asphyxia, are known. In all reported cases static loading of the chest resulted in rib fractures and demise of the child. This rare abusive mechanism should be known to pediatric radiologists and pathologists.
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Affiliation(s)
- M E M Vester
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands; Amsterdam Center for Forensic Science and Medicine, The Netherlands.
| | - R A C Bilo
- Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands
| | - H G T Nijs
- Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands
| | - R R van Rijn
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands; Amsterdam Center for Forensic Science and Medicine, The Netherlands
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Helmus J, Poetsch M, Freislederer A, Bajanowski T. Positionelle Asphyxie in Kopftieflage – fallbezogene Diskussion. Rechtsmedizin (Berl) 2017. [DOI: 10.1007/s00194-017-0162-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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31
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Migliorini AS, Boracchi M, Gentile G, Maciocco F, Piccinini A, Zoja R. A particularly complex case of matricide by means of plastic bag suffocation: Case report. MEDICINE, SCIENCE, AND THE LAW 2017; 57:137-142. [PMID: 28697681 DOI: 10.1177/0025802417720511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A rare case of homicide with plastic bag suffocation is presented in which forensic genetic investigations were carried out on the inner surface of a plastic bag placed over the head of an elderly woman, bedridden after a stroke. The results obtained suggested that she had been murdered and hinted at the perpetrator of the crime. In fact, it emerged that biological traces left by the victim matched those of her principal caregiver, her psychotic daughter, who later confessed to the crime. The old woman also had a son affected by a serious illness, whose genetic profile was found on the same bag. In a later interview, he stated that his sister had tried to kill him too, thus confirming the genetic findings and allowing the investigators to hypothesise that the daughter had used the same means to try to kill him. Based on these results, the usefulness of forensic genetic testing when investigating complex plastic bag suffocation deaths is highlighted. This peculiar case deserves interest, since no murder of this kind has ever been reported in the Italian forensic literature.
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Affiliation(s)
| | - Michele Boracchi
- 2 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Italy
| | - Guendalina Gentile
- 2 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Italy
| | - Francesca Maciocco
- 2 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Italy
| | - Andrea Piccinini
- 2 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Italy
| | - Riccardo Zoja
- 2 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Italy
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Tyler MD, Richards DB, Reske-Nielsen C, Saghafi O, Morse EA, Carey R, Jacquet GA. The epidemiology of drowning in low- and middle-income countries: a systematic review. BMC Public Health 2017; 17:413. [PMID: 28482868 PMCID: PMC5423024 DOI: 10.1186/s12889-017-4239-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 04/06/2017] [Indexed: 12/03/2022] Open
Abstract
Background According to the World Health Organization, drowning is the 3rd leading cause of unintentional injury-related deaths worldwide, accounting for 370,000 annual deaths and 7% of all injury-related deaths. Low- and middle-income countries are the most affected, accounting for 91% of unintentional drowning deaths. Methods The authors performed a systematic review of literature indexed in EMBASE, PubMed, Web of Science, Cochrane Library, and Traumatology journals formerly indexed in PubMed in January 2014 and again in September 2016. Abstracts were limited to human studies in English, conducted in low- and middle-income countries, and containing quantitative data on drowning epidemiology. Results A total of 62 articles met inclusion criteria. The majority of articles originate from Asia (56%) and Africa (26%). Risk factors for drowning included young age (<17–20 years old), male gender (75% vs. 25% female), rural environment (84% vs. 16% urban), occurring in the daytime (95% vs. 5% night time), lack of adult supervision (76% vs. 18% supervised), and limited swimming ability (86% vs. 10% with swimming ability). There was almost equal risk of drowning in a small body of water versus a large body of water (42% ponds, ditches, streams, wells; 46% lakes, rivers, sea, ocean). Conclusion Drowning is a significant cause of injury-related deaths, especially in LMICs. Young males who are unsupervised in rural areas and have limited formal swimming instruction are at greatest risk of drowning in small bodies of water around their homes. Preventative strategies include covering wells and cisterns, fencing off ditches and small ponds, establishing community daycares, providing formal swimming lessons, and increasing awareness of the risks of drowning. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4239-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | - Robert Carey
- Boston University School of Medicine, Boston, USA
| | - Gabrielle A Jacquet
- Boston Medical Center, Boston, USA.,Boston University School of Medicine, Boston, USA
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Dirlik M, Bostancıoğlu B. Deaths due to carbon monoxide poisoning in Aydın, western Turkey. DEATH STUDIES 2017; 41:246-250. [PMID: 27849445 DOI: 10.1080/07481187.2016.1259693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to retrospectively investigate cases of death due to carbon monoxide (CO) poisoning in the province of Aydın in western Turkey. The study investigated the cases of death due to CO poisoning that were autopsied at the Adnan Menderes University Department of Forensic Medicine from 2002 to 2012. The mean age of the 33 autopsied cases of fatal CO poisoning was 60.30 ± 4.082 years, and 75.8% of the cases were men. The highest level of CO in blood was 79.7%. It was found that most of the CO poisoning deaths were related to accidents.
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Affiliation(s)
- Musa Dirlik
- a Department of Forensic Medicine , Adnan Menderes University , Aydın , Turkey
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Abstract
Hanging is a form of asphyxia caused by external pressure on the upper airways deriving from a band tightened by the gravitational weight of the body. During a 33-year period from 1983 to 2015, there were 260 hanging deaths examined at the Brescia Institute of Forensic Medicine (Northern Italy), which represented approximately 40% of all the asphyxial deaths recorded during this period. Almost all of the cases were represented by suicidal events, 1 case was a homicide event and there also was a case of sexual asphyxia. Eighty-two percent of the victims were men; 18% were women. There was an increasing tendency in the ages between 20 and 60 years, and the highest number of cases was observed in the 41- to 50-year age group (23% of the cases). The most common place chosen by the victim was the home setting followed by isolated outdoor places. The most common ligature material was a rope. The pathological findings were evaluated in all cases.
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35
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Current Analysis of Hangings That Deviates From Recently Published Studies. ACTA ACUST UNITED AC 2016; 37:299-305. [DOI: 10.1097/paf.0000000000000270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chettri R, Gurung J, Singh B. A 10-year retrospective study of suicide in Sikkim, India: Sociodemographic profile and risk assessment. Indian J Psychiatry 2016; 58:448-453. [PMID: 28197004 PMCID: PMC5270272 DOI: 10.4103/0019-5545.196712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The present study had been undertaken to investigate the sociodemographic profile of individuals who had committed suicide in Sikkim which may throw light on the vulnerable groups. MATERIALS AND METHODS Ten-year suicide data (2006-2015) obtained from Police Headquarters, Crime Branch, Gangtok, have been statistically evaluated to study the sociodemographic profile. RESULTS The results showed that out of 1604 suicide cases recorded for the past 10 years, 1051 were males (65.5%) and 553 (34.5%) were females. Suicide was found to be common among the age group of 21-30 years (24.4%), Rai community (15.8%), population of rural areas (82.6%), and among the population of eastern districts (50.6%). Hanging (94.8%) was found to be the most common method adopted for suicide. CONCLUSION The study provides preliminary information about the vulnerable groups for suicide in the state which may be vital for taking necessary steps for its prevention shortly.
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Affiliation(s)
- Reshma Chettri
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, Sikkim, India
| | - Jiwan Gurung
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, Sikkim, India
| | - Bisu Singh
- Department of Zoology, School of Life Sciences, Sikkim University, Gangtok, Sikkim, India
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37
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Tugaleva E, Gorassini DR, Shkrum MJ. Retrospective Analysis of Hanging Deaths in Ontario. J Forensic Sci 2016; 61:1498-1507. [DOI: 10.1111/1556-4029.13179] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/23/2016] [Accepted: 01/30/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Elena Tugaleva
- Department of Pathology & Laboratory Medicine; London Health Sciences Centre; London ON N6A 5A5 Canada
| | - Donald R. Gorassini
- Department of Psychology; King's College; Western University; London ON N6A 2M3 Canada
| | - Michael J. Shkrum
- Department of Pathology & Laboratory Medicine; London Health Sciences Centre; London ON N6A 5A5 Canada
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38
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Viero A, Cecchetto G, Boscolo-Berto R, Viel G, Montisci M. Suicidal Smothering by Rubber Latex Gloves and Handkerchief. J Forensic Sci 2015; 61:268-70. [PMID: 26248524 DOI: 10.1111/1556-4029.12891] [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: 10/06/2014] [Accepted: 12/29/2014] [Indexed: 11/28/2022]
Abstract
Asphyxial deaths are common in forensic practice, being sustained by a variety of mechanisms that cause an oxygen deficiency to the brain. Several classification models have been proposed in the literature, the most recent one being that of the International Network for Forensic Research Group (INFOR). This report describes an unusual case of suffocation where the obstruction of the airways was caused by a gag formed of three latex gloves and a handkerchief. The manner of death (differential diagnosis between homicide and suicide) and the different alternatives of classification are discussed.
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Affiliation(s)
- Alessia Viero
- Legal Medicine and Toxicology, Department of Cardiological, Thoracic and Vascular Sciences, University-Hospital of Padova, Via Falloppio, 50, 35121, Padova, Italy
| | - Giovanni Cecchetto
- Legal Medicine and Toxicology, Department of Cardiological, Thoracic and Vascular Sciences, University-Hospital of Padova, Via Falloppio, 50, 35121, Padova, Italy
| | - Rafael Boscolo-Berto
- Legal Medicine and Toxicology, Department of Cardiological, Thoracic and Vascular Sciences, University-Hospital of Padova, Via Falloppio, 50, 35121, Padova, Italy
| | - Guido Viel
- Legal Medicine and Toxicology, Department of Cardiological, Thoracic and Vascular Sciences, University-Hospital of Padova, Via Falloppio, 50, 35121, Padova, Italy
| | - Massimo Montisci
- Legal Medicine and Toxicology, Department of Cardiological, Thoracic and Vascular Sciences, University-Hospital of Padova, Via Falloppio, 50, 35121, Padova, Italy
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39
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An overhung mute suspect died during restraint – Is this a case of positional asphyxia? J Forensic Leg Med 2015; 33:98-100. [DOI: 10.1016/j.jflm.2015.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 04/04/2015] [Accepted: 04/07/2015] [Indexed: 11/18/2022]
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40
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Al-Kandary N, Al-Waheeb S. Patterns of accidental deaths in Kuwait: a retrospective descriptive study from 2003-2009. BMC Public Health 2015; 15:302. [PMID: 25884428 PMCID: PMC4392780 DOI: 10.1186/s12889-015-1630-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 03/12/2015] [Indexed: 11/19/2022] Open
Abstract
Background Accidents are a preventable cause of death. Unfortunately it accounts for a large number of deaths in many societies. In Kuwait, road traffic accidents (RTA) is the leading cause of death in young people. The study investigated the patterns of accidental deaths in Kuwait, one of the Gulf States which incorporates a wide variety of multi-ethnic communities. Methods The study was retrospective from 2003–2009. Data of forensic cases were collected from the general department of criminal evidence (GDCE) in the ministry of interior (MOI).We attempted to find out causes of accidental death and the prevelance of each cause. Furthermore, the relationship of demographic factors (eg. Age, sex, marital status and nationality) with each cause of accidental death in Kuwait were studied. Results The material of this study constituted a total of 4886 reported accidental deaths referred for Medico-legal examination. Road traffic accidents was by far the most prevalent cause of death (64.6%) followed by fall from height (13.1%). Poisoning and mine explosions were amongst the least common causes. Conclusion The government of Kuwait needs to take strong measures to promote safety in the workplace and households by educational campaigns.
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Affiliation(s)
- Nadia Al-Kandary
- Director of the Forensic Pathology Unit, General Department of Criminal Evidence, Ministry of Interior, Farwaniyah, Kuwait.
| | - Salah Al-Waheeb
- Assistant Professor of Pathology, Faculty of Medicine, Kuwait University, Po Box 72, Shamiyah, Kuwait City, Code 71661, Kuwait.
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Ma S, You S, Hao L, Zhang D, Quan L. Fatal mechanical asphyxia induces changes in energy utilization in the rat brain: An (18)F-FDG-PET study. Leg Med (Tokyo) 2015; 17:239-44. [PMID: 25725531 DOI: 10.1016/j.legalmed.2015.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/16/2015] [Accepted: 02/10/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE This study was designed to evaluate changes in brain glucose metabolism in rats following ligature strangulation. MATERIALS AND METHODS Thirteen male Wistar rats were used in the present study, divided into control (n=7) and asphyxia groups (n=6, ligature strangulation). Positron emission tomography (PET) with 2-deoxy-2-[(18)F]fluoro-D-glucose ((18)F-FDG) was used to evaluate brain glucose metabolism. Rats were scanned for PET-CT, and image data co-registered with a T2WI MRI template using SPM8 software. Image J was employed to draw regions of interest (ROIs) from the MRI template and acquire ROI activity information from the PET images. RESULTS In the asphyxia group vs. controls, (18)F-FDG uptake (FU) was decreased in the substantia nigra (25.26%, p<0.001), rhombencephalon (pons/medulla oblongata, 13.92%, p<0.01), hypothalamus (22.06%, p<0.01), ventral tegmentum (10.12%, p<0.05) and amygdala (12.74%, p<0.05); however, FU was increased in motor (18.21%, p<0.05) and visual cortices (19.2%, p<0.05). CONCLUSIONS The glucose metabolism distribution map in the asphyxiated rat brains were substantially changed versus controls. PET with (18)F-FDG can demonstrate excitement and inhibition of different brain areas even in cases of ligature strangulation.
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Affiliation(s)
- Suhua Ma
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China
| | - Shengzhong You
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China
| | - Li Hao
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China
| | - Dongchuan Zhang
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China
| | - Li Quan
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China; Department of Legal Medicine, Osaka City University Medical School, Osaka 545-8585, Japan.
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Dirlik M, Bostancıoğlu B. Child drowning deaths in Aydin province, western Turkey, 2002-2012. Eur J Trauma Emerg Surg 2015; 41:683-8. [PMID: 26038014 DOI: 10.1007/s00068-015-0493-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 01/05/2015] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Drowning, a major public health problem worldwide, occurs as an accident, suicide, or homicide. Deaths with an accidental origin are common in childhood in the 0-18 age group. In our study, pediatric drowning cases for whom a postmortem examination and an autopsy were conducted by Adnan Menderes University Department of Forensic Medicine were evaluated. The characteristics were determined and compared with domestic and foreign studies. MATERIALS AND METHODS A total of 39 cases in the 0-18 age group in Aydın between 2002 and 2012 were analyzed regarding age, gender, cause of death, origin, the accident scene, and the month in which the death occurred. RESULTS Of the drowning cases, 33 (84.6 %) were male, and 6 (15.4 %) were female. The average age was 9.08 years, and drowning is most common in the 0-4 age group (33.3 %). The scene of the accident was an irrigation channel in 43.5 % of the cases, a river in 15.3 %, a sea in 12.8 %, a pool in 10.2 %, and a lake or pond in 7.69 %. CONCLUSION Drowning deaths are a serious and preventable public health problem worldwide. There are strong correlations among lack of adult supervision, lack of precautions, and neglect.
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Affiliation(s)
- M Dirlik
- Department of Forensic Medicine, Faculty of Medicine, Adnan Menderes University, Aydın, 09100, Turkey.
| | - B Bostancıoğlu
- Ministry of Justice, Forensic Science Institute, Antakya, Hatay, Turkey
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Khokhlov VD. Trauma to the hyoid bone and laryngeal cartilages in hanging: Review of forensic research series since 1856. Leg Med (Tokyo) 2015; 17:17-23. [DOI: 10.1016/j.legalmed.2014.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/22/2014] [Accepted: 09/25/2014] [Indexed: 10/24/2022]
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When the hidden features become evident: The usefulness of PMCT in a strangulation-related death. Leg Med (Tokyo) 2014; 16:364-6. [DOI: 10.1016/j.legalmed.2014.06.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 06/22/2014] [Indexed: 11/16/2022]
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Evaluation and management of pediatric near-hanging injury. Int J Pediatr Otorhinolaryngol 2013; 77:1899-901. [PMID: 24094721 DOI: 10.1016/j.ijporl.2013.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/29/2013] [Accepted: 09/04/2013] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Children surviving a strangulation event are unique from adults in that they are at risk for significant airway compromise due to the smaller relative size of their airways. To date, no study has specifically evaluated the laryngeal findings and management of pediatric near-hanging patients. METHODS A retrospective chart review was performed on all near-hangings presenting to the a tertiary care children's hospital from January 2001 until June 2010. Demographic information was compiled in addition to laryngeal findings. RESULTS Sixteen children were identified. Four had a documented laryngeal injury, one of which was a major injury requiring a tracheotomy. CONCLUSION Laryngeal examination should be standard of care for any child presenting after a near-hanging event.
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Kurtulus A, Yonguc GN, Boz B, Acar K. Anatomopathological findings in hangings: a retrospective autopsy study. MEDICINE, SCIENCE, AND THE LAW 2013; 53:80-84. [PMID: 23275431 DOI: 10.1258/msl.2012.012030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND In this retrospective autopsy study, we aimed to review the anatomopathological findings observed in cases of hanging death for a five year period and to evaluate the role of contributing factors such as age, sex, type of hanging and localization of the ligature knot. METHODS Autopsy reports of 102 hanging cases performed by the Department of Forensic Medicine, Faculty of Medicine of Pamukkale University, between January 2007 and September 2011, were retrospectively reviewed. RESULTS In the 102 hanging cases 73 of the victims were males (71.6%) and 29 (28.4%) were females, with a mean age of 40.97 ± 17.41 years. All cases were suicidal hanging. Fifty four cases (52.9%) were typical hanging, with the ligature knot located posteriorly. There were petechial hemorrhage on the face and eye lids in 46 (45.1%), ecchymoses of the cervicale muscles in 43 (42.2%), and fractures of the neck structure(s) in 69 cases (67.6%). CONCLUSIONS The incidence of neck structure fractures increased with age. In addition, there was no correlation between the incidence of neck structure fractures and sex or type of hanging.
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Affiliation(s)
- Ayse Kurtulus
- Department of Forensic Medicine, Pamukkale University, Kinikli, Turkey.
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Forensic and clinical carbon monoxide (CO) poisonings in Turkey: A detailed analysis. J Forensic Leg Med 2013; 20:95-101. [DOI: 10.1016/j.jflm.2012.04.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 02/23/2012] [Accepted: 04/21/2012] [Indexed: 12/28/2022]
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Fracture of the cricoid as a potential pointer to homicide. A 6-year retrospective study of neck structures fractures in hanging victims. Am J Forensic Med Pathol 2012; 33:4-7. [PMID: 22442828 DOI: 10.1097/paf.0b013e3181d3dc24] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The distinction of a suicidal hanging from a simulated hanging following a homicidal strangulation is highly challenging. The present study evaluates the fracture of the cricoid cartilage as a potential pointer toward homicide. Despite the numerous studies on neck structures fractures in hanging, this is the first study to concentrate on the cricoid cartilage. Neck structures fractures in all cases of suicidal hanging over a 6-year period were retrospectively reviewed (231 cases) and a comparison with homicidal hangings (4 cases) and homicidal no-hanging strangulations cases (52 cases) was performed. Overall, neck structures fractures were found in 23.4% of suicidal cases (54 cases). The cricoid cartilage was intact in all suicidal hangings. The general incidence of fractures in homicidal no-hanging strangulation was 65.4% (34 cases),with an incidence of fracture of the cricoid cartilage of 20.6%. By compiling studies from the literature, only one cricoid cartilage over 2700 suidical hanging cases was found, whereas an incidence of 5 to 20% is found for homicidal strangulation. It is therefore proposed that the presence of a fracture of the cricoid in an apparent suicidal hanging should be considered highly suspicious.
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Abstract
A 40-year-old man was found dead in his prison cell, hanging on a twisted bandage tightened around his neck. His permanent metal tracheostomy tube was completely corked with a piece of paper wrapped with transparent cellophane from a cigarette case. After police investigation and complete autopsy, suicide was determined as the manner of death. Although suicides by 1 form of asphyxia are relatively common, combination of several different forms of asphyxia is far less frequent. We present this unusual and very rare case of suicide by combination of 2 forms of asphyxia, that is, choking and hanging, along with autopsy findings and discussion.
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Homicidal hanging. Leg Med (Tokyo) 2011; 13:259-61. [DOI: 10.1016/j.legalmed.2011.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 05/22/2011] [Accepted: 05/27/2011] [Indexed: 11/18/2022]
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