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Raniero D, Schiraldi M, Ausania F, Turrina S, De Leo D. When fire burns the evidence - Lesson 1: It is not always what it seems. Leg Med (Tokyo) 2024; 70:102483. [PMID: 39029292 DOI: 10.1016/j.legalmed.2024.102483] [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: 02/08/2024] [Revised: 03/18/2024] [Accepted: 07/08/2024] [Indexed: 07/21/2024]
Abstract
When a charred corpse is found, a primary unavoidable phase of the subject's identification is performed. Then, the medico-legal investigation must clarify whether the charring occurred before or after death, and so establish a differential diagnosis between accidental, homicidal, or suicidal modality. We report three cases of charred corpses in which a death dynamic was initially suspected but subsequently disproved: a suicidal intoxication in arson at first thought to be homicidal strangulation, a suicidal hanging revealed by neck haemorrhages in a suspected accidental fire, a femicide through ligature strangulation concealed with the simulation of a car accident. Many of the events are accidental, related to fires or traffic accidents. However, it must be considered that charring following a murder was deliberately provoked to prevent the identification of the subject and to conceal evidence of how the murder occurred. Because of the complex operational conditions in the study of a charred corpse, all the diagnostic tools proper to forensic science should be held beyond the preliminary circumstantial suggestions. We aim to emphasise the importance of a multidisciplinary approach since the solution of the three cases was possible thanks to the combination of crime scene investigation, radiological exams, autopsy, and histopathological and genetic analysis.
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Affiliation(s)
- Dario Raniero
- Department of Diagnostics and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy.
| | - Michela Schiraldi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Forensic Medicine Unit, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Francesco Ausania
- Department of Diagnostics and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Stefania Turrina
- Department of Diagnostics and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Domenico De Leo
- Department of Diagnostics and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
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Simonit F, Da Broi U, Giudici F, Sciarappa OE, Innocenti D, Desinan L. Autopsy findings in fire deaths in relation to manner of death: Analysis of autopsy records in Friuli, Italy (1993-2020). Leg Med (Tokyo) 2024; 67:102372. [PMID: 38154314 DOI: 10.1016/j.legalmed.2023.102372] [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: 12/04/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
The determination of the cause and manner of death can be particularly difficult in burned and charred bodies and autopsy remains a key element in the investigation. In this study, 39 autopsy records of fire deaths were reviewed in relation to the manner of death (25 accidents, 8 suicides, 3 homicides and 3 instances in which the manner of death remained undetermined). The analysis focused on the study of the burns, the degree to which the bodies were consumed by fire and the evidence of signs of vital exposure to fire and of non-fire-related injuries. Total surface body area (TBSA) was found to be significantly higher (p = 0.02) in suicides than in accidents. Moreover, the degree of destruction according to the Crow-Glassman Scale and the presence of a pugilistic posture tended to be higher in suicides compared to accidental deaths, whereas such parameters were found to be variable in homicides. With regard to the anatomical distribution of burns, in contrast with the literature, the feet were affected by burning in all suicides, with a significantly higher prevalence than in accidents (p < 0.01). Traumatic non-fire related injuries were noted in all homicides (with no signs of vital exposure to fire), 1 complicated suicide, 1 undetermined death and 13 accidents. We found that very few studies have focused on the analysis of burn distribution and extension according to manner of death and that there is currently no standardised anatomical model with which to study these variables for forensic purposes.
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Affiliation(s)
- Francesco Simonit
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy.
| | - Ugo Da Broi
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy
| | - Fabiola Giudici
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Orazio Elia Sciarappa
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy
| | - Dario Innocenti
- Università degli Studi di Udine, Dipartimento di Studi Umanistici, Italy
| | - Lorenzo Desinan
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy
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Liu JL, Zheng YH, Chen LJ, Zhang KK, Li JH, Yang JZ, Li XW, Zhao D, Xie XL, Wang Q. mRNA microarray analysis for the identification of potential biomarkers for vital reaction in burned skin: a preliminary pilot study. Forensic Sci Med Pathol 2022; 18:319-328. [PMID: 35543929 DOI: 10.1007/s12024-022-00474-5] [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] [Accepted: 03/13/2022] [Indexed: 12/14/2022]
Abstract
The identification of ante- and post-mortem burns is challenging in forensic pathology. In this study, microarray analysis was used to detect the mRNA expression profiles in the skin of an experimental burn mouse model; the results were validated using RT-qPCR. Differentially expressed mRNAs (DE-mRNAs) were assessed using the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases. Our results revealed that mRNA expression of 501 genes was significantly different, of which 273 were upregulated and 228 were downregulated in ante-mortem burned mice skin. The expression levels of eight random mRNAs were consistent when measured using the microarray assay-based method and RT-qPCR. Genes from different functional categories and signalling pathways were enriched, including interleukin-20 binding, type IV hypersensitivity, negative regulation of acute inflammatory response, sensory organ development, endocytosis, neuroactive ligand-receptor interaction, and Jak-STAT signalling pathway. Only five of the eight mRNAs exhibited consistent changes in expression between burned skin samples of mice and human autopsy specimens. Our findings showed that DE-mRNAs revealed using microarray are potential biomarkers of ante-mortem burns. However, DE-mRNAs identified from experimental animal models cannot be directly extended to autopsy specimens without careful validation.
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Affiliation(s)
- Jia-Li Liu
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, China
| | - Ye-Hua Zheng
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, China
| | - Li-Jian Chen
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, China
| | - Kai-Kai Zhang
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, China
| | - Jia-Hao Li
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, China
| | - Jian-Zheng Yang
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, China
| | - Xiu-Wen Li
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, China
| | - Dong Zhao
- Key Laboratory of Evidence Science (China University of Political Science and Law), Ministry of Education, Beijing, 100088, China
| | - Xiao-Li Xie
- Department of Toxicology, School of Public Health, Southern Medical University, (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1838 North Guangzhou Road, Guangzhou, 510515, China.
| | - Qi Wang
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, China.
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Maiese A, Ciallella C, dell’Aquila M, De Matteis A, Toni C, Scatena A, La Russa R, Mezzetti E, Di Paolo M, Turillazzi E, Frati P, Fineschi V. Cause of Death in Charred Bodies: Reflections and Operational Insights Based on a Large Cases Study. Diagnostics (Basel) 2022; 12:1986. [PMID: 36010336 PMCID: PMC9407296 DOI: 10.3390/diagnostics12081986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/26/2022] [Accepted: 08/14/2022] [Indexed: 11/17/2022] Open
Abstract
Our study aims to demonstrate the experience of analyzing fully or partially charred corpses to offer a proper implementation protocol for determining the cause of death. In this study, we present a total of 103 cases obtained from the University of Rome La Sapienza and the University of Pisa archives. All cases were classified based on the extent and severity of burns using a visual method. We divided all cases into two groups. The first group included grade I-II burns (21 cases) without the need for identification. The second group (82 cases) included injuries worse than grade burns II, so all cases were analyzed using an analytical method. For each case, we have documented which of the following analyses have been used and the corresponding findings: inspection, autopsy examination, imaging examination, genetic and toxicological examinations, and histological examination. The results describe the main diagnostic findings and show that only the application of all the above systematic analyses can provide greater accuracy and reliability in describing the causes of death or solving problems, such as identification. In conclusion, we propose an available protocol that defines the main steps of a complete diagnostic pathway that pathologists should follow daily in studying charred bodies.
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Affiliation(s)
- Aniello Maiese
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Costantino Ciallella
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Massimiliano dell’Aquila
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Alessandra De Matteis
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Chiara Toni
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Andrea Scatena
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Raffaele La Russa
- Section of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Eleonora Mezzetti
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Marco Di Paolo
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Emanuela Turillazzi
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
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Carbon monoxide related deaths in Jeddah, Saudi Arabia: A forensic carboxyhemoglobin autopsy-based study. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2021. [DOI: 10.1016/j.fsir.2021.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Conway KS, Schmidt CJ, Brown TT. Medical Examiner Review of the Characteristics of Fire-Related Homicides. Acad Forensic Pathol 2020; 10:87-93. [PMID: 33282042 DOI: 10.1177/1925362120964377] [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: 06/02/2020] [Accepted: 09/13/2020] [Indexed: 11/16/2022]
Abstract
While fire-related deaths are regularly encountered by medical examiners, fire-related homicides are relatively uncommon. Although some large retrospective studies of fire-related deaths have been performed, few large studies have specifically reviewed fire-related homicides. Autopsy, scene investigation, and ancillary studies were reviewed for 38 fire-related homicides evaluated at the Wayne County Medical Examiner's Office in Detroit, Michigan. The largest proportion of cases were inhalation-related deaths in dwelling fires (n = 21, 55%), followed by deaths from thermal injury after immolation (n = 8, 21%) and traumatic death with contemporaneous or subsequent immolation (n = 8, 21%). There was one case of postmortem immolation. Although carboxyhemoglobin (COHb) levels played a significant role in evaluation of these cases, no single factor was diagnostic of a particular cause or manner of death. Fire-related homicides present unique diagnostic challenges because multiple insults frequently contribute to the cause death. Death at the scene and COHb level above 10% are the most useful factors in establishing smoke and soot inhalation as the cause of death. Some autopsy findings are helpful in establishing or ruling out smoke and soot inhalation as contributing to or sole cause of death, but an evaluation of the entire circumstances and autopsy findings is necessary.
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Morobadi K, Blumenthal R, Saayman G. Thermal fatalities in Pretoria: A 5-year retrospective review. Burns 2019; 45:1707-1714. [PMID: 31174970 DOI: 10.1016/j.burns.2019.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 05/02/2019] [Accepted: 05/15/2019] [Indexed: 11/26/2022]
Abstract
In South Africa, research on burn mortality has emanated primarily from specialised burn centres and has focused on specific age groups and hospital-based fatalities. This study describes the demographic profile and the pathology of trauma related to burn fatalities as seen at the Pretoria Medico-Legal Laboratory (PTA MLL), a large urban medico-legal mortuary over a 5-year period from January 2011 to December 2015. Mortuary admission records and autopsy reports were used to gather information on demographics, circumstances of injury, apparent manner and cause of death, pathology of burns, toxicology and histology reports and identification of the decedents. RESULTS: Of the 9558 unnatural deaths admitted to the PTA MLL during this time period, 291 (3.0%) of the fatalities met the inclusion criteria. The male:female ratio was 2.9:1. Most fatalities occurred between the ages of 0-4 years. One hundred and forty-two (142) decedents were charred beyond recognition. Identification was confirmed in 134 (94.4%) of the charred remains. In 208 (69.8%) of the cases the manner of death was deemed to be accidental, 23 (7.9%) were homicidal and 11 (3.8%) were suicides. Two hundred and fifty-five (87.4%) of the fatalities were as a result of open flames/fires. Shack fires were responsible for 105 (36%) of all fatalities. In 32 (11.0%) cases of open flame/fire fatalities where death occurred at the scene of injury, more than one fatality was reported per incident. In 122 (79.2%) of scene fatalities, soot deposition was noted in the upper and lower airways. Forty-five (32.8%) of hospital fatalities occurred within 24 h of admission. The most common complications in hospital fatalities were from the respiratory system. The mean blood alcohol concentrations (BAC) was 0.09 g/100 ml. The mean carboxyhaemoglobin concentrations (COHb) was 19.9%. All available cyanide results were negative. CONCLUSION: The study is the first of its kind in South Africa to generate bimodal descriptive statistics for burn fatalities. Approximately 3% of unnatural deaths at the PTA-MLL were due to burns, occurring at a rate of ±1 death per week. The data provides a platform for funding, collaborative research, planning and development of public health programs.
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Affiliation(s)
- K Morobadi
- Department of Forensic Medicine, University of Pretoria, Pathology Building, Prinshof Campus, Corner Dr Savage Rd. and Bophelo Rd., South Africa.
| | - R Blumenthal
- Department of Forensic Medicine, University of Pretoria, Pathology Building, Prinshof Campus, Corner Dr Savage Rd. and Bophelo Rd., South Africa.
| | - G Saayman
- Department of Forensic Medicine, University of Pretoria, Pathology Building, Prinshof Campus, Corner Dr Savage Rd. and Bophelo Rd., South Africa.
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