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Sacco MA, Galassi FM, Varotto E, Landini L, Gualtieri S, Mazzuca W, Ricci P, Chiaravalloti G, Aquila I. A Multidisciplinary Approach to a Complex Fatal Attack Due to a Pack of Maremma Sheepdogs: Is It Always an Accident? Cureus 2024; 16:e56911. [PMID: 38659560 PMCID: PMC11042836 DOI: 10.7759/cureus.56911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Deaths due to dog attacks are a worldwide issue. Fatal dog attacks may occur in various environments, including the dog owner's property. A lot of difficulties emerge when the attack involves a pack of dogs, of different species and sizes. In this case, it becomes much more difficult for forensic investigators to evaluate the event, especially regarding the identification of the dog or dogs that caused the death as well as the identification of the owner and the reconstruction of the dynamics for forensic purposes. In this paper, we analyze a specific case of an attack by a herd of Maremma sheepdogs. A crime scene investigation has been carried out. In the first phase of this case, the victim interacted with dogs that had non-aggressive attitudes. Then, after an escape attempt, she was assaulted by about 20 Maremma dogs of different sizes, leading to multiple injuries all over her body. The greatest difficulty was precisely that of reconstructing the dynamics due to the numerous injuries and dogs involved in the attack. The dynamics were divided into several stages following the analysis of the injuries found on the victim. This case study highlights how the forensic multidisciplinary approach has made it possible to precisely reconstruct the event. The analysis of the dogs' state of malnutrition and their suddenly aggressive attitude towards the victim revealed profiles of responsibility of the owner attributable to improper management and training of the animals to defend their property.
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Affiliation(s)
- Matteo Antonio Sacco
- Department of Medical and Surgical Sciences, Institute of Legal Medicine, Magna Graecia University of Catanzaro, Catanzaro, ITA
| | - Francesco Maria Galassi
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, POL
| | - Elena Varotto
- College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, AUS
| | - Laura Landini
- Forensic Anthropology, Forensic Anthropology, Paleopathology and Bioarchaeology (FAPAB) Research Center, Avola, ITA
| | - Saverio Gualtieri
- Department of Medical and Surgical Sciences, Institute of Legal Medicine, Magna Graecia University of Catanzaro, Catanzaro, ITA
| | - Wandamaria Mazzuca
- Department of Medical and Surgical Sciences, Institute of Legal Medicine, Magna Graecia University of Catanzaro, Catanzaro, ITA
| | - Pietrantonio Ricci
- Department of Medical and Surgical Sciences, Institute of Legal Medicine, Magna Graecia University of Catanzaro, Catanzaro, ITA
| | | | - Isabella Aquila
- Department of Medical and Surgical Sciences, Institute of Legal Medicine, Magna Graecia University of Catanzaro, Catanzaro, ITA
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Sacco MA, Gualtieri S, Ricci P, Aquila I. The Risk of Suicide in the Post-COVID-19 Emergency Era: Psychological and Forensic Implications. Cureus 2023; 15:e49081. [PMID: 38125261 PMCID: PMC10731125 DOI: 10.7759/cureus.49081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 12/23/2023] Open
Abstract
The emergence of the coronavirus disease 2019 (COVID-19) pandemic brought numerous challenges, including the management of psychological and psychiatric disorders, leading to an increased risk of suicide. At the end of the COVID-19 emergency, we wonder what the impact of the pandemic has been, and still is, on the state of public mental health with respect to the phenomenon of suicide. Therefore, this review aims to explore the psychological and forensic aspects of suicide in the post-COVID-19 emergency era. The paper will delve into the various psychiatric disorders associated in the literature with COVID-19, the risk factors for suicide during the pandemic, and measures that can be taken to prevent suicide in the post-COVID-19 era. Additionally, the paper will look at how forensic experts investigate suicide cases due to COVID-19 and the legal implications of suicide due to the pandemic. The findings of this study will provide insights into the psychological and forensic aspects of suicide in the post-COVID era, and emphasize interventions and policy development to address this growing public health concern.
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Affiliation(s)
- Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Saverio Gualtieri
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
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Sacco MA, Ricci C, Fragomeni G, Bonetta CF, Cordasco F, Gualtieri S, Cavalcanti B, Ricci P, Aquila I. Reconstruction of Trauma Dynamics Due to Ligature Strangulation by Using a Dynamometer: A Technical Report. Cureus 2023; 15:e48982. [PMID: 38111449 PMCID: PMC10726159 DOI: 10.7759/cureus.48982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
Asphyxiation caused by violence, particularly through ligature strangulation, necessitates the application of a force that is characterized by a point of application, direction, and intensity. These properties can be quantified through the use of a dynamometer, which is composed of a graduated scale and a spring. In this particular study, an experimental model utilizing a dynamometer was employed to aid in the diagnosis and analysis of the dynamics of violent trauma resulting from homicidal ligature strangulation. The experimental model was applied to an attempted murder case involving strangulation. The primary challenge in this case was to establish the attempted murder scientifically, as the offender claimed that there had been no intent to kill, but instead an attempt to frighten the victim. To prove his assertion, the assailant emphasized the absence of strangulation injuries on the victim's neck. To investigate, a crane scale dynamometer was fixed on a cable and placed on a manikin's neck. The potential measurable combinations with the dynamometer were then compared to witness accounts and the injuries found on the victim. The utilization of a dynamometer in our case permitted the diagnosis and verification of a trauma that was undoubtedly caused by violent asphyxiation via strangulation. The information yielded by the dynamometer was subsequently submitted as scientific evidence in Court, serving to substantiate the intent to commit homicide and substantiate the credibility of the victim's testimony.
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Affiliation(s)
- Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Cristoforo Ricci
- Department of Jurisprudence, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Gionata Fragomeni
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Carlo Filippo Bonetta
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Fabrizio Cordasco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Saverio Gualtieri
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Berardo Cavalcanti
- Department of Forensic Medicine, Forensic Medical Office, Corso Mazzini Giuseppe, Cosenza, ITA
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
| | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, ITA
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Abenavoli L, Aquila I, Sacco MA, Scarlata GGM, Procopio AC, Boccuto L, Scarpellini E, Greco M, Foti DP, Ricci P, Luzza F. Liver Damage and Impaired Coagulation in COVID-19 Patients: A Case Series. Diseases 2023; 11:141. [PMID: 37873785 PMCID: PMC10594514 DOI: 10.3390/diseases11040141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has generated an unprecedented challenge for healthcare systems worldwide. Currently, the scientific community wonders if liver injury in patients suffering from severe forms is a direct consequence of the virus or secondary manifestations of systemic inflammation. The liver plays an essential role in the development of the inflammatory storm typical of this disease, and its involvement is associated with worse clinical outcomes and a higher risk of morbidity and mortality from Coronavirus disease 2019 (COVID-19). METHODS Ten patients suffering from severe COVID-19 disease who died between January 2020 and December 2021 were included in the present analysis. These subjects underwent a post mortem examination with a focused evaluation of the hepatic injury. Also, several laboratory parameters have been evaluated, with a primary focus on prothrombin time, partial thromboplastin time, fibrinogen, antithrombin III, and D-dimers to detect coagulative changes. RESULTS The main cause of death was represented by pulmonary thromboembolism events (50%). The analysis of coagulation laboratory parameters and liver biomarkers revealed a statistically significant rise in aPTT and ALP, and a decrease in albumin, when comparing the blood value at admission and death. We also found high levels of D-dimers in most of the subjects at the time of hospitalization. Interestingly, the post mortem analysis of the liver showed ample morphologic variability, with several disease features. In detail, the liver histology revealed the following: the presence of a variable degree of micro- and macrovacuolar steatosis, inflammation (also, hepato-cholangitis), and variable fibrosis. Of mention, we were also able to detect organized fibrinous material. CONCLUSIONS Our results indicate that in subjects with a severe form of COVID-19, liver disease is related to changes in coagulative and fibrinolytic pathways. In particular, we noted low fibrinogen levels and high D-dimer levels with histological liver findings. Our data suggest that fibrinogen and D-dimers may be used as prognostic markers to detect the severity of liver disease in patients with COVID-19. Finally, we underline the crucial role of coagulation balance in subjects with severe forms of COVID-19.
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Affiliation(s)
- Ludovico Abenavoli
- Department of Health Sciences, University “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (G.G.M.S.); (A.C.P.); (M.G.); (F.L.)
| | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy; (I.A.); (M.A.S.); (P.R.)
| | - Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy; (I.A.); (M.A.S.); (P.R.)
| | - Giuseppe Guido Maria Scarlata
- Department of Health Sciences, University “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (G.G.M.S.); (A.C.P.); (M.G.); (F.L.)
| | - Anna Caterina Procopio
- Department of Health Sciences, University “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (G.G.M.S.); (A.C.P.); (M.G.); (F.L.)
| | - Luigi Boccuto
- Healthcare Genetics and Genomics Doctoral Program, School of Nursing, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC 29631, USA;
| | - Emidio Scarpellini
- Translationeel Onderzoek van Gastroenterologische Aandoeningen (T.A.R.G.I.D.), Gasthuisberg University Hospital, KU Leuven, Herestraat 49, 3000 Leuven, Belgium;
| | - Marta Greco
- Department of Health Sciences, University “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (G.G.M.S.); (A.C.P.); (M.G.); (F.L.)
| | - Daniela Patrizia Foti
- Department of Experimental and Clinical Medicine, University “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy;
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy; (I.A.); (M.A.S.); (P.R.)
| | - Francesco Luzza
- Department of Health Sciences, University “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (G.G.M.S.); (A.C.P.); (M.G.); (F.L.)
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Aquila I, Sacco MA, Gorniak J, Rouse M, Gualtieri S, Cordasco F, Tarallo AP, Raffaele R, Ricci P. Unexplained and Unexpected Pediatric Deaths: Forensic Review and New Perspectives. Diagnostics (Basel) 2023; 13:3111. [PMID: 37835854 PMCID: PMC10572571 DOI: 10.3390/diagnostics13193111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023] Open
Abstract
Unexplained and unexpected pediatric deaths are a major challenge in global healthcare. The role of the forensic pathologist is crucial in determining the cause and manner of death in these cases, although to date, there are many limitations in post-mortem diagnosis. The role of the autopsy and related forensic investigations become a fundamental tool to investigate and give an explanation for an unacceptable event, considering the young age of the victims. From this point of view, even today, it is necessary that this phenomenon is correctly recorded through standardized systems and universally accepted methods. Furthermore, it is essential that scientific research on this topic is increased through the implementation of universally accepted operating protocols recognizing real risk factors in order to prevent such events. The purpose of the study is to offer a review of the state of the art about unexplained pediatric death and, above all, to propose an international reporting platform, extending proper investigations not only to judicial cases but also to all the other cases of unexpected pediatric death.
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Affiliation(s)
- Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (F.C.); (A.P.T.); (R.R.); (P.R.)
| | - Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (F.C.); (A.P.T.); (R.R.); (P.R.)
| | - Jan Gorniak
- Clark County Office of Coroner Medical Examiner, 1704 Pinto Lane, Las Vegas, NV 89106, USA; (J.G.); (M.R.)
| | - Melanie Rouse
- Clark County Office of Coroner Medical Examiner, 1704 Pinto Lane, Las Vegas, NV 89106, USA; (J.G.); (M.R.)
| | - Saverio Gualtieri
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (F.C.); (A.P.T.); (R.R.); (P.R.)
| | - Fabrizio Cordasco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (F.C.); (A.P.T.); (R.R.); (P.R.)
| | - Alessandro Pasquale Tarallo
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (F.C.); (A.P.T.); (R.R.); (P.R.)
| | - Roberto Raffaele
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (F.C.); (A.P.T.); (R.R.); (P.R.)
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (F.C.); (A.P.T.); (R.R.); (P.R.)
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Sacco MA, Gualtieri S, Verrina MC, Ricci P, Aquila I. Sudden Death of a Young Man Due to Massive Haemoptysis Associated With Pulmonary Tuberculosis: A Rare Case. Cureus 2023; 15:e47635. [PMID: 38021513 PMCID: PMC10668203 DOI: 10.7759/cureus.47635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Asphyxia includes a large number of possible causes and mechanisms, such as infectious diseases of the lungs. Among these, tuberculosis (TB) is one of the main infectious causes of death worldwide. The burden of TB is very high, by virtue of antibiotic resistance and the risk of other concomitant infections, such as HIV. A major problem is related to the omitted diagnosis of TB infection which, in some cases, may remain completely unknown to the patient, with a significant increase in mortality and morbidity risk. There has been a decrease in the reported cases of sudden death due to TB, especially that associated with hemoptysis and aspiration of blood. In this report, we describe a case of sudden death that occurred in a young male in the workplace, under unclear circumstances. The autopsy detected acute asphyxia due to a massive pulmonary hemorrhage in the individual, who was apparently suffering from TB. The autopsy proved to be essential for understanding the cause of death and investigating the adequacy of the health surveillance measures carried out on the individual.
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Affiliation(s)
- Matteo Antonio Sacco
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, ITA
| | - Saverio Gualtieri
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, ITA
| | - Maria Cristina Verrina
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, ITA
| | - Pietrantonio Ricci
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, ITA
| | - Isabella Aquila
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, ITA
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Sacco MA, Gualtieri S, Tarda L, Ricci P, Aquila I. Clinical and Forensic Investigation Protocols for Diagnosing Abusive Head Trauma: A Literature Review. Diagnostics (Basel) 2023; 13:3093. [PMID: 37835835 PMCID: PMC10572508 DOI: 10.3390/diagnostics13193093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Abusive head trauma (AHT) represents a very serious global public health problem. Prevention of these episodes is essential to reduce the morbidity and mortality of this phenomenon. All healthcare professionals should be able to recognize the signs of abuse. However, diagnosis is very complex as the signs are often blurred and cannot be recognized with certainty without carrying out adequate instrumental investigations. It has been calculated that approximately one-third of AHT cases remain undetected and require more than one medical visit to be correctly interpreted and diagnosed. On the other hand, the literature has recently also emphasized the problems related to possible false diagnoses of abuse and the numerous family and personal repercussions that follow from this issue. For these reasons, correct and timely recognition is essential to avoid the risk of recurrence of AHT and to start proper forensic investigations, in order to identify the offender or exonerate a suspect. The present work explores the most recent evidence of recent years in the field of AHT diagnostics through a literature review. The purpose of this article is to provide forensic pathologists with clear tools for diagnosis based on the literature. To this end, the review suggests clinical and forensic protocols aimed at the timely diagnosis of AHT in order to prevent abuse from remaining undetected.
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Affiliation(s)
| | | | | | | | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (L.T.); (P.R.)
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Sacco MA, Gualtieri S, Calanna L, Ricci P, Aquila I. Exploring the Potential of Proteome Analysis as a Promising Tool for Evaluation of Sudden Cardiac Death (SCD) in Forensic Settings: A Literature Review. Int J Mol Sci 2023; 24:14351. [PMID: 37762655 PMCID: PMC10531952 DOI: 10.3390/ijms241814351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Sudden cardiac death (SCD) represents a global emergency, with a high number of cases affecting all age groups every year. The prevention of these fatal events requires an accurate knowledge of etiology and pathogenesis, which can vary. Autopsy is an indispensable tool in cases of SCD for diagnostic purposes, as well as for judicial and preventive purposes for family members. Despite the completion of all routine post-mortem investigations, it is often complicated for the forensic pathologist to define the triggering cause of these events. The study of the proteome is proving to be extremely promising in the field of human cardiovascular disease. This paper aims to offer a literature review on the study of the proteome in post-mortem cadaveric biological samples obtained from SCD cases. The aim of this work is to outline the state of the art of the scientific advances that protein analysis can offer in the diagnosis of SCD and the limits that various studies have traced up to now. In conclusion, the work defines the future perspectives of this field in SCD, suggesting strategies to overcome the reported limits and improve the diagnostics of these events.
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Affiliation(s)
| | | | | | | | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (M.A.S.); (S.G.); (L.C.); (P.R.)
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Sacco MA, Aquila I. Proteomics: A New Research Frontier in Forensic Pathology. Int J Mol Sci 2023; 24:10735. [PMID: 37445913 DOI: 10.3390/ijms241310735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Proteomics, the study of proteins and their functions, has revolutionized the field of forensic science by providing a powerful approach to identify and characterize proteins for various aims [...].
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Affiliation(s)
- Matteo Antonio Sacco
- Department of Medical and Surgical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Isabella Aquila
- Department of Medical and Surgical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy
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10
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Sacco MA, Ricci P, Aquila I. The Effects of COVID-19 Pandemic on Public Mental Health: State of Art and Future Perspectives. Int J Environ Res Public Health 2023; 20:ijerph20095665. [PMID: 37174184 PMCID: PMC10178235 DOI: 10.3390/ijerph20095665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
The COVID-19 pandemic has radically changed our lives in every way [...].
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Affiliation(s)
- Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy
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Sacco MA, Cordasco F, Abenavoli L, Lavano A, Gallotta G, Garofalo E, Bruni A, Scalise C, Gualtieri S, Tarallo AP, Aquila VR, Ricci P, Aquila I. The Role of Autopsy and Post-Mortem Investigations in Falling Traumas in the Hospital Environment. Diagnostics (Basel) 2022; 12:diagnostics12123168. [PMID: 36553175 PMCID: PMC9777541 DOI: 10.3390/diagnostics12123168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/03/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
Falls in a hospital setting are a global public health problem. Despite the production of sensors and various preventive tools to reduce the risk, falls remain a dangerous event with a significant impact on the morbidity and mortality of patients. Despite numerous prevention strategies, falling in the hospital are not always investigated and the autopsy is not always performed in these cases, so it is often not known whether the death is related to the fall or to other causes, inevitably affecting the assessment of any profiles of medical liability for health personnel or for the hospital in the accident. We describe three cases of falls that occurred in different hospitals, in which the autopsy allowed to diagnose with certainty the extent of the trauma and to reconstruct its dynamics. Along with the circumstantial and documentary analyses, deficiencies both in the trauma diagnostics and in the application of the safety measures on the patients were showed. Together with the description of our cases, we propose the post-mortem investigations of these events, both for judicial and risk management purposes.
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Affiliation(s)
- Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Fabrizio Cordasco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Ludovico Abenavoli
- Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Angelo Lavano
- Unit of Neurosurgery, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Giovanni Gallotta
- Department of Clinical and Experimental Medicine, Federico II University, 80138 Naples, Italy
| | - Eugenio Garofalo
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Andrea Bruni
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Carmen Scalise
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Saverio Gualtieri
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Alessandro Pasquale Tarallo
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Valerio Riccardo Aquila
- Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-09613647304; Fax: +39-09613647560
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12
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Llorens Castelló P, Sacco MA, Aquila I, Moltó Cortés JC, Juan García C. Evaluation of Zearalenones and Their Metabolites in Chicken, Pig and Lamb Liver Samples. Toxins (Basel) 2022; 14:toxins14110782. [PMID: 36422956 PMCID: PMC9692590 DOI: 10.3390/toxins14110782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 11/12/2022] Open
Abstract
Zearalenone (ZON), zearalanone (ZAN) and their phase I metabolites: α-zearalenol (α-ZOL), β-zearalenol (β-ZOL), α-zearalalanol (α-ZAL) and β-zearalalanol (β-ZAL) are compounds with estrogenic activity that are metabolized and distributed by the circulatory system in animals and can access the food chain through meat products from livestock. Furthermore, biomonitoring of zearalenones in biological matrices can provide useful information to directly assess mycotoxin exposure; therefore, their metabolites may be suitable biomarkers. The aim of this study was to determine the presence of ZON, ZAN and their metabolites in alternative biological matrices, such as liver, from three different animals: chicken, pig and lamb, in order to evaluate their exposure. A solid-liquid extraction procedure coupled to a GC-MS/MS analysis was performed. The results showed that 69% of the samples were contaminated with at least one mycotoxin or metabolite at varying levels. The highest value (max. 152.62 ng/g of β-ZOL) observed, and the most contaminated livers (42%), were the chicken liver samples. However, pig liver samples presented a high incidence of ZAN (33%) and lamb liver samples presented a high incidence of α-ZOL (40%). The values indicate that there is exposure to these mycotoxins and, although the values are low (ranged to 0.11-152.6 ng/g for α-ZOL and β-ZOL, respectively), analysis and continuous monitoring are necessary to avoid exceeding the regulatory limits and to control the presence of these mycotoxins in order to protect animal and human health.
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Affiliation(s)
- Paula Llorens Castelló
- Laboratory of Food Chemistry and Toxicology, Faculty of Pharmacy, University of Valencia, 46100 Burjassot, Spain
| | - Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia”, Università degli Studi “Magna Graecia” di Catanzaro, 88100 Catanzaro, Italy
| | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia”, Università degli Studi “Magna Graecia” di Catanzaro, 88100 Catanzaro, Italy
| | - Juan Carlos Moltó Cortés
- Laboratory of Food Chemistry and Toxicology, Faculty of Pharmacy, University of Valencia, 46100 Burjassot, Spain
| | - Cristina Juan García
- Laboratory of Food Chemistry and Toxicology, Faculty of Pharmacy, University of Valencia, 46100 Burjassot, Spain
- Correspondence:
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13
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Scalise C, Cordasco F, Sacco MA, Aquila VR, Ricci P, Aquila I. Hospital Restraints: Safe or Dangerous? A Case of Hospital Death Due to Asphyxia from the Use of Mechanical Restraints. Int J Environ Res Public Health 2022; 19:8432. [PMID: 35886284 PMCID: PMC9322702 DOI: 10.3390/ijerph19148432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 02/03/2023]
Abstract
Asphyxia can be defined as an impediment to the influx of air into the respiratory tract, leading to tissue hypoxia. By restraint, we mean the use of physical, pharmacological and/or environmental means to limit the subject's ability to move. Fall prevention is the main reason restraint is used. Unfortunately, restraint can sometimes be fatal. There are few studies in the literature on this subject. We report the case of a man with Down syndrome in a psychiatric clinic found dead between the bed and the floor of the room where he was hospitalized. The analysis of the scene showed the presence of a means of a restraint, located around the man's chest and neck, which kept him tied to the bed and applied a constricting mechanical action. There was doubt as to the cause of death. For this reason, an inspection of the scene and an autopsy were carried out. Upon opening the chest, blood infiltration of the left intercostal muscles that was topographically compatible with external cutaneous excoriation (sign of restraint) became evident. In view of the danger of using restraint, it is necessary to evaluate the means of restraint as an extraordinary and not an ordinary procedure in patient management. Each patient undergoing restraint measures must be carefully monitored by specialized personnel. Greater surveillance of the nurse/patient ratio is necessary to reduce the use of restraints. In this case report, we highlight the lack of surveillance of patients subjected to restraint.
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Affiliation(s)
- Carmen Scalise
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (C.S.); (F.C.); (M.A.S.); (P.R.)
| | - Fabrizio Cordasco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (C.S.); (F.C.); (M.A.S.); (P.R.)
| | - Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (C.S.); (F.C.); (M.A.S.); (P.R.)
| | - Valerio Riccardo Aquila
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (C.S.); (F.C.); (M.A.S.); (P.R.)
| | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (C.S.); (F.C.); (M.A.S.); (P.R.)
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14
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Sacco MA, Abenavoli L, Cordasco F, Galassi FM, Varotto E, Ricci P, Aquila I. Sudden death due to fulminant lymphocytic myocarditis with atypical prodromal symptoms. Clin Case Rep 2022; 10:e5983. [PMID: 35769236 PMCID: PMC9210130 DOI: 10.1002/ccr3.5983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/30/2022] [Accepted: 06/03/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Matteo Antonio Sacco
- Department of Medical and Surgical Sciences, Institute of Legal Medicine University “Magna Graecia” of Catanzaro Catanzaro Italy
| | - Ludovico Abenavoli
- Department of Health Sciences University "Magna Graecia" of Catanzaro Catanzaro Italy
| | - Fabrizio Cordasco
- Department of Medical and Surgical Sciences, Institute of Legal Medicine University “Magna Graecia” of Catanzaro Catanzaro Italy
| | - Francesco Maria Galassi
- FAPAB Research Center Avola Italy
- Archeology, College of Humanities Arts and Social Sciences Flinders University Adelaide SA Australia
| | - Elena Varotto
- FAPAB Research Center Avola Italy
- Archeology, College of Humanities Arts and Social Sciences Flinders University Adelaide SA Australia
| | - Pietrantonio Ricci
- Department of Medical and Surgical Sciences, Institute of Legal Medicine University “Magna Graecia” of Catanzaro Catanzaro Italy
| | - Isabella Aquila
- Department of Medical and Surgical Sciences, Institute of Legal Medicine University “Magna Graecia” of Catanzaro Catanzaro Italy
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15
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Sacco MA, Abenavoli L, Juan C, Ricci P, Aquila I. Biological Mechanisms behind Wischnewsky Spots Finding on Gastric Mucosa: Autopsy Cases and Literature Review. Int J Environ Res Public Health 2022; 19:ijerph19063601. [PMID: 35329287 PMCID: PMC8955028 DOI: 10.3390/ijerph19063601] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 02/04/2023]
Abstract
Hypothermia is an emergency caused by the lowering of the central body temperature with a slowdown of basic vital functions. Reduced mobility, old age, psychiatric or metabolic disorders are relevant risk factors. Diagnosis of death from hypothermia is a challenge, as there are no pathognomonic signs, and supportive findings can be inconstant. Wischnewsky Spots (WS) are blackish lesions of gastric mucosa, typically associated with hypothermic death. The pathophysiology of these lesions is still uncertain. The aim of this paper is to investigate the pathological mechanisms determining the appearance of WS by analyzing the current scientific knowledge in this area. We performed a narrative review of the literature published in the last 20 years, comparing the results with three cases of hypothermia reported from our experience. The review proved that WS show a multifactorial etiology, i.e., not only body temperature decrease, but also various extrinsic and intrinsic factors, such as physical and psychological stress, agony, causa mortis and metabolic comorbidities. The review summarizes the current knowledge in the field of incidence, pathology and morphology of WS by proposing some scientific and technical points for clinical and forensic analysis of this phenomenon.
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Affiliation(s)
- Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (M.A.S.); (P.R.)
| | - Ludovico Abenavoli
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Cristina Juan
- Laboratory of Food Chemistry and Toxicology, Faculty of Pharmacy, University of Valencia, Burjassot, 46100 València, Spain;
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (M.A.S.); (P.R.)
| | - Isabella Aquila
- Institute of Legal Medicine, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (M.A.S.); (P.R.)
- Correspondence:
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16
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Sacco MA, Ricci P, Aquila I. Barium sulfate aspiration pneumonia: A fatal case of death. Clin Case Rep 2022; 10:e05281. [PMID: 35035966 PMCID: PMC8752370 DOI: 10.1002/ccr3.5281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/22/2021] [Accepted: 12/25/2021] [Indexed: 11/07/2022] Open
Abstract
Accidental aspiration of barium is a rare event. We present the case of a patient who, after the administration of barium, he showed sudden cough with dyspnea and vomiting and chemical pneumonia with areas of consolidation. The case emphasizes caution when administering barium to patients at risk of aspiration.
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Affiliation(s)
- Matteo Antonio Sacco
- Institute of Legal MedicineDepartment of Medical and Surgical SciencesUniversity “Magna Graecia” of CatanzaroCatanzaroItaly
| | - Pietrantonio Ricci
- Institute of Legal MedicineDepartment of Medical and Surgical SciencesUniversity “Magna Graecia” of CatanzaroCatanzaroItaly
| | - Isabella Aquila
- Institute of Legal MedicineDepartment of Medical and Surgical SciencesUniversity “Magna Graecia” of CatanzaroCatanzaroItaly
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17
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Aquila I, Abenavoli L, Sacco MA, Ricci P. The limits of diagnosis of testicular torsion in the child: Medicolegal implications in clinical practice. Clin Case Rep 2021; 9:e05180. [PMID: 34938556 PMCID: PMC8659548 DOI: 10.1002/ccr3.5180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/07/2021] [Accepted: 11/22/2021] [Indexed: 11/05/2022] Open
Abstract
Testicular torsion is a pediatric urological emergency. We report a case of testicular torsion that occurred in a 10-year-old child. The case shows that it is a disease with risk of medicolegal litigation. We demonstrate the role of proper triage, and we analyze the limits and critical points for diagnosing it.
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Affiliation(s)
- Isabella Aquila
- Institute of Legal MedicineDepartment of Medical and Surgical SciencesUniversity “Magna Graecia” of CatanzaroCatanzaroItaly
| | - Ludovico Abenavoli
- Department of Health SciencesUniversity “Magna Graecia” of CatanzaroCatanzaroItaly
| | - Matteo Antonio Sacco
- Institute of Legal MedicineDepartment of Medical and Surgical SciencesUniversity “Magna Graecia” of CatanzaroCatanzaroItaly
| | - Pietrantonio Ricci
- Institute of Legal MedicineDepartment of Medical and Surgical SciencesUniversity “Magna Graecia” of CatanzaroCatanzaroItaly
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18
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Sacco MA, Ricci P, Gratteri S, Scalise C, Aquila I. The forensic analysis of homemade explosive suicides: Case report and systematic review of the literature. J Forensic Sci 2021; 66:2013-2019. [PMID: 34042187 DOI: 10.1111/1556-4029.14757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/28/2021] [Accepted: 05/03/2021] [Indexed: 11/28/2022]
Abstract
The illegal construction of explosive devices for recreational purposes has become increasingly widespread in recent years. This phenomenon is spurred on by numerous websites that explain how to build a self-made device. The correlation between the use of firearms and suicide is known in the literature, but the use of explosive devices and self-harm is little studied. Unfortunately, the risk associated with the manufacture of homemade explosives is poorly known. For this purpose, we describe a rare suicide carried out by a man suffering from depressive disorder with psychotic and delusional features. The forensic investigations at the scene showed that the man had designed a homemade device, and disseminated numerous suicide notes in his home, transcribed in the previous weeks in which he revealed his suicidal motivation. Crime scene investigation showed on the body and on the road in front of the explosion point: multiple fragments of glass (zone 1), a lighter with blood stains (zone 2), and shreds of clothing scattered along the road (zone 3). Autopsy revealed that the cause of death was extensive blunt injury to head and trunk due to barotrauma due to the explosion of a homemade device. The case is compared with data from a systematic review of the forensic literature on suicides involving explosives. The study proposes the analysis of planimetric areas in these crime scene investigations and active surveillance in these subjects.
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Affiliation(s)
- Matteo Antonio Sacco
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Santo Gratteri
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Carmen Scalise
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Isabella Aquila
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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19
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Aquila I, Ricci P, Bonetta CF, Sacco MA, Longhini F, Torti C, Mazzitelli M, Garofalo E, Bruni A, Trecarichi EM, Serapide F, Gratteri S, Quirino A, Barreca GS, Abenavoli L, Arena V, Oliva A, Giancotti A, Iavicoli I, Liberto MC, Matera G. Analysis of the persistence time of the SARS-CoV-2 virus in the cadaver and the risk of passing infection to autopsy staff. Med Leg J 2021; 89:40-53. [PMID: 33475037 DOI: 10.1177/0025817220980601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The activity of the SARS-CoV-2 virus has not yet been studied in a post-mortem setting. The absence of these data has led to the prohibition of exposure of infected corpses during burial procedures. Our aim was to assess the virus's persistence and the possibility of transmission in the post-mortem phase including autopsy staff. The sample group included 29 patients who were admitted to our Covid-19 Centre who died during hospitalisation and the autopsy staff. All the swabs were subjected to a one-step real-time reverse transcription polymerase chain reaction with cycle threshold (Ct) values. Swab collection was performed at 2 h, 4 h, 6 h, 12 h, over 24 since death. The following were the analysis of patients' swabs: 10 cases were positive 2 h after death; 10 cases positive 4 h after death; 9 cases were found positive 6 h after death; 7 cases positive 12 h after death; 9 cases remained positive 24 h after death. The swabs performed on all the forensic pathologist staff on duty who performed the autopsies were negative. The choice to avoid rituals and the display of corpses before and at the burial procedures given appears cautiously valid due to the persistence of the SARS-CoV-2 virus in the post-mortem period. Although the caution in choosing whether or not to perform an autopsy on infected corpses is acceptable, not to perform autopsies is not biologically supported.
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Affiliation(s)
- Isabella Aquila
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Carlo Filippo Bonetta
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Federico Longhini
- Intensive Care Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Eugenio Garofalo
- Intensive Care Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Andrea Bruni
- Intensive Care Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Francesca Serapide
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Santo Gratteri
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Giorgio Settimo Barreca
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Ludovico Abenavoli
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Vincenzo Arena
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Anatomia Patologica, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Aida Giancotti
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Maria Carla Liberto
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
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20
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Affiliation(s)
- Isabella Aquila
- University Magna Graecia of Catanzaro, Institute of Legale Medicine, Catanzaro, Italy
| | - Matteo Antonio Sacco
- University Magna Graecia of Catanzaro, Institute of Legale Medicine, Catanzaro, Italy
| | - Fabrizio Cordasco
- University Magna Graecia of Catanzaro, Institute of Legale Medicine, Catanzaro, Italy
| | - Pietrantonio Ricci
- University Magna Graecia of Catanzaro, Institute of Legale Medicine, Catanzaro, Italy
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21
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Aquila I, Ricci C, Sacco MA, Gratteri S, De Aloe L, De Pasquale CC, Ricci P. The role of ethanethiol in deaths from acute poisoning by gas mixtures: A suicide case involving a decomposed corpse and a review of the literature. Med Leg J 2020; 88:199-204. [PMID: 32228376 DOI: 10.1177/0025817219891948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The most common volatile substances used in suicide are liquefied petroleum gas mixtures, which consist of propane and butane gases mixed in different proportions. These substances are odourless and colourless. Some substances, such as ethanethiol, are added to liquefied petroleum gas mixtures to provide a garlic scent. The main causes of death in acute liquefied petroleum gas inhalation are cardiac arrest and asphyxia, but determining the manner of death is difficult. We present a case of a 30-year-old man found dead at home. On his head was a black plastic bag with a hole through which he had run a gas hose connected to a domestic liquefied petroleum gas cylinder tank. Toxicological analysis revealed butane and ethanethiol in his body. This study aims at understanding the lethal role of ethanethiol through the analysis of its chemical action and its influence on decomposition.
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Affiliation(s)
| | | | | | | | - Luigi De Aloe
- Magna Græcia University of Catanzaro, Catanzaro, Italy
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22
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Aquila I, Sacco MA, Abenavoli L, Malara N, Arena V, Grassi S, Ausania F, Boccuto L, Ricci C, Gratteri S, Oliva A, Ricci P. Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic. Arch Pathol Lab Med 2020; 144:1048-1056. [PMID: 32383963 DOI: 10.5858/arpa.2020-0165-sa] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The novel coronavirus disease 2019 (COVID-19) pandemic is significantly changing methodologic approaches in all branches of the health system. From a forensic point of view, this event is partly changing the manner in which forensic pathologists and all those who work in autopsy services operate, but above all, it is changing the patterns established for years by which cadavers are analyzed postmortem. OBJECTIVE.— To present a review of the literature and a proposal for COVID-19 autopsy protocols. To contain the infection risk, a revision of all the protocols that until now have been applied to the examination of bodies that require autopsy services is required. DATA SOURCES.— Currently, the diagnosis and postmortem analysis of positive or suspected COVID-19 cases plays a crucial role in scientific research. A review of the main recommendations proposed by international scientific societies regarding the risk of infection during autopsy was carried out. Scientific papers currently available via the PubMed NCBI search engine on COVID-19 postmortem diagnosis were also examined. CONCLUSIONS.— Throughout the history of medicine, autopsy has been fundamental to the understanding of multiple pathogenic processes that are investigated postmortem. The purpose of the study is to propose an operating protocol that can be useful for all clinical and forensic autopsies, with particular reference to the correct methods to be applied to the examination of positive or suspected COVID-19 cases, regarding both the autopsy procedure and the collection and analysis of biological samples.
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Affiliation(s)
- Isabella Aquila
- From the Institute of Legal Medicine and Department of Surgical and Medical Sciences (Aquila, Sacco, C. Ricci, Gratteri, P. Ricci)
| | - Matteo Antonio Sacco
- From the Institute of Legal Medicine and Department of Surgical and Medical Sciences (Aquila, Sacco, C. Ricci, Gratteri, P. Ricci)
| | - Ludovico Abenavoli
- Department of Health Sciences (Abenavoli), University "Magna Graecia," Catanzaro, Italy
| | - Natalia Malara
- Department of Clinical and Experimental Medicine (Malara), University "Magna Graecia," Catanzaro, Italy
| | - Vincenzo Arena
- Area of Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Anatomia Patologica (Arena)
| | - Simone Grassi
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS (Grassi, Ausania, Oliva), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Ausania
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS (Grassi, Ausania, Oliva), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Boccuto
- JC Self Research Institute, Greenwood Genetic Center, Greenwood, South Carolina (Boccuto).,School of Health Research, Clemson University, Clemson, South Carolina (Boccuto)
| | - Cristoforo Ricci
- From the Institute of Legal Medicine and Department of Surgical and Medical Sciences (Aquila, Sacco, C. Ricci, Gratteri, P. Ricci)
| | - Santo Gratteri
- From the Institute of Legal Medicine and Department of Surgical and Medical Sciences (Aquila, Sacco, C. Ricci, Gratteri, P. Ricci)
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS (Grassi, Ausania, Oliva), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Pietrantonio Ricci
- From the Institute of Legal Medicine and Department of Surgical and Medical Sciences (Aquila, Sacco, C. Ricci, Gratteri, P. Ricci)
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23
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Cordasco F, Sicilia F, Sacco MA, Ricci P, Savastano S, Iezzi I, Aquila I. A forensic case of erosive cystitis and septic pulmonary embolism: is there a correlation? Clin Ter 2020; 171:e192-e196. [PMID: 32323705 DOI: 10.7417/ct.2020.2213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Septic pulmonary embolism (SPE) is an uncommon disease in which a microorganism- containing thrombus causes an inflammatory reaction and a mechanical obstruction in the vascular system of the lungs. Usually it is associated with tricuspid valve vegetation, septic thrombophlebitis or infected venous catheters. We present a rare and fatal case of massive septic pulmonary thromboembolism occurred in a diabetic woman, who complained in previous days dyspnoea, abdominal pain and nausea. Autopsy findings showed evidence of an erosive cystitis, while lungs examination showed total occlusion of pulmonary circulation system due to thrombo-embolic clots. In literature cases report about an association between septic pulmonary thromboembolism and erosive cystitis haven't been reported. So, we here show the first reported fatal case of a septic pulmonary thromboembolism as a lethal evolution of an erosive cystitis.
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Affiliation(s)
- F Cordasco
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - F Sicilia
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - M A Sacco
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - P Ricci
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - S Savastano
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - I Iezzi
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - I Aquila
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Italy
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Cordasco F, Scalise C, Sacco MA, Bonetta CF, Zibetti A, Cacciatore G, Caputo F, Ricci P, Aquila I. The silent deaths of the elderly in long-term care facilities during the Covid-19 pandemic: The role of forensic pathology. Med Leg J 2020; 88:66-68. [PMID: 32507030 DOI: 10.1177/0025817220930552] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Covid-19 pandemic is currently a major global public health problem. We know that the elderly and people with chronic diseases contract the infection more easily and they develop clinically more serious and often lethal forms. To date, the reasons for this have been generically attributed to old age and underlying diseases. Most Covid-19 deaths occurred in long-term care facilities because the residents are elderly people with chronic illness living in close contact. Therefore, facilities have become epidemic outbreaks. Forensic knowledge is very limited because an autopsy is rarely performed. Post-mortem investigations can help increase knowledge about Covid-19 and identify any undiagnosed pathologies in life. Therefore, forensic investigations play a role in protecting a frail population. Autopsies should be encouraged on elderly people who died of Covid-19.
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Affiliation(s)
- Fabrizio Cordasco
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Carmen Scalise
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Matteo Antonio Sacco
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Carlo Filippo Bonetta
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Angelica Zibetti
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Giulia Cacciatore
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Fiorella Caputo
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Isabella Aquila
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
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25
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Sacco MA, Caputo F, Ricci P, Sicilia F, De Aloe L, Bonetta CF, Cordasco F, Scalise C, Cacciatore G, Zibetti A, Gratteri S, Aquila I. The impact of the Covid-19 pandemic on domestic violence: The dark side of home isolation during quarantine. Med Leg J 2020; 88:71-73. [PMID: 32501175 DOI: 10.1177/0025817220930553] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Domestic violence is a global public health problem. It takes many different forms and leads to significant physical and psychological consequences for the victim and the whole family. Situations that may prompt episodes of violence in the family include stress, emotional disappointment, economic factors, bad and cramped housing, and alcohol or drug abuse. How does the government's forced home isolation to contain Covid-19 infections impact on this type of abuse? Numerous articles have reported a decrease in reports of domestic violence since quarantine began but how reliable is these data? Is it a potential wake-up call for public institutions? We discuss the risks associated with quarantine measures during the pandemic and suggest the measures to prevent and improve the reporting of abuse cases.
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Affiliation(s)
- Matteo Antonio Sacco
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Fiorella Caputo
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Francesco Sicilia
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Luigi De Aloe
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Carlo Filippo Bonetta
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Fabrizio Cordasco
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Carmen Scalise
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Giulia Cacciatore
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Angelica Zibetti
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Santo Gratteri
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Isabella Aquila
- Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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26
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Aquila I, Sacco MA, Ricci C, Gratteri S, Montebianco Abenavoli L, Oliva A, Ricci P. The role of the COVID-19 pandemic as a risk factor for suicide: What is its impact on the public mental health state today? Psychol Trauma 2020; 12:S120-S122. [PMID: 32496095 DOI: 10.1037/tra0000616] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The phenomenon of suicide is a much studied but still little-known issue. In this particular period of health emergency, quarantine and mandatory restrictions could play a role in the genesis of fatal events or suicide attempts not only in people at risk. However, this issue has not yet been adequately addressed in the literature. The influence of the global pandemic could change the way suicide cases are analyzed; in the future, it is necessary to reconsider and analyze the various risk groups by population but above all to evaluate new methods of intervention for avoiding the increase in fatal events related to the current emergency whose duration is still unknown. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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27
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Caputo F, Gratteri S, Sacco MA, Scalise C, Cacciatore G, Bonetta F, Zibetti A, Aloe LD, Sicilia F, Cordasco F, Ricci P, Aquila I. Covid-19 emergency in prison: Current management and forensic perspectives. Med Leg J 2020; 88:185-186. [PMID: 32437228 DOI: 10.1177/0025817220923693] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The Covid-19 pandemic is currently a major worldwide public health problem. Contagion within prisons and in other custodial settings will need to be addressed promptly, but the management of preventive measures will be difficult due to overcrowding and inmates and officers' close physical contact. There may also be less access to care than in community settings. Accordingly, prisons are particularly vulnerable to outbreaks of infection, and in addition to the likely greater risks of contagion attention must be paid to the psychological problems that the pandemic can have on the prison population. Riots and episodes of violence have already taken place in various prisons. With the inevitable restrictions on social contact and family meetings, prisoners who already are at increased risk of mental illness and suicide are more susceptible to adverse psychological repercussions. From a forensic point of view, therefore, we stress the need for the development of a strong support network by mental health workers for the prison population.
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Affiliation(s)
- Fiorella Caputo
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Santo Gratteri
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Matteo Antonio Sacco
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Carmen Scalise
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Giulia Cacciatore
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Filippo Bonetta
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Angelica Zibetti
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Luigi De Aloe
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Francesco Sicilia
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Fabrizio Cordasco
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Isabella Aquila
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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28
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Abstract
The epidemiology of suicide has identified numerous psychiatric and occupational risk factors. The circumstances surrounding a suicide are fundamental to determining whether its characteristics will play a crucial role in the decision-making process. The state of emergency arising from the Covid-19 pandemic has introduced a new element, given the general concern and feelings of alarm which are global. The most suitable forensic method to analyse these cases is the psychological autopsy. This study's purpose is to analyse the application of the psychological autopsy method to evaluate the impact of the pandemic where government lockdowns impose restrictions on personal freedom. We set out to consider how far this together with other factors may induce suicide. The literature does not as yet offer us a retrospective analysis of the influence of the global pandemic state on rates of suicide. Accordingly, we report a forensic case and examine the critical issues and problems in the management of these cases.
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Affiliation(s)
- Isabella Aquila
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Matteo Antonio Sacco
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Cristoforo Ricci
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Santo Gratteri
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Department of Surgical and Medical Sciences, Institute of Legal Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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29
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Aquila I, Boca S, Ricci P, Perozziello G, Candeloro P, Di Fabrizio E, Malara N, Gratteri S, Sacco MA, Francardi M. The use of scanning electron microscopy and energy dispersive X-ray spectroscopy in a case of occupational death. Med Leg J 2020; 88:163-168. [PMID: 32233908 DOI: 10.1177/0025817219891085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Scanning electron microscopy is a technique that provides high-resolution images at the micro- and nano-scale. The combination of scanning electron microscopy and energy dispersive X-ray spectroscopy analysis is developing fast for application in forensic science. In this work, we report a case of work-related traumatic death of a 50-year-old man. The autopsy showed cranial fractures with cerebral haemorrhage. It was more difficult to understand the accident dynamics because the body had been shifted from the accident site to mask what had really taken place. Scanning electron microscopy/energy dispersive X-ray spectroscopy was used to identify the material of the impacting tool and to establish the possible legal responsibility of the employer. In this study, we demonstrate that scanning electron microscopy/energy dispersive X-ray spectroscopy is a useful forensic tool for the analysis of biological samples. Further, for studying the lacerations on the corpse from doubtful blunt tools, scanning electron microscopy/energy dispersive X-ray spectroscopy can assist in demonstrating that the scene has been falsified, as it was in this case.
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Affiliation(s)
- I Aquila
- Institute of Legal Medicine, Magna Græcia, Department of Medical and Surgical Sciences, Institute of Legal Medicine, University of Catanzaro, Catanzaro, Italy
| | - S Boca
- U.O. di Medicina Legale, ASL Torino, Italy
| | - P Ricci
- Institute of Legal Medicine, Magna Græcia, Department of Medical and Surgical Sciences, Institute of Legal Medicine, University of Catanzaro, Catanzaro, Italy
| | - G Perozziello
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - P Candeloro
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - E Di Fabrizio
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - N Malara
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - S Gratteri
- Institute of Legal Medicine, Magna Græcia, Department of Medical and Surgical Sciences, Institute of Legal Medicine, University of Catanzaro, Catanzaro, Italy
| | - M A Sacco
- Institute of Legal Medicine, Magna Græcia, Department of Medical and Surgical Sciences, Institute of Legal Medicine, University of Catanzaro, Catanzaro, Italy
| | - M Francardi
- Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
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30
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Aquila I, Sicilia F, Ricci P, Antonio Sacco M, Manno M, Gratteri S. Role of post-mortem multi-slice computed tomography in the evaluation of single gunshot injuries. Med Leg J 2019; 87:204-210. [PMID: 31564213 DOI: 10.1177/0025817219848264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Post-mortem multi-slice computed tomography (MSCT) is a new approach in forensic pathology for gunshot injuries. This study determines the role of MSCT in the characterisation of single gunshot injuries. We report three cases. In the first case, an 80-year-old man was found dead in his bedroom with a gun. External examination showed devastating head injuries. In the second case, an 81-year-old man was found dead in his apartment, without a gun. External examination showed gunshot injuries. In the third case, a 56-year-old man was found dead on a road. MSCT and autopsy were performed in all these cases. MSCT not only allowed the determination of entrance and exit wounds but also showed some artefacts. In conclusion, radiology is fundamental for the reconstruction of gunshot injuries, and the manner of death can only be ascertained by autopsy.
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Affiliation(s)
- Isabella Aquila
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Francesco Sicilia
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Petrantomo Ricci
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Matteo Antonio Sacco
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Maria Manno
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Santo Gratteri
- Institute of Legal Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Abstract
When death is sudden and unexpected, autopsy may not provide sufficient information to be sure of the cause of death. Some causes can only be identified by microscopy. We report a case of sudden death in a woman who suffered from vertigo and hypertension. The autopsy only showed sclerosis of the thoracic aorta, abdominal aorta and coronary arteries, and the toxicological results were negative and did not explain the cause of death. A microscopic and immunohistochemical analysis of samples from various organs was carried out. The histopathological examination revealed eosinophilia in the aortic wall, consistent with a vasculitis such as Takayasu's arteritis. This case emphasises the association between systemic vasculitis and sudden death, as well as the role of histopathological investigation and the importance of post-mortem diagnosis to prevent similar fatal events among family members.
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Affiliation(s)
- Isabella Aquila
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | | | - Matteo Antonio Sacco
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Orazio Malfa
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Santo Gratteri
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
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32
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Aquila I, Gratteri S, Sacco MA, Ricci P. A rare case of fatal meningoencephalitis with septic thromboembolism due to otitis media: a forensic case and review of literature. BMJ Case Rep 2017; 2017:bcr-2017-220594. [PMID: 28739620 DOI: 10.1136/bcr-2017-220594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Isabella Aquila
- Institute of Legale Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | | | - Matteo Antonio Sacco
- Institute of Legale Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legale Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
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33
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Abstract
Avian leukosis virus subgroup J (ALV-J), an exogenous avian retrovirus, is thought to have evolved by recombination with the highly identical env gene of the endogenous avian retrovirus EAV-HP. Embryonic expression of EAV-HP env has been suggested to be associated with the induction of immunological tolerance, a feature observed in a significant proportion of meat-type chickens infected with ALV-J. In support of this hypothesis, we demonstrate that EAV-HP loci, some of which could be associated with tolerance, are still segregating within the chicken population.
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Affiliation(s)
- M A Sacco
- Institute for Animal Health, Compton, Newbury, Berkshire RG20 7NN, United Kingdom
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34
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Abstract
The EAV-HP group of chicken endogenous retrovirus elements was previously shown to be defective, with large deletions of the pol gene. In this report, we demonstrate that genomes of other Gallus species also maintain EAV-HP elements with similar deletions. The chicken EAV-HP1 locus was detected in both red (Gallus gallus gallus) and Sonnerat's (Gallus sonneratii) jungle fowl with identical integration sites, indicating that these elements had integrated before separation of the Gallus species. Furthermore, we demonstrate for the first time that the G. sonneratii genome carries EAV-HP elements with intact pol regions.
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Affiliation(s)
- M A Sacco
- Institute for Animal Health, Compton, Newbury, Berkshire RG20 7NN, United Kingdom
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Sacco MA, Flannery DM, Howes K, Venugopal K. Avian endogenous retrovirus EAV-HP shares regions of identity with avian leukosis virus subgroup J and the avian retrotransposon ART-CH. J Virol 2000; 74:1296-306. [PMID: 10627540 PMCID: PMC111464 DOI: 10.1128/jvi.74.3.1296-1306.2000] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The existence of novel endogenous retrovirus elements in the chicken genome, designated EAV-HP, with close sequence identity to the env gene of avian leukosis virus (ALV) subgroup J has been reported (L. M. Smith, A. A. Toye, K. Howes, N. Bumstead, L. N. Payne, and K. Venugopal, J. Gen. Virol. 80:261-268, 1999). To resolve the genome structure of these retroviral elements, we have determined the complete sequence of two proviral clones of EAV-HP from a line N chicken genomic DNA yeast artificial chromosome library and from a meat-type chicken line 21 lambda library. The EAV-HP sequences from the two lines were 98% identical and had a typical provirus structure. The two EAV-HP clones showed identical large deletions spanning part of the gag, the entire pol, and part of the env genes. The env region of the EAV-HP clones was 97% identical to the env sequence of HPRS-103, the prototype subgroup J ALV. The 5' region of EAV-HP comprising the R and U5 regions of the long terminal repeat (LTR), the untranslated leader, and the 5' end of the putative gag region were 97% identical to the avian retrotransposon sequence, ART-CH. The remaining gag sequence shared less than 60% identity with other ALV sequences. The U3 region of the LTR was distinct from those of other retroviruses but contained some of the conserved motifs required for functioning as a promoter. To examine the ability of this endogenous retroviral LTR to function as a transcriptional promoter, the EAV-HP and HPRS-103 LTR U3 regions were compared in a luciferase reporter gene assay. The low luciferase activity detected with the EAV-HP LTR U3 constructs, at levels close to those observed for a control vector lacking the promoter or enhancer elements, suggested that these elements function as a weak promoter, possibly accounting for their low expression levels in chicken embryos.
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Affiliation(s)
- M A Sacco
- Institute for Animal Health, Compton, Newbury, Berkshire RG20 7NN, United Kingdom
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