Cyclists fatalities: Forensic remarks regarding 335 cases

A retrospective study was carried out on post-mortem examination data regarding 335 cyclists involved in fatal accidents along the period 1983-2012. The following variables were considered: temporal data (year, month, day of the week and hour of the day), circumstances of the accident, vehicles involved, victims' features (sex, age), pathological and toxicological findings, cause of death. Most victims were male (77.62%), with a mean age of 58 years. In most cases vehicles other than only bicycles were involved, more frequently cars, followed by heavy motor vehicles. Head was the most frequently body region involved in lethal injuries (65.37%); low extremities were the body district most frequently involved in non-lethal injuries (63.9%). This study confirmed the importance of using helmet; head protection should be a priority for bikers.

Further considerations in terms of the permanent impairment of the of chewing organ

Nowadays, the drawbacks to utilizing criminal law with regards to a traumatic event, whether accidental or iatrogenic, involving the dental apparatus are still prevailing. A lesion affecting the stomatognathic apparatus can in fact integrate the offense of grievous bodily harm under Art.583 of the Italian Criminal Code (cc) as "permanent weakening of the organ" or the functions to which is appointed, i.e. the masticatory function, but also to the indwelling voice, appearance and taste. Repeatedly, jurisprudence, in the past and more recently, has set an opinion on the issue and, currently, it is possible to indicate some recognized cornerstones as deep-seated on the matter. It is a well-known fact that the organ of mastication does not represent a defined anatomical organ but, instead, it is an anatomical and functional entity consisting of a complex of different structures and not just from the dental apparatus. Moreover, any functional anatomic alteration of any single entity can have a certain weight on the other components and, therefore, on the whole organ in its entirety. Medical-legal doctrine, already in the past, supported the need for a tangible assessment of the impairment, determining whether and how much the loss of even one anatomical element could have a negative impact on the operational equilibrium of the entire stomatognathic system, whilst verifying the actual subsistence of a weakening. The loss of a dental element can take on a different meaning when such event occurs on a system already functionally deficient. In such instances, one should consider whether any pre-existing condition compromise the system, and to what extent, so that the trauma has considerable bearing on the remaining masticatory function. If the apparatus is in a position to perform even in part its function, the blunt force trauma is likely to set the aggravating circumstance.

Application of alternative fixatives to formalin in diagnostic pathology

Fixation is a critical step in the preparation of tissues for histopathology. The objective of this study was to investigate the effects of different fixatives vs formalin on proteins and DNA, and to evaluate alternative fixation for morphological diagnosis and nucleic acid preservation for molecular methods. Forty tissues were fixed for 24 h with six different fixatives: the gold standard fixative formalin, the historical fixatives Bouin and Hollande, and the alternative fixatives Greenfix, UPM and CyMol. Tissues were stained (Haematoxylin-Eosin, Periodic Acid Schiff, Trichromic, Alcian-blue, High Iron Diamine), and their antigenicity was determined by immunohistochemistry (performed with PAN-CK, CD31, Ki-67, S100, CD68, AML antibodies). DNA extraction, KRAS sequencing, FISH for CEP-17, and flow cytometry analysis of nuclear DNA content were applied. For cell morphology the alternative fixatives (Greenfix, UPM, CyMol) were equivalent to formalin. As expected, Hollande proved the best fixative for morphology. The morphology obtained with Bouin was comparable to that with formalin. Hollande was the best fixative for histochemistry. Bouin proved equivalent to formalin. The alternative fixatives were equivalent to formalin, although with greater variability in haematoxylin-eosin staining. It proved possible to obtain immunohistochemical staining largely equivalent to that following formalin-fixation with the following fixatives: Greenfix, Hollande, UPM and CyMol. The tissues fixed in Bouin did not provide results comparable to those obtained with formalin. The DNA extracted from samples fixed with alternative fixatives was found to be suitable for molecular analysis.

Application of alternative fixatives to formalin in diagnostic pathology

Fixation is a critical step in the preparation of tissues for histopathology. The objective of this study was to investigate the effects of different fixatives vs formalin on proteins and DNA, and to evaluate alternative fixation for morphological diagnosis and nucleic acid preservation for molecular methods. Forty tissues were fixed for 24 h with six different fixatives: the gold standard fixative formalin, the historical fixatives Bouin and Hollande, and the alternative fixatives Greenfix, UPM and CyMol. Tissues were stained (Haematoxylin-Eosin, Periodic Acid Schiff, Trichromic, Alcian-blue, High Iron Diamine), and their antigenicity was determined by immunohistochemistry (performed with PAN-CK, CD31, Ki-67, S100, CD68, AML antibodies). DNA extraction, KRAS sequencing, FISH for CEP-17, and flow cytometry analysis of nuclear DNA content were applied. For cell morphology the alternative fixatives (Greenfix, UPM, CyMol) were equivalent to formalin. As expected, Hollande proved the best fixative for morphology. The morphology obtained with Bouin was comparable to that with formalin. Hollande was the best fixative for histochemistry. Bouin proved equivalent to formalin. The alternative fixatives were equivalent to formalin, although with greater variability in haematoxylin-eosin staining. It proved possible to obtain immunohistochemical staining largely equivalent to that following formalin-fixation with the following fixatives: Greenfix, Hollande, UPM and CyMol. The tissues fixed in Bouin did not provide results comparable to those obtained with formalin. The DNA extracted from samples fixed with alternative fixatives was found to be suitable for molecular analysis.

Patients' rights versus family rights: the situation in Italy

The authors, on the basis of Italian legislative and deontological regulation, discuss the problems which are faced in reconciling rights and ethical considerations involving patients and their families. In Italy, with the exception of parents and guardians (for minors and those incapable of consent), there is no family member that Italian law recognises for the purposes of giving consent in the name of another. In all cases, contact with the family must be authorised by the patient in accordance with Law 675/1996 regarding privacy. However, in some situations having the advice of a member of the family can be useful, as it can be of benefit to know the will, tacitly or expressly demonstrated, of the patient. Nonetheless, their opinion cannot be binding on the doctor and he or she is not obliged to request it. Ethically, this usually demands evaluation of almost every case.

A histological procedure to determine dental age

Sclerosis of dentine has become one of the well established indicators of ageing and age determination. In this study a new technique was reported where a photomicrographic image of a cross section of sclerotic dentine was converted to a grey scale of 256 tones and then reduced to black and white and read by computer using specially developed software. A regression analysis was applied to a sample of 62 teeth (age range 17-84 years) and an age determination within an error limit of 11 years was obtained. Using a Neural Network software however the error was reduced to 8 years.

Age determination by teeth examination: a comparison between different morphologic and quantitative analyses

Age determination by teeth examination is one of the main means of determining personal identification. Current studies have suggested different techniques for determining the age of a subject by means of the analysis of microscopic and macroscopic structural modifications of the tooth with ageing. The histological approach is useful among the various methodologies utilized for this purpose. It is still unclear as to what is the best technique, as almost all the authors suggest the use of the approach they themselves have tested. In the present study, age determination by means of microscopic techniques has been based on the quantitative analysis of three parameters, all well recognized in specialized literature: 1. dentinal tubules density/sclerosis 2. tooth translucency 3. analysis of the cementum thickness. After a description of the three methodologies (with automatic image processing of the dentinal sclerosis utilizing an appropriate computer program developed by the authors) the results obtained on cases using the three different approaches are presented, and the merits and failings of each technique are identified with the intention of identifying the one offering the least degree of error in age determination.

Italian population data on the loci LDLR, GYPA, HBGG, D7S8 and GC

Allele and genotype frequencies for the five loci LDLR, GYPA, HBGG, D7S8 and GC were determined for 374 unrelated Italians using a multiplex PCR-amplification and typing commercial kit. The distribution of the genotype frequencies showed no deviations from Hardy-Weinberg expectations. The combined power of discrimination and chance of exclusion for all five loci were 0.999 and 0.702, respectively. A test for homogeneity was performed and no significant differences were observed among the Caucasian population samples.

Genetic polymorphism of orosomucoid (ORM1 and ORM2) in Lombardy (Italy)

Orosomucoid subtypes have been analysed in 600 unrelated individuals from the Brescia Area (Lombardy-Italy) by the isoelectric focusing technique and immunoprinting. Five ORM1 phenotypes were observed. The ORM2 pattern was found to be virtually monomorphic, but one variant with an additional single band was found. The estimated allele frequencies were: ORM1*F1 = 0.5992, ORM1*F2 = 0.0150, ORM1*S = 0.3858.

Genetic polymorphism of alpha-2-HS glycoprotein in Lombardy (Italy)

Alpha 2HS-subtypes have been analysed in samples from 700 unrelated individuals from the Brescia area (Italy) by the isoelectric focusing technique and immunofixation. The observed allele frequencies were: alpha 2HS*1 = 0.7472; alpha 2HS*2 = 0.2507; alpha 2HS*V = 0.0021.

[The concept of disease and causality relations]

The author recalls the doctrinal and jurisprudential evolution of the concept of disease, with particular reference to the time of onset of the pathological state during the period in which workers are under health surveillance. It is strongly recommended to provide insurance coverage in situations where the worker is transferred for purely preventive purposes and it is equally important to make a strictly accurate assessment of the relationship of causality between exposure to the pathogenic noxious agent and the onset of disease, particularly for penal law purposes.

[Use of RIA (radioimmunoassay) technics in the identification of narcotics in biological fluids]

Radioimmunoassay has been compared with extraction thin-layer chromatography and gas-chromatography for the detection of morphine and barbiturate in urine. Radioimmunoassay has been found to be the most sensitive and rapid method and its use in large scale screening and forensic toxicology is considered.