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Crudele GDL, Amadasi A, Franceschetti L, Cattaneo C. Pathological Findings in Hanging: Is the Traditional Knowledge Correct? Diagnostics (Basel) 2024; 14:318. [PMID: 38337834 PMCID: PMC10855091 DOI: 10.3390/diagnostics14030318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/20/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND In forensic pathology, asphyxia presents a problem as frequently as it is thorny and challenging. Some knowledge in forensic pathology is still considered to be traditionally acquired and is not critically assessed with modern statistical or technical tools. In this study, we seek to examine the injuries that are considered to be typical of cases of hanging (neck lesions, haemorrhages, and pleural and epicardial petechiae). METHODS We evaluated whether there was, indeed, a statistically significant association between these injuries and deaths from hanging as compared to non-hanging deaths. We collected 399 cases (32 deaths by hanging and 367 cases of non-hangings), built contingency tables and performed chi-square tests for each variable (lesion) examined; we also analysed this association in various subgroups of the sample (according to sex, age and weight ranges). RESULTS Our results did not deviate from the expected outcome based on traditional knowledge, although they do provide a more detailed demonstration and clarification of traditional knowledge regarding this topic. CONCLUSIONS These findings provide valuable insights for future discussion, examination and deepening of knowledge that is traditionally accepted but often undersupported in the literature.
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Affiliation(s)
- Graziano Domenico Luigi Crudele
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milan, Italy (C.C.)
| | - Alberto Amadasi
- Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charité, University of Berlin, Turmstr. 21, Building N, 10559 Berlin, Germany
| | - Lorenzo Franceschetti
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milan, Italy (C.C.)
| | - Cristina Cattaneo
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milan, Italy (C.C.)
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Amadasi A, Franceschetti L, Crudele GDL, Roselli MR, Gentile G, Zoja R. The hidden aspect of carotid lesions in traffic accidents: A little-known phenomenon. J Forensic Leg Med 2022; 86:102316. [PMID: 35021120 DOI: 10.1016/j.jflm.2022.102316] [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: 09/16/2021] [Revised: 01/02/2022] [Accepted: 01/03/2022] [Indexed: 11/17/2022]
Abstract
Vascular injuries that occur during traffic accidents are a commonly neglected aspect that can add more detail to the framework of a case. In this study, we analysed a case series of 150 traffic accidents, 39 of which were marked by microscopically identifiable vascular lesions. The purpose was to identify the presence of carotid injuries in individuals who died due to traffic accidents and had nonpenetrating trauma of the neck. We focused on the discrepancies regarding the macroscopical aspect and the histology and demonstrated how histological analysis of the carotids in cases of trauma can reveal injuries that are attributable to the trauma itself. We conducted a histological analysis of the lesions to describe their distribution and type and investigate potential correlations. The study offers insight on how to examine road accidents that involve traumatic injury of the carotid arteries. Indeed the main task of the forensic pathologist in the case of death is to establish the existence of a causal relationship between the micro- or macroscopic alterations observed in the autopsy and the traumatic event that led to the death of the subject. Thus, further morphological elements were provided to the forensic practitioners that may reveal injuries attributable to the trauma itself and should be evaluated in cases of trauma in traffic accidents.
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Affiliation(s)
- Alberto Amadasi
- Institute of Legal Medicine, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Lorenzo Franceschetti
- Institute of Legal Medicine, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | | | - Maria Rosa Roselli
- Institute of Legal Medicine, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Guendalina Gentile
- Institute of Legal Medicine, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Riccardo Zoja
- Institute of Legal Medicine, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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Luigi Crudele GD, Galante N, Fociani P, Del Gobbo A, Tambuzzi S, Gentile G, Zoja R. The forensic application of the Glycophorin A on the Amussat's sign with a brief review of the literature. J Forensic Leg Med 2021; 82:102228. [PMID: 34388443 DOI: 10.1016/j.jflm.2021.102228] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 11/18/2022]
Abstract
Even if the Amussat's sign is known since the mid-19th century, few studies have been made in order to assess its real occurrence. In particular, the histopathologic examination of the Amussat's sign lacks in the medicolegal literature. The review of the literature shows indeed a significant range of variability (from 1.1 % up to 25 %) regarding the macroscopic detection of the Amussat's sign. In this study, the authors report that the identification of a vital Amussat's sign is important and may require the immunohistochemical staining for the Glycophorin A (a marker of vital reaction). The victim was a 63-year-old man, who was found suspended from the staircase with a rope. Both the carotid arteries were opened in situ by using fine scissors with blunt tips. A horizontal lesion (length 4 mm) of the intima of the left common carotid artery was documented. A sample was obtained; then, a standard post-fixative histopathologic examination and immunohistochemical staining for the Glycophorin A were carried out. The standard histopathologic examination only revealed the intimal laceration with a poor hemorrhagic infiltration. However, the immunohistochemical staining for the Glycophorin A allowed the clear identification of the hemorrhagic infiltration, which was documented both in the intimal laceration and in the periadventitial soft tissues. The immunohistochemical staining for the Glycophorin A can identify the vitality of an Amussat's sign. When an Amussat's sign is documented, the Glycophorin A may therefore help the forensic pathologist to differentiate a hanging death from a postmortem suspension of the body.
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Affiliation(s)
- Graziano Domenico Luigi Crudele
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano Via Luigi Mangiagalli, 37, 20133, Milano, Italy
| | - Nicola Galante
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano Via Luigi Mangiagalli, 37, 20133, Milano, Italy
| | - Paolo Fociani
- Unità Operativa Complessa di Anatomia Patologica, Ospedale Nuovo di Legnano ASST Ovest Milanese Soma Srl, Università degli Studi di, Milano, Italy
| | - Alessandro Del Gobbo
- Unità Operativa Complessa di Anatomia Patologica, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico Milano, Università degli Studi di, Milano, Italy
| | - Stefano Tambuzzi
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano Via Luigi Mangiagalli, 37, 20133, Milano, Italy
| | - Guendalina Gentile
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano Via Luigi Mangiagalli, 37, 20133, Milano, Italy.
| | - Riccardo Zoja
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano Via Luigi Mangiagalli, 37, 20133, Milano, Italy
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Blandino A, Maggioni L, Chiaffarino F, Parazzini F, Capano D, Florio EM, Margherita M, Bertelle GM, Franceschetti L, Amadasi A, Vignali G, Ciprandi B, Crudele GDL, Merelli VG, Collini F, Muccino EA, Nicolò P, Barbara G, Kustermann A, Cattaneo C, Gentilomo A. Sexual assault and abuse committed against family members: An analysis of 1342 legal outcomes and their motivations. PLoS One 2021; 16:e0253980. [PMID: 34185821 PMCID: PMC8241090 DOI: 10.1371/journal.pone.0253980] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/16/2021] [Indexed: 11/26/2022] Open
Abstract
Background Over the past years medical centres specifically addressed in gender-based violence have developed protocols for the collections of evidence useful in the courtroom, including accurate documentation of physical and psychological states of the victim and collection of samples. Previous studies showed an association between documented physical trauma and conviction but unfortunately, few studies in the recent literature analysed the factors that influence the legal outcome and final judgement. The present study focused on the elements that appeared of significance in the legal outcome, including medico-legal evaluation, source of the crime report and circumstance of the assault. Methods It was conducted a retrospective analysis of all the judgments issued by the Public Prosecutor’s Office at a Court of a Metropolitan Italian city regarding sexual and domestic violence, from January 1st 2011 to 31st December 31st 2015. Examination regarded the demographic information of the victim and of the defendant, information on the crime, the circumstances of the aggression and medical information retrieved. Sentences were subsequently divided into two categories based on the legal outcome (conviction vs acquittal) and the different characteristics of the two sub-populations were compared to verify if there were variables significantly associated to the judge’s final judgment. Results Over the 5 years taken into consideration, there have been 1342 verdicts regarding crimes of sexual violence (374 cases) and regarding abuses against family members or cohabitants (875): other 93 cases regarded both sexual violence and abuse. 66.3% ended in conviction of the offender and 33.7% in acquittal of the accused. Cases of conviction were more frequent when they involved: use of a weapon by the assailant, as well as if the assailant had a criminal record and had a history of drug abuse or other addictions; duration of proceeding less 22 months and a civil party involved; presence of clinical documentation together with other deposition in addition to victim’s deposition; also frequent episodes of violence and application of precautionary measures were associated to conviction. Conclusions Many factors seem able to influence the judge’s judgment, although clearly each case must be singularly evaluated. The mere presence of medical documentation, without the support of other sources of evidence, such as the victim’s statement or further declarations, however, is almost always not definitive for the verdict. Despite so, in cases where there are multiple sources of evidence, clinical documentation can provide useful elements and can give clues on the consistency between the history told and injuries observed.
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Affiliation(s)
- Alberto Blandino
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
- * E-mail:
| | - Lidia Maggioni
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Francesca Chiaffarino
- Department of Woman, Newborn and Child, Gynaecology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, Università Degli Studi, Milan, Italy
| | | | - Elena Maria Florio
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Manuela Margherita
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Gian Marco Bertelle
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Lorenzo Franceschetti
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Alberto Amadasi
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Giulia Vignali
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Barbara Ciprandi
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | | | - Vera Gloria Merelli
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Federica Collini
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Enrico Angelo Muccino
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | | | - Giussy Barbara
- Department of Obstetrics and Gynecology and Service for Sexual and Domestic Violence (SVSeD), Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Kustermann
- Department of Obstetrics and Gynecology and Service for Sexual and Domestic Violence (SVSeD), Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Cattaneo
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
| | - Andrea Gentilomo
- Department of Biomedical Science for Health, Institute of Legal Medicine, Università Degli Studi, Milan, Italy
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Crudele GDL, Merelli VG, Vener C, Cattaneo C. Authors' Response. J Forensic Sci 2019; 65:344. [PMID: 31792969 DOI: 10.1111/1556-4029.14245] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Graziano Domenico Luigi Crudele
- Department of Biomedical and Health Sciences, Section of Legal Medicine, University of Milan, Via Luigi Mangiagalli, 37, Milan, 20133, Italy
| | - Vera Gloria Merelli
- Department of Biomedical and Health Sciences, Section of Legal Medicine, University of Milan, Via Luigi Mangiagalli, 37, Milan, 20133, Italy
| | - Claudia Vener
- Laboratory of Medical Statistics and Biometry "GA Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Via Augusto Vanzetti, 5, Milan, 520133, Italy
| | - Cristina Cattaneo
- Department of Biomedical and Health Sciences, Section of Legal Medicine, University of Milan, Via Luigi Mangiagalli, 37, Milan, 20133, Italy
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Migliorini AS, Bailo P, Boracchi M, Crudele GDL, Gentile G, Zoja R. Forensic - Pathological SEM/EDX analysis in prosecution of medical malpractice. Leg Med (Tokyo) 2019; 40:43-46. [PMID: 31351409 DOI: 10.1016/j.legalmed.2019.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/05/2018] [Revised: 05/31/2019] [Accepted: 07/21/2019] [Indexed: 11/16/2022]
Abstract
The retention of gauze within the mediastinum is considered an exceptional finding. We are presenting the case of a woman, affected by aorto-mitral valvulopathy, in whose mediastinum was found, during the autopsy, a gauzome without signs of active phlogosis, which had been "forgotten" in a previous surgery, acted 14 years before the death. A 39 y.o. woman had received surgical treatment of double aorto-mitral valve substitution and tricuspid plastic. At age 53, she successfully received surgery once again at a different hospital; she then started rehabilitation therapy, during which she deceased due to sudden hematemesis with infectious multi organ failure. During the autopsy, a 5 cm long surgical gauze was found in the mediastinum. A SEM/EDX (Scanning Electron Microscopy with Energy Dispersive X-ray spectroscopy) exam was ran on the foreign body and a sample of the same gauze used in the cardiac-surgical department of the hospital the victim had passed away in, to act a comparison between the two kinds of material. The exam showed a morphological difference between exogenous fibers incorporated within the gauzome and the control gauze. This case highlights the diagnostic and interpretative challenges in finding a foreign body within the mediastinum without signs of active phlogosis. SEM/EDX investigations executed on the gauzome and a "control gauze" allowed the attribution of malpractice to the first hospital the victim had been operated in 14 years before the exitus. The SEM/EDX exam confirms its importance in correctly identifying the case, which becomes an example for similar happenings.
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Affiliation(s)
| | - Paolo Bailo
- Forensic Genetics Laboratory, Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy
| | - Michele Boracchi
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy
| | - Graziano Domenico Luigi Crudele
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy
| | - Guendalina Gentile
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy
| | - Riccardo Zoja
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
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Boracchi M, Crudele GDL, Gentile G, Maciocco F, Maghin F, Marchesi M, Muccino E, Zoja R. Extensive study on electrocution at the Bureau of Legal Medicine of Milan (1993-2017): Determination of the current mark with scanning electron microscope/energy-dispersive X-ray analysis on paraffin-embedded samples. Med Leg J 2019; 87:67-73. [PMID: 30968747 DOI: 10.1177/0025817219833328] [Citation(s) in RCA: 5] [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] [Indexed: 11/17/2022]
Abstract
Literature on electrocution in Italy is limited. The authors have focused their attention on the use of scanning electron microscope/energy-dispersive X-ray analysis in order to evaluate the current mark even on paraffin-embedded samples. A total of 24,104 autopsies were performed at the Section of Legal Medicine of Milan (1993-2017); all cases of death caused by electrocution (low and high voltage) were selected. We assessed a regular histological examination, a toxicological examination and detected metallisation with energy-dispersive X-ray spectroscopy analysis on paraffin-embedded tissues of typical current marks. We collected 27 high-voltage fatalities and five cases of low-voltage suicide electrocution; the technique revealed itself as sensitive. In all cases, microscopic examination highlighted the typical signs of electric current and thermal damage but the histochemical specific stainings for copper and iron gave negative results. Scanning electron microscope/energy-dispersive X-ray analysis, assessed on these same samples, even when paraffin-embedded, however, enabled us to detect these elements and differentiate between the various metal residues involved in the electrocution process. Based on their experience, authors advise the use of scanning electron microscope/energy-dispersive X-ray analysis on electrocution deaths to provide information for forensic diagnosis.
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Affiliation(s)
- Michele Boracchi
- 1 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Milano, Italy
| | - Graziano Domenico Luigi Crudele
- 1 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Milano, Italy
| | - Guendalina Gentile
- 1 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Milano, Italy
| | - Francesca Maciocco
- 1 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Milano, Italy
| | - Francesca Maghin
- 2 Medicina Legale, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - Matteo Marchesi
- 3 Responsabile USS Medicina Legale - AO Papa Giovanni XXIII, Bergamo, Italy
| | - Enrico Muccino
- 1 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Milano, Italy
| | - Riccardo Zoja
- 1 Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Milano, Italy
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Casati S, Minoli M, Angeli I, Ravelli A, Crudele GDL, Orioli M. An ocfentanil-related death case: UHPLC-MS/MS analysis of the drug. Drug Test Anal 2018; 11:173-177. [DOI: 10.1002/dta.2473] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/24/2018] [Accepted: 07/24/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Sara Casati
- Laboratory of Forensic Toxicology, Department of Biomedical, Surgical and Dental Science; University of Milan; via Luigi Mangiagalli 37 20133 Milan Italy
| | - Mauro Minoli
- Laboratory of Forensic Toxicology, Department of Biomedical, Surgical and Dental Science; University of Milan; via Luigi Mangiagalli 37 20133 Milan Italy
| | - Ilaria Angeli
- Laboratory of Forensic Toxicology, Department of Biomedical, Surgical and Dental Science; University of Milan; via Luigi Mangiagalli 37 20133 Milan Italy
| | - Alessandro Ravelli
- Laboratory of Forensic Toxicology, Department of Biomedical, Surgical and Dental Science; University of Milan; via Luigi Mangiagalli 37 20133 Milan Italy
| | | | - Marica Orioli
- Laboratory of Forensic Toxicology, Department of Biomedical, Surgical and Dental Science; University of Milan; via Luigi Mangiagalli 37 20133 Milan Italy
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Muccino E, Giovanetti GF, Crudele GDL, Gentile G, Marchesi M, Rancati A, Zoja R. Characterisation of the weapon used in a patricide by SEM/EDS analysis of a microscopic trace from the object. Med Sci Law 2016; 56:221-226. [PMID: 26700496 DOI: 10.1177/0025802415623094] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article presents a case of patricide. The murder was characterised by multiple blunt traumas and asphyxia. A mass of contused wounds was localised to the head and neck, and included the complete avulsion of the left eye (by an unknown tool), which was recovered near the cadaver. This case is of interest due to the possibility of identifying microscopic traces of the object that was used for the homicide by examining the skin margins around the ocular injury. The analysis was conducted using scanning electron microscopy combined with energy dispersive X-ray analysis (SEM/EDX). Analysis of the skin margins allowed microscopic inorganic traces to be detected, which were identified as ceramic material. This result focused the attention of the investigation on a small fish-shaped statue that had been previously found by the police when examining the crime scene. The use of SEM/EDX was therefore essential in determining a match between the microscopic traces detected on the perilesional skin and the composition of the statue. This led to the suspicion that the statue was the murder weapon.
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Affiliation(s)
| | | | | | | | - Matteo Marchesi
- USS Medicina Legale - Azienda Ospedaliera Papa Giovanni XXIII - Bergamo, Italy
| | | | - Riccardo Zoja
- Sezione di Medicina Legale e delle Assicurazioni, Italy
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Crudele GDL, Amadasi A, Marasciuolo L, Rancati A, Gentile G, Zoja R. A case report of lethal post-viral lymphocytic myocarditis with exclusive location in the right ventricle. Leg Med (Tokyo) 2016; 19:1-4. [PMID: 26980245 DOI: 10.1016/j.legalmed.2016.01.005] [Citation(s) in RCA: 8] [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: 10/15/2015] [Revised: 01/04/2016] [Accepted: 01/12/2016] [Indexed: 11/29/2022]
Abstract
The inflammatory involvement of vital organs may represent a dangerous and life-threatening situation: in particular, the inflammation of the myocardial tissue of the heart may lead to severe consequences since the clinical history of the disease may be completely asymptomatic, any clinical sign may be lacking, thus preventing correct diagnosis and treatment. This may occur even in the case of myocarditis and may lead to unexpected death whose cause can be assessable only by means of a thorough histopathological examination. The article reports the case of 61-year old female who developed a flu-like syndrome with very few symptoms, followed by sudden death in three weeks. The autopsy and following histopathological investigations identified the cause of death in a post-viral lymphocytic myocarditis, probably related to the previous infectious disease, and alternative causes (as arrhythmic ventricular dysplasia, vasculitis, sarcoidosis and giant cell myocarditis) were excluded. The exclusive location in the right ventricle was a peculiar finding. The case highlights the importance of the myocardium of the right ventricle, a tissue which is often less considered even in histopathological surveys. The exclusive location of myocarditis in the right ventricle is a rare event but in this case fully responsible for death.
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Affiliation(s)
- Graziano Domenico Luigi Crudele
- Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy
| | - Alberto Amadasi
- Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy.
| | - Laura Marasciuolo
- Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy
| | - Alessandra Rancati
- Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy
| | - Guendalina Gentile
- Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy
| | - Riccardo Zoja
- Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy
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Crudele GDL, Di Candia D, Gentile G, Marchesi M, Rancati A, Zoja R. One Hundred and One Cases of Plastic Bag Suffocation in the Milan Area Between 1993 and 2013-Correlations, Circumstances, Pathological and Forensic Evidences and Literature Review. J Forensic Sci 2015; 61:361-366. [DOI: 10.1111/1556-4029.13003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 03/16/2015] [Accepted: 05/24/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Graziano Domenico Luigi Crudele
- Dipartimento di Scienze Biomediche per la Salute; Sezione di Medicina Legale e delle Assicurazioni; Via Luigi Mangiagalli 37 20133 Milan Italy
| | - Domenico Di Candia
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche; Sezione di Tossicologia Forense; Università degli Studi di Milano; Via Luigi Mangiagalli 37, 20133 Milan Italy
| | - Guendalina Gentile
- Dipartimento di Scienze Biomediche per la Salute; Sezione di Medicina Legale e delle Assicurazioni; Via Luigi Mangiagalli 37 20133 Milan Italy
| | - Matteo Marchesi
- Ospedale Papa Giovanni XXIII; Piazza OMS 1 24127 Bergamo Italy
| | - Alessandra Rancati
- Dipartimento di Scienze Biomediche per la Salute; Sezione di Medicina Legale e delle Assicurazioni; Via Luigi Mangiagalli 37 20133 Milan Italy
| | - Riccardo Zoja
- Dipartimento di Scienze Biomediche per la Salute; Sezione di Medicina Legale e delle Assicurazioni; Via Luigi Mangiagalli 37 20133 Milan Italy
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Muccino E, Crudele GDL, Gentile G, Marchesi M, Rancati A, Zoja R. Suicide drowning in the non-coastal territory of Milan. Int J Legal Med 2014; 129:777-84. [PMID: 25398634 DOI: 10.1007/s00414-014-1115-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 11/05/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION A cadaver in water sets a relevant issue for the forensic pathologist, concerning the differential diagnosis between homicide, suicide, accidental event, and natural death in water. In the present study, the drowning suicides in a non-coastal territory are analyzed, discussing the main diagnostic difficulties, the preventive intervention, and the strategies for outlining the profile of a "mean victim" that is at risk of committing suicide by drowning. METHODS The cases of drowning suicide were extrapolated by the database of the 21,472 autopsies performed at the Civic Morgue of Milan, in the period between 1993 and 2013. RESULTS Drowning represents the fifth cause of suicide registered in Milan for the study period, with 139 cases (3.8% of all suicides). Victims were mainly elderly males (61-80 years old) with a history of psychiatric diseases in pharmacological therapy; they committed suicide mainly during summer, in the rivers. The diatoms test was positive in 82 cases (59%) and highlighted typical taxa of fresh water. Alcohol and illicit drugs were not noticed, at high levels. CONCLUSION Drowning suicide occurs even in a non-coastal territory, far from the sea, if there is an easy access to the water: specifically, many natural and artificial waterways in the Milan district represent a high-risk factor predisposing the drowning suicide.
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Affiliation(s)
- Enrico Muccino
- Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milano, Italy
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Rancati A, Crudele GDL, Gentile G, Zoja R. The case of a prosthetic limb used to cause lethal intravaginal injuries: forensic medical aspects in a case of intimate partner violence. Forensic Sci Int 2013; 234:e21-4. [PMID: 24252425 DOI: 10.1016/j.forsciint.2013.10.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 06/14/2013] [Accepted: 10/17/2013] [Indexed: 11/24/2022]
Abstract
A common form of violence against women is sexual coercion on the part of their husbands/partners, the uncontrollable effects of which can lead to extreme consequences, as in the case of uxoricide examined in this report. It involved a 59-year-old female alcoholic, under observation on the part of social services as the possible victim of abuse by her husband, an amputee with a transtibial prosthesis. The woman had never admitted to her social workers that her husband was abusing her. One night, she was admitted to hospital in a state of hemorrhagic shock due to massive vaginal bleeding, but despite treatment, she died 20 min after arrival. The anatomical-pathological examination conducted by the hospital revealed serious genital lesions which warranted reporting the case to the Judicial Authorities, who arranged for a forensic autopsy. The cause of death was identified as acute meta-hemorrhagic anemia in a cirrhotic woman, secondary to a large, irregular vaginal lesion involving both the vaginal wall and the soft perivaginal tissues as well as the medium and small urogenital vascular branches. To identify the foreign body used to inflict this injury, a scanning electron microscope and energy dispersive X-ray spectrometer (SEM-EDS) were used. This revealed tiny splinters of wood in the vaginal tissues examined. In addition to the genetic-forensic techniques used, this finding allowed the investigators to identify the husband's prosthetic limb as the instrument of sexual coercion. The report describes a particular case of marital rape that resulted in uxoricide, in which the overall concordance of the investigations carried out played a fundamental role in identifying the offending body and, consequently, the murderer.
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Affiliation(s)
- Alessandra Rancati
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
| | - Graziano Domenico Luigi Crudele
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
| | - Guendalina Gentile
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
| | - Riccardo Zoja
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
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