In The Body of Evidence. Corpses and Proofs in Early Modern European Medicine Francesco Paolo de Ceglia offers an overview of the evolution of the science of the 'signs of the corpse', from ...necromancy to forensic medicine.
Sudden unexplained death (SUD) is not uncommon in forensic pathology. Yet, diagnosis of SUD remains challenging due to lack of specific biomarkers. This study aimed to screen differentially expressed ...proteins (DEPs) and validate their usefulness as diagnostic biomarkers for SUD cases. We designed a three-phase investigation, where in the discovery phase, formalin-fixed paraffin-embedded (FFPE) heart specimens were screened through label-free proteomic analysis of cases dying from SUD, mechanical injury and carbon monoxide (CO) intoxication. A total of 26 proteins were identified to be DEPs for the SUD cases after rigorous criterion. Bioinformatics and Adaboost-recursive feature elimination (RFE) analysis further revealed that three of the 26 proteins (MYH6, COX5B and TNNT2) were potential discriminative biomarkers. In the training phase, MYH6 and COX5B were verified to be true DEPs in cardiac tissues from 29 independent SUD cases as compared with a serial of control cases (n = 42). Receiver operating characteristic (ROC) analysis illustrated that combination of MYH6 and COX5B achieved optimal diagnostic sensitivity (89.7 %) and specificity (84.4 %), with area under the curve (AUC) being 0.91. A diagnostic software based on the logistic regression formula derived from the training phase was then constructed. In the validation phase, the diagnostic software was applied to eight authentic SUD cases, seven (87.5 %) of which were accurately recognized. Our study provides a valid strategy towards practical diagnosis of SUD by integrating cardiac MYH6 and COX5B as dual diagnostic biomarkers.
•Label-free proteomic profiling discovers 26 potential biomarkers for SUD.•MYH6 and COX5B were verified as true biomarkers for SUD.•The two biomarkers-based diagnostic model and software was developed for SUD.•The developed software was successfully validated in authentic human cases.
Electrocution is a leading cause of unnatural deaths, especially in industrial and developing regions like India. In a recent case, an individual was brought in for autopsy following an apparent ...accidental electrocution. Strikingly, the postmortem examination revealed no typical entry or exit wounds associated with electric shocks. The body exhibited rigor mortis and a unique sign: reddish froth draining from the nasal cavities. Internal examination unveiled distinctive findings. Multiple tiny hemorrhages were observed over the heart’s left ventricle, while the heart’s blood vessels and valves remained unobstructed. In contrast, the lungs showed a frothy, whitish-red appearance extending into the bronchioles. This case presents an unprecedented observation: the presence of froth in the respiratory tract during electrocution. This case underscores the need for thorough autopsies. Even when specific indicators are absent, it highlights the importance of considering electrocution when froth is found in the respiratory tract. Such cases remind forensic pathologists of the diverse and occasionally unexpected manifestations they may encounter, encouraging the exploration of new phenomena within forensic medicine.
Objectives
The principal aim of our study was to establish concordance between post-mortem CT (PMCT) and forensic standard autopsy (SA) in detecting lesions according to different anatomical regions. ...A secondary aim was to determine the efficacy of PMCT in showing lethal lesions.
Methods
PMCTs were compared with autopsies in 236 cadavers in different contexts of death. PMCT findings were assessed by two independent radiologists.
Results
Concordance between PMCT and autopsy was almost perfect in showing skull, basal skull and hyoid bone fractures as well as in detecting facial, vertebral or pelvic fractures. Both examinations were discordant in demonstrating some intracranial injuries, vascular or organ wounds (more findings showed by autopsy), as well in showing free air in anatomical cavities (more findings detected by PMCT). Moreover, PMCT was effective in determining lethal lesions in the context of craniofacial trauma or after a gunshot wound. Concordance between the findings of the two radiologists was almost perfect for each type of lesion.
Conclusion
PMCT could be considered as effective as SA in determining the cause of death in certain traumatic events. It was also effective in showing lethal lesions and could be a useful tool in reducing the number of SA.
Key Points
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Post
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mortem CT is increasingly performed as an alternative
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adjunct to formal autopsy.
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More modern CT systems provide greater anatomical scope.
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PMCT can usually determine the cause of most deaths following trauma.
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Prospective studies are still required to establish an algorithm for forensic CT
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