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  1. Article: Traumatic Aneurysm Involving the Posterior Communicating Artery.

    Napoletano, Gabriele / Di Fazio, Nicola / Delogu, Giuseppe / Del Duca, Fabio / Maiese, Aniello

    Healthcare (Basel, Switzerland)

    2024  Volume 12, Issue 2

    Abstract: Traumatic intracranial aneurysms (TICAs) are rare, accounting for less than 1% of all intracranial aneurysms. However, they are associated with a mortality rate of over 50%. The case presented herein focuses on a posterior communicating artery TICA ... ...

    Abstract Traumatic intracranial aneurysms (TICAs) are rare, accounting for less than 1% of all intracranial aneurysms. However, they are associated with a mortality rate of over 50%. The case presented herein focuses on a posterior communicating artery TICA caused by violent aggression. A 41-year-old man with massive subarachnoid hemorrhage (SAH), on admission to hospital, had a CT angiography that showed a ruptured left posterior communicating artery aneurysm with continuous blood loss and underwent neurosurgical cooling. The CT scan also showed fractures of the mandible, mastoid and left styloid process, as well as brain contusions caused by blows and kicks. Despite medical treatment and surgery, after four days, he died. The assault dynamics were recorded by a camera in the bar. The damage was caused by kicks to the neck and head. The forensic neuropathological examination showed the primary injury (SAH, subdural hemorrhage, cerebral contusions, head-neck fractures), as well as secondary damage following the attack (cerebral infarcts, edema, supratentorial hernia, midbrain hemorrhage). The coil was intact and well positioned. In this case, circumstantial information, medical records, and the type of injury could shed light on the mechanism of the production of a TICA. In addition, the CT angiography and histological investigations helped to distinguish a recent and traumatic aneurysm from a pre-existing one. Following precise steps, the study of aneurysms can be helpful in clarifying their traumatic origin even when the victim was taking drugs. The aim of this study is also to share the diagnostic process that we used in the forensic field for the assessment of suspected traumatic aneurysms.
    Language English
    Publishing date 2024-01-13
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare12020192
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Butane-related deaths in post-mortem investigations: A systematic review.

    Iacoponi, Naomi / Del Duca, Fabio / Marcacci, Ilaria / Occhipinti, Carla / Napoletano, Gabriele / Spadazzi, Federica / La Russa, Raffaele / Maiese, Aniello

    Legal medicine (Tokyo, Japan)

    2024  Volume 69, Page(s) 102442

    Abstract: Volatile substance abuse is widespread among adolescents due to its easy availability and methods of consumption. Inhalant abuse represents a current problematic issue, causing significant morbidity and mortality due to direct toxicity on several target ... ...

    Abstract Volatile substance abuse is widespread among adolescents due to its easy availability and methods of consumption. Inhalant abuse represents a current problematic issue, causing significant morbidity and mortality due to direct toxicity on several target organs and displacement of gas which results in a lack of oxygen. This review aims to evaluate post-mortem and toxicological investigations in cases of suspected butane intoxication. We performed comprehensive research using the Preferred Reporting Items for Systematic Review (PRISMA) standards. Forty scientific papers fulfilled the inclusion criteria. A total of 58 cases of butane-related deaths were found. Among these, we found 11 cases of suicide (18%), 1 case of homicide (2%), 44 cases of accidental poisoning (76%), and 2 cases of work-related deaths (4%). Autopsy and post-mortem examinations were performed in 54 cases, whereas toxicological analyses were presented in 56 cases. In autopsy, pulmonary edema (51%) and poli-visceral congestion (59%) were the most common findings. When death by butane inhalation is hypothesized, autopsy and histological findings may be nonspecific, therefore toxicological investigations assume a crucial role along with attention to the methods used to collect biological samples.
    Language English
    Publishing date 2024-03-30
    Publishing country Ireland
    Document type Journal Article ; Review
    ZDB-ID 2019555-2
    ISSN 1873-4162 ; 1344-6223
    ISSN (online) 1873-4162
    ISSN 1344-6223
    DOI 10.1016/j.legalmed.2024.102442
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Autoptic Findings in Cases of Sudden Death Due to Kawasaki Disease.

    Visi, Giacomo / Spina, Federica / Del Duca, Fabio / Manetti, Alice Chiara / Maiese, Aniello / La Russa, Raffaele / Frati, Paola / Fineschi, Vittorio

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 11

    Abstract: Kawasaki disease (KD) is the second-most-common childhood vasculitis, and its etiology is still unknown today. Even though the acute illness is usually self-limiting, sometimes, it can generate complications, such as coronary artery aneurysms (CAA), ... ...

    Abstract Kawasaki disease (KD) is the second-most-common childhood vasculitis, and its etiology is still unknown today. Even though the acute illness is usually self-limiting, sometimes, it can generate complications, such as coronary artery aneurysms (CAA), acute myocardial infarction (AMI), heart failure, or arrhythmias, and can rarely cause sudden or unexpected deaths. We present a review of the literature, which collects autoptic and histopathological data relating to many of the cases of these deaths. On the basis of the titles and abstracts, we selected 54 scientific publications for a total of 117 cases. Among them, as expected, the majority of the deaths were due to AMI (41.03%), arrhythmia (8.55%), acute coronary syndrome (8.55%), and CAA rupture (11.97%), involving mostly 20-year-olds or younger individuls (69.23%). This is not surprising since the CAs are the most involved arteries. Gross autoptic and histopathological findings are reported in the paper. Our work revealed that, when compared with the incidence of KD, only a few cases suffered from sudden death, underwent an autoptic examination, and were then described in the literature. We suggest that researchers should perform autopsies to gain a better understanding of the molecular pathways involved in KD so as to propose further innovative therapeutic protocols or implement more appropriate prevention schemes.
    Language English
    Publishing date 2023-05-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13111831
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: FOXO3 Depletion as a Marker of Compression-Induced Apoptosis in the Ligature Mark: An Immunohistochemical Study.

    Maiese, Aniello / Manetti, Alice Chiara / Santoro, Paola / Del Duca, Fabio / De Matteis, Alessandra / Turillazzi, Emanuela / Frati, Paola / Fineschi, Vittorio

    International journal of molecular sciences

    2023  Volume 24, Issue 2

    Abstract: One of the most challenging issues in forensic pathology is lesion vitality demonstration, particularly in cases of hanging. Over the past few years, immunohistochemistry has been applied to this field with promising results. In particular, protein and ... ...

    Abstract One of the most challenging issues in forensic pathology is lesion vitality demonstration, particularly in cases of hanging. Over the past few years, immunohistochemistry has been applied to this field with promising results. In particular, protein and transcription factors involved in the apoptotic process have been studied as vitality markers for the ligature mark. This study represents an implementation of our previous studies on ligature mark vitality demonstration. In this study, we evaluated the FOXO3 expression in post-mortem cervical skin samples through an immunohistochemical analysis. To evaluate FOXO3 expression, anti-FOXO3 antibodies (GTX100277) were used. The study group comprised 21 cases, 8 women and 13 men, whereas the control group consisted of 13 cases of subjects who died due to other causes. Decomposition and no clear circumstantial data were exclusion criteria. We found that FOXO3 is decreased in hanging cases compared with normal skin in other causes of death (p-value < 0.05). No differences were seen concerning the type of hanging material (hard or soft), type of hanging (complete or incomplete), and position of the knot. Our results suggest that FOXO3 depletion could be a valid immunohistochemical marker of ligature mark vitality.
    MeSH term(s) Male ; Humans ; Female ; Suicide ; Asphyxia/pathology ; Forensic Pathology ; Autopsy ; Apoptosis ; Forkhead Box Protein O3
    Chemical Substances FOXO3 protein, human ; Forkhead Box Protein O3
    Language English
    Publishing date 2023-01-11
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms24021396
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Death Due to Anaphylactic Reaction: The Role of the Forensic Pathologist in an Accurate Postmortem Diagnosis.

    Del Duca, Fabio / Manetti, Alice Chiara / Maiese, Aniello / Napoletano, Gabriele / Ghamlouch, Alessandro / Pascale, Natascha / Giorgio, Bolino / Paola, Frati / Russa, Raffaele La

    Medicina (Kaunas, Lithuania)

    2023  Volume 59, Issue 12

    Abstract: Background and ... ...

    Abstract Background and Objectives
    MeSH term(s) Humans ; Tryptases/metabolism ; Anaphylaxis/diagnosis ; Pathologists ; Mast Cells/metabolism ; Lung
    Chemical Substances Tryptases (EC 3.4.21.59)
    Language English
    Publishing date 2023-12-15
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2188113-3
    ISSN 1648-9144 ; 1010-660X
    ISSN (online) 1648-9144
    ISSN 1010-660X
    DOI 10.3390/medicina59122184
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Blood-brain barrier breakdown, central nervous system cell damage, and infiltrated T cells as major adverse effects in CAR-T-related deaths: a literature review.

    Del Duca, Fabio / Napoletano, Gabriele / Volonnino, Gianpietro / Maiese, Aniello / La Russa, Raffaele / Di Paolo, Marco / De Matteis, Serena / Frati, Paola / Bonafè, Massimiliano / Fineschi, Vittorio

    Frontiers in medicine

    2024  Volume 10, Page(s) 1272291

    Abstract: Background: CAR-T-related deaths observed worldwide are rare. The underlying pathogenetic mechanisms are the subject of study, as are the findings that enable diagnosis. A systematic literature search of the PubMed database and a critical review of the ... ...

    Abstract Background: CAR-T-related deaths observed worldwide are rare. The underlying pathogenetic mechanisms are the subject of study, as are the findings that enable diagnosis. A systematic literature search of the PubMed database and a critical review of the collected studies were conducted from the inception of this database until January 2023. The aim of the study is to determine when death is related to CAR-T cell therapy and to develop a shareable diagnostic algorithm.
    Methods: The database was searched by combining and meshing the terms ("CAR-t" OR "CART") AND ("Pathology" OR "Histology" OR "Histological" OR "Autopsy") AND ("Heart" OR "Cardiac" OR "Nervous System" OR "Kidney" OR "Liver") with 34 results and also the terms: [(Lethal effect) OR (Death)] AND (CAR-T therapy) with 52 results in titles, abstracts, and keywords [all fields]. One hundred scientific articles were examined, 14 of which were additional records identified through other sources. Fifteen records were included in the review.
    Results: Neuronal death, neuronal edema, perivascular edema, perivascular and intraparenchymal hemorrhagic extravasation, as well as perivascular plasmatodendrosis, have been observed in cases with fatal cerebral edema. A cross-reactivity of CAR-T cells in cases of fatal encephalopathy can be hypothesized when, in addition to the increased vascular permeability, there is also a perivascular lymphocyte infiltrate, which appears to be a common factor among most authors.
    Conclusion: Most CAR-T-related deaths are associated with blood-brain barrier breakdown, central nervous system cell damage, and infiltrated T cells. Further autopsies and microscopic investigations would shed more light on the lethal toxicity related to CAR-T cells. A differential diagnosis of CAR-T-related death is crucial to identifying adverse events. In this article, we propose an algorithm that could facilitate the comparison of findings through a systematic approach. Despite toxicity cases, CAR-T therapy continues to stand out as the most innovative treatment within the field of oncology, and emerging strategies hold the promise of delivering safer therapies in future.
    Language English
    Publishing date 2024-01-08
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2023.1272291
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Point-of-Care Ultrasound (POCUS) in Adult Cardiac Arrest: Clinical Review.

    Magon, Federica / Longhitano, Yaroslava / Savioli, Gabriele / Piccioni, Andrea / Tesauro, Manfredi / Del Duca, Fabio / Napoletano, Gabriele / Volonnino, Gianpietro / Maiese, Aniello / La Russa, Raffaele / Di Paolo, Marco / Zanza, Christian

    Diagnostics (Basel, Switzerland)

    2024  Volume 14, Issue 4

    Abstract: Point-of-Care Ultrasound (POCUS) is a rapid and valuable diagnostic tool available in emergency and intensive care units. In the context of cardiac arrest, POCUS application can help assess cardiac activity, identify causes of arrest that could be ... ...

    Abstract Point-of-Care Ultrasound (POCUS) is a rapid and valuable diagnostic tool available in emergency and intensive care units. In the context of cardiac arrest, POCUS application can help assess cardiac activity, identify causes of arrest that could be reversible (such as pericardial effusion or pneumothorax), guide interventions like central line placement or pericardiocentesis, and provide real-time feedback on the effectiveness of resuscitation efforts, among other critical applications. Its use, in addition to cardiovascular life support maneuvers, is advocated by all resuscitation guidelines. The purpose of this narrative review is to summarize the key applications of POCUS in cardiac arrest, highlighting, among others, its prognostic, diagnostic, and forensic potential. We conducted an extensive literature review utilizing PubMed by employing key search terms regarding ultrasound and its use in cardiac arrest. Apart from its numerous advantages, its limitations and challenges such as the potential for interruption of chest compressions during image acquisition and operator proficiency should be considered as well and are discussed herein.
    Language English
    Publishing date 2024-02-16
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics14040434
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Insulin and Oral Hypoglycemic Drug Overdose in Post-Mortem Investigations: A Literature Review.

    Manetti, Alice Chiara / Visi, Giacomo / Spina, Federica / De Matteis, Alessandra / Del Duca, Fabio / Turillazzi, Emanuela / Maiese, Aniello

    Biomedicines

    2022  Volume 10, Issue 11

    Abstract: Background and Objectives: ...

    Abstract Background and Objectives:
    Language English
    Publishing date 2022-11-05
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2720867-9
    ISSN 2227-9059
    ISSN 2227-9059
    DOI 10.3390/biomedicines10112823
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: An Overview on Actual Knowledge About Immunohistochemical and Molecular Features of Vitality, Focusing on the Growing Evidence and Analysis to Distinguish Between Suicidal and Simulated Hanging.

    Maiese, Aniello / Del Duca, Fabio / Santoro, Paola / Pellegrini, Lavinia / De Matteis, Alessandra / La Russa, Raffaele / Frati, Paola / Fineschi, Vittorio

    Frontiers in medicine

    2022  Volume 8, Page(s) 793539

    Abstract: In forensic practice, the pathologist is often asked to determine whether a hanging was committed as suicide or as a simulated hanging (when a dead body is suspended after death). When exterior evidence of violence is absent and the crime scene ... ...

    Abstract In forensic practice, the pathologist is often asked to determine whether a hanging was committed as suicide or as a simulated hanging (when a dead body is suspended after death). When exterior evidence of violence is absent and the crime scene investigation fails to identify useful proof, it is nearly impossible to tell whether the dead body was suspended or not. As a result, determining whether the ligature mark was created during life or not should rely on the research and demonstration of vital reactions on the ligature mark. The main purpose of this review article is to provide a summary of current knowledge about the histological and immunohistochemical characteristics of vitality in hanging. The authors also aim to identify the most significant vitality markers on ligature marks for further scientific validation and to propose a standardized diagnostic protocol for hanging. The study was conducted according to the Preferred Reporting Items for Systematic Review (PRISMA) Protocol. Relevant scientific papers were found from PubMed up to April 2021, using the following keywords: hanging AND skin AND vitality. Three main points were studied: ligature mark dehydration, immunological response to mechanical injury, and apoptosis induction as a result of the previous points. An increase in apoptosis is evident in the ligature mark (due to physical and chemical processes involved), as demonstrated by FLICE-inhibitory protein (FLIP) depletion. Immunohistochemical detection of Aquaporin 3 (AQP3) and increase in the concentration of different electrolytes rely solely on ligature mark dehydration. Also, microRNAs (MiRNAs) could become reliable forensic biomarkers for ligature mark vitality diagnosis in the near future. To ensure high reliability in court cases, forensic investigation in hanging should rely on modern and proven markers, even a mix of several markers.
    Language English
    Publishing date 2022-01-14
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2021.793539
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: The Expression of FOXO3a as a Forensic Diagnostic Tool in Cases of Traumatic Brain Injury: An Immunohistochemical Study.

    Maiese, Aniello / Spina, Federica / Visi, Giacomo / Del Duca, Fabio / De Matteis, Alessandra / La Russa, Raffaele / Di Paolo, Marco / Frati, Paola / Fineschi, Vittorio

    International journal of molecular sciences

    2023  Volume 24, Issue 3

    Abstract: Traumatic brain injury (TBI) is one of the most well-known causes of neurological impairment and disability in the world. The Forkhead Box class O (FOXO) 3a is a transcription factor that is involved in different molecular processes, such as cell ... ...

    Abstract Traumatic brain injury (TBI) is one of the most well-known causes of neurological impairment and disability in the world. The Forkhead Box class O (FOXO) 3a is a transcription factor that is involved in different molecular processes, such as cell apoptosis regulation, neuroinflammation and the response to oxidative stress. This study is the first to evaluate the post-mortem immunohistochemical (IHC) positivity of FOXO3a expression in human cases of TBI deaths. The autopsy databases of the Legal Medicine and Forensic Institutes of the "Sapienza" University of Roma and the University of Pisa were retrospectively reviewed. After analyzing autopsy reports, 15 cases of TBI deaths were selected as the study group, while the other 15 cases were chosen among non-traumatic brain deaths as the control group. Decomposed bodies and those with initial signs of putrefaction were excluded. Routine histopathological studies were performed using hematoxylin-eosin (H&E) staining. Furthermore, an IHC investigation on cerebral samples was performed. To evaluate FOXO3a expression, anti-FOXO3a antibodies (GTX100277) were utilized. Concerning the IHC analysis, all 15 samples of TBI cases showed positivity for FOXO3a in the cerebral parenchyma. All control cerebral specimens showed FOXO3a negativity. In addition, the longer the survival time, the greater the positivity to the reaction with FOXO3a was. This study shows the important role of FOXO3a in neuronal autophagy and apoptosis regulation and suggests FOXO3a as a possible potential pharmacological target.
    MeSH term(s) Humans ; Forkhead Box Protein O3/metabolism ; Retrospective Studies ; Brain Injuries, Traumatic/diagnosis ; Gene Expression Regulation ; Autopsy ; Forkhead Transcription Factors/genetics
    Chemical Substances Forkhead Box Protein O3 ; Forkhead Transcription Factors
    Language English
    Publishing date 2023-01-30
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms24032584
    Database MEDical Literature Analysis and Retrieval System OnLINE

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