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  1. Article ; Online: A case of complex asphyxia sheds light on problems in the classification of asphyxias.

    D'Elia, Francesco / Simonit, Francesco / Desinan, Lorenzo

    Legal medicine (Tokyo, Japan)

    2023  Volume 66, Page(s) 102368

    Abstract: Death from positional asphyxia is often an accidental event occurring when the victim's body assumes a position which can compromise an effective respiration. Its diagnosis is usually not simple, because it needs to know the exact circumstance in which ... ...

    Abstract Death from positional asphyxia is often an accidental event occurring when the victim's body assumes a position which can compromise an effective respiration. Its diagnosis is usually not simple, because it needs to know the exact circumstance in which the body was found and the original positioning of all the body segments. In this case, a 41-year-old man with a history of opioid drugs abuse was found dead in a knee-chest position; the head was down on the floor with the face resting on a plastic bag. Pictures of the scene of death was taken while the body was still in its original position. At first, the main suspicion was that of a fatal overdose. Following the autopsy examination, completed by histological and toxicological examinations, the cause of death was determined as postural asphyxia secondary to intoxication by methadone, in the presence of ischemic heart disease. Some features, moreover, were typical of the death in head down position, and the prolonged knee-chest position was also associated with the obstruction of mouth and nose by the plastic bag, which may have contributed to the asphyxiation. These cases of "combined" asphyxia represent a challenge for the current classifications of asphyxia, which are very variable and not standardized, as we observe from a brief review of the literature. The elaboration of new systems of classification for asphyxias, which must be clear, simple and shareable, is necessary to avoid confusion in categorizing cases that present overlapping between several types of asphyxiation modalities.
    MeSH term(s) Male ; Humans ; Adult ; Asphyxia/etiology ; Asphyxia/pathology ; Autopsy
    Language English
    Publishing date 2023-11-26
    Publishing country Ireland
    Document type Review ; Case Reports ; Journal Article
    ZDB-ID 2019555-2
    ISSN 1873-4162 ; 1344-6223
    ISSN (online) 1873-4162
    ISSN 1344-6223
    DOI 10.1016/j.legalmed.2023.102368
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Burning temperature and bone modification: The cremation dynamics.

    Innocenti, Dario / Simonit, Francesco / Desinan, Lorenzo

    Legal medicine (Tokyo, Japan)

    2023  Volume 67, Page(s) 102376

    Abstract: Burning a body is one of the best-known methods to conceal a crime. The aim of this study is to identify thermal changes in bones burned at pre-set temperatures. 100 cadavers undergone cremation were analysed. Cremation temperatures ranged from 600 to ... ...

    Abstract Burning a body is one of the best-known methods to conceal a crime. The aim of this study is to identify thermal changes in bones burned at pre-set temperatures. 100 cadavers undergone cremation were analysed. Cremation temperatures ranged from 600 to 1200 °C, whereas cremation time was monitored. Morphological and colour changes of the bones, the development of fire-related fractures and surface were studied to analyse bone response to thermal alteration.
    MeSH term(s) Humans ; Temperature ; Cremation ; Bone and Bones ; Crime ; Fires
    Language English
    Publishing date 2023-12-22
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 2019555-2
    ISSN 1873-4162 ; 1344-6223
    ISSN (online) 1873-4162
    ISSN 1344-6223
    DOI 10.1016/j.legalmed.2023.102376
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Manner of death determination in a case of gastric mucosal tears.

    Perogio, Maurizio / Simonit, Francesco / Da Broi, Ugo / Desinan, Lorenzo

    Legal medicine (Tokyo, Japan)

    2023  Volume 66, Page(s) 102367

    Abstract: Gastric tears are rarely described in the forensic pathological literature, although they can lead to a fatal acute exsanguination. Such lesions can arise from several conditions leading to an increased intragastric pressure, such as Mallory Weiss ... ...

    Abstract Gastric tears are rarely described in the forensic pathological literature, although they can lead to a fatal acute exsanguination. Such lesions can arise from several conditions leading to an increased intragastric pressure, such as Mallory Weiss syndrome, cardiopulmonary resuscitation, acute barotrauma and operative procedures, showing peculiar morphological features. We present a case of a 32-year-old drug addicted white woman found dead in a pool of blood in the house of her drug dealer, after taking a dose of intravenous heroin. At autopsy, abundant bloody gastric content and multiple and long gastric tears, extending from the cardias and fundus regions to the gastric corpus were observed; one of them involved the subserous region, resulting in a gastric wall rupture. The victim had no history of recent vomiting and of gastro-intestinal pathologies. Drugs and ethanol levels detected in the specimens of the victim were not consistent with lethal concentrations, thus the death was attributed to acute exsanguination. After reviewing the literature, it turned out that morphological aspects of the gastric tears, such as number, size and topographical distribution, observed at autopsy were atypical compared to those of typical gastric lacerations.
    MeSH term(s) Humans ; Female ; Adult ; Exsanguination/pathology ; Stomach/pathology ; Mallory-Weiss Syndrome/pathology ; Autopsy ; Lacerations
    Language English
    Publishing date 2023-11-25
    Publishing country Ireland
    Document type Case Reports ; Journal Article
    ZDB-ID 2019555-2
    ISSN 1873-4162 ; 1344-6223
    ISSN (online) 1873-4162
    ISSN 1344-6223
    DOI 10.1016/j.legalmed.2023.102367
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Disease-knowledge-related suicide by cutting subclavian catheters in a woman undergoing haemodialysis: case report and review of the literature.

    Simonit, Francesco / Zamai, Valentina / Desinan, Lorenzo

    Legal medicine (Tokyo, Japan)

    2022  Volume 59, Page(s) 102141

    Abstract: Patients undergoing haemodialysis have a higher incidence of depression and a higher suicidal rate than general population. In this report we present the case of a 49-year-old woman with a history of chronic renal insufficiency and subclavian catheters ... ...

    Abstract Patients undergoing haemodialysis have a higher incidence of depression and a higher suicidal rate than general population. In this report we present the case of a 49-year-old woman with a history of chronic renal insufficiency and subclavian catheters for haemodialysis, who was suffering from depression and alcohol abuse. She was found unconscious on her bed by her father, with profuse bleeding from the cut ends of the two catheters. After ruling out air embolism, the cause of death was ascribed to acute haemorrhage, whereas the manner of death was consistent with a suicide. This paper highlights the easier access to some peculiar suicide methods that some subjects can have due to their knowledge about their pathological conditions and/or the treatments they undergo, otherwise not available in the general population. Because of this particular feature, such self-suppressions can be termed "disease-knowledge-related" or "medical-knowledge-related" suicide.
    MeSH term(s) Humans ; Female ; Middle Aged ; Renal Dialysis ; Suicide ; Incidence ; Catheters
    Language English
    Publishing date 2022-08-28
    Publishing country Ireland
    Document type Review ; Case Reports
    ZDB-ID 2019555-2
    ISSN 1873-4162 ; 1344-6223
    ISSN (online) 1873-4162
    ISSN 1344-6223
    DOI 10.1016/j.legalmed.2022.102141
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: A fatal and unusual genital mutilation in an elderly man as a result of sharp force injuries and domestic dog predation.

    Simonit, Francesco / Moreschi, Carlo / Desinan, Lorenzo

    Forensic science, medicine, and pathology

    2022  Volume 19, Issue 3, Page(s) 398–402

    Abstract: Cases of genital amputation require a careful investigation, since they may be the result of self-inflicted injuries, assaults, animal predation, or post-mortem body mutilation. In the present case, an 81-year-old man affected by liver cirrhosis and ... ...

    Abstract Cases of genital amputation require a careful investigation, since they may be the result of self-inflicted injuries, assaults, animal predation, or post-mortem body mutilation. In the present case, an 81-year-old man affected by liver cirrhosis and dementia and suffering from sexual disinhibition was found lying half-naked and unconscious in his courtyard; profuse bleeding in the perineal area and the absence of the external genitalia were observed. The victim was transferred to hospital and underwent surgical emergency treatment, but he died 2 days later. No sharp tools were found on the scene. Moreover, the autopsy did not reveal any defense or tentative wound on the body and no blood stains on the hands of the victim. Several linear scratches were detected close to the edges of the wound; according to the surgical report, these scratches were clean-cut in the lower part and crenated and infiltrated by blood in the cranial part. Although the medical history of the man could be consistent with self-mutilation, it was not possible to rule out the involvement of other people, including the possibility of an attempt by his relatives to cover up what may have been a self-amputation. Furthermore, the victim's dog vomited parts of the man's genitalia while being transported to a dog shelter. Similar cases have rarely been published in the current forensic literature.
    MeSH term(s) Male ; Humans ; Dogs ; Animals ; Aged ; Aged, 80 and over ; Predatory Behavior ; Autopsy ; Forensic Medicine ; Genitalia ; Hemorrhage
    Language English
    Publishing date 2022-10-14
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2195904-3
    ISSN 1556-2891 ; 1547-769X
    ISSN (online) 1556-2891
    ISSN 1547-769X
    DOI 10.1007/s12024-022-00542-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Medicolegal Implications of Deaths due to Agricultural Accidents.

    Da Broi, Ugo / Simonit, Francesco / Desinan, Lorenzo / Tse, Rexson / Garland, Jack / Ondruschka, Benjamin / Mann, Danny

    The American journal of forensic medicine and pathology

    2024  

    Abstract: Abstract: Agriculture encompasses a variety of activities that carry with them a variety of different risks. The unsafe use of vehicles, machinery, and tools as well as animal husbandry, working at heights, and exposure to chemical, biological, and ... ...

    Abstract Abstract: Agriculture encompasses a variety of activities that carry with them a variety of different risks. The unsafe use of vehicles, machinery, and tools as well as animal husbandry, working at heights, and exposure to chemical, biological, and weather events may result in the deaths of agricultural workers. Inexperienced operators and/or their inappropriate conduct may lead to avoidable fatalities. Forensic pathologists operating with the support of agricultural engineers or other professionals must evaluate the death scene, the case background and circumstances, the autopsy findings, and the toxicological data to establish the factors and dynamics responsible for such accidents and deaths.The aim of this review is to focus on the diagnostic approach required, by means of an interdisciplinary approach, to identify the cause of some typical agricultural fatalities, to confirm that death was accidental, and to help exclude the possibility of homicide or suicide.
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604537-6
    ISSN 1533-404X ; 0195-7910
    ISSN (online) 1533-404X
    ISSN 0195-7910
    DOI 10.1097/PAF.0000000000000909
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  7. Article ; Online: A charred body inside a burning car with a garden hose connected to the exhaust pipe: Post-mortem self-immolation, a complex or a complicated suicide after the ingestion of alcohol? The importance of an interdisciplinary approach.

    Simonit, Francesco / Da Broi, Ugo / Angeli, Federica / Innocenti, Dario / Desinan, Lorenzo

    Journal of forensic sciences

    2023  Volume 69, Issue 1, Page(s) 341–345

    Abstract: The analysis of charred bodies represents a serious challenge for forensic pathologists, and an interdisciplinary approach is often the only way to determine the cause and manner of death. We present an unusual case in which the charred body of a 61-year- ...

    Abstract The analysis of charred bodies represents a serious challenge for forensic pathologists, and an interdisciplinary approach is often the only way to determine the cause and manner of death. We present an unusual case in which the charred body of a 61-year-old man was found inside his burning vehicle. In order to determine cause and manner of death, an interdisciplinary team was employed, with experts in forensic pathology, forensic radiology, toxicology and fire investigations. Post-mortem computed tomography, autopsy and toxicology ruled out the presence of trauma injury and detected signs of vital exposure to fire and blood alcohol levels. On the other hand, according to fire investigations, the fire started inside the car and partially burned fragments of a garden hose were found along the right side of the car. A suicide could therefore be hypothesized, with the man having attempted to poison himself with the car's exhaust fumes and having set the car on fire. The death was consistent with a complicated suicide in which the victim, in a state of reduced capability, accidentally set his car on fire and was unable to escape. The hypothesis of a complex suicide, with the car having been set deliberately on fire, could not, however, be ruled out.
    MeSH term(s) Humans ; Middle Aged ; Gardens ; Automobiles ; Carbon Monoxide Poisoning ; Suicide ; Autopsy ; Vehicle Emissions ; Eating
    Chemical Substances Vehicle Emissions
    Language English
    Publishing date 2023-10-03
    Publishing country United States
    Document type Case Reports
    ZDB-ID 219216-0
    ISSN 1556-4029 ; 0022-1198
    ISSN (online) 1556-4029
    ISSN 0022-1198
    DOI 10.1111/1556-4029.15383
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  8. Article ; Online: Pitfalls in arrhythmogenic left ventricular cardiomyopathy (ALVC). A review of the literature with considerations on a single case of sudden death in a juvenile athlete.

    Simonit, Francesco / Muser, Daniele / Morocutti, Giorgio / Desinan, Lorenzo

    Journal of forensic and legal medicine

    2021  Volume 82, Page(s) 102208

    Abstract: Sudden cardiac death (SCD) in young athletes represents a challenging issue in forensic practice. The pathologist is frequently asked to establish the cause of death basing upon anatomical findings and to evaluate the role of the physician in ... ...

    Abstract Sudden cardiac death (SCD) in young athletes represents a challenging issue in forensic practice. The pathologist is frequently asked to establish the cause of death basing upon anatomical findings and to evaluate the role of the physician in preparticipation evaluation (PPE) and eligibility decision. Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a leading cause of SCD during sport activity. However, in the last few years, forms with predominant or even isolated involvement of the left ventricle (LV) have progressively been correlated with a high risk of SCD. We present a case of SCD in an apparently healthy 19-year-old semi-professional football player. Annual PPEs performed in accordance with international and Italian recommendations, were unremarkable. At autopsy, a 1-cm area of subepicardial fibro-fatty replacement was observed at the postero-lateral wall of the LV. The finding was diagnostic of arrhythmogenic left ventricular cardiomyopathy (ALVC). A review of this rare pathology has been performed under a forensic perspective, focusing on the evaluation of the medico-legal responsibility of the physician in the PPE and on the morphological aspects of the disease. Current diagnostic criteria and recommendations result to be focused on the right ventricular pattern, with a risk of misdiagnosis for isolated LV forms. Furthermore, few detailed autopsies cases concerning ALVC have been published. There is a need, therefore, to study this rare disease with a careful and revised approach.
    MeSH term(s) Arrhythmogenic Right Ventricular Dysplasia/diagnosis ; Athletes ; Cardiomyopathies/complications ; Death, Sudden, Cardiac/etiology ; Diagnosis, Differential ; Forensic Pathology ; Humans ; Italy/epidemiology ; Male ; Ventricular Dysfunction, Left/physiopathology ; Young Adult
    Language English
    Publishing date 2021-06-29
    Publishing country England
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 2268721-X
    ISSN 1878-7487 ; 1752-928X
    ISSN (online) 1878-7487
    ISSN 1752-928X
    DOI 10.1016/j.jflm.2021.102208
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Filamin C (FLNC) truncating mutation in a fatal arrhythmogenic left ventricular cardiomyopathy (ALVC).

    Simonit, Francesco / Da Broi, Ugo / D'Elia, Angela Valentina / Fabbro, Dora / Mio, Catia / Bussani, Rossana / Pinamonti, Maurizio / Desinan, Lorenzo

    Legal medicine (Tokyo, Japan)

    2024  Volume 69, Page(s) 102438

    Abstract: Forensic pathologists are frequently asked to investigate cases of sudden death (SD), and identifying the cause of death can be of particular importance, especially where it may be necessary to perform family screening among the relatives of the victim. ... ...

    Abstract Forensic pathologists are frequently asked to investigate cases of sudden death (SD), and identifying the cause of death can be of particular importance, especially where it may be necessary to perform family screening among the relatives of the victim. A multidisciplinary approach inclusive of genetic analysis is therefore strongly recommended. According to forensic practice, arrhythmogenic cardiomyopathy (ACM) is a well-known cause of SD. However, cases of SD caused by a left ventricular pattern of ACM diagnosed at autopsy are rarely reported in the literature. We present the case of an apparently healthy, 37-year-old male found dead at his home. At autopsy, multiple foci of epicardial and mid-wall fibrous and fibro-adipose tissue were observed within the left ventricle and, to a lesser extent, within the interventricular septum. Toxicology was negative, whereas a filamin C truncating mutation was detected through genetic analysis. To our knowledge, this is the first instance of arrhythmogenic left ventricular cardiomyopathy being diagnosed at autopsy.
    Language English
    Publishing date 2024-03-26
    Publishing country Ireland
    Document type Case Reports
    ZDB-ID 2019555-2
    ISSN 1873-4162 ; 1344-6223
    ISSN (online) 1873-4162
    ISSN 1344-6223
    DOI 10.1016/j.legalmed.2024.102438
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: A bizarre case of fatal main renal artery partial laceration without primary kidney injury due to a single stab wound in the chest.

    Simonit, Francesco / Marcuzzi, Gabriella / Desinan, Lorenzo

    Legal medicine (Tokyo, Japan)

    2021  Volume 51, Page(s) 101892

    Abstract: Reno-vascular injuries are a rare type of renal injury, and their second most frequent cause is penetrating wounds. The majority of the reports and of the studies are present in the urological and radiological literature and they focus on the clinical ... ...

    Abstract Reno-vascular injuries are a rare type of renal injury, and their second most frequent cause is penetrating wounds. The majority of the reports and of the studies are present in the urological and radiological literature and they focus on the clinical approach to such injuries. In the case here presented, an 18-year-old male died after being stabbed in the left hemithorax. During body examination, thoracic organs were found to be unremarkable (except for a small peripheral laceration of the left lung), but the diaphragm was transfixed and the upper wall of the left main renal artery was lacerated. The adjacent renal vein, the kidney, the aorta, the vena cava and the surrounding internal structures were not damaged (except for a small laceration of the pancreatic tail). A massive haemothorax and a large retroperitoneal haematoma in the left kidney area were observed. The cause of death was attributed to haemorrhagic shock following a partial laceration of the left main renal artery due to the stab wound to the chest. No other cases of similar fatal renovascular injuries due to stab wounds have been published in the current forensic literature.
    MeSH term(s) Adolescent ; Humans ; Kidney ; Lacerations/etiology ; Male ; Renal Artery ; Thoracic Injuries/complications ; Wounds, Stab/complications
    Language English
    Publishing date 2021-04-20
    Publishing country Ireland
    Document type Case Reports ; Journal Article
    ZDB-ID 2019555-2
    ISSN 1873-4162 ; 1344-6223
    ISSN (online) 1873-4162
    ISSN 1344-6223
    DOI 10.1016/j.legalmed.2021.101892
    Database MEDical Literature Analysis and Retrieval System OnLINE

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