Preliminary Metabolomic Profiling of the Vitreous Humor from Hypothermia Fatalities.

The postmortem diagnosis of hypothermia fatalities is often complex due to the absence of pathognomonic lesions and biomarkers. In this study, potential novel biomarkers of hypothermia fatalities were searched in the vitreous humor of known cases of hypothermia fatalities ( = 20) compared to control cases ( = 16), using a targeted metabolomics approach allowing quantitative detection of 188 metabolites. A robust discriminant model with good predictivity was obtained with the supervised OPLS-DA multivariate analysis, showing a distinct separation between the hypothermia and control groups.

Age estimation based on the acetabulum using global illumination rendering with computed tomography.

Introduction: The acetabulum has been reported as a reliable age estimation marker. However, analyzing its morphological changes can be challenging using computed tomography (CT) imaging. Newly introduced global illumination rendering (GIR) applied to CT can improve the visualization of the fine details and thus the method's performance.

A fatal case after an intravenous injection of levamisole.

Levamisole is a drug originally prescribed as an antihelmintic. Because of the occurrence of severe cases of agranulocytosis and leukoencephalitis it was removed from the French market in 1998 for human use, while it remains available for veterinary use. Nowadays in France its only use in humans is regulated by authorization for temporary use for its immunomodulatory properties in the treatment of nephritic syndrome.

Pitfalls of toxicological investigations in hair, bones, and nails in extensively decomposed bodies: illustration with two cases.

It is difficult to carry out toxicological investigations in biological samples collected from extensively decomposed bodies and to interpret obtained results as several pitfalls should be considered: redistribution phenomena, degradation of xenobiotics during the postmortem period, contamination by putrefaction fluids, and external contamination. This work aims to present two cases in order to illustrate and discuss these difficulties in this tricky situation. Case#1: the body of a 30-year-old woman was found in a wooded area (1 month after she has been reported missing by her family): hair and a femur section were sampled.

[Thanatobiochemistry: its contribution to the diagnosis of hypothermia fatalities].

Hypothermia is a potentially lethal pathology whose in vivo diagnosis is relatively easy, based on the observation of a body temperature below 35̊C. However, its post mortem diagnosis is much more complex because of a thermal decrease occurring systematically after the death, which renders most often uninterpretable the body temperature as a diagnostic argument for hypothermia. Moreover, none of the macroscopic or microscopic autopsy elements described as suspicious of hypothermia are pathognomonic of a hypothermic death.

A serum metabolomics signature of hypothermia fatalities involving arginase activity, tryptophan content, and phosphatidylcholine saturation.

Introduction: Hypothermia is a potentially lethal condition whose postmortem diagnosis is often complex to perform due to the absence of pathognomonic lesions and biomarkers. Our first study of human serum and urinary metabolome in hypothermia fatalities sought novel biomarkers with better diagnostic performances than those already existing.

Material And Method: Thirty-two cases of hypothermia deaths and 16 cases excluding known antemortem exposure to cold or postmortem elements suggesting hypothermia were selected.

Updated review of postmortem biochemical exploration of hypothermia with a presentation of standard strategy of sampling and analyses.

Hypothermia is defined as a core body temperature below 35°C and can be caused by environmental exposure, drug intoxication, metabolic or nervous system dysfunction. This lethal pathology with medico-legal implications is complex to diagnose because macroscopic and microscopic lesions observed at the autopsy and the histological analysis are suggestive but not pathognomonic. Postmortem biochemical explorations have been progressively developed through the study of several biomarkers to improve the diagnosis decision cluster.

[The law of March 5, 2007 and the care of persons placed under guardianship].

The care of persons placed under guardianship has changed considerably since the law of March 5, 2007, as greater autonomy is granted to them. By advocating greater autonomy of protected adults, the French Civil Code is in opposition with the French Public Health Code since the latter states that the systematic consent of the guardian is required in addition to that of the protected adult for so-called general care. In cases of serious injury to bodily integrity, the guardianship judge's opinion must be sought by the guardian.

Twenty-five years of French jurisprudence in criminal medical liability.

We report on a comprehensive 25-year study on criminal medical liability in France, undertaken to establish trends in the number of cases being brought before the criminal courts. We did this by interrogating the database on the Légifrance website using a Boolean equation (' pénal' (criminal) AND ' médecin' (physician) OR ' docteur' (doctor)). In total 539 cases were selected, in which the status of the physician either influenced the punishment imposed, or was a prerequisite for the commission of the offence.

Left Diaphragm Laceration Due to Cardiopulmonary Resuscitation.

External cardiac massage is the essential life-saving gesture for the management of any cardiac arrest. Since the 1960s, many recommendations have been published to improve the effectiveness of chest compressions alongside the development of automated systems intended to maximize the chances of survival. The use of these manual and/or instrumental techniques can cause secondary injuries, of which rib fractures are the most commonly observed by forensic pathologists.

Specific Characteristics of Injuries Inflicted by Claw Hammer.

Claw hammers have the specific characteristic of having two distinct ends: one a flat head of variable form, the other bifurcated. So the use of this tool as a blunt instrument will cause varying injuries. The authors present two clinical cases of assault with a claw hammer.

Organ Procurement in Forensic Deaths: Specific Features of Nonheart-Beating Donors.

The need for organs has increased in the recent years, and this shortage will only worsen. In addition to the organs procured from brain-dead donors, a procedure for non-heart-beating donors was therefore developed. When deaths involve legal proceedings, the medical examiner makes the decision of whether or not to remove organs.

Anal lesions presenting in a cohort of child gastroenterological examinations. Implications for sexual traumatic injuries.

The purpose of this study was to describe the anal lesions found in children during a pediatric gastroenterology consultation when the reason for the complaint was related to a digestive disease. This prospective descriptive study included 100 children under 15 years of age over a 13-month period, consulting due to digestive symptoms. The children were under 8 years old (90%) and 25% were under 3.

The contribution of Micro-CT to the evaluation of trabecular bone at the posterior part of the auricular surface in men.

Aim: Using multi-slice computed tomography (MSCT), Barrier et al. described the disappearance at the posterior auricular surface of a "central line" (CL) and "juxtalinear cells" (JLCs) belonging to a trabecular bundle, and a trabecular density gradient around the CL that decreased with age. The aim of our study was to use micro-CT to test these findings, referring to the concept of Ascadi and Nemeskeri.

Abdominal stab wounds: self-inflicted wounds versus assault wounds.

Intentional penetrating wounds, self inflicted or inflicted by others, are increasingly common. As a result, it can be difficult for the forensic examiner to determine whether the cause is self-inflicted or not. This type of trauma has been studied from a psychological perspective and from a surgical perspective but the literature concerning the forensic perspective is poorer.

Sudden death due to black esophagus: a case report.

Black esophagus, also known as acute esophageal necrosis syndrome, is a rare but often fatal pathology. It can be identified during autopsy examination and should be diagnosed by the forensic examiner via simple macroscopic examination. We report the case of an elderly man who was found dead, presenting with this pathology.

[Evaluating the functional impairment of assault survivors in a judicial context: frequency of aggravating factors according to the French Penal Code and evidence for heterogeneous medical practice].

Objectives: In cases of assault and battery, the French Penal Code considers some aggravating factors. No data are available on the frequency of aggravating factors. Our main objective was to determine this frequency.

Organ donation in France: legislation, epidemiology and ethical comments.

The Bioethics Laws revised in 2004 have defined rules concerning organ donation and transplantation. They have also permitted the creation of the French Biomedicine Agency which guarantees the right of enforcement. In France there are three situations in which organs may be harvested: from cadaveric donors, from living donors and, since 2005, from non heart beating donors.

Development of a method to estimate skeletal age at death in adults using the acetabulum and the auricular surface on a Portuguese population.

Aging techniques that use the posterior or middle part of the pelvis are of interest because this part of the body is very resistant to decay. In a preliminary study, acetabular criteria correlated with age were isolated. In a second study, three acetabular criteria and four auricular surface criteria were described and it was demonstrated that it is of interest to associate these criteria.

Age at death estimation of adult males using coxal bone and CT scan: a preliminary study.

Introduction: Age at death estimation is of major importance for the forensic scientist. Currently, various methods have used macroscopic osseous criteria for articular surfaces. Particularly in the pelvis, articular surfaces are used to classify bone evolution and age.

[Recovery of transportable organs after cardiac arrest].

The transplant of an allograft after cardiac arrest has been allowed in France since 2005 (decree of 2 august 2005: art R.1232-4-1, 2 and 3 of the public health code). Recently, according to the international scale, 4 situations that could lead to the realization of transplantable organs after cardiac arrest were identified according to a classification called "Maastricht" which describes the potential donors.

Practitioner sex abuse: occurrence, prevention and disciplinary sanction.

Studies put forward figures for male practitioner sex abuse of around ten per cent. This practice, which is contrary to medical ethics, is highly reprehensible in ethical terms. The assaults range from uninvited meddling in patients' sexual lives to proven rape and inappropriate touching.

Contribution of the study of acetabulum for the estimation of adult subjects.

Introduction: The study of the posterior part of the pelvis is of interest in forensic anthropology since it is an anatomical region that is very often preserved. The Lovejoy technique, using the auricular surface has brought about many studies and attracted many authors, among them Buckberry and Chamberlain utilized the criteria described by Lovejoy and developed new methods. By using this research as a starting point, we have described acetabular criteria.