An Analysis of the Characteristics of Thoracic and Abdominal Injuries Due to Gunshot Homicides in Israel.

De-identified wound data from 197 homicidal gunshot postmortems were obtained between 2000 and 2008. Forensic ballistics data were only available for cases between 2004 and 2008. Males represent 91% of gunshot victims and were struck in the thorax/abdomen with an average of 2.

[Identification of unknown cadavers--multidisciplinary approach].

The comparison of fingerprints, dentition, genetic profile, imaging data and anthropological characteristics constitute the scientific basis for identification of unknown cadavers. The complexity of the identification process stems from a variety of factors such as the circumstances surrounding the death, the preservation state of the cadaver, availability of identification data and their quality, which affect the feasibility of the identification. This article reviews the most common identification techniques, the various sources of data accessible to the forensic scientist and the strategic decisions through which the unidentified body and the missing person are integrated.

[Combination of imaging studies and autopsy in death investigations].

The progress in quality and availability of imaging studies has made them an invaluable part of the clinical diagnostic process, so much so that the forensic medical community had to acknowledge their importance and to implement them in death investigations. Since 2011 roughly 200 post-mortem radiographic examinations were conducted, mostly followed by full autopsies. Four of those cases are given as an example of the benefits and limitations of these methods.

[Detection of wooden rod in pleural and peritoneal cavities during forensic autopsy].

Introduction: A rare event of fatal sexual assault by the insertion of a wooden rod through the anus to the upper chest is reported. Examination of the body at the scene did not raise any suspicion of assault while the subsequent autopsy revealed findings that changed the assessment of the cause of death and the circumstances.

Case History: The body of a 57 years old man with a history of psychiatric illness was found in his room.

[Sudden death due to eosinophilic arteritis of a major coronary artery].

Coronary arteritis is the fourth most common cause of fatal cardiac disease, after coronary atheroscLerosis, congenital anomalies and coronary dissection. Eosinophilic inflammation of the coronary arteries is extremely rare, involves the major coronaries and occurs as an isolated disease or as part of Churg-Strauss syndrome or Wegener's granulomatosis with involvement of other internal organs. A case of sudden and unexpected death of a healthy young woman is presented.

[The prevalence of physical evidence in the anogenital area in sexual assault cases of children in Israel].

Introduction: Sexual abuse includes obscenity, rape and sodomy. Forensic medical examinations routinely include the genital area, anus and the body of the victims for signs of recent or old injury.

Objectives: To evaluate the incidence of physical evidence in forensic sexual abuse cases and to compare the Israeli findings to data from other countries, including the USA.

[Death due to hypothermia and paradoxical undressing].

Hypothermia is a rare cause of death in Israel, and usually occurs among risk groups such as elderly people, homeless persons, psychiatric patients and persons who function in cold environments or are unintentionally exposed to such conditions. Death due to hypothermia generally occurs in extremely cold conditions, although ambient temperatures of 15-20 degrees C can also be lethal. The phenomenon of paradoxical undressing that characterizes death due to hypothermia rather occurs in moderate ambient temperatures, and takes place when the victim is in extremis.

Atlas occipitalization in a supersonic fighter pilot involved in a midair collision: a case report.

We report a case of a midair collision between two F16 fighter aircraft, in which one pilot survived and the other was ejected upon impact and his remains recovered from sea. In autopsy, no patholgy was detected, other than the expected evidence of mechanical trauma. No defects in the aircraft or faults in the parachute or ejection mechanism were found.

Infantile asphyxia due to aberrant uvula--an anatomic misadventure.

A case of unexpected death of an infant with an abnormally elongated uvula is presented. The child, born prematurely, was recovering from protracted treatment in hospital, including surgical interventions and periods of ventilation support necessitating recurrent intubations and anesthesia. She was discharged home in good general health, affected by episodes of cough, and was found dead in her crib a week later.

The elusive slug: bullet intestinal "embolism".

Bullet retrieval from the body of a gunshot victim is one of many tasks in post-mortem forensic examination. Rarely, it is complicated by the migration of the missile away from the entry point by vessel embolism. Abdominal firearm injuries, in which the bullet enters the intestines and moves inside the lumen away from the point of penetration, are even less common.

Sudden cardiac death of a woman during extramarital sex: a case report and review of the literature.

Sudden death of cardiac patients related to sexual activity has been widely reported in the medical and forensic literature, specifically of male partners in heterosexual relationships, usually with extramarital partners. We present a unique case of a 46 year old woman who died during a sexual encounter with her lover. Cause of death was an acute cardiac failure due to hypertensive chronic cardiovascular disease, following sexual activity.

Accidental fetal decapitation: a case of medical and ethical mishap.

Blunt trauma to the head and neck of a newborn during delivery process is a rare event. We report a peculiar case of decapitation of a live fetus during vacuum-assisted delivery, where excessive traction on the head of the full-term macrosomic fetus with shoulder dystocia resulted in overstretching of the neck up to the point of decapitation. The ethical considerations related to the case are discussed in light of the policy of complete transparency advocated by the medical profession.

Alcohol and driver fatalities in Israel: an examination of the current problem.

Background: The role of alcohol in driver fatalities in Israel is unknown, and monitoring blood alcohol concentration among drivers is not routine. Moreover, over the past decade, self-reported access to and consumption of alcohol in Israel has been on the rise.

Objectives: To use available data to characterize alcohol-related driver fatalities.

["Scared to death"--lethal cardiac arrhythmia caused by emotional stress].

Background: The cause of death in cases of sudden and unexpected death is determined by the forensic pathologist based on autopsy findings and toxicological analysis. In cases where no acute pathology or lethal injury are detected, and the circumstances surrounding the death were highly stressful or emotional, it is possible to attribute the inciting event as contributory to the death by causing cardiac dysrhythmia.

Method: Ten cases of sudden death related to stressful events were examined over a period of 2 years in the National Center of Forensic Pathology, all of which lacked findings of acute disease or serious injury.

[Gunshot wounds to the head--common errors of clinicians in diagnosing direction and range of fire].

Background: Evaluating direction and range of fire based on gunshot wound characteristics requires theoretical and/or practical training in terminal ballistics. Clinicians specializing in trauma, surgery and neurosurgery are sometimes called upon to assess direction of fire without prior knowledge or experience in the field. Descriptions of gunshot wounds and determination of bullet direction are documented in medical records.

Cardiac perforation by a pectus bar after surgical correction of pectus excavatum: case report and review of the literature.

Pectus excavatum (PE) is a congenital sternal depression. The two most popular methods of correction are the highly modified Ravitch repair (HMRR) and the Nuss procedure. Presented here is a case of PE surgical correction in a 17.

Self-inflicted gunshot wound mimicking assault: a rare variant of factitious disorder.

This paper presents the case of 52-year-old man who died in an attempt to prove factitious allegations of persecution. To the best of our knowledge, there are no other reported cases of a self-inflicted, long-distance gunshot injury causing death. We discuss other cases of crime-scene "staging" and review the literature on factitious disorders and malingering in our search for motive, and stress again the importance of crime scene analysis and investigation of circumstances in determining the manner of death.

The forensic expert witness--an issue of competency.

Scientists submitting expert opinions within the legal system are expected to be knowledgeable in the forensic aspects of their particular science, as well as to be ethical and unbiased. Scientists are seldom able to decline a request to provide an expert opinion in their field, even when their forensic expertise is minimal. The competence of scientists providing expert opinions in forensic cases is reviewed here.

Influence of personal armor on distribution of entry wounds: lessons learned from urban-setting warfare fatalities.

Background: This study was undertaken to examine the distribution of entry wounds resulting from firearms and shrapnel in soldiers wearing military personal armor systems (MPAS) in low-intensity urban combat conditions.

Methods: Data were collected for a retrospective analysis on all combat fatalities sustained by the Israeli Defense Force (IDF) between March 30, 2002, and April 22, 2002, during Defensive Shield Operation in the West Bank. Twenty-six of the 30 fatalities were evaluated in the Israeli National Center of Forensic Medicine.

Souvenir knife: a retained transcranial knife blade.

Upon necroscopic examination of a homeless male found comatose in the street and pronounced dead at a medical center 12 hours later, a sharp tip of a knife lodged in the right parietal region of his skull was incidentally discovered. The blade transected the diploe and penetrated the cerebral cortex. Subsequent police investigation revealed that this was the remnant of a stabbing attempt on his life several months prior to his death.