RESUMEN
Medicolegal evaluation of postmortem findings at the death scene represents an important part of forensic medicine. The aim of this study was to investigate the occurrence and characteristics of suicide events. Data collection was performed from the police scene investigation reports in capital Budapest between 2009 and 2011. In this study, epidemiological parameters such as age, gender, time and place of death, postmortem changes, suicidal method, seasonal and daily distribution, natural diseases, earlier psychiatric treatment, socioeconomic risks, supposed cause of death, final notes, earlier suicide attempts, and suicide ideations were analyzed. There were 892 suicide cases (619 males, 273 females) detected in the investigated period. Hanging, overdose of prescription medications, jumping, use of firearms, drowning, and electrotrauma showed statistical differences among genders (p<0.05). The most common methods of suicide among men and women were hanging (57.4%) and overdose of prescription medications (33%), respectively. Death scene characteristics represent the important factors for forensic medicine.
Asunto(s)
Suicidio/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Asfixia/mortalidad , Ahogamiento/mortalidad , Sobredosis de Droga/mortalidad , Traumatismos por Electricidad/mortalidad , Femenino , Humanos , Hungría/epidemiología , Masculino , Persona de Mediana Edad , Traumatismos del Cuello/mortalidad , Distribución por Sexo , Heridas por Arma de Fuego/mortalidad , Heridas Punzantes/mortalidad , Adulto JovenRESUMEN
The mechanisms leading to death from anaphylaxis after insect sting involve antigen cross-linkage of antibody molecules that activate immunoglobulin receptors on inflammatory cells. The aim of our study was to investigate the pathomorphology and the expression of C5aR in fatal anaphylaxis in a patient after a fatal insect sting. A 38-year-old women was stung by a honeybee. C5R1 expression was detected in many dilated capillaries in the lungs. Pulmonary epithelial cells did not bind the monoclonal antibody for C5R1; however, intensive cytoplasmic staining was detected in endothelial cells. The findings of this case provide evidence for an active role of complement in fatal anaphylaxis elicited by bee venom. C5aR detection could be useful in the identification of sudden death cases because of unwitnessed fatal insect sting cases. Authors can recommend this immunohistochemical analysis on all sudden unexpected deaths outdoors where a possible bee sting might occur.
Asunto(s)
Anafilaxia/inmunología , Abejas/inmunología , Mordeduras y Picaduras de Insectos/inmunología , Receptores de Complemento/metabolismo , Adulto , Animales , Capilares/metabolismo , Capilares/patología , Dilatación Patológica/patología , Células Endoteliales/metabolismo , Femenino , Patologia Forense , Humanos , Inmunohistoquímica , Mucosa Laríngea/patología , Pulmón/irrigación sanguínea , Pulmón/metabolismo , Mastocitos/patología , Receptor de Anafilatoxina C5aRESUMEN
Propofol is a short acting intravenous anaesthetic, active agent of Diprivan. The abuse potential of propofol has not completely defined, but there are anecdotal case reports in the literature about propofol abuse and dependency. This report presents a fatal case of a middle age female victim who died of self-administered propofol intoxication. The propofol level of the blood sample was measured with gas chromatography-mass spectrometry after liquid-liquid extraction. The results of toxicological investigation suggested that death was not directly caused by propofol intoxication, however, based on the pathomorphological changes detected during the medico-legal autopsy we supposed that the fatal outcome was resulted by respiratory depression after rapid injection.
Asunto(s)
Hipnóticos y Sedantes/efectos adversos , Propofol/efectos adversos , Insuficiencia Respiratoria/inducido químicamente , Accidentes , Sobredosis de Droga , Femenino , Toxicología Forense , Cromatografía de Gases y Espectrometría de Masas , Humanos , Hipnóticos y Sedantes/administración & dosificación , Hipnóticos y Sedantes/sangre , Inyecciones , Persona de Mediana Edad , Propofol/administración & dosificación , Propofol/sangre , Autoadministración , Trastornos Relacionados con Sustancias/complicacionesRESUMEN
Hanging is one of the most frequent methods for suicides among young males. This report presents two cases of suicide by hanging on pylons carrying high-voltage power lines. The male victims suffered electrocution while committing suicide. Electrocution was the cause of death in both cases, however in one case blunt force injuries from hanging contributed to death. In these two cases hanging was the intentional method of suicide and it was followed by electrocution. The cases demonstrate that scene investigation, a detailed autopsy with histology, and amamnestic data are essential in the evaluation of suicides by hanging and that the determination of the cause of death remains a challenge in investigating such cases.
Asunto(s)
Asfixia/patología , Traumatismos por Electricidad/patología , Traumatismos del Cuello/patología , Suicidio , Adulto , Asfixia/etiología , Traumatismos por Electricidad/etiología , Patologia Forense , Humanos , Masculino , Púrpura/patología , Piel/lesiones , Piel/patología , Adulto JovenRESUMEN
Complete or incomplete decapitation is an unusual complication of suicidal hanging. We present a case of incomplete decapitation due to hanging with soft tissue injuries, spinal cord dissection between C2 and C3, fracture of the hyoid bone and injuries of cartilages. The 52-year-old male victim with a 95kg body mass used a 1.5cm thick and 3.1m long nylon rope snap-hooked to a rafter. The comprehensive literature review of incomplete or complete decapitation by suicidal hanging emphasises the importance of investigation of biomechanical process. In the presented case we calculated the physical parameters (final speed: 7.8m/s, kinetic energy: 2945J, force: 9500N). The previous observations were confirmed that body weight and falling distance were the most important factors in the pathomechanism of decapitation. In the hanging process energy can be stored by changing the position of the human body in the gravitational field, by changing the shape of the hanging rope and by changing the motion of the hanging body. We concluded that the occurrence of complete or incomplete decapitation can increase by the increasing energy stored as potential energy at the starting position and the characteristics of the rope extended by the hanging body.
Asunto(s)
Asfixia/patología , Decapitación/patología , Suicidio , Vértebras Cervicales/lesiones , Vértebras Cervicales/patología , Epiglotis/lesiones , Epiglotis/patología , Humanos , Hueso Hioides/lesiones , Hueso Hioides/patología , Disco Intervertebral/lesiones , Disco Intervertebral/patología , Masculino , Persona de Mediana Edad , Traumatismos de los Tejidos Blandos/patología , Cartílago Tiroides/lesiones , Cartílago Tiroides/patologíaRESUMEN
We have firstly presented a case using post mortem corrosive method in forensic medical practice after coronary stent implantation. Occlusions, fate of side branches could be detected during the clinical diagnostic angiography, intravascular ultrasound, computed tomography; however, the forensic medical determination of cause of death, identification of complications needs a careful post-mortem investigation. The injection-corrosive method seems to be a useful assistance in the characterisation of pathomorphological changes after stent implantation. Besides the classical techniques of histology, immunohistochemistry, electron microscopic investigation we have introduced a new synthetic resin corrosion cast method. This three-dimensional corrosion cast preparation may provide new data about the actual morphological condition of the coronary vessels and a better understanding of the pathomechanisms of sudden cardiac death after percutaneous coronary intervention.