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ABSTRACT: Reanimation procedures may cause changes of autopsy findings. Disregarding this condition may result in erroneous determination of the cause of death. The paper presents a case of a woman, age 77, complaining of general weakness who reported to the outpatient department. Paroxysmal tachycardia was diagnosed on EKG. The patient was referred to the internal ward. The transfer to the hospital was offered by the neighbour who had brought her to the outpatient department. In front of the department the patient fainted. Reanimation was performed by 5 persons, including non-medical staff. The patient's death was pronounced within an hour. The autopsy findings included numerous injuries within the thorax and the abdomen, which aroused suspicion about their origin during reanimation and about the cause of death. Detailed analysis of medical history, witness testimonies and histological findings, taking into account the knowledge about potential changes caused by reanimation procedures enabled correct assessment of injuries within the thorax and the abdomen.
Annales Academiae Medicae Stetinensis 01/2007; 53 Suppl 2:46-9; discussion 49.
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ABSTRACT: The authors carried out the analysis of autopsy reports of road accident victims, aging between 0-18, exposed to the post mortal studies made in the above mentioned department between 1997-2006.
The number of victims, aging between 0-18 amounts to 2.97% of all autopsies carried out in this period. Among the analysed 84 victims were male, while 41 female. The victims have been divided into age groups: 0-6, 7-10, 11-15 and 16-18. The largest number appeared in the age range 15-18 (78; 47 males and 31 females), the smallest number in the age range 0-6 (15; 10 males and 5 females) and the age range 7-10 (15; 12 males and 3 females). In the age groups 0-6 and 7-10 pedestrians prevail as victims, while 11-15 car passengers are in majority and the same percentage refers to cyclists. Group 16-18 is predominantly dominated by private car drivers and their passengers.
In all age groups the direct causes of death were mainly head injuries, the most frequent among pedestrians, cyclists, two wheeled engine vehicle passengers, drivers and private car passengers as well as other victims of not exactly defined road accidents. The most alarming is the high percentage of road users under the influence of alcohol in the range 16-18 amounting to 21.8 % (27.7% of males and 12.9% of females respectively).
Annales Academiae Medicae Stetinensis 01/2007; 53 Suppl 2:50-4; discussion 54.
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ABSTRACT: PURPOSE: The object of analysis were suicide cases autopsied in the department in 2004-2006. MATERIAL AND METHODS: Of the 1331 autopsies, 126 were undertaken in suicide victims. This number constituted 9.47% of the total number of autopsies, of those 87.3% were males and 12.7% females. The highest percent rate of suicide was observed among males in the ages of 19-25 year old, among females 19-25 and 31-45. The greatest number of inebriated males was found in ages of 19-25 and 36-40 years old, whereas for females the corresponding age group was 31-35 years. Among the places of suicide predominance of public places was noted. The most common method of committing suicide was by hanging.
Annales Academiae Medicae Stetinensis 01/2007; 53 Suppl 2:55-9.
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ABSTRACT: Finding more than one body in the place of residence brings suspicion of poisoning or action of a third party. The authors present a case of two bodies--a handicapped mother and her son--found in their own house. The son was last seen by their neighbours three days before the bodies were revealed. There was a stove in the house which was cold with no signs of penetration. No indication of a third party action was found on the corpses. The autopsy on the son revealed a heart attack with subsequent rupture and tamponade which resulted in death. The cause of the mother's death was assumed to be total starvation of the handicapped person deprived of care. In the presented case autopsy findings contributed to the assessment of the factual cause and sequence of the deaths.
Annales Academiae Medicae Stetinensis 01/2007; 53 Suppl 2:65-6; discussion 66.
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ABSTRACT: The authors presented an analysis of homicides based on autopsy material collected at the Institute of Forensic Medicine Medical University of Białystok in the years 2004-2006. Of 1331 postmortem examinations, this type of death accounted for 4.28% of cases, including 19,3% women and 80.7% men. Married persons predominated among females and men. 63.1% of victims died on the crime scene, 29.8% within 24 hours. In immediate conflicts, fights and robberies, the perpetrators most commonly employed hard, blunt or blunt-edged crime weapons. In cases of murder with sexual and robbery homicides the strangulation method was used. No seasonal character in homicide prevalence was observed.
Annales Academiae Medicae Stetinensis 01/2007; 53 Suppl 2:67-70; discussion 70.
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ABSTRACT: INTRODUCTION, MATERIAL AND METHODS: The objective of the paper was a comparative analysis of traffic accident fatalities in autopsy material collected in the years 1970-1986 and 1987-2006 at the Department of Forensic Medicine, Medical University of Białystok (624 and 1463 cases, respectively). Based on autopsy reports, main criteria included gender, site of death (urban area, rural area, non-built-up), mode of movement (driver, passenger, pedestrian, biker and cyclist), age, localisation of fatal injuries (head, thorax, abdomen and pelvis, upper and lower limbs, multiorgan injuries) and blood alcohol level. The collected data were analysed statistically according to the criteria applied and presented as text and graphs. RESULTS AND CONCLUSIONS: The number of traffic accidents increased by 4% in the years 1987-2006 when compared to period of 1970-1986. The percentage male mortality increased 72-77%. Pedestrians predominated as traffic accident fatalities in Podlasie, with mortality rate slowly decreasing 47-42%. In the years 1987-2006 mortality rate among drivers and bikers/motorbikes increased by 7% and decreased by 3%, respectively. Number of fatalities among passengers remained on constant level. Regardless of time period fatal cases were predominant in non-built-up area. Localisation of fatal injuries in respective groups appears invariable excluding pedestrian cases, where multiorgan rather, than head and neck injuries prevail. Mean age of traffic accident fatalities decreased by 3 years in the period of 1987-2006, predominantly due to the increasing number of fatal cases among young males. Mean blood alcohol level of traffic accident victims in the years 1987-2006 increased by 0.5 promille and 0.2 promille in males and in females, respectively.
Annales Academiae Medicae Stetinensis 01/2007; 53 Suppl 2:76-9.
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ABSTRACT: In the years 1980-2000 a total of 302 cases of suicidal hanging were analysed at the Department of Forensic Medicine, Medical University of Białystok. In 140 cases (46.36%) the knot was situated on the neck. In 131 corpses 206 intravital reactions were revealed. Descending incidence of the reactions was as follows: petechial subcutaneous facial and palpebre hemorrhages (33.5%), hemorrhages of muscules sternocleidomustoideus (18.4%), hemorrhages within ligature furrow (11.6%), vertebral cervical fracture (0.7%). In overall material 71.8% were sober persons presenting intravital reactions of the cervical organs to ligature. During autopsy examination skin sections were excised from ligature furrow, muscules sternocleidomustoideus and the carotid artery and then stained with hematoxilin-eosin, orcein, Fuller staining and alcian blue. The carotid artery sections were examined in scanning electron microscope. Macroscopically revealed intravital reactions were fully confirmable by scanning electron microscopic examination. Furthermore, in cases with negative macroscopic image lesions of the common carotid arteries were detected.
Annales Academiae Medicae Stetinensis 01/2007; 53 Suppl 2:80-4; discussion 84-5.
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ABSTRACT: The aim of this study is to analyze the problem of child abuse. Non-accidental injuries of young children constitute a very important diagnostic issue, which continues to be faced by both clinicians and forensic medicine specialists. This report presents an extremely interesting case of a young boy, in which a very detailed assessment of the files allowed for determining the circumstances of his sustaining injuries.
Archiwum medycyny sa̧dowej i kryminologii 59(3):255-8.
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ABSTRACT: In the last years in Poland, the number of medicolegal opinions issued concerning the health status of defendants or convicts with regard to their ability to participate in legal proceedings (taking part in trial) and serve a sentence of imprisonment or restriction of freedom (doing free social labor) has been increasing. In the years 2005-2009, in our department, 115 opinions about defendants, convicts, one witness and one sufferer were issued. In this number, 37 opinions were associated with estimation of ability to serve a sentence of imprisonment, 22--estimation of ability to serve a penalty of restricted liberty or possibility of alternative serving a sentence of imprisonment, 56--estimation of ability to take part in legal proceedings. In 8 cases the experts estimated if the health status allowed a defendant to be detained awaiting trial and be detained in custody pending inquiry. The age, sex, place of residence, diseases the opinioned persons suffered from and the judicial organ that commissioned the opinion were taken into consideration in the analysis. The opinions were issued on the basis of court files and medical documentation only--18 opinions, or on the basis of court files, documentation and medical examination--97 opinions. In 52 cases, only specialists of forensic medicine issued the opinions, but in 63 instances, participation of experts in other medical specialties was necessary. Most often, the opinions of cardiologists were sought.
Archiwum medycyny sa̧dowej i kryminologii 60(2-3):102-8.
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ABSTRACT: Opinionating in civil proceeding is difficult and carries much responsibility, especially in the period of increasing claiming for damages. The authors analyzed civil opinions issued by the Forensic Medicine Department, Medical University of Białystok, in the years 2004-2008. The above-mentioned opinions addressed neurologic diseases and symptoms. The victims were invited to the Department for examinations which were performed by a forensic medicine expert and a neurologist, alternatively also by other specialists depending on the reported ailments. The paper presents an analysis of the victims' age and sex, type of the event, injuries and ailments, duration of physical and mental suffering, percentage of health impairment. The study comprised 126 civil opinions issued. Occupationally active persons were predominantly subject to injuries. The most common symptoms reported were headache, vertigo and pain in the C, L-S spine.
Archiwum medycyny sa̧dowej i kryminologii 60(2-3):109-11.
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ABSTRACT: The subject of analysis was the crash of a helicopter of the Polish Border Guards, which happened on October 31, 2009, in the Byelorussian territory about two hundred meters from the Polish border. In the accident, three crew members perished: the pilot, navigator and operator. Based on the accounts obtained directly after the crash on the site of the tragedy, it was established that the pilot tried to land, but the impact was so strong that the aircraft sank about one meter into the ground. On November 3, 2009, a committee consisting of two prosecutors from the County Prosecutor Office in Bialystok, a forensic science expert and a representative from the Border Guards, went to Department of Forensic Medicine in Brzesc. The prosecutors and forensic science expert took part in recovering the bodies. During the process of internal and external examination, severe body injuries were noted, without any surviving tissue and intestines. Samples of blood, urine and fragments of internal organs were collected for chemical, biochemical, toxicological and histopathological examinations. Muscle DNA was also taken.
Archiwum medycyny sa̧dowej i kryminologii 60(2-3):146-50.
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ABSTRACT: Declaration of death in a human being is a medical diagnosis, which results in numerous legal consequences. The demise of an individual can only be recognized by a doctor on the basis of a conscientious, personally conduced examination. Declaration of death releases a doctor from the obligation to rescue and save the individual's life. In the case of an incorrect death declaration, necessary aid is neglected by omission and the threat to human life is increased. Incorrect declaration of death in a living woman provided the basis for adopting an erroneous, contrary to current medical standards in force, management strategy.
Archiwum medycyny sa̧dowej i kryminologii 60(2-3):156-8.
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ABSTRACT: Post-traumatic cerebrasthenia and post-traumatic encephalopathy are the effects of a head trauma. Most physicians overuse these diagnoses. They do not perform differential diagnostic management, what leads to issuing erroneous opinions. The aim of this report is to show the symptoms of posttraumatic cerebrasthenia and posttraumatic encephalopathy and diagnostic investigations, which could be helpful for diagnosing these conditions. Cerebrasthenia (the subjective posttraumatic syndrome, subjective syndrome, posttraumatic neurosis) is usually a functional--"unorganic" disorder. It happens in the cases of many people who had brain concussion. The most common symptoms are: headache, vertigo, irritability, insomnia, attention deficits, fatigability. Posttraumatic encephalopathy is a persistent brain tissues injury which could be caused by more severe trauma (brain contusion, endocranial bleeding). The clinical picture of this disease entity is not unambiguous. The most frequently encountered form is a simple (common) form, which is similar to cerebrasthenia, but with differences in the neurological examination (focal signs) and with persistent changes in EEG.
Archiwum medycyny sa̧dowej i kryminologii 60(2-3):172-6.
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ABSTRACT: The objective of the investigation was evaluation of visualization of human blood and saliva stains with the use of alternative light source for the purpose of genetic identification. Experimental bloodstains on the bright base were the most clearly seen in the natural light and white light, up to blood dilution of 1:600. Complete typeability of AmpFISTR SGM Plus kit profiles was obtained from bloodstains at dilution 1:1500. Partial AmpFISTR SGM Plus kit profiles were typed from bloodstains at dilutions 1:1750 and 1:2000. Experimental saliva stains on the light-colored base were completely invisible in the natural light and white light, while they were visualized at wavelength range 300-415 nm through yellow goggles, and at wavelength range 300-455 nm through orange goggles at saliva dilution 1: 600. Complete typeability of AmpFISTR SGM Plus kit loci was obtained from saliva stains at dilution 1:1750. Partial AmpFISTR SGM Plus kit profiles were typed from saliva stains at dilution 1:2000. The wavelength of 455 nm and orange goggles were the optimal set for visualization of bloodstains on various, noncontrasting materials. Other useful wavelength/combinations of goggles were CSS light/red goggles. In case of saliva, the most useful general condition for visualization of stains on various, non-contrasting materials was with the wavelength set to 300-415 nm, while wearing yellow goggles. Other useful combinations of wavelength/goggles were 300-455 nm/orange or red goggles, and also CSS light/orange or red goggles.
Archiwum medycyny sa̧dowej i kryminologii 60(4):248-57.
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ABSTRACT: Detection of seminal stains on items such as clothing and bedding is a significant element of investigation in sexual assault cases. The use of alternative light source may assist in their identification. The objective of the investigation was the evaluation of human semen visualization with the use of alternative light source for the purpose of genetic identification. The tests demonstrated that experimentally prepared semen stains on the bright base could be best seen in the natural light and white light when the semen was diluted at a ratio 1:10. The complete typeability of AmpFISTR SGM Plus kit loci was evaluated in semen which was diluted at a ratio 1:1750 and typeability of AmpFISTR SGM Plus kit loci was incomplete in semen diluted at a ratio 1:2000. After washing with laundry detergents, semen stains were still recognizable under ALS wavelength 455 nm, while wearing orange goggles.
Archiwum medycyny sa̧dowej i kryminologii 60(4):258-62.
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ABSTRACT: The authors present two cases of deaths resulting from asphyxia of one of the partners in the act of intercourse to escalate their experience. The first case involved a heterosexual intercourse, in which a 30-year-old woman was led to state of hypoxia through choking and closing respiratory orifices. The other case represented a homosexual intercourse between two men, in which the victim's hands and legs were tied. Moreover, the partner put an open knot around the victim's neck and was holding it controlling the state of asphyxia, while performing an anal intercourse. Both presented victims practiced such paraphilia-associated behaviors in the past. The fact of sexual intercourse was confirmed in both cases by genetic analysis of the man's anus and the woman's oral cavity and vagina. This resulted in finding the genetic material of their partners. Escalating of sexual experience through inducing asphyxia of the nervous system is extremely dangerous and may result in death of one of the sexual partners, what has been proven by the present investigation.
Archiwum medycyny sa̧dowej i kryminologii 60(4):275-80.
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ABSTRACT: The paper presents the analysis of acute fatal ethanol poisonings in the material of the Forensic Medicine Institute in Białystok. Our study has shown that a predominant majority of the deceased died during the phase of alcohol elimination. Moreover, these people were often in good health and generally fit. In view of the immense material analyzed by the present authors and the 20-year time span under investigation, it may be concluded that middle-aged men constitute a group the highest risk of death resulting from acute alcohol poisoning. The assessment of alcohol concentration in blood and other body liquids, for example in urine, allows for defining the phase when death of an alcohol-imbibing individual occurred. In medico-legal and clinical practice, such a determination is very important in terms of initiating appropriate treatment or specifying the mechanism of death.
Archiwum medycyny sa̧dowej i kryminologii 59(3):183-9.
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ABSTRACT: The issue of sudden deaths due to acute para methoxy amphetamine (PMA) poisoning is presented in the report. The analysis included three cases autopsied at the Forensic Medicine Department in Białystok at the beginning of 2009. The toxicological analysis of samples of blood and urine did not confirm the presence of MDMA, also known as ecstasy, but it revealed the presence of para methoxy amphetamine (PMA). During post-mortem examinations, the cause of the death was not established in either case. Based on the above investigations it may be said that the common cause of death was acute para methoxy amphetamine (PMA) poisoning.
Archiwum medycyny sa̧dowej i kryminologii 59(3):190-3.
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ABSTRACT: The paper presents an analysis of legal opinions compiled by the Forensic Medicine Department, Medical University of Białystok in the years 2003-2008. The above-mentioned opinions addressed medical treatment in the area of neurology. During this period, opinions were given in 142 cases, the majority of them representing idiopathic diseases (such as strokes, cerebral aneurysms, cerebral infections), followed by falls from high altitudes and traffic road accidents, further followed by fights, medical treatment and work accidents. In sixteen (11.27%) of such cases, the employed medical procedures were found to be incorrect; what might be qualified as medical decisive errors, committed in emergency ambulances or in admission rooms. Incorrect medical treatment consisted in negligence to perform necessary diagnostic examinations. In ten of the analyzed cases, the patients ultimately died.
Archiwum medycyny sa̧dowej i kryminologii 59(3):203-7.
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ABSTRACT: Ethanol is the most common and widespread protoplasmatic poison. The destruction of cells and tissues occurs in both addicted and nonaddicted individuals, who use alcohol occasionally or temporarily. Apoptosis constitutes a very crucial factor in the pathogenesis of acute alcohol poisoning and chronic addiction. Ethanol and its metabolites induce suicidal cell death in crucial internal organs. However, despite extensive research on the role of alcohol and its metabolites in programmed cell death induction, the problem continues to be widely discussed and has no unambiguous explanation. The aim of this study is to present a review of up-to-date literature addressing the inducing influence of alcohol in apoptosis.
Archiwum medycyny sa̧dowej i kryminologii 59(3):238-42.
