Forensic Medicine - Science topic

My suggestion to Research of Medicolegal Issue, Medical Negligence, Ethical Issues which help in improving the quality of helathcare

From a medico-legal/forensic science standpoint (mine), pharmacology, pharmaceutical science and toxicology all explain the relationship between various substances and the human body. The pharmacology folks can explain drug composition, effects, therapeutic vs. toxic dosages, and the kinetic mechanisms by which drugs are absorbed, transported, distributed and eliminated in/from a living organism. Toxicologists can do the same, but with more substances. Drug interactions are also relevant in forensic science. Many drug analysts falsely bill themselves as toxicologists--that name requires an advanced degree in toxicology, just as pharmacists aren't pharmacologists. Forensic science has a very robust relationship with pharmaceutical sciences and toxicology.

In my view, it depends on what type of experiment you want to do. If you want organ transplantation or conduct a DNA fingerprint then consent will be required. For example, Section 45 of Britain states that it is an offense to possess without appropriate consent any human bodily material with the intent of analyzing its DNA. There are some exceptions when obtaining consent is not practicable.

Ok so People I have a question. Let us say we calculated incest indices and combined incest indices. How do we proceed from there? What do the results indicate??

Sukone Pradutkanchana Rüdiger Lessig Yaşar Bilge

Try this link my friend:

https://www.coursehero.com/search/results/648787034/9724fc29b9873ec3d8/

(Clinical, Cosmetic and Investigational Dentistry) also appeared in SJR, from 2009- 0ngoing, H index: 16

Recent recombinant DNA technology has provided some novel and powerful methods for forensic science application. Human genomic DNA can be analyzed directly for individual identification and paternity testing on the basis of variations in its sequence. The analysis of DNA isolated from forensic biological evidence provides valuable information relating to the identification of the source of the sample. Restriction fragment length polymorphism (RFLP) testing, using a combination of single locus probe (SLP) that vary highly among individuals, produces a DNA fingerprint or profile. The PCR method using STR (microsatellite) and mitochondrial DNA analysis (mtDNA) is suitable for examination of the forensic biological samples (bloodstains, hairs, seminal stains, bones, tooth). For sex identification of bloodstains, bleached skeletons and teeth, Southern blot hybridization with Y-chromosome specific probe (pHY10; 3.4 kb) and PCR amplifying with sex chromosome specific fragments, can be used.

Thank you for your help. I hope we find some method. Best wishes

Radka

o gun Atlanta da meeting de olacagim. Ama sanirim o Saatde musait olurum

“Nihfellow” id !!! gorusmek uzere

In Spain, forensic microbiology is not used routinely in all autopsied cases. However, we use this ancillary examination in specific cases such as SIDS, sudden death in the young with suspected infection (e.g. meningococcal sepsis, myocarditis) and in all natural or violent deaths where the antecedents, death scenario and autopsy findings suggest an infection. We use also microbiology in cases of alimentary intoxication. The core centre of the forensic microbiology lab is located in Madrid at the National Institute of Toxicology and Forensic Sciences.  

Hi Amy,

Thank you for the offer! Information about chemical changes during the putrefaction stage are highly welcome, too. Besides that I search for data about physical properties of putrefaction transudates, including relative density as well as Reynolds number (at different temperatures, pressures and chemical compositions).

Best wishes, Achim

I would first look for systematic reviews., then move down the evidence pyramid of knowledge to ground your analysis and conclusions. One study maybe filled with bias unknown to the researchers.

As we can see in the article attached , it is not only electrocution marks which are present in the body but also other injuries were found suggestive of homicide. By meticulous post mortem examination, we can differentiate between antemortem and post mortem injuries.It will be more challenging if the findings of homicide are nor evident and post mortem electrical injuries are present.

Respected sir,in addition to rehabilitation of victims of sexual offences, even providing quick filling of form of life insurance policies without creating any hurdles as well proper guiding to the relatives of deceased.It is our responsibility to prevent harassment of relatives of deceased while conducting post mortem at the hands of mortuary attendants.

For lower voltage contacts, there is about a 50% chance of there being no burn marking.  Because the burn mark is a local effect, the presence or absence of burns does not necessarily predict the severity of internal injury.  (Obviously severe and extensive full thickness burns are a predictor.)  The mechanism of internal electrical injury is not necessarily thermal.  Burning is the result of I-squared R heating where R is the localized resistance and I is directly proportional to voltage and inversely proportional to resistance between entry and exit points.  The greater the value of I-squared times R, the more likely that a burn will occur in a shorter time.  Energy imparted is I-squared x R x T where T is time.  Simply stated if there is enough current density and enough resistance and enough time to elevate the skin locally to a temperature that will induce a burn, then there will be a burn.  Absent those factors, a burn will not occur.  Wet skin causing lower Resistance and more diffuse entry causing lower current density can reduce the chance of burning even when the contact is quite significant.

I agrree with Dr. Lucena. However, in tropical climates (40 ° C, 80% humidity), eg., the influence of environment is very intense. So, I believe not be possible to choose only one criterion (https://www.researchgate.net/publication/271530578_Chronothanatognosis_the_influence_of_the_tropical_climate_in_determining_the_post-mortem_interval)

Thanks my colleague,

it is an important information 

All the best 

I'm not sure in all cases but this article might answer some of your questions.

New insights in carbohydrate-deficient transferrin analysis with capillary electrophoresis-mass spectrometry by Kohler, Augsburger, Rudaz, and Schappler

In Brazil , whenever there is suspicion of a crime and the existence of traces , the examination of the body is essential . Even when the victim came to a hospital, later, if the death is violent , the body goes to the coroner .

Oky, I found it. I used 5 Zirconia Beads II / tube with a SpeedMill PLUS Cell Homogenizer at 50 Hz-power for 15 min. before starting the Quiagen extraction protocol. Maybe you can try. Good luck!

I agree with Fernando regarding alcohol abuse markers - CDT is the one most used in the clinic and is easy enough to assay - many commercial kits available. However, it is somewhat unspecific in particular in polypharmacy settings with possibility of e.g. antiepileptics affecting your results. There are also the rare genetic variants leading to pathological transferrin. Phosphatidylethanol (PEth) (and other direct ethanol adducts) are completely specific for ethanol consumption and are thus excellent specific markers with PEth having a suitable duration in human blood (and tissue e.g. in brain). GGT of  course is even more unspecific than CDT. Have you considered using a battery of different tests?

I am just curious to know, if crystal test ( Teichman or takayama) would come positive in such cases or not?

I just want to add to my earlier input that forensic nursing or forensic midwifery skills (depending on each local circumstance) is critical in maternal death reviews or inquiry, which are not necessarily criminal. This would facilitate quality care and help reduce maternal and neonatal or perinatal mortality

Dear Tumram,

Night postmortems are not necessary. However there may be circumstances that law enforcement authorities may require the results as early as possible. In our area where the police or other security agencies become victims Night P M is done to avoid deterioration in law and order situation . In some cases the diseased has to be carried to ancestral place for disposal. So our KPK Assembly has given the ruling for such cases. Otherwise there are many problems in Night PM examinations.  

Thanks.

You might find these articles helpful as well.

National Association of Medical Examiners position paper on the medical examiner release of organs and tissues for transplantation. Pinckard JK, Wetli CV, Graham MA; National Association of Medical Examiners. Am J Forensic Med Pathol. 2007 Sep;28(3):202-7.

Profile of organ donors not authorized for judicial reasons. Frutos MA, Ruiz P, Mansilla JJ, Lebrón M, Guerrero F, Ortuño R, Daga D, Carballo M, Baquedano B, Navarrete P, Gallego A, Pérez-Bernal J. Transplant Proc. 2008 Nov;40(9):2879-80.

The expire date for any compound is the beginning of the degradation of the active ingredient i the compound. Sometimes the degradation lead to break down  into different compounds, which may act as more toxic compared to the parent compound or may loss it toxicity. On the other hand, the active ingredient changed to another for by oxidation lead to produce more toxic compound or loss it toxicity. So it is recommended to avoid the using these compounds after expiration date.

I think the issue here is intent.  The World Health Organization has defined suicide as "the act of deliberately killing oneself."  (See first link.)  It is entirely possible for people to intentionally "self harm by hanging, strangulation, and suffocation" without intending to die from this.  An example is auto-erotic asphyxia, also known as breath play.  A person might die as a result of this even though they didn't intend to kill themself.  Similarly, a person might intentionally self-poison by exposure to narcotics in order to 'get high' without intending to kill themself.  Based upon some very quick research, I couldn't find any operational definition of "intentional self-harm" for ICD-10 and did find at least one researcher state that this phrase was not defined in ICD-10 (see second link).

I suspect the expert you spoke to might have understood this definitional issue between the WHO definition of suicide (which requires intent to die from the act) and the ICD-10 coding titles which state "intentional self-harm" without defining if the subject intended to die from the intentional self-harm.

In Forensic practice there is no option except to be honest and admit one's limitations. That is absolutely non debatable.

I would like to refer you to read what recently retired Coroner, who was a Forensic Pathologist also, Dr Michael Dobersen, had to say. I quote this example because I read it just two days back. He mentions a case where strangulation mark (antemortem) mentioned by him on gross examination now haunts him as to whether it could be postmortem due to the position of the head causing blood to settle in a particular way. This is not even a decomposed body!

There are difficulties in gross examination with decomposed bodies, but there are cases where it is quite obvious also on gross examination. In decomposed bodies, it would depend on the stage of decomposition and the immediate environment of the body, whether buried in ground, immersed in water or in air, amongst a whole multitude of other factors. You could have a decomposed body where injury is obvious as antemortem beyond doubt and there could be injuries where you have your doubts.

Semen is fluorescent due to the presence of conjugated choline and/or flavin proteins. The emission range is quite broad, extending anywhere between 400-700 nm depending on the light source used

Manner is a difficult question. It needs all collation of all circumstantial evidence, along with the postmortem examination findings (thus scene, eye witness and participants in the case's evidence, etc. all play a key role). An even bigger contributor in determining the manner is if the victim was able to make a dying declaration about her circumstances of death.

I would think the one situation where all things come together in a decent system of death investigation and death investigators is the US Medical Examiners' system, but I have qualms about their interpretation of the manner of death automatically transcribed on all death certifications - where the ME's manner may be at variance with what the courts find out later!

In all cases of suspected electrocution, there should be an examination of the alleged source of the electrical current including electrical devices the individual was handling at the time of death. In low-voltage electrocutions, examination of the device rather than examination of the body will often provide the cause of death, because burns may not be present. Thus, one can make a diagnosis of electrocution without an electrical burn, based on the circumstances of the death, negative autopsy findings and the examination of the electrical device in use. In high-voltage electrocution, tissue from the victim may be adherent at the point of contact with the source of the current (e.g., a metal ladder).

* Firstly, "poisoning" and "poisons" are the broadest of terms. Many poison determinations utilize a very wide variety of methodologies that I could not discuss without some specificity.

Secondly, bed side testing, also called "point of care" testing, for toxicology related situations is an untapped area. Mostly because the current types of testing require involved sample prepping and the use of sizable instruments to analyze the products.

In cases of poisoning what are the test/ bedside test done to diagnose it?

* There are very few tests that can be used at bedside. There are numerous drugs of abuse testing that can be run on a card and a little urine, other poisons, not so much.

Are they routinely done in your hospital set-up?

* point of care testing-- no. However our laboratory screens for many drugs using a mass spectrometer. As to other poisons, there is literature that descrbes many techniques for quick testing of other poisons like heavy metals, cyanide etc..

Are there any quick test to diagnose/ confirm a known poison?

* By "quick tests" you may be referring to what we call "spot tests". Spot test can be very general or very specific for a particular compound or classes of compounds. Again literature can be helpful here. A word of caution, spot tests should not be used soley for the determination of a poison or compound. It is strongly suggested that confirmatory (using another methodology) testing be performed before acting on a presumptive spot test.

Are there any test like urine pregnancy test kits to diagnose poisoning cases?

* Yes mostly pertaining to drug use.

Is it really helpful to diagnose poisoning cases by such test?

* In cases involving drugs of abuse, yes. Again, confirmatory testing should be followed up.

Can this be of some importance to medical or medicolegal purpose?

* Testing of newborn urine to determine drug abuse by pregnant mothers is an example of a medicolegal purpose.

Dear nilesh,

in Germany where I am from and in the UK. Blood test are not done routinely after death has occured. One exeption at least in Germany are trafiic accidents when alcohol or drugs are possibly involved.

Even during an autopsy blood is not taken routinly for toxicology. I have no figures for Germany but the Senior Coroner,s statistics 2012 for England & Wales gives the following rates for all autopsies

Level 1 autopsy only 67%, With histology 20 % and / or Toxycology 13 %

Genetics are performed here very rarely (no figures for that)

As you know probably much better then I do it's the costs that are the limiting factor.

In deaths (natural or not) occurring outside a hospital without an Inquest or. Autopsy there is never a blood testing.

I hope this helps. The source is below, the link is attached

Greetings

Stephan

Coroners Statistics 2012 England and Wales

Ministry of Justice Statistics

I can refer you to 17025 Standards that are generic but have lot of meat in terms of technical standards. I agree that most relevant technical details are available with the Society of Wildlife Forensics.

The situation in Slovakia is quit complex. The term “forensic science work” is quit broad and vague therefore so I will address in in a more extensive form.

The police corps has its own forensic science institute which is a part of the police force. As such this institute is funded by the Ministry of Interior. This staff includes about 200 experts in fields as DNA typing, ballistics, mechanoscopy, biology, anthropology, toxicology etc. Institute is registered as expert witness with the Ministry of Justice.

Ministry of Justice registers expert witness in various fields – this is similar to licensing of the experts. I have to note that generally only persons and legal entities registered with Ministry of Justice could be appointed as expert witnesses in civil and criminal proceedings. As a demonstration - I am individually registered in forensic pathology and I am at the same time partner in forensic company registered as expert in health care related matters. Most of the experts are private and not funded by anyone. The activity of these experts is supervised by the Ministry of Justice.

As for the forensic pathology, there are departments/institutes of forensic pathology attached to medical schools of universities. At the same time, we have an special independent public authority vested with the power to supervise delivery of the health care. Its name is Healthcare Surveillance Authority and their integral parts are several departments of pathology/forensic pathology (these were attached to the major hospitals prior to the 2005 and thus under the umbrella of the Ministry of Health).

And this is only overview of the major stakeholders :)

I think imaging and pathology are always going to be linked, to what extent remains to be seen. Virtopsy is a great supplementary tool to the traditional autopsy. Will it replace the traditional autopsy completely? I'm not sure. Will it change the way cases are approached? Absolutely. It's not just a simple CT scan and then you're done as many people say. It is very meticulous series of analyses involving multiple imaging modalities (CT, MR, and laser scanning) as well as selected biopsies and biochemical panels. While I recognize that it's a major concern for pathologists that radiologists are going to think that the pathologists are suddenly unnecessary, I don't think it's a legitimate concern. As Michael said, there are things that a normal autopsy picks up that can't be seen in imaging. However, wouldn't it be better if we were smarter about our traditional approach because we were informed by the imaging? We do this in surgery all the time with image guided pre-operative planning. Simple X-ray can't pick up the detail that CT or MR can even in the deceased. Yes, the big concern is the matter of access to the resource & funding but I think as proof of concept is established more here in the US that you will see more and more ME's offices using advanced imaging in the course of their normal case procedure. As a very wise pathologist pointed out to me during autopsy, the traditional autopsy hasn't changed much in hundreds of years. It's about time that technology helps serve as an additional tool as it does in the rest of clinical medicine. If for no other reason but long term digital evidence preservation, Virtopsy is a very useful tool to the ME. Not only can you preserve the data but you can also "share" or collaborate on that autopsy much like is routinely done in clinical telemedicine. I'd be very cautious against throwing the concept or practice out altogether. Regardless, it will be interesting to see where it goes.