Postmortem increase in body core temperature is a well-known phenomenon in forensic practice. Despite this, cases of reliably documented postmortem hyperthermia are rarely reported in the forensic literature, and it is still not clear how frequently postmortem hyperthermia occurs and in which cases we may it predict. In routine forensic practice, the standard course of body cooling is expected, and the prediction of normal body core temperature in the time of death is used for back-calculating the time of death by Henssge method. The unexpected rising in body core temperature may considerably misguide the estimation of time since death in the early postmortem period. We present a rare case of nonviolent death in the hospital with exactly recorded unusual elevation of body core temperature after death, although the body temperature shortly before the death was normal. In the presented case, the "standard" cooling of the body began up to 4 hours after death.
- MeSH
- Skin Diseases, Bacterial pathology MeSH
- Time Factors MeSH
- Fever * MeSH
- Humans MeSH
- Postmortem Changes * MeSH
- Aged MeSH
- Heart Failure pathology MeSH
- Streptococcus pyogenes MeSH
- Streptococcal Infections pathology MeSH
- Body Temperature MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
OBJECTIVE: AIDS-related mortality has changed dramatically with the onset of highly active antiretroviral therapy (HAART), which has even allowed compensated HIV-infected patients to withdraw from secondary therapy directed against opportunistic pathogens. However, in recently autopsied HIV-infected patients, we observed that associations with a broad spectrum of pathogens remain, although detailed analyses are lacking. Therefore, we focused on the possible frequency and spectrum shifts in pathogens associated with autopsied HIV-infected patients. DESIGN: We hypothesized that the pathogens frequency and spectrum changes found in HIV-infected patients examined postmortem did not recapitulate the changes found previously in HIV-infected patients examined antemortem in both the pre- and post-HAART eras. Because this is the first comprehensive study originating from Central and Eastern Europe, we also compared our data with those obtained in the West and Southwest Europe, USA and Latin America. METHODS: We performed autopsies on 124 HIV-infected patients who died from AIDS or other co-morbidities in the Czech Republic between 1985 and 2014. The pathological findings were retrieved from the full postmortem examinations and autopsy records. RESULTS: We collected a total of 502 host-pathogen records covering 82 pathogen species, a spectrum that did not change according to patients' therapy or since the onset of the epidemics, which can probably be explained by the fact that even recently deceased patients were usually decompensated (in 95% of the cases, the last available CD4+ cell count was falling below 200 cells*μl-1) regardless of the treatment they received. The newly identified pathogen taxa in HIV-infected patients included Acinetobacter calcoaceticus, Aerococcus viridans and Escherichia hermannii. We observed a very limited overlap in both the spectra and frequencies of the pathogen species found postmortem in HIV-infected patients in Europe, the USA and Latin America. CONCLUSIONS: The shifts documented previously in compensated HIV-infected patients examined antemortem in the post-HAART era are not recapitulated in mostly decompensated HIV-infected patients examined postmortem.
- MeSH
- Residence Characteristics MeSH
- Adult MeSH
- Species Specificity MeSH
- HIV Infections drug therapy immunology MeSH
- Humans MeSH
- AIDS-Related Opportunistic Infections immunology MeSH
- Autopsy MeSH
- CD4 Lymphocyte Count MeSH
- Postmortem Changes * MeSH
- Antiretroviral Therapy, Highly Active * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
Three-dimensional surface technologies particularly close range photogrammetry and optical surface scanning have recently advanced into affordable, flexible and accurate techniques. Forensic postmortem investigation as performed on a daily basis, however, has not yet fully benefited from their potentials. In the present paper, we tested two approaches to 3D external body documentation - digital camera-based photogrammetry combined with commercial Agisoft PhotoScan(®) software and stereophotogrammetry-based Vectra H1(®), a portable handheld surface scanner. In order to conduct the study three human subjects were selected, a living person, a 25-year-old female, and two forensic cases admitted for postmortem examination at the Department of Forensic Medicine, Hradec Králové, Czech Republic (both 63-year-old males), one dead to traumatic, self-inflicted, injuries (suicide by hanging), the other diagnosed with the heart failure. All three cases were photographed in 360° manner with a Nikon 7000 digital camera and simultaneously documented with the handheld scanner. In addition to having recorded the pre-autopsy phase of the forensic cases, both techniques were employed in various stages of autopsy. The sets of collected digital images (approximately 100 per case) were further processed to generate point clouds and 3D meshes. Final 3D models (a pair per individual) were counted for numbers of points and polygons, then assessed visually and compared quantitatively using ICP alignment algorithm and a cloud point comparison technique based on closest point to point distances. Both techniques were proven to be easy to handle and equally laborious. While collecting the images at autopsy took around 20min, the post-processing was much more time-demanding and required up to 10h of computation time. Moreover, for the full-body scanning the post-processing of the handheld scanner required rather time-consuming manual image alignment. In all instances the applied approaches produced high-resolution photorealistic, real sized or easy to calibrate 3D surface models. Both methods equally failed when the scanned body surface was covered with body hair or reflective moist areas. Still, it can be concluded that single camera close range photogrammetry and optical surface scanning using Vectra H1 scanner represent relatively low-cost solutions which were shown to be beneficial for postmortem body documentation in forensic pathology.
- MeSH
- Algorithms MeSH
- Adult MeSH
- Photogrammetry * MeSH
- Middle Aged MeSH
- Humans MeSH
- Computer Simulation * MeSH
- Software MeSH
- Forensic Pathology methods MeSH
- Imaging, Three-Dimensional methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Recent advances in unmanned aerial technology have substantially lowered the cost associated with aerial imagery. As a result, forensic practitioners are today presented with easy low-cost access to aerial photographs at remote locations. The present paper aims to explore boundaries in which the low-end drone technology can operate as professional crime scene equipment, and to test the prospects of aerial 3D modeling in the forensic context. The study was based on recent forensic cases of falls from height admitted for postmortem examinations. Three mock outdoor forensic scenes featuring a dummy, skeletal remains and artificial blood were constructed at an abandoned quarry and subsequently documented using a commercial DJI Phantom 2 drone equipped with a GoPro HERO 4 digital camera. In two of the experiments, the purpose was to conduct aerial and ground-view photography and to process the acquired images with a photogrammetry protocol (using Agisoft PhotoScan® 1.2.6) in order to generate 3D textured models. The third experiment tested the employment of drone-based video recordings in mapping scattered body parts. The results show that drone-based aerial photography is capable of producing high-quality images, which are appropriate for building accurate large-scale 3D models of a forensic scene. If, however, high-resolution top-down three-dimensional scene documentation featuring details on a corpse or other physical evidence is required, we recommend building a multi-resolution model by processing aerial and ground-view imagery separately. The video survey showed that using an overview recording for seeking out scattered body parts was efficient. In contrast, the less easy-to-spot evidence, such as bloodstains, was detected only after having been marked properly with crime scene equipment.
- MeSH
- Video Recording instrumentation MeSH
- Photography instrumentation MeSH
- Photogrammetry MeSH
- Blood Stains MeSH
- Aircraft * MeSH
- Humans MeSH
- Computer Simulation MeSH
- Forensic Sciences instrumentation MeSH
- Remote Sensing Technology * MeSH
- Body Remains MeSH
- Imaging, Three-Dimensional * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Vyd. 1. 136 s. : il. ; 21 cm
Lékařka-homeopatka se specializací na porodnictví a gynekologii, bývalá internistka a asistentka v nemocnicích v Lyonu, začala ve své soukromé praxi odhalovat účinky a význam homeopatie. Pracuje jako gynekoložka a zároveň přednáší homeopatii. Účastní se gynekologicko-porodnických kongresů, kde propaguje použití homeopatie ve svém oboru.
- MeSH
- Diagnosis MeSH
- Homeopathy classification methods utilization MeSH
- Pathological Conditions, Signs and Symptoms MeSH
- Perimenopause physiology immunology metabolism MeSH
- Publication type
- Handbook MeSH
- Conspectus
- Gynekologie. Porodnictví
- NML Fields
- gynekologie a porodnictví
- homeopatie
BACKGROUND AND OBJECTIVE: Large deformations in synthetic meshes used in pelvic organ prolapse surgery may lead to suboptimal support for the underlying tissue, graft-related complications as well as recurrence. Our aim was to quantify in vivo longitudinal changes in mesh shape and geometry in a large animal model. We compare two commonly used mesh shapes, armed and flat, that are differently affixed. The secondary outcomes were active and passive biomechanical properties. METHODS: A total of 18 animals were used. Six each were implanted with either an arm mesh, a flat mesh or underwent a sham surgery. PVDF meshes loaded with Fe2O3were used to facilitate their visualization in vivo. MR images were taken at 2, 14 and 60 days after implantation and 3D models of the meshes were created at each time point. We calculate the Effective Surface Area (ESA), i.e. the support that the mesh provides to the underlying tissue using custom developed techniques. Longitudinal changes in the mesh shape were studied by comparing the respective 3D models using part comparison analyses. The root means square difference (RMSD) and the modified Hausdorff distance (MHD) were calculated to obtain an objective value for the part comparisons. Wall thickness maps were produced on 3D models. Mesh arm length and their ellipticity profiles were also evaluated. Active and passive biomechanical tests on vaginal tissue overlaying the mesh were conducted using a contractility assay and a uniaxial loading protocol. RESULTS: MR images of 5 animals in each group were used for longitudinal comparison. Compared to the initial implant size, there was an immediate drop in the ESA measurement at day 2 of almost 32.22 [7.06] % (median [IQR]) for flat meshes, and by 17.59 [6.50] % for arm meshes. After 14 days, the reduction in area was 41.84 [14.89] % and 27.18 [20.44] %, and at day 60 it was 36.61 [6.64] % and 26.43 [14.56] % for the flat and armed meshes respectively. The reduction in area in the two groups was different between the two groups only day 14 (p = 0.046). The ellipticity of the arms was 0.81 [0.08] (median [IQR]) and there was no significant change in the ellipticity profiles over time. The mesh arm length did not change significantly over time. The part comparison showed a maximum difference of 4.26 [3.29] mm in 3D models according to the MHD measure, which is clinically not relevant. Comparison of high thickness areas on the thickness maps correlated well with the areas of mesh folding in the arm mesh group observed during postmortem dissection. Thickness maps did not help us understand why the flat meshes had a reduction in support area. The comfort zone stiffness of the flat mesh and of the central part of the arm mesh were 2.4 fold and 4.5 times stiffer compared to sham groups, respectively. The arms were 36% stiffer than the central part of the mesh. The comfort zone length of the sham group was 46% longer than the flat mesh group (p = 0.027) and 59% longer than that of the central part of the arm mesh (p = 0.005). There was no significant difference in vaginal contractile forces generated in samples from the arm, flat mesh, and sham groups. CONCLUSIONS: This is a first longitudinal study observing deformations in vaginally implanted synthetic meshes in a large animal model. A novel methodology is presented to calculate the area of the vaginal tissue effectively supported by the mesh implant. Immediately post-operatively, a reduction in 32% and 17% was noted, which remained stable over the 60 following days of observation. We use thickness maps to analyze the cause of this dramatic immediate reduction. In the armed mesh we found it to be mesh folding at the interface between the arms and central part. For the flat mesh we suggest that pore aggregation during suturing.
- MeSH
- Surgical Mesh * MeSH
- Longitudinal Studies MeSH
- Magnetic Resonance Imaging * MeSH
- Sheep MeSH
- Pelvic Organ Prolapse surgery MeSH
- Materials Testing * MeSH
- Vagina surgery MeSH
- Ferric Compounds MeSH
- Animals MeSH
- Check Tag
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Súčasným trendom poskytovania súdnolekárskych služieb v USA je postupná prestavba koronerského systému, ktorý je ešte dodnes etablovaný v niektorých štátoch USA, na modernejšiu koncepciu „medical examiner“. Autor publikácie prezentuje vybrané poznatky a skúsenosti zo šúdijného pobytu na poprednom súdnolekárskom pracovisku v USA.
The contemporary trend in providing medicolegal service in USA is a progressive reconstruction of Coroner System (still in practise in some states within the USA) into the modern Medical Examiner System. Author presents selected knowledge and experiences acquired during the fellowship at the prominent Medical Examiner Department in USA.
Krevní výron, jako důsledek intravitálního krvácení, je z forenzního hlediska považován za důležitou známku vitální reakce poranění. Ve zvláštních případech je však nutno připustit možnost, že hematom vznikl až postmortálně. Vznik supravitálních změn je zřejmý kupř. u dárců orgánů u nichž je po smrti mozku udržován krevní oběh a plicní ventilace. Posmrtný vznik krevních výronů ale pozorujeme i u dárců po enukleaci očních bulbů odebraných až před pitvou na Ústavu soudního lékařství a toxikologie; tyto krevní výrony se manifestují za několik hodin po odběru. Mimoto jsme ale zaznamenali vznik hematomu v očnici, který nebyl způsoben ani intravitálním ani postmortálním přímým násilím; jeho vznik nelze vysvětlit jinak než posmrtnou propagací výronu ze zlomeniny přední jámy lební do očnice. V dostupné literatuře jsme nezjistili údaj o posmrtném vzniku resp. přemístění hematomu takového rozsahu. Jde tedy, v rámci znalostí o supravitální reakci o poznatek obecného významu, ovšem i s forenzním dopadem. V konkrétním případě, dokumentace z místa činu umožnila korigovat posouzení mechanismu vzniku poranění resp. úrazového děje z hlediska podezření na cizí zavinění, které by v takovém případě přicházelo v úvahu (jako např. úder do očnice a pád pod projíždějící soupravu metra).
The hemorrhage as a result of intravital bleeding is considered, from forensic point of view, as important sign of vital reaction of injury. However, in special cases it must be accepted that hemorrhage occurred after the death. The formation of supravital changes is evident e.g. in organ donors whose blood circulation and pulmonary ventilation is kept after the brain death. The post-mortem origin of hemorrhages can also be seen in donors of eyeballs after enucleation made before the autopsy at Institute of Forensic Medicine and Toxicology. These hemorrhages are manifested after several hours when eyeballs were removed. Moreover, we observed the origin of hemorrhage in orbit which was caused nor by intravital bleeding neither by direct force. Its origin could not be explained nothing but postmortem propagation of the hemorrhage from the fracture of anterior fossa of the scull base. We did not find information about postmortem origin or relocation of hemorrhage of such extent in the literature. In the frame of knowledge about supravital reaction, this finding is of general importance with forensic impact. The documentation from the scene of death allowed correcting the appreciation of the mechanism of injury and traumatic process from the point of view of foreign culpability which should be considered in such case (e.g. a blow to the orbit with following fall under passing subway train).
- Keywords
- forenzní význam, postmortální propagace hematomu, vitální a supravitální reakce,
- MeSH
- Adult MeSH
- Hematoma diagnosis classification MeSH
- Craniocerebral Trauma diagnosis classification pathology MeSH
- Humans MeSH
- Autopsy methods MeSH
- Multiple Trauma diagnosis classification MeSH
- Electric Injuries diagnosis classification MeSH
- Postmortem Changes MeSH
- Accidents classification MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
