Differences in volume, density, electrolyte concentration, and total proteins in the fluid of the paranasal sinuses of freshwater and saltwater drowning victims: a systematic review and meta-analysis.

This study summarized the available evidence on the differences in volume, density, electrolyte concentration, and total proteins in paranasal sinus fluid between freshwater and saltwater drowning victims. A systematic search was conducted in electronic databases and gray literature, resulting in the inclusion of five studies with 234 drowning victims (92 saltwater incidents and 142 freshwater incidents). Meta-analyses using the inverse-of-variance method and a random-effects model were performed, reporting effect sizes as standardized mean differences (SMD) with 95% confidence intervals (CI). The findings showed a significantly higher sinus density in saltwater drowning cases compared to freshwater drowning cases (SMD 0.91, 95% CI 0.50 to 1.32). However, no significant differences were observed in sinus fluid volume. Saltwater drowning victims exhibited higher electrolyte concentrations (sodium: SMD 3.77, 95% CI 3.07 to 4.48; potassium: SMD 0.78, 95% CI 0.07 to 1.49; chloride: SMD 3.48, 95% CI 2.65 to 4.31; magnesium: SMD 4.01, 95% CI 3.00 to 5.03) and lower total protein concentrations (SMD - 1.20, 95% CI - 1.82 to - 0.58) in sinus fluid compared to freshwater drowning victims. This meta-analysis highlights the importance of analyzing the characteristics and composition of sinus fluid in forensic investigations of drowning cases. While no differences were found in sinus fluid volume, saltwater drowning victims exhibited higher sinus density, elevated electrolyte concentrations, and lower total protein concentrations compared to freshwater drowning victims.

Is facial geometric morphometrics a useful method for age estimation in children and adolescents? Limited evidence and lack of studies leave us with an uncertain answer.

Facial geometric morphometrics is a non-invasive method that has recently shown potential applications, including age estimation, diagnosis of facial abnormalities, monitoring facial development, and evaluating treatment outcomes. A systematic review identified two studies that demonstrated the use of facial geometric morphometrics for age estimation in children and adolescents, showing promising results in terms of accuracy and error. This finding could be particularly relevant in forensic investigations. However, a research agenda should be established to prioritize the assessment of the diagnostic accuracy of facial morphometric geometrics in estimating age among children and adolescents.

Accuracy of geometric morphometrics for age estimation using frontal face photographs of children and adolescents: A promising method for forensic practice.

Age estimation is crucial in legal and humanitarian contexts. Forensic professionals may use various procedures to estimate age, including dental analysis, bone density tests, evaluation of physical characteristics including facial bone structure and development, and image-based methods. Although images are often the only material available, visual observation of photographic material is an imprecise method in age estimation, which can compromise judicial decision-making. Analyzing 4000 photographs from the Brazilian Federal Police database, representing four age groups (6, 10, 14, and 18 years), the study employed automated analysis by marking 28 photogrammetric points. Data were used to establish facial patterns by age and sex using the facial geometric morphometrics method. Performance was assessed through a Multinomial Logistic Regression model, evaluating accuracy, sensitivity, and specificity across the categorical age groups. Analyses were conducted using R software, with a 5 % significance level. The study found that facial geometric morphometrics achieved an overall accuracy of 69.3 % in age discrimination, with higher accuracy in males (74.7 %) compared to females (65.8 %) (p < 0.001). The method excelled at predicting the age of 6-year-olds with 87.3 % sensitivity and 95.6 % specificity but had lower performance at 14 years. It showed greater accuracy in distinguishing age groups with larger age gaps, achieving up to 99.5 % accuracy between certain groups, and was particularly effective in differentiating ages of 6 and 10 years in females and 10, 14, and 18 years in males. The facial geometric morphometrics emerges as a promising approach for age estimation among children and adolescents in forensic settings.

Biochemical analysis of vitreous humor and synovial fluid in the estimation of early postmortem interval: A meta-analytical approach.

The estimation of the postmortem interval (PMI) is a significant challenge in legal medicine and forensic sciences due to the dynamic and continuous decomposition of organisms after death. Thanatochemistry has emerged as a promising area to estimate PMI by measuring the concentrations of postmortem biochemical markers. This systematic review and meta-analysis aimed to summarize evidence on postmortem biochemical alterations in vitreous humor (VH) and synovial fluid (SF) to estimate early PMI. Comprehensive searches of electronic databases identified studies measuring postmortem biomarker concentrations in both matrices. Our analysis included three meta-analytical approaches: calculating standardized mean differences to assess variations in biochemical parameters, executing correlation meta-analysis (ρ) to explore relationships between these parameters and PMI, and conducting meta-regression to derive a predictive model. Results from five eligible studies indicated no correlation between sodium levels and PMI in both matrices. However, a strong correlation was found between potassium levels and PMI in VH (ρ = 0.69; 95 % CI 0.52 to 0.86) and SF (ρ = 0.81; 95 % CI 0.75 to 0.87), with the meta-regression yielding the optimal predictive equation for SF: [K+] = 6.15 + 0.21 × PMI. These findings support the use of potassium as a reliable biomarker for PMI estimation, particularly in SF.

The role of paranasal sinus fluid in determining drowning as the cause of death: A systematic review and meta-analysis.

Drowning is a significant global cause of unintentional injury fatalities, and accurate forensic diagnosis of drowning remains a challenge due to the nonspecific nature of post-mortem findings obtained through classical autopsy methods. Our manuscript addresses this issue by focusing on the emerging use of paranasal sinus fluid as a valuable tool in determining the cause of death, specifically in distinguishing drowning from non-drowning cases. The study provided a comprehensive summary of available evidence from observational studies that compared findings in the paranasal sinuses between drowning and non-drowning victims, analyzing parameters such as the presence of fluid, fluid volume, and density. The study encompassed a total of 14 selected studies involving 1044 subjects and utilized rigorous risk of bias assessment and data synthesis techniques. The meta-analysis demonstrated a strong association between the presence of fluid in the paranasal sinuses and drowning (OR = 17.1; 95% CI 7.2 to 40.5; p < 0.001). In addition, drowning victims had a significantly greater volume of fluid (SMD = 0.8; 95% CI 0.5 to 1.2; p < 0.001) and lower fluid density (SMD = -1.4; 95% -2.5 to -0.4; p = 0.008) compared to non-drowning cases. The results support the utility of paranasal sinus fluid analysis as a valuable diagnostic method in cases where drowning is suspected but cannot be definitively confirmed through traditional approaches.

Temporal Analysis of Malaria Cases in the Brazilian Yanomami Pediatric Population: A Retrospective Ecologic Study From 2003 to 2022.

This retrospective ecological study investigated malaria incidence among Brazilian Yanomami children and adolescents from 2003 to 2022. Of the 145,573 recorded cases, 75.9% occurred in the Yanomami pediatric population. Moreover, an increase in the proportion of cases among the 10-19 age group has been observed, potentially associated with the recruitment of Indigenous adolescents to mining areas in recent years.

Recommendations for procedures related to the evidence chain of custody in forensic anthropology in Brazil.

Forensic anthropologists perform specialised analysis, mainly involving skeletonised human remains, cadavers in advanced stages of decomposition, disassociated elements from the human body, and human remains in extreme carbonisation. The main objectives of the forensic anthropology expertise are human identification and assisting in determining the cause and manner of death. Estimating the time since death is also a priority for some cases, especially ones involving missing persons. This science works on individual cases, violent deaths, missing persons, mass disasters, suspected violations of human rights, and crimes against humanity. Forensic anthropological evidence is, in general, very sensitive. Thus, it is important to detail aspects relevant to the maintenance of the chain of custody at all phases of the investigation, as well as standardise the actions of the individuals involved. This aims to preserve the evidence integrity and sameness (Sameness: free translation of the Portuguese word "mesmidade", derived from a Spanish word that does not possess a translation to Portuguese. Sameness of evidence is understood as the guarantee that the evidence under valuation (or under analysis of its probative value) is exactly and integrally the same one which was collected, corresponding, therefore, to "the same" (and not "part of", "derived from"), safeguarding its value. Brazil Law No. 13.964 of 14 December 2019 establishes and lists 10 phases related to the evidence chain of custody that must be followed. These newly introduced requirements resulted in the need for adaptation of the forensic, investigative, and legal actors involved in an investigation, and in the detailed description of the procedures for the different areas related to criminalistics, including forensic anthropology. The information provided in this article should be interpreted as recommendations, even though their non-compliance may weaken the investigative and forensic analysis processes in whole or in part.

Uso da radiografia panorâmica como fonte de informação para a identificação humana ­ relato de caso pericial / Use of panoramic radiograph as a source for human identification ­ forensic case report

Introdução: A odontologia legal permite a identificação humana por meio da comparação de dados observados em uma documentação odontológica ante mortem (AM) com as informações coletadas post mortem (PM), sendo os exames radiográficos grandes aliados neste processo. Objetivo: Demostrar a contribuição da radiografia panorâmica como fonte de informação para a identificação humana. Relato do caso: foi encaminhado um corpo carbonizado, com parte da região bucomaxilofacial preservada e que ao exame necroscópico era possível identificar a presença de restaurações e ausências dentais. A apresentação de radiografia panorâmica anterior à morte e a realização de exame radiográfico panorâmico no corpo carbonizado possibilitou a comparação de pontos coincidentes e divergências explicáveis, permitindo a identificação positiva do caso. Conclusão: Ao final da perícia foi determinada a identidade da vítima e foi comprovada a importância da radiografia panorâmica para a identificação humana com base em caracteres identificadores anatômicos e terapêuticos presentes no complexo bucomaxilofacial

Introduction: Forensic dentistry allows human identification through the comparison of data observed in ante-mortem (AM) dental documentation with information collected post-mortem (PM), with radiographic examinations being great allies in this process. Objective: To demonstrate the contribution of panoramic radiography as a source of information for human identification. Case report: a charred body was sent, with part of the oral and maxillofacial region preserved and upon necroscopic examination it was possible to identify the presence of restorations and missing teeth. The presentation of a panoramic radiograph prior to death and the performance of a panoramic radiographic examination of the charred body made it possible to compare coincident points and explainable divergences, allowing positive identification of the case. Conclusion: At the end of the forensic examination of the case, the identity of the victim was determined and the importance of panoramic radiography for human identification based on anatomical and therapeutic identifying characters present in the oral and maxillofacial complex was proven

Testing the extraction of DNA from human teeth exposed to different chemical solutions / Prueba de extracción de ADN de dientes humanos expuestos a diferentes soluciones químicas

The aim of this study was to evaluate the extraction of dental DNA exposed to different chemical solutions. The sample was composed by 15 subjects, from which 5 samples of oral mucosal cells (reference population) and 15 teeth (experimental population) were collected. The experimental population was divided in three equal parts, which were exposed to different chemical solutions, namely hydrochloric acid (HCl) at 37 %, formaldehyde (CH2O) at 10 % and sodium hypochlorite (NaOCl) at 2.5 %. The DNA from the oral mucosa was extracted using organic method, while the dental DNA was extracted using the AFDIL method, including amplification by PCR and sequencing through capillary electrophoresis. The DNA exposed to hydrochloric acid dissolved, lacking extraction. The exposure of teeth to formaldehyde and sodium hypochlorite did not interfere in the extraction of DNA, once the amplification was visible in both experimental populations. The present outcomes demonstrated that DNA extraction may be limited under exposure to chemical solutions.

El objetivo de este estudio fue evaluar la extracción de ADN dental expuesto a diferentes soluciones químicas. La muestra estuvo compuesta por 15 sujetos, de los cuales se recogieron 5 muestras de células de la mucosa oral (población de referencia) y 15 dientes (población experimental). La población experimental se dividió en tres partes iguales, que fueron expuestas a diferentes soluciones químicas, a saber, ácido clorhídrico (HCl) al 37 %, formaldehído (CH2O) al 10 % e hipoclorito de sodio (NaOCl) al 2,5 %. El ADN de la mucosa oral se extrajo utilizando el método orgánico, mientras que el ADN dental se extrajo utilizando el método AFDIL, incluyendo la amplificación por PCR y la secuenciación a través de electroforesis capilar. El ADN expuesto al ácido clorhídrico se disolvió, careciendo de extracción. La exposición de los dientes al formaldehído e hipoclorito de sodio no interfirió en la extracción de ADN, una vez que la amplificación era visible en ambas poblaciones experimentales. Los resultados actuales demostraron que la extracción de ADN puede ser limitada bajo la exposición a soluciones químicas.

Análise clínica de pacientes portadores de lesões cervicais não cariosas e sua relação com hábitos / Clinical analysis of patients with non-carious cervical lesions and its relation to habits / Clinical analysis of patients with non-cariouscervical lesions and its relation to habits

Introdução e objetivo: Este estudo teve por objetivo identificar apresença de lesões cervicais não cariosas (LCNCs) e correlacioná-lascom a presença de contatos dentários prematuros e hábitos alimentares,parafuncionais e de higiene envolvidos em seu desenvolvimento.Material e métodos: Foram avaliados 100 pacientes da UniversidadeFederal de Sergipe, de ambos os gêneros, com idade de 18 a 64 anos,de acordo com critérios para identificação de LCNCs. Os indivíduosresponderam ao questionário com perguntas referentes a idade, gênero,dieta, hábitos parafuncionais e hábitos de higiene. Na identificação delesões cervicais, as faces vestibulares e linguais ou palatinas foramexaminadas. Posteriormente os pacientes que apresentaram LCNCs foram avaliados em relação à presença de algum contato prematuro.A análise estatística para avaliar as associações dos hábitos com apresença de LCNCs foi feita por meio do teste qui-quadrado de Pearson.Em alguns casos foi utilizado o teste exato de Fisher. Para comparar amédia de idade foi empregado o teste T-Student. Em todas as situaçõesfoi considerado o nível de significância de 5% (p < 0,05). Resultados:Os resultados foram analisados estatisticamente e não foi encontradaassociação entre a presença de LCNCs e os hábitos avaliados, comexceção de mastigação unilateral. Conclusão: A ocorrência de LCNCsnão pode ser atribuída somente a um único fator etiológico. A maiorfrequência de lesões foi em pré-molares, seguidos pelos molares, e amenor ocorrência, entre os incisivos e os caninos. Há elevada frequênciade pessoas com contatos prematuros na amostra de pacientes comlesão. O avançar da idade dos pacientes está diretamente relacionadocom a presença das lesões.

Introduction and objective: This study aimed to identify the presenceof non-carious cervical lesions (NCLs) and correlate them to thepresence of premature dental contacts and eating, parafunctional andhygiene habits involved in its development. Material and methods:100 patients were evaluated at the Federal University of Sergipe, bothgenders, aged 18 to 64 years, according to criteria for identifying NCLs.Individuals answered to the questionnaire with questions regarding age,gender, diet, parafunctional and hygiene habits. In the identificationof cervical lesions, the vestibular and lingual or palatine faces wereexamined. Subsequently, the patients who presented NCLs wereevaluated for the presence of a premature contact. Statistical analysisto evaluate the associations of habits with NCLs was performed usingthe Pearson?s chi-square test. In some cases the Fisher?s exact test wasused. The T-Student test was used in order to compare the mean age.In all cases the significance level of 5% (p < 0.05) was considered.Results: The results were statistically analyzed and no associationbetween the presence of NCLs and the evaluated habits was found,except for unilateral mastication. Conclusion: The occurrence of NCLscannot be attributed only to a single etiological factor. The highestfrequency of lesions was in premolars, followed by molars, and thelowest occurrence was between incisors and canines. There is a highfrequency of patients with premature contacts in the sample of patientswith lesion. The increasing age of patients is directly related to thepresence of lesions.