Multiple nail gun injuries: suicide or homicide?

Nail gun injuries are a forensic problem; it can be difficult to distinguish self-inflicted injuries from accident and homicide instances. This kind of injuries shares some characteristics with both gunshot and puncture wounds. We describe a peculiar case of a man who committed suicide driving nails into his skull using a pneumatic nail gun. Entrance wounds were found on both temporal regions of the head. Reviewing scientific literature, this is the first case in Italy reporting the macroscopic data of bilateral head and brain nail gun injuries during an autopsy. Circumstantial elements were not sufficient to clarify if these lesions were self-inflicted, inflicted by accident, or else. Radiological examination can be helpful to show the exact location of the nails, but it has also its own limitations. We firmly believe that autopsy, especially the head section, is crucial to identify the nature and the extension of these lesions, thus giving us much more information about the mechanism of death and the circumstances in which it occurred.

'Compressed Baby Head': A New 'Abusive Head Trauma' Entity?

BACKGROUND: Child abuse represents an important issue in the medico-legal and social context. In the last few decades, various aspects and mechanisms have been identified in child abuse case studies; however, constant research is needed in the field. With this paper, the authors will present a case of a new entity of Abusive Head Trauma that has come to the attention of medico-legal experts. DISCUSSION: The trauma analysis performed on the cranio-encephalic district of the baby revealed quite peculiar lesions that led the authors to exclude that the injuries had been solely caused by violent shaking of the baby's head, as suggested by Shaken Baby Syndrome. Instead, the authors hypothesised that another lesion mechanism had been added to this one, namely latero-lateral cranial compression. The comprehensive and exhaustive analysis of the case led the authors to present a new possible entity in child abuse trauma, namely 'Compressed Baby Head'. CONCLUSIONS: To the best of our knowledge, in the current literature, no similar clinical cases have ever been described. Thus, the case's uniqueness deserves to be brought to the attention of experts and the entire scientific community, as well as medical personnel, paediatricians, and reanimators. These professional figures are the first individuals who may encounter complex clinical cases such as the one presented in this paper; thus, they need to know how to properly manage the case and ensure protection for the abused infants and children.

Avian influenza epidemiology in semi-intensive free ranging duck flocks of the Moyingyi Wetland in Bago East District, Myanmar.

Highly pathogenic avian influenza virus subtype H5N1 first entered Myanmar in 2006 in the Mandalay District. Several H5N1 outbreaks followed and the one of Bago East District (2007) required post outbreak surveillance in the at-risk domestic duck population of the Moyingyi Wetland. A field epidemiological study based on a randomised prospective stratified study with five surveys provided the serological evidence that the avian influenza H5 subtype circulates in the domestic duck population and spreads to almost all the newly housed (and negative) flocks in the time span of a seasonal production cycle. Virological investigation was negative. The survival analysis showed that the probability of seroconversion increased rapidly over the study period, without significant difference among different agro-ecosystems. The analysis suggests that viral spread in the new cycle could be limited if control measures were adopted at the time new flocks are housed. The study recommends that future surveillance schemes for ducks are designed in a way to get as much information as possible from serological results which should drive virological sampling to determined farms.

Practical problems in controlling H5N1 high pathogenicity avian influenza at village level in Vietnam and introduction of biosecurity measures.

After a consultancy mission funded by a nongovernmental organization (NGO), information was collected on the dynamics of avian influenza (AI) infection at the rural level in a Vietnamese province with several ongoing outbreaks. AI outbreaks are frequent at village level due to environmental, ecological, agroecological, physical, social, and cultural factors, the underlying factor being poor hygienic conditions. Viral circulation is facilitated by the interactions of the integrated aquaculture, animal raising, horticulture agroecosystem, which relies in the peculiar integration of aquaculture (ponding), animal activities, and horticulture and by the connections with the live-bird market system. The interactions of these factors determine the complex system in which wild birds interact with domestic birds and in which people are constantly exposed to sources of infection, leading to the association between poverty and AI infection in humans. This experience underlines that despite all efforts by the Vietnamese Government, international institutions, and the NGO sector, awareness of AI at the village level needs to be improved. In turn, the leading institutions and international donors funding projects of technical cooperation aimed at tackling AI in Vietnam should invest in a system based on a deep knowledge of the practical problems of village condition to address AI with an effective approach. On the basis of the data collected during the mission, particularly on rural and semi-intensive poultry rearing systems, proposals that encompass the application of an effective vaccination strategy including backyard flocks coupled with dissemination of relevant information on biosecurity measures have been developed for decision makers.

A conventional, inactivated oil emulsion vaccine suppresses shedding and prevents viral meat colonisation in commercial (Pekin) ducks challenged with HPAI H5N1.

The ongoing H5N1 epidemic is currently affecting a number of avian species, including waterfowl. These birds appear to have an important role as reservoirs of infection and comprehensive data on the efficacy of vaccination is currently lacking. The present paper reports the effect of a two dose vaccination programme with a conventional inactivated product on infection, lateral spread, shedding and presence of virus in commodities such as meat and viscera of Pekin ducks. Vaccination of this species appears to be efficacious in suppressing viral shedding, and preventing viraemia and lateral spread of infection to unvaccinated and vaccinated Pekin ducks.